For Kant, Fichte, and Hegel, the significance of rights lay in the value of freedom. The distinctive feature of persons, their capacity to determine their own ends, grounded the obligation of other human beings to respect the conditions of free agency and thus to acknowledge one another as bearers of rights. All understood rights as universal and intersubjective: it follows that rights can only be fully realized in an appropriately constituted social state. For Kant, this meant that rights in the state of nature are merely provisional, and that to make rights claims is to commit oneself to the pursuit of a civil state, indeed to a civil state in federation with other such states, subject to principles of international law and cosmopolitan right. For Fichte, the intersubjective nature of rights was even more central to their meaning, for the guarantee of rights enables our self-understanding as free beings, with the capacity to cultivate our individuality and pursue a distinctive identity. Rights thus understood not only respect our personhood but actually constitute us as persons. Kant’s emphasis on external freedom, freedom from outside interference, led him to focus almost exclusively on property rights, while Fichte recognized far more expansive socioeconomic rights as security the material conditions of free agency. Finally, Hegel’s account, though deeply influenced by Kant and Fichte’s grounding of rights in the value of freedom, maintained that individual rights are insufficient for the realization of complete freedom, which must be realized in common. In so doing he partly anticipated Marx’s critique of the limitations of rights as fundamentally bourgeois property rights and thus as incapable of undergirding truly human emancipation.

Chapter 5 examines Plato's account of the "fevered" polis in exploring the thesis that societies are to be understood as composed of parts well suited to carry out specific functions and that it is primarily in this respect that they resemble biological organisms. Thus, in the healthy polis each part carries out the specific function appropriate to it, and functions are coordinated such that all are well executed and society's essential needs satisfied. From Plato we learn that a defensible account of social pathology embraces a weak holism, according to which "ill" may apply to society as a whole without any part of it being ill (since it is institutions or societies that are dysfunctional, not individuals). At the same time, it eschews strong a normative holism that holds that things can be good or bad for societies without them also being good or bad for individual members.

Chapter 8 examines and partially defends Durkheim's functionalism as practiced in The Division of Labor in Society. His position is reconstructed with an eye to determining which aspects are worth retaining for a contemporary theory of social pathology, including the functionally organized nature of society. Focusing on claims regarding the moral function of the division of labor, it examines epistemological issues bound up with ascribing functions to features of society, including the relation between functional explanation and functional analysis and the role played by historical narratives. Durkheim's method is a complex holism whose claims depend less on single facts and individual arguments than on the plausibility of the whole picture that emerges from mutually reinforcing arguments, empirical facts, interpretive suggestions, and analogies. Thus, Durkheim's method for ascribing functions to social phenomena bears similarities to other interpretive enterprises, from the reading of texts to the construction of theories in the natural sciences.

Chapter 2 examines the extent to which theories of social pathology are committed to thinking of human societies on the model of animal organisms. It rejects the thought that societies exhibit a complete teleological harmony, where all parts work together perfectly to maintain the organism's stability and cohesiveness. Societies are totalities in the more modest sense that their parts – institutions or practices – cannot be adequately grasped or evaluated in isolation. Like organisms, societies are functional beings in that how they are constituted and how their parts interact cannot be understood without ascribing ends to both parts and the whole they make up. Societies are, moreover, functionally organized in that they carry out their characteristic functions – including both material and spiritual reproduction – via specialized and coordinated functional subsystems (or social spheres). Finally, even though social functions extend beyond material reproduction, the latter remains an essential part of healthy social functioning.

Chapter 1 begins to define the concept of social pathology and to assess its usefulness for social philosophy. It distinguishes five conceptions of social illness different from the one employed in this book, which places dysfunction, rather than suffering, at the core of social illness. It argues, further, that while social pathologies must be bad in some way for social members, those individuals are not typically ill themselves. Although there are good reasons for approaching the concept of social pathology with caution – societies differ in important ways from biological organisms, for example – judicious use of the concept can bring to light critique-worthy social phenomena to which theories focused exclusively on justice are blind. The method espoused for diagnosing social illnesses is a form of ethically informed immanent critique that bears some similarities to medical diagnosis but refrains from ascribing moral blame to the individual participants in unhealthy social practices.

Chapter 12 examines Hegel's characterization of human society as the "living good," which expresses his version of the analogy between societies and organisms. For him the analogy implies that societies both incorporate processes of life (in carrying out the activities necessary for material reproduction) and possess the same structure as biological life (that of a "self-positing" subject, which maintains itself by positing "contradictions" internal to itself and then negotiating them so as establish its own identity). Hegel also insists on the differences between life and social being: the presence in social life of self-consciousness and the capacity for freedom. Thus, societies are normatively and functionally constituted living beings that realize the good via specialized, coordinated functions, which, unlike the activities of organisms, are infused with ethical content deriving from their potential to be consciously self-determined. Analyzing Hegel's master–slave dialectic illustrates these ontological claims.

This book examines the concept of social pathology as it figures in the thought of Plato, Rousseau, Hegel, Comte, Marx, and Durkheim, demonstrating what it means to describe societies as "ill" and what the fact that we are so often drawn to conceiving of social problems as illnesses says about social ontology, or the kind of thing human society is. It explores the connections between social pathology and such phenomena as alienation, anomie, ideology, and social dysfunction and argues for the continuing relevance of the idea of "social sickness" for social critique. The aptness of the concept of social pathology in comprehending social ills points to important respects in which human societies are to be grasped as functionally-constituted, "living" beings and therefore as analogous to biological organisms, even if there are equally important respects in which the analogy does not hold, deriving primarily from the self-conscious and potentially free character of social activity. Human societies are understood as "spiritual" entities, the functions of which extend beyond material reproduction to include freedom, recognition, and self-transparency.

Chapter 6 examines Rousseau's claim that human societies are artificial and that recognizing this is crucial to understanding how theories of social pathology can ascribe non-arbitrary standards of healthy functioning to institutions. The most important sense in which society is made by us is expressed in the claim that institutions are grounded in conventions. The upshot of this claim is that a kind of self-consciousness is intrinsic to social life, namely, collective acceptance of the authority of the rules governing social institutions, which, in the most fundamental institutions, includes a shared conception of the good that explains their "point," part of which consists in promoting the freedom of social members. Because acting in accordance with such a conception is constitutive of activity in institutional life, the functions of institutions – including a conception of their healthy functioning – are accessible, if imperfectly, to the agents on whose activity those functions depend.

Chapter 3 examines some problems Marx takes to be inherent in capitalism that can be regarded as social pathologies, clarifying how dysfunction must be understood if his most sophisticated critiques are to be grasped. It focuses on forms of social pathology bound up with Marx's account of the formula for the circulation of capital, which distinguishes capital from mere money in terms of the function of each. Marx's biological language makes it plausible to interpret the dysfunctions of capitalism as pathologies: for example, its cancer-like growth that ignores the needs of producers. Yet these dysfunctions cannot be grasped without taking into account the spiritual aspects of human social being. Marx regards social life as spiritual – as informed by the aspiration to unite the ends of life with those of freedom in one's social activity – and capitalism's failure to allow for this unity as its principal defect.

Chapter 9 explains Durkheim's understanding of moral facts and the conception of social solidarity at the core of his account of the division of labor's function in organized societies: crucial to what holds societies together and enables them to live are moral facts that inform relations among social members. Durkheim views human society as normatively constituted – governed by rules accepted as authoritative by social members – and claims that social institutions serve moral and not merely "useful" social functions. The chapter articulates the resources Durkheim has for conceiving of social pathology (itself an ethical phenomenon), examines the modern pathology most important to him, anomie, and coins a term for a related social pathology, hypernomie, a condition in which social rules are excessively rigid or constraining. Finally, the chapter reconstructs Durkheim's understanding of what is bad about social pathology – why social members should care whether their society is ill.

Chapter 10 reconstructs Durkheim's conception of sociology as a science of morality, which includes three tasks: orienting our conduct via an account of a morally healthy society; illuminating the connection between social functioning and morality (explaining why moral and social health are the same; and explaining why the moral ideals animating a given society do so and how they vary with changing social conditions. Durkheim's science of morality is similar to Marx's historical materialist account of morality, although the former leaves the moral authority of the rules it explains largely intact. While Durkheim's accounts of specific pathologies imply a critique of certain social rules, they do not discredit the fundamental norms at work in the societies he studies. The chapter concludes that Durkheim does not adequately explain how historically specific moral systems can claim a moral authority irreducible to the narrowly functional value they have for social reproduction.

Chapter 4 examines the importance of labor in Marx's diagnoses of social pathologies. Marx conceives of labor as social, productive activity that has the potential to make material reproduction a spiritual phenomenon subject to normative standards beyond those internal to biological life. Meeting those standards requires a re-appropriation of our activity that turns alienated social powers into free activity, where re-appropriation takes place along three dimensions: knowing (or understanding) it as it really is; collectively controlling or organizing it; and affirming it without illusion as appropriate to human beings' spiritual nature. In other words, unalienated social powers must be transparent, self-determined, and productive of the good of those whose powers they are. Moreover, making social powers productive of the good, and hence genuinely affirmable, requires re-organizing, and not merely re-interpreting, our activity so as to make it social in a sense that in capitalism it is not.

Chapter 7 treats two philosophers who directly influenced Durkheim: Auguste Comte and Herbert Spencer. Looking at their use of the society–organism analogy, their versions of functional explanation and functional analysis, and their conceptions of what a scientific sociology must be like helps one to understand both the content of Durkheim's positions and why he held them. Three types of functional explanation employed by Comte are relevant: two forms of existential functional explanation as well as functional analysis, which makes no claims regarding the existence of what it analyzes but "explains" what it is by specifying the function it serves and showing how its features are suited to accomplishing that purpose without implying anything about how it originated or why it persists. The chapter argues that Comte and Spencer rely too heavily on the society–organism analogy, leading to an overly biologistic understanding of normative critique available to social pathologists.