A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...) between health and other social goods: deficits in health typically undermine one's abilities to secure advantage in other areas, which in turn often have further negative effects on health. This paper outlines the degree to which this latter relationship between health and other social goods exacerbates an existing problem for proponents of responsibilisation (the ‘harshness objection’) in ways that standard responses to this objection cannot address. Placing significant conditions on healthcare access because of a person's prior responsibility risks trapping them in, or worsening, negative cycles where poor health and associated lack of opportunity reinforce one another, making further poor yet ultimately responsible choices more likely. It ends by considering three possible solutions to this problem. (shrink)

This paper proposes a sufficientarian theory with an interval of sufficiency levels. I assume that there are upper and lower bounds of sufficiency and that all well-being levels in between can be considered sufficiency levels. This interval reflects the vagueness of the concept of sufficiency. According to the proposed principle, a distribution is morally better than another if and only if, for each threshold within the interval, the headcount of those below the threshold under the former distribution is smaller than (...) that under the latter distribution. This necessarily leads to incommensurability in moral relations. I argue that such incommensurability makes sufficientarian principles invulnerable to some fundamental objections. (shrink)

According to the ‘starting-gate’ interpretation of equality of opportunity, individuals who enjoy equal starts can legitimately become unequal to the extent that their differences derive from choices for which they can be held responsible. There can be no coercive transfers of resources in favour of individuals who disregarded their own futures, and no limits on the right of an individual to distribute resources intrapersonally. This paper assesses two ways in which advocates of equality of opportunity might depart from the starting-gate (...) interpretation. The first involves limiting the degree to which people are liable to pay the costs of their past choices. The second involves limiting their initial opportunities so as to prevent certain risky or apparently short-sighted choices. The paper compares these alternatives in terms of their compatibility with a particular conception of persons as morally equal and temporally extended. It constructs this conception by combining reductionist premises about personal identity with the premise that our status as equals is based on the fundamental requirement of opacity respect. Two conclusions about equality of opportunity are shown to follow from this conception of persons as morally equal and temporally extended: the first is that an individual’s liability to pay the costs of her past choices does not diminish over time; the second is that the individual’s initial scope of choice, in bringing about intrapersonal distributions between her current and future selves, can nevertheless be permissibly limited. The two conclusions are consistent, and the second allows for departures from starting-gate equality of opportunity. (shrink)

Public health ethicists face two difficult questions. First, what makes something a matter of public health? While protecting citizens from outbreaks of communicable diseases is clearly a matter of public health, is the same true of policies that aim to reduce obesity, gun violence or political corruption? Second, what should the scope of the government’s authority be in promoting public health? May government enact public health policies some citizens reasonably object to or policies that are paternalistic? Recently, some theorists have (...) attempted to address these questions by arguing that something is a matter of public health if and only if it involves a health-related public good, such as clean water or herd immunity. Relatedly, they have argued that appeals to the promotion of public health should only be used to justify the provision of health-related public goods. This public goods conception of public health (PGC) is meant to enjoy advantages over its rivals in three respects: it provides a better definition of public health than rival views, it respects moral disagreement, and it avoids licensing objectionably paternalistic public health policies. We argue, however, that the PGC does just as poorly, or worse, than its rivals in all three respects. (shrink)

The idea that people’s numerical identity may sometimes be discontinuous over time initially appears to provide useful material for defending restrictions on putatively self-harming behaviour in a non-paternalistic manner. According to this line of thinking, sometimes a putatively self-harming act is, in fact, a matter of ‘harm to others’. Yet, in this paper I argue that if we, as we ought to do, take into consideration the non-identity problem, this challenges the notion that the agent at T1 is in fact (...) imposing harm on anyone, even when we accept that he or she is numerically different from the agent at T2. If the life of the agent at T2 is still worth living, the agent is not worse off than he or she would have been in spite of the consequences pertaining to the putatively self-harming act since he or she would otherwise never have come into existence. In this way, the argument I put forward in this paper calls in question the ability of the shifting identity argument to actually justify imposing restrictions on self-harming behaviour. (shrink)

According to luck egalitarianism, it is unjust if some are worse off than others through no fault or choice of their own. The most common criticism of luck egalitarianism is the ‘harshness objection’, which states that luck egalitarianism allows for too harsh consequences, as it fails to provide justification for why those responsible for their bad fate can be entitled to society's assistance. It has largely gone unnoticed that the harshness objection is open to a number of very different interpretations. (...) We present four different interpretations of the harshness objection in which the problem pertains to counterintuitive implications, badness of outcome, disproportionality, or inconsistency, respectively. We analyse and discuss appropriate luck egalitarian replies. Disentangling these different versions clarifies what is at the heart of this dispute and reveals the point of the harshness objection. We conclude that only the inconsistency version involves a durable problem for luck egalitarianism. (shrink)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in distributive (...) justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

In this article, I propose a novel characterization of sufficientarianism. I argue that sufficientarianism combines three claims: a priority claim that we have non-instrumental reasons to prioritize benefits in certain ranges over benefits in other ranges; a continuum claim that at least two of those ranges are on one continuum; and a deficiency claim that the lower a range on a continuum, the more priority benefits in that range have. This characterization of sufficientarianism sheds new light on two long-standing philosophical (...) debates, namely about the distinctiveness of sufficientarianism as a distributive principle and about the common objections to sufficientarianism. (shrink)

According to luck egalitarianism, it is not unfair when people are disadvantaged by choices they are responsible for. This implies that those who are disadvantaged by choices that prevent disadvantage to others are not eligible for compensation. This is counterintuitive. We argue that the problem such cases pose for luck egalitarianism reveals an important distinction between responsibility for creating disadvantage and responsibility for distributing disadvantage which has hitherto been overlooked. We develop and defend a version of luck egalitarianism which only (...) holds people responsible for creating disadvantage. This revision enables luck egalitarianism to offer compensation to those who are disadvantaged by preventing disadvantage to others, like dependent caretakers, without compromising the responsibility–sensitivity at the heart of luck egalitarianism. (shrink)

According to luck egalitarianism, it is not unfair when people are disadvantaged by choices they are responsible for. This implies that those who are disadvantaged by choices that prevent disadvantage to others are not eligible for compensation. This is counterintuitive. We argue that the problem such cases pose for luck egalitarianism reveals an important distinction between responsibility for creating disadvantage and responsibility for distributing disadvantage which has hitherto been overlooked. We develop and defend a version of luck egalitarianism which only (...) holds people responsible for creating disadvantage. This revision enables luck egalitarianism to offer compensation to those who are disadvantaged by preventing disadvantage to others, like dependent caretakers, without compromising the responsibility–sensitivity at the heart of luck egalitarianism. (shrink)

Social egalitarians hold that one fundamental requirement of the ideal of social equality is that people should stand in relations of non-domination to one another. In the light of this, they reject luck egalitarian principles of justice as incompatible with a society of equals, because the former violate the non-domination requirement. I call this the domination objection. In this paper I examine its force against Dworkinian resource egalitarianism. There are two reasons why equality of resources might be thought to be (...) vulnerable to it. First, Dworkin has been interpreted to maintain that as long as people’s preferences are authentic, people should be consequentially responsible for the choices that flow from such preferences. However, Dworkin’s view on when people’s choices should be considered to be authentic does not rule out that the latter are sometimes influenced by norms and processes that are the outcome of domination and oppression, and so holding people fully consequentially responsible for choices that are the outcome of such preferences is itself unjust. Second, equality of resources objectionably permits bad-option-luck victims to become vulnerable to domination. I argue that Dworkinian egalitarianism is not susceptible to either of the two parts of the domination objection and defend the view that it is—contrary to the social egalitarian criticism—faithful to the social egalitarian demand for non-domination. (shrink)

In this paper, I ask what is wrong with sufficiency. I formulate a generic sufficiency principle in relation to which I discuss possible problems for sufficientarianism. I argue against the arbitrariness–concern, that sufficiency theory need only to identify a possible space for determining a plausible threshold, and I argue against the high–low threshold dilemma concern, that multiple-threshold views can solve this dilemma. I then distinguish between currency-pluralist and currency-monist multiple-threshold views and test them against two different versions of the widely (...) shared ‘ignorance of inequality objection’ to sufficientarianism—a benefit-driven and a burden-driven version. I argue that currency-pluralist sufficiency views are better capable of responding to the former than currency-monist views. However, I show that no existing sufficiency view can provide a plausible response to the burden-driven version. Hence, I conclude that the problem of unequal distribution of burdens above the thresholds represents an overlooked threat to the sufficiency view, in any version. (shrink)

This paper argues in defence of sufficientarianism that there is a general flaw in the most common critiques against it. The paper lays out sufficientarianism and presents the problems of indifference, of outweighing priority, and of discontinuity. Behind these problems is a more general objection to the abruptness of the sufficiency threshold relying upon an assumption regarding arithmeticism about value. The paper argues that sufficientarians need not accept arithmeticism about value and that the commonly held critiques of sufficientarianism are in (...) fact instances of the numbers fallacy pertaining to the construction of numerical counterexamples that gain intuitive traction from ‘empty numbers’ – numbers without meaningful content in reference to the view under investigation. The paper concludes that we should remain sceptical about such use of numerical counterexamples, and while this does not by itself prove sufficientarianism correct, it is an important and novel contribution to its justification. (shrink)

This paper explores the role individual responsibility plays in contemporary political theory. It argues that the standard luck egalitarian view—the view according to which distributive justice is ensured by holding people accountable for their exercise of responsibility in the distribution of benefits and burdens—obscures the more fundamental value of being responsible. The paper, then, introduces an account of ‘self-creative responsibility’ as an alternative to the standard view and shows how central elements on which this account is founded has been prominently (...) defended in the history of Western political thought but are comparatively neglected in contemporary political theory. Relying on this account, the paper argues that society should hold persons responsible when, and only when, doing so enables them to lead responsible lives, and only on the condition that doing so does not infringe other persons’ equivalently valuable ability to lead responsible lives. The account of self-creative responsibility, the paper concludes, plausibly captures the intuitive attraction of holding responsible while respecting the value of being responsible. (shrink)

The standard version of sufficientarianism maintains that providing people with enough, or as close to enough as is possible, is lexically prior to other distributive goals. This article argues that this is excessive – more than distributive justice allows – in four distinct ways. These concern the magnitude of advantage, the number of beneficiaries, responsibility and desert, and above-threshold distribution. Sufficientarians can respond by accepting that providing enough unconditionally is more than distributive justice allows, instead balancing sufficiency against other considerations.

Political philosophers commonly tackle the issue of climate change by focusing on fundamental interests as a basis for human rights. This approach struggles, however, in cases where one set of fundamental interests requires one course of action, and another set of fundamental interests requires another course of action. This article advances an alternative response to climate change based on an account of global justice that gives weight to utilitarian, prioritarian, and luck egalitarian considerations. A practical application of this pluralistic account (...) is provided, which shows that it handles trade-offs between individuals’ interests in an appealing way, and that it supports an aggressive policy of climate change mitigation. This account provides a more plausible justification for rights against the harms of climate change. (shrink)

The harshness objection is the most important challenge to luck egalitarianism. Very recently, Andreas Albertsen and Lasse Nielsen provided a scrupulous analysis of the harshness objection and claim that only the inconsistency objection—the objection that luck egalitarianism is incompatible with the ideal of basic moral equality—has real bite. I argue that the relevantly construed incoherence objection is not as strong as Albertsen and Nielsen believe. In doing so, first, I show that the deontological luck egalitarian conception of equal treatment does (...) not endorse harsh policies such as excessive responsibility-sensitive healthcare that would be disrespectful to the imprudent. Second, I demonstrate that deontological luck egalitarianism is not troubled by the case that involves a lack of respect for the prudent, which vexes Anderson’s relational egalitarianism that Kasper Lippert-Rasmussen’s argument highlights. I thus claim that the harshness objection is not a truly decisive objection against the luck egalitarian project. (shrink)

The issue of distributive justice receives substantial amount of attention in our society. On the one hand, we are sensitive to whether and the extent to which people are responsible for being worse off. On the other hand, we are mindful of society’s worst-off members. There has been a debate over luck egalitarianism, which relates to the former concern, and relational egalitarianism, which echoes the latter. By investigating the psychological processes of these two concerns, this paper examines the reliability of (...) the argument that Elizabeth Anderson, a renowned relational egalitarian, presents against luck egalitarianism and for relational egalitarianism. It also considers whether it is possible to support luck egalitarianism and relational egalitarianism simultaneously, using an online experiment. The results of the experiment show that, first, for ordinary people, the luck consideration is as important as the basic capabilities consideration. Second, while real people consider the degree of compensation through the factors of causality and responsibility, the lack of basic capabilities directs them to determine how much victims of bad luck should be compensated. This suggests that pluralist egalitarianism is on the right track. (shrink)

What, if anything, do we owe others as a basic minimum? Sufficiency theorists claim that we must provide everyone with enough – but, to date, few well-worked-out accounts of the sufficiency threshold exist, so it is difficult to evaluate this proposition. Previous theories do not provide plausible, independent accounts of resources, capabilities, or welfare that might play the requisite role. Moreover, I believe existing accounts do not provide nearly enough guidance for policymakers. So, this article sketches a mechanism for arriving (...) at an account of the minimally good life that can help locate the sufficiency threshold. (shrink)

Luck egalitarianism has come under a lot of criticism for its apparent harshness towards negligent victims of voluntary actions (the harshness objection) and its inability to respond to morally-acceptable voluntary acts that lead to disadvantage (the discrimination objection). This paper surveys a series of responses in the luck egalitarian literature, showing that for the most part each one is unable to respond, on its own, to the crux of the objections. These responses often face a dilemma: Either they must bite (...) the bullet on the objections to retain their luck egalitarian commitments, or they must propose a reply to the objection that diverges from their core luck egalitarian principles. In this paper, I advance a preliminary framework for grounding luck egalitarian theories of justice based upon a two-level model and what I shall call the Fact of Inherent Normativity. Two-level luck egalitarianism makes fundamental rights and basic needs de facto insensitive to responsibility at the first level, while retaining the scope for responsibility for the distribution of second-level goods. The account remains distinctly luck egalitarian, while leaving scope for the consideration of rights, respect, and a host of other morally relevant considerations within the luck egalitarian framework. Luck egalitarianism, properly understood as a two-level theory, can successfully respond to objections against its harshness and propensity to discriminate. (shrink)

Luck egalitarianism provides a reason to object to conditionality in health incentive programmes in some cases when conditionality undermines political values such as solidarity or inclusiveness. This is the case with incentive programmes that aim to restrict access to essential healthcare services. Such programmes undermine solidarity. Yet, most people's lives are objectively worse, in one respect, in non-solidary societies, because solidarity contributes both instrumentally and directly to individuals' well-being. Because solidarity is non-excludable, undermining it will deprive both the prudent and (...) the imprudent citizens of its goods. Thereby, undermining solidarity can make prudent citizens worse off than they would have otherwise been, out of no fault or choice of their own, but rather as a result of somebody else's imprudent choice. This goes against the spirit of luck egalitarianism. Therefore (luck egalitarian) justice can require us to save the imprudent and avoid conditionality in access to essential healthcare services. (shrink)

In this paper, we start by comparing the two agents, Ann and Bob, who are involved in two car crashes. Whereas Ann crashes her car through no fault of her own, Bob crashes as a result of reckless driving. Unlike Ann, Bob is held criminally responsible, and the insurance company refuses to cover the car’s damages. Nonetheless, Ann and Bob both receive emergency hospital treatment that a third party covers, regardless of any assessment of personal responsibility. What warrants such apparent (...) exceptionalism with respect to personal responsibility in the healthcare context? We turn our attention to an understudied aspect of the debate on personal health responsibility, namely, the conceptualisation of the person in need of emergency hospital treatment. Drawing on the research of Joshua Knobe and Shaun Nichols, we propose that a context-dependent conceptualisation of the person may help explain a reluctance to ascribe responsibility to the individual for negative health outcomes. (shrink)

Recent literature on responsibility-sensitive egalitarianism has suggested that an opposition to unchosen inequality on the grounds of unfairness is compatible with a range of accounts as to which inequalities are fair. I argue that forms of responsibility-sensitive egalitarianism face a challenge in the construction of such accounts; namely to explain the fairness of such inequalities specifically, as opposed to their being merely justified in a broader sense. I illustrate the nature of this challenge through an interesting parallel with an issue (...) in value theory in the form of the so-called ‘wrong kind of reason’ problem. (shrink)

Despite the prominence of thresholds and limits in theories of distributive justice, there is no general account of their role within such theories. This has allowed an ongoing lack of clarity and misunderstanding around threshold views in distributive justice. In this thesis, I develop an account of the conceptual structure of such views. Such an account helps understand and characterize threshold views, can subsume what may seem to be different debates about such views under one conceptual header, and can be (...) used to further examine and develop patterns of justice that draw on thresholds. In light of this account, I propose a novel characterization of sufficientarianism which sheds new light on the distinctiveness of sufficientarianism as a distributive principle and on the common objections to sufficientarianism. Moreover, I examine and defend limitarianism, which is the view that people should not have more than a certain amount of wealth. In particular, I argue in favour of limitarianism as a midlevel principle for guiding institutional design and individual actions and, furthermore, as a specification of what a just allocation of wealth requires under epistemic constraints. (shrink)