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  1. added 2020-06-01
    Calibration Dilemmas in the Ethics of Distribution.Jacob M. Nebel & H. Orri Stefansson - manuscript
    This paper presents a new kind of problem in the ethics of distribution. The problem takes the form of several "calibration dilemmas," in which intuitively reasonable aversion to small-stakes inequalities requires leading theories of distribution to recommend intuitively unreasonable aversion to large-stakes inequalities—e.g., inequalities in which half the population would gain an arbitrarily large quantity of well-being or resources. We first lay out a series of such dilemmas for a family of broadly prioritarian theories. We then consider a widely endorsed (...)
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  2. added 2020-02-24
    Rank-Weighted Utilitarianism and the Veil of Ignorance.Jacob M. Nebel - forthcoming - Ethics.
    Lara Buchak argues for a version of rank-weighted utilitarianism that assigns greater weight to the interests of the worse off. She argues that our distributive principles should be derived from the preferences of rational individuals behind a veil of ignorance, who ought to be risk averse. I argue that Buchak’s appeal to the veil of ignorance leads to a particular way of extending rank-weighted utilitarianism to the evaluation of uncertain prospects. This method recommends choices that violate the unanimous preferences of (...)
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  3. added 2019-10-26
    Ambiguity Aversion Behind the Veil of Ignorance.H. Orri Stefánsson - forthcoming - Synthese:1-24.
    The veil of ignorance argument was used by John C. Harsanyi to defend Utilitarianism and by John Rawls to defend the absolute priority of the worst off. In a recent paper, Lara Buchak revives the veil of ignorance argument, and uses it to defend an intermediate position between Harsanyi's and Rawls' that she calls Relative Prioritarianism. None of these authors explore the implications of allowing that agent's behind the veil are averse to ambiguity. Allowing for aversion to ambiguity---which is both (...)
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  4. added 2019-10-10
    Health(Care) and the Temporal Subject.Ben Davies - 2018 - Les Ateliers de l'Éthique / the Ethics Forum 13 (3):38-64.
    Many assume that theories of distributive justice must obviously take people’s lifetimes, and only their lifetimes, as the relevant period across which we distribute. Although the question of the temporal subject has risen in prominence, it is still relatively underdeveloped, particularly in the sphere of health and healthcare. This paper defends a particular view, “momentary sufficientarianism,” as being an important element of healthcare justice. At the heart of the argument is a commitment to pluralism about justice, where theorizing about just (...)
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  5. added 2019-06-12
    Sufficiency, Comprehensiveness of Health Care Coverage, and Cost-Sharing Arrangements in the Realpolitik of Health Policy.Govind Persad & Harald Schmidt - 2016 - In Carina Fourie & Annette Rid (eds.), What is Enough?: Sufficiency, Justice, and Health. New York: Oxford University Press. pp. 267-280.
    This chapter explores two questions in detail: How should we determine the threshold for costs that individuals are asked to bear through insurance premiums or care-related out-of-pocket costs, including user fees and copayments? and What is an adequate relationship between costs and benefits? This chapter argues that preventing impoverishment is a morally more urgent priority than protecting households against income fluctuations, and that many health insurance plans may not adequately protect individuals from health care costs that threaten to drop their (...)
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  6. added 2019-03-11
    Transparency Trade-Offs: Priority Setting, Scarcity, and Health Fairness.Govind Persad - 2019 - In I. Glenn Cohen, Barbara Evans, Holly Lynch & Carmel Shachar (eds.), Transparency in Health and Health Care. New York: Cambridge UP.
    This chapter argues that rather than viewing transparency as a right, we should regard it as a finite resource whose allocation involves tradeoffs. It then argues that those tradeoffs should be resolved by using a multi-principle approach to distributive justice. The relevant principles include maximizing welfare, maximizing autonomy, and giving priority to the worst off. Finally, it examines some of the implications for law of recognizing the tradeoffs presented by transparency proposals.
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  7. added 2018-04-30
    ANTICORRUPTION NATIONAL SYSTEM: Model Whistleblowers Direct Citizen Action Against Corruption in Mexico.Carlos Medel-Ramírez - 2018 - Social Science Research Network:1-12.
    The phenomenon of corruption is a cancer that affects our country and that it is necessary to eradicate; This dilutes the opportunities for economic and social development, privileging the single conjunction of particular interests, political actors in non-legal agreements for their own benefit, which lead to acts of corruption. Recent studies indicate that the level of corruption present in a political system is directly related to the type of institutional structure that defines it (Boehm and Lambsdorff, 2009), as well as (...)
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  8. added 2017-10-01
    The Case for Resource Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health.Govind C. Persad & Ezekiel J. Emanuel - 2017 - Hastings Center Report 47 (5):17-24.
    We consider an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.
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  9. added 2017-04-12
    Taking Risks Behind the Veil of Ignorance.Buchak Lara - 2017 - Ethics 127 (3):610-644.
    A natural view in distributive ethics is that everyone's interests matter, but the interests of the relatively worse off matter more than the interests of the relatively better off. I provide a new argument for this view. The argument takes as its starting point the proposal, due to Harsanyi and Rawls, that facts about distributive ethics are discerned from individual preferences in the "original position." I draw on recent work in decision theory, along with an intuitive principle about risk-taking, to (...)
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  10. added 2017-03-11
    Dilemmas in Access to Medicines: A Humanitarian Perspective – Authors' Reply.Ezekiel J. Emanuel & Govind Persad - 2017 - Lancet 387 (10073):1008-1009.
    Our Viewpoint argues that expanding access to less effective or more toxic treatments is supported not only by utilitarian ethical reasoning but also by two other ethical frameworks: those that emphasise equality and those that emphasise giving priority to the patients who are worst off. The inadequate resources available for global health reflect not only natural constraints but also unwise social and political choices. However, pitting efforts to reduce inequality and better fund global health against efforts to put available resources (...)
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  11. added 2017-03-11
    Why Inequality Matters: Luck Egalitarianism, its Meaning and Value. [REVIEW]Alex Voorhoeve - 2017 - Notre Dame Philosophical Reviews 3.
    I review Shlomi Segall's book 'Why Inequality Matters'. I argue that it conclusively establishes that alongside egalitarians, prioritarians and sufficientarians must sometimes regard a prospect as better (in at least one respect) when it is not better (in terms of well-being) for anyone. Sufficientarians and prioritarians must therefore relinquish a treasured anti-egalitarian argument. It also makes a powerful case that among these three views, egalitarians are in the best position to explain such departures from what is in each person’s prudential (...)
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  12. added 2017-03-02
    Priority, Not Equality, for Possible People.Jacob M. Nebel - 2017 - Ethics 127 (4):896-911.
    How should we choose between uncertain prospects in which different possible people might exist at different levels of wellbeing? Alex Voorhoeve and Marc Fleurbaey offer an egalitarian answer to this question. I give some reasons to reject their answer and then sketch an alternative, which I call person-affecting prioritarianism.
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  13. added 2016-12-26
    Restricted Prioritarianism or Competing Claims?Benjamin Lange - 2017 - Utilitas 29 (2):137-152.
    I here settle a recent dispute between two rival theories in distributive ethics: Restricted Prioritarianism and the Competing Claims View. Both views mandate that the distribution of benefits and burdens between individuals should be justifiable to each affected party in a way that depends on the strength of each individual’s separately assessed claim to receive a benefit. However, they disagree about what elements constitute the strength of those individuals’ claims. According to restricted prioritarianism, the strength of a claim is determined (...)
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  14. added 2016-10-26
    Justice, Claims and Prioritarianism: Room for Desert?Matthew Adler - manuscript
    Does individual desert matter for distributive justice? Is it relevant, for purposes of justice, that the pattern of distribution of justice’s “currency” (be it well-being, resources, preference-satisfaction, capabilities, or something else) is aligned in one or another way with the pattern of individual desert? -/- This paper examines the nexus between desert and distributive justice through the lens of individual claims. The concept of claims (specifically “claims across outcomes”) is a fruitful way to flesh out the content of distributive justice (...)
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  15. added 2016-09-30
    Fair Innings and Time-Relative Claims.Ben Davies - 2016 - Bioethics 30 (6):462-468.
    Greg Bognar has recently offered a prioritarian justification for ‘fair innings’ distributive principles that would ration access to healthcare on the basis of patients' age. In this article, I agree that Bognar's principle is among the strongest arguments for age-based rationing. However, I argue that this position is incomplete because of the possibility of ‘time-relative' egalitarian principles that could complement the kind of lifetime egalitarianism that Bognar adopts. After outlining Bognar's position, and explaining the attraction of time-relative egalitarianism, I suggest (...)
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  16. added 2016-09-21
    The Priority View.David McCarthy - 2017 - Economics and Philosophy 33 (2):215–57.
    According to the priority view, or prioritarianism, it matters more to benefit people the worse off they are. But how exactly should the priority view be defined? This article argues for a highly general characterization which essentially involves risk, but makes no use of evaluative measurements or the expected utility axioms. A representation theorem is provided, and when further assumptions are added, common accounts of the priority view are recovered. A defense of the key idea behind the priority view, the (...)
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  17. added 2016-08-24
    A Silenced Cry: Should Stillbirth Be Given Greater Priority on the Global Health Agenda?Z. U. Qureshi - 2015 - British Medical Journal 351 (h4620).
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  18. added 2015-10-04
    Principles for Allocation of Scarce Medical Interventions.Govind Persad, Alan Wertheimer & Ezekiel J. Emanuel - 2009 - The Lancet 373 (9661):423--431.
    Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off, maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multiprinciple allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and (...)
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  19. added 2015-02-03
    Equality Versus Priority.Michael Otsuka & Alex Voorhoeve - 2018 - In Serena Olsaretti (ed.), Oxford Handbook of Distributive Justice. Oxford: Oxford University Press. pp. 65-85.
    We discuss two leading theories of distributive justice: egalitarianism and prioritarianism. We argue that while each has particular merits and shortcomings, egalitarian views more fully satisfy a key requirement of distributive justice: respect for both the unity of the individual and the separateness of persons.
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  20. added 2015-02-03
    Introduction to the Symposium on Equality Versus Priority.Alex Voorhoeve - 2015 - Economics and Philosophy 31 (2):201-202.
    This paper introduces a symposium on Equality versus Priority. It explains how cases involving risk are key to distinguishing these views and discusses a 'social egalitarian' critique of both 'telic egalitarians' and 'telic prioritarians'.
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  21. added 2014-11-28
    Response to Our Critics.Alex Voorhoeve, Trygve Ottersen & Ole Frithjof Norheim - 2016 - Health Economics, Policy and Law 11 (1):103-111.
    We reply to critics of the World Health Organisation's Report "Making Fair Choices on the Path to Universal Health Coverage". We clarify and defend the report's key moral commitments. We also explain its role in guiding policy in the face of both financial and political constraints on making fair choices.
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  22. added 2014-10-28
    Concerns for the Poorly Off in Ordering Risky Prospects.Luc Bovens - 2015 - Economics and Philosophy 31 (3):397-429.
    The Distribution View provides a model that integrates four distributional concerns in the evaluation of risky prospects. Starting from these concerns, we can generate an ordering over a set of risky prospects, or, starting from an ordering, we can extract a characterization of the underlying distributional concerns. Separability of States and/or Persons for multiple-person risky prospects, for single-person risky prospects and for multiple-person certain prospects are discussed within the model. The Distribution View sheds light on public health policies and provides (...)
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  23. added 2014-10-28
    Evaluating Risky Prospects: The Distribution View.Luc Bovens - 2015 - Analysis 75 (2):243-253.
    Risky prospects represent policies that impose different types of risks on multiple people. I present an example from food safety. A utilitarian following Harsanyi's Aggregation Theorem ranks such prospects according to their mean expected utility or the expectation of the social utility. Such a ranking is not sensitive to any of four types of distributional concerns. I develop a model that lets the policy analyst rank prospects relative to the distributional concerns that she considers fitting in the context at hand. (...)
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  24. added 2014-08-17
    The Pigou-Dalton Principle and the Structure of Distributive Justice.Matthew Adler - manuscript
    The Pigou-Dalton (PD) principle recommends a non-leaky, non-rank-switching transfer of goods from someone with more goods to someone with less. This Article defends the PD principle as an aspect of distributive justice—enabling the comparison of two distributions, neither completely equal, as more or less just. It shows how the PD principle flows from a particular view, adumbrated by Thomas Nagel, about the grounding of distributive justice in individuals’ “claims.” And it criticizes two competing frameworks for thinking about justice that less (...)
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  25. added 2014-08-17
    Prioritarianism and the Measure of Utility.Michael Otsuka - 2015 - Journal of Political Philosophy 23 (1):1-22.
    I argue that prioritarianism cannot be assessed in abstraction from an account of the measure of utility. Rather, the soundness of this view crucially depends on what counts as a greater, lesser, or equal increase in a person’s utility. In particular, prioritarianism cannot accommodate a normatively compelling measure of utility that is captured by the axioms of John von Neumann and Oskar Morgenstern’s expected utility theory. Nor can it accommodate a plausible and elegant generalization of this theory that has been (...)
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  26. added 2014-08-17
    On the Possibility of Nonaggregative Priority for the Worst Off.Marc Fleurbaey, Bertil Tungodden & Peter Vallentyne - 2009 - Social Philosophy and Policy 26 (1):258-285.
    We shall focus on moral theories that are solely concerned with promoting the benefits (e.g., wellbeing) of individuals and explore the possibility of such theories ascribing some priority to benefits to those who are worse off—without this priority being absolute. Utilitarianism (which evaluates alternatives on the basis of total or average benefits) ascribes no priority to the worse off, and leximin (which evaluates alternatives by giving lexical priority to the worst off, and then the second worst off, and so on) (...)
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  27. added 2014-08-17
    Equality, Priority, and Positional Goods.Harry Brighouse & Adam Swift - 2006 - Ethics 116 (3):471-497.
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  28. added 2014-05-14
    Minimizing Maximin.D. Clayton Hubin - 1980 - Philosophical Studies 37 (4):363 - 372.
    In A Theory of Justice, John Rawls provides several arguments contractors in the original position using maximin reasoning, which leads directly to the difference principle. These arguments are inadequate to support the claim that maximin reasoning is the uniquely rational approach to choice in the original position.
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  29. added 2014-03-02
    Review of Matthew D. Adler: Well-Being and Fair Distribution. Beyond Cost-Benefit Analysis. [REVIEW]Alex Voorhoeve - 2014 - Social Choice and Welfare 42 (1):245-54.
    In this extended book review, I summarize Adler's views and critically analyze his key arguments on the measurement of well-being and the foundations of prioritarianism.
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  30. added 2013-10-25
    Prioriteit voor patienten met een lagere levenskwaliteit.Alex Voorhoeve - 2010 - Filosofie En Praktijk 31:40-51.
    This paper critically analyses the priority-setting rules used by the National Institute for Health and Clinical Excellence (NICE) in the UK and proposed by the Netherlands' Council on Public Health and Health Care (RVZ). It argues that neither gives proper weight to improving the lot of those who are worse off than others.
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  31. added 2013-08-04
    Priority and Desert.Matthew Rendall - 2013 - Ethical Theory and Moral Practice 16 (5):939-951.
    Michael Otsuka, Alex Voorhoeve and Marc Fleurbaey have challenged the priority view in favour of a theory based on competing claims. The present paper shows how their argument can be used to recast the priority view. All desert claims in distributive justice are comparative. The stronger a party’s claims to a given benefit, the greater is the value of her receiving it. Ceteris paribus, the worse-off have stronger claims on welfare, and benefits to them matter more. This can account for (...)
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  32. added 2013-04-19
    The Injustice of Discrimination.Carl Knight - 2013 - South African Journal of Philosophy 32 (1):47-59.
    Discrimination might be considered unjust on account of the comparative disadvantage it imposes, the absolute disadvantage it imposes, the disrespect it shows, or the prejudice it shows. This article argues that each of these accounts overlooks some cases of unjust discrimination. In response to this state of affairs we might combine two or more of these accounts. A promising approach combines the comparative disadvantage and absolute disadvantage accounts.
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  33. added 2012-10-18
    Decide As You Would With Full Information! An Argument Against Ex Ante Pareto.Marc Fleurbaey & Alex Voorhoeve - 2013 - In Ole Norheim, Samia Hurst, Nir Eyal & Dan Wikler (eds.), Inequalities in Health: Concepts, Measures, and Ethics. Oxford University Press.
    Policy-makers must sometimes choose between an alternative which has somewhat lower expected value for each person, but which will substantially improve the outcomes of the worst off, or an alternative which has somewhat higher expected value for each person, but which will leave those who end up worst off substantially less well off. The popular ex ante Pareto principle requires the choice of the alternative with higher expected utility for each. We argue that ex ante Pareto ought to be rejected (...)
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  34. added 2011-09-14
    Describing Equality.Carl Knight - 2009 - Law and Philosophy 28 (4):327 - 365.
    This articles proposes that theories and principles of distributive justice be considered substantively egalitarian iff they satisfy each of three conditions: (1) they consider the bare fact that a person is in certain circumstances to be a conclusive reason for placing another relevantly identically entitled person in the same circumstances, except where this conflicts with other similarly conclusive reasons arising from the circumstances of other persons; (2) they can be stated as 'equality of x for all persons', making no explicit (...)
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  35. added 2011-05-10
    Egalitarianism and the Separateness of Persons.Alex Voorhoeve & Marc Fleurbaey - 2012 - Utilitas 24 (3):381-398.
    The difference between the unity of the individual and the separateness of persons requires that there be a shift in the moral weight that we accord to changes in utility when we move from making intrapersonal tradeoffs to making interpersonal tradeoffs. We examine which forms of egalitarianism can, and which cannot, account for this shift. We argue that a form of egalitarianism which is concerned only with the extent of outcome inequality cannot account for this shift. We also argue that (...)
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