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Fair Innings

Bioethics 29 (4):251-261 (2014)

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  1. Ageing as Equals: Distributive Justice in Retirement Pensions.Manuel Sá Valente - 2022 - Dissertation, Université Catholique de Louvain
    Despite being increasingly available to us all, retirement pensions remain unequally distributed: between rich and poor, young and old, men and women, and possibly different generations. As this topic receives little attention in moral and political philosophy, the articles in this thesis aim to deliver an original account of justice in retirement pensions along liberal egalitarian lines. The first part defends retirement pensions as a distribution of free time. It shows that including free time in the list of goods that (...)
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  • Healthcare Priorities: The “Young” and the “Old”.Ben Davies - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):174-185.
    Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should have a (...)
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  • Covid-19 and age discrimination: benefit maximization, fairness, and justified age-based rationing.Andreas Albertsen - 2023 - Medicine, Health Care and Philosophy 26 (1):3-11.
    Age-based rationing remains highly controversial. This question has been paramount during the Covid-19 pandemic. Analyzing the practices, proposals, and guidelines applied or put forward during the current pandemic, three kinds of age-based rationing are identified: an age-based cut-off, age as a tiebreaker, and indirect age rationing, where age matters to the extent that it affects prognosis. Where age is allowed to play a role in terms of who gets treated, it is justified either because this is believed to maximize benefits (...)
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  • On the margins: personhood and moral status in marginal cases of human rights.Helen Ryland - 2020 - Dissertation, University of Birmingham
    Most philosophical accounts of human rights accept that all persons have human rights. Typically, ‘personhood’ is understood as unitary and binary. It is unitary because there is generally supposed to be a single threshold property required for personhood. It is binary because it is all-or-nothing: you are either a person or you are not. A difficulty with binary views is that there will typically be subjects, like children and those with dementia, who do not meet the threshold, and so who (...)
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  • The Prospects for ‘Prospect Utilitarianism’.Ben Davies - 2022 - Utilitas 34 (3):335-343.
    Hun Chung argues for a theory of distributive justice – ‘prospect utilitarianism’ – that overcomes two central problems purportedly faced by sufficientarianism: giving implausible answers in ‘lifeboat cases’, where we can save the lives of some but not all of a group, and failing to respect the axiom of continuity. Chung claims that prospect utilitarianism overcomes these problems, and receives empirical support from work in economics on prospect theory. This article responds to Chung's criticisms of sufficientarianism, showing that they are (...)
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  • The value of longevity.Greg Bognar - 2020 - Politics, Philosophy and Economics 19 (3):229-247.
    Longevity is valuable. Most of us would agree that it’s bad to die when you could go on living, and death’s badness has to do with the value your life would have if it continued. Most of us would also agree that it’s bad if life expectancy in a country is low, it’s bad if there is high infant mortality and it’s bad if there is a wide mortality gap between different groups in a population. But how can we make (...)
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  • Health, priority to the worse off, and time.Anders Herlitz - 2018 - Medicine, Health Care and Philosophy 21 (4):517-527.
    It is a common view that benefits to the worse off should be given priority when health benefits are distributed. This paper addresses how to understand who is worse off in this context when individuals are differently well off at different times. The paper argues that the view that this judgment about who is worse off should be based solely on how well off individuals are when their complete lives are considered (i.e. 'the complete lives view') is implausible in this (...)
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  • ¿No es país para viejos? La edad como criterio de triaje durante la pandemia COVID-19.Jon Rueda - 2020 - Enrahonar: Quaderns de Filosofía 65:85-98.
    La pandemia de la COVID-19 ha levantado sospechas de edadismo y gerontofobia en diversas prácticas de racionamiento sanitario. La edad es un criterio de triaje controvertido. En este artículo se esclarece la relevancia ética de la edad dentro de los sistemas de triaje, analizando particularmente su rol dentro de los principios de equidad y de eficiencia. La equidad requiere dar más oportunidades a aquellos que han cumplido menos ciclos vitales. La eficiencia tiene en cuenta la edad de manera subrepticia al (...)
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  • Federalism and Responsibility for Health Care.Douglas MacKay & Marion Danis - 2016 - Public Affairs Quarterly 30 (1):1-29.
    Political philosophers often formulate the problem of distributive justice as the problem of how the government ought to distribute different types of goods—for example, income or health care—to its citizens. They therefore presuppose that the government is a unitary agent that governs its citizens directly. However, although a number of governments are unitary in this way, many are federations, exhibiting a division of sovereignty between two or more levels of government having independent grounds of authority. In contrast to unitary states, (...)
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  • Competing Principles for Allocating Health Care Resources.Drew Carter, Jason Gordon & Amber M. Watt - 2016 - Journal of Medicine and Philosophy 41 (5):558-583.
    We clarify options for conceptualizing equity, or what we refer to as justice, in resource allocation. We do this by systematically differentiating, expounding, and then illustrating eight different substantive principles of justice. In doing this, we compare different meanings that can be attributed to “need” and “the capacity to benefit”. Our comparison is sharpened by two analytical tools. First, quantification helps to clarify the divergent consequences of allocations commended by competing principles. Second, a diagrammatic approach developed by economists Culyer and (...)
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  • Cost-Effectiveness and the Avoidance of Discrimination in Healthcare: Can We Have Both?Kasper Lippert-Rasmussen - 2023 - Cambridge Quarterly of Healthcare Ethics 32 (2):202-215.
    Many ethical theorists believe that a given distribution of healthcare is morally justified only if (1) it is cost-effective and (2) it does not discriminate against older adults and disabled people. However, if (3) cost-effectiveness involves maximizing the number of quality-adjusted life-years (QALYs) added by a given unit of healthcare resource, or cost, it seems the pursuit of cost-effectiveness will inevitably discriminate against older adults and disabled patients. I show why this trilemma is harder to escape than some theorists think. (...)
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  • Value choices in European COVID-19 vaccination schedules: how vaccination prioritization differs from other forms of priority setting.Karolina Wiśniowska, Tomasz Żuradzki & Wojciech Ciszewski - 2022 - Journal of Law and the Biosciences 9 (2):lsac026.
    With the limited initial availability of COVID-19 vaccines in the first months of 2021, decision-makers had to determine the order in which different groups were prioritized. Our aim was to find out what normative approaches to the allocation of scarce preventive resources were embedded in the national COVID-19 vaccination schedules. We systematically reviewed and compared prioritization regulations in 27 members of the European Union, the United Kingdom, and Israel. We differentiated between two types of priority categories: groups that have increased (...)
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  • Let Us Be Fair to 5-Year-Olds: Priority for the Young in the Allocation of Scarce Health Resources.Kelsey Gipe & Samuel J. Kerstein - 2018 - Public Health Ethics 11 (3):325-335.
    Life-saving health resources like organs for transplant and experimental medications are persistently scarce. How ought we, morally speaking, to ration these resources? Many hold that, in any morally acceptable allocation scheme, the young should to some extent be prioritized over the old. Govind Persad, Alan Wertheimer and Ezekiel Emanuel propose a multi-principle allocation scheme called the Complete Lives System, according to which persons roughly between 15 and 40 years old get priority over younger children and older adults, other things being (...)
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  • For the Greater Individual and Social Good: Justifying Age-Differentiated Paternalism.Viki Møller Lyngby Pedersen - 2024 - Utilitas 36 (1):1-15.
    What justifies differences in the acceptance of paternalism towards competent minors and older people? I propose two arguments. The first argument draws on the widely accepted view that paternalism is easier to justify the more good it promotes for the paternalizee. It argues that paternalism targeting young people generally promotes more good for the people interfered with than similar paternalism targeting older people. While promoting people's interests or well-being is essential to the justification of paternalism, the first argument has certain (...)
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  • Precision medicine and the principle of equal treatment: a conjoint analysis.Ole Frithjof Norheim, Trygve Ottersen, Roger Strand & Eirik Joakim Tranvåg - 2021 - BMC Medical Ethics 22 (1):1-9.
    BackgroundIn precision medicine biomarkers stratify patients into groups that are offered different treatments, but this may conflict with the principle of equal treatment. While some patient characteristics are seen as relevant for unequal treatment and others not, it is known that they all may influence treatment decisions. How biomarkers influence these decisions is not known, nor is their ethical relevance well discussed.MethodsWe distributed an email survey designed to elicit treatment preferences from Norwegian doctors working with cancer patients. In a forced-choice (...)
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  • We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - 2022 - Public Health Ethics 15 (1):87-103.
    In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...)
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  • Against proportional shortfall as a priority-setting principle.Samuel Altmann - 2018 - Journal of Medical Ethics 44 (5):305-309.
    As the demand for healthcare rises, so does the need for priority setting in healthcare. In this paper, I consider a prominent priority-setting principle: proportional shortfall. My purpose is to argue that proportional shortfall, as a principle, should not be adopted. My key criticism is that proportional shortfall fails to consider past health.Proportional shortfall is justified as it supposedly balances concern for prospective health while still accounting for lifetime health, even though past health is deemed irrelevant. Accounting for this lifetime (...)
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  • Pandemic prioritarianism.Lasse Nielsen - 2022 - Journal of Medical Ethics 48 (4):236-239.
    Prioritarianism pertains to the generic idea that it matters more to benefit people, the worse off they are, and while prioritarianism is not uncontroversial, it is considered a generally plausible and widely shared distributive principle often applied to healthcare prioritisation. In this paper, I identify social justice prioritarianism, severity prioritarianism and age-weighted prioritarianism as three different interpretations of the general prioritarian idea and discuss them in light of the effect of pandemic consequences on healthcare priority setting. On this analysis, the (...)
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  • Income-based equity weights in healthcare planning and policy.Anders Herlitz - 2017 - Journal of Medical Ethics 43 (8):510-514.
    Recent research indicates that there is a gap in life expectancy between the rich and the poor. This raises the question: should we on egalitarian grounds use income-based equity weights when we assess benefits of alternative benevolent interventions, so that health benefits to the poor count for more? This article provides three egalitarian arguments for using income-based equity weights under certain circumstances. If income inequality correlates with inequality in health, we have reason to use income-based equity weights on the ground (...)
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  • Wir müssen abwägen – aber wie sollen wir abwägen?: Fragen der Moral in einer pandemischen Corona-Krise.Lutz Wingert - 2021 - Deutsche Zeitschrift für Philosophie 69 (1):29-66.
    The global Covid-19 crisis raises at least three moral questions, which my contribution answers as follows: (1) Which patient should get treatment according to triage criteria? The patient whose treatment has the best prospect of success. (2) How should we resolve the conflict between public health measures and economic needs? Public health should have priority, but reaches its limits where the individual right to stay afloat through one’s own work is violated. (3) How should we resolve the conflict between public (...)
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  • Ageism Without Anticipation-Blindness.Martin Marchman Andersen & Lasse Nielsen - 2023 - Public Health Ethics 16 (3):271-279.
    Ageism is the view that it is of greater moral value to allocate health care resources to younger people than to older people. In medical ethics, it is well-known that standard interpretations of distributive principles such as utilitarianism and egalitarianism imply some form of ageism. At times, ethicists argue as if practical complications are the only or main reason for not abiding to ageism. In this article, we argue that inferences to ageism from such distributive principles tend to commit what (...)
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