Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather (...) than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. (shrink)

Of all the risks we face in life, ranging from unemployment to old age, early death is among the most tragic and yet most neglected by modern states. Liberal egalitarians might find it easy to dismiss social insurance against early death, but I argue they should not. Early in this paper, I explain why social insurance should include the risk of premature death by replying to four common criticisms. What follows is a case for a novel form of insurance that (...) is more liberal and egalitarian across ages than the status quo. More specifically, I show that granting storable pensions in all life stages - youth, middle and old age - promotes liberty and reduces lifetime inequality. Writers on age group and longevity justice often overlook the extent to which liberal lifetime equality can supply insightful arguments against inequality across ages. These call for a policy that gives each age group the freedom to draw a storable pension. I call that policy "freetirement". (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)

This article develops the argument that the state must provide parental subsidies if, and to the extent that, individuals would, under certain specified hypothetical conditions, purchase ‘insurance cover’ that would provide the funds they need for adequate childrearing. I argue that most citizens would sign up to an insurance scheme, in which they receive a guarantee of a means-tested parental subsidy in return for an obligation to pay a progressive income tax to fund the scheme. This argument from insurance bolsters (...) the weaker case that proponents of parental subsidies might offer were they to rely exclusively on arguments from fair play and efficiency. (shrink)

Oppression can be unjust from a luck egalitarian point of view even when it is the consequence of choices for which it is reasonable to hold persons responsible. This is for two reasons. First, people who have not been oppressed are unlikely to anticipate the ways in which their choices may lead them into oppressive conditions. Facts about systematic phenomena (like oppression) are often beyond the epistemic reach of persons who are not currently subject to such conditions, even when they (...) possess adequate information about the particular consequences of their choices. Second, people may be (much) less responsible for remaining in oppressive conditions, even if they are responsible for entering circumstances of oppression. Oppression that results from a person’s choice may cause or contribute to dramatic changes in that person, and these changes may be sufficient to undermine the person’s responsibility for the results of her earlier choice. (shrink)

Journal of Political Philosophy, EarlyView.

Production in sweatshops entails an elevated risk of occupational injury and sickness due to accidents and exposure to dangerous working conditions. As most sweatshop locations lack basic social security systems, health problems have severe consequences for affected workers. Against this background, this article considers what obligations employers of sweatshop labor have to their workers, and how they should meet them. Based on core libertarian concepts, it shows that they are morally responsible for health problems caused by their management decisions, that (...) they should compensate affected workers, and that they must prevent potentially irreversible health problems. In line with Nozick’s contractarian method, the article further argues that these obligations should be implemented through a compulsory employment injury insurance system. Such a system would impose industry-wide health and safety standards, in contrast to the view that libertarianism excludes any labor regulation for the protection of workers, as an illegitimate interference in voluntary labor contracts. (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, inequalities are justified if and only if they arise from choices for which it is reasonable to hold agents responsible. This position has been criticised for its purported harshness in responding to the plight of individuals who, through their own choices, end up destitute. This paper aims to assess the Harshness Objection. I put forward a version of the objection that has been qualified to take into account some of the more subtle elements of the luck (...) egalitarian approach. Revising the objection in this way suggests that the Harshness Objection has been overstated by its proponents: because luck egalitarians are sensitive to the influence of unequal brute luck on individuals’ choices, it is unlikely that there will be any real world cases in which the luck egalitarian would not have to provide at least partial compensation. However, the Harshness Objection still poses problems for the luck egalitarian. First, it is not clear that partial compensation will be sufficient to avoid catastrophic outcomes. Second, the Harshness Objection raises a theoretical problem in that a consistent luck egalitarian will have to regard it as unjust if any assistance is provided to the victim of pure option luck, even if such assistance could be provided at no cost. I consider three strategies the luck egalitarian could pursue to accommodate these concerns and conclude that none of these strategies can be maintained without either violating basic luck egalitarian principles or infringing upon individual liberty. (shrink)

University of Utrecht, Department of Philosophy, Heidelberglaan 6, 3584 CS Utrecht, The Netherlands. Tel.: +31 30 253 28 74, Email: Thomas.Nys{at}phil.uu.nl ' + u + '@' + d + ' '//-->Measures in public health care seem vulnerable to charges of paternalism: their aim is to protect, restore, or promote people's health, but the public character of these measures seems to leave insufficient room for respect for individual autonomy. This paper wants to explore three challenges to these charges: Measures in PHC (...) are aimed to protect, restore or promote ‘deep autonomy’, Measures in PHC are directed at the public and, as such, they do show respect for autonomy, and Some measures in PHC can be justified on grounds of justice and need not be defended as cases of ‘justified paternalism’. Although charges of unjustified paternalism in PHC might still be relevant, we should at least face these different challenges. CiteULike Connotea Del.icio.us What's this? (shrink)

A common objection to paternalism concerns its expressive content. Many reject paternalistic policies and actions on the ground that they arguably involve insulting expressions of disrespect toward those subjected to them. The paper challenges this view. It argues that refraining from acting paternalistically can be disrespectful. Specifically, the paper argues that there is a relevant way in which A disregards the moral worth of B if A stands idly by when B is about to act very imprudently. If true, treating (...) others with equal respect and concern, as relational egalitarians and others rightly ask us to do, will somewhat surprisingly sometimes involve treating them paternalistically. (shrink)

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 (...) unfair implications in that it disfavours paternalism towards the worse off. The second argument caters to such fairness concerns. It argues that priority or inequality aversion supports age-differentiated paternalism because young people, who act imprudently and thereby risk their interests or well-being, are worse off than older people who act in similar ways. I suggest that both arguments are pertinent in evaluating specific paternalistic acts and policies. (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 the influential disrespect account of what paternalism is, and why it is wrong, paternalism involves an anti-egalitarian, disrespectful attitude on the part of the paternalist: X (the paternalist) assumes an attitude of superiority when interfering in Y's matters for Y's good. Pace this account, the article argues that an important, although somewhat overlooked, form of paternalism is not, all things considered, insulting. This form of paternalism focusses on people's occasional lack of appropriate self-respect or their failure to see (...) themselves as equals or to stand vis-à-vis others as such. (shrink)

This paper develops a full account of Rawls's notion of a well-ordered society and uses it to address two luck egalitarian objections to his principles of justice. The first is an internal criticism which claims that Rawls's account of justice is better captured by a responsibility-sensitive egalitarian account. The second is an external objection according to which, regardless of the alleged inconsistency between Rawls's principles and his account of justice, we should reject those principles in favour of a responsibility-sensitive criterion (...) because it better captures our moral intuitions about distributive justice. The argument presented answers both objections by defending the value of well-orderedness and showing the difficulties of responsibility-sensitive egalitarian conceptions in realizing this ideal. (shrink)

This paper examines G. A. Cohen's final criticism of Ronald Dworkin's theory of equality of resources, which targets its treatment of inequalities that arise when some individuals make luckier choices than others make. Rebutting Cohen's argument that such option luck inequalities fail to be just in an unqualified sense, the paper argues that choice does not merely render inequality legitimate but instead can sometimes make inequality just. It also examines the relationship between Cohen's criticism and the conception of equality developed (...) in his earlier influential paper,. (shrink)

The notion of a non-renounceable right is an integral part of recent liberal reconciliatory attempts to justify apparently paternalistic policies, such as compulsory insurance or providing people with certain goods irrespective of their subjective preferences, non-paternalistically. However, non-renounceable rights cannot be justified non-paternalistically. A critical scrutiny of the liberal reconciliatory arguments in question reveals this and points towards a plausible paternalist justification of the policies in question.