The COVID-19 pandemic has exacerbated many social problems and put the already vulnerable, such as racial minorities, low-income communities, and older individuals, at an even greater risk than before. In this paper we focus on older adults’ well-being during the COVID-19 pandemic and show that the risk-mitigation measures presumed to protect them, alongside the generalization of an ageist public discourse, exacerbated the pre-existing marginalization of older adults, disproportionately affecting their well-being. This paper shows that states have duties to adopt and (...) put into practice redress measures to compensate for the negative consequences of COVID-19 public health policies on older adults’ overall well-being. These duties flow from the minimal ethical requirement of respect for persons. We show that respect is a morally basic attitude that presupposes taking the others’ interests into account, with the aim of advancing their well-being. This duty is not limited to kinship, relatives, and friends but it extends to states and the rest of the civil society. In the conclusion, we draw lessons from the COVID-19 pandemic and sketch some redress measures that could compensate for the decrease in older adults’ well-being as a result of the adoption of measures to contain the spread of the virus. (shrink)

One of the societal problems in a new influenza pandemic will be how to use the scarce medical resources that are available for prevention and treatment, and what medical, epidemiological and ethical justifications can be given for the choices that have to be made. Many things may become scarce: personal protective equipment, antiviral drugs, hospital beds, mechanical ventilation, vaccination, etc. In this paper I discuss two general ethical principles for priority setting (utility and equity) and explain how these principles will (...) often point in diverging directions. Moreover, each of these principles can be understood in different, again often competing, ways. Notwithstanding these controversies and conflicts, in the context of pandemic response there are at least some points of convergence: several policies can be justified by appeal to different ethical principles and theories. Convergence may be found with respect to a focus on saving the most lives (instead of other aggregative accounts); giving priority antiviral prophylaxis and therapy for life-saving pandemic responders; and, partly depending on epidemiology of the pandemic, to prioritise vaccination of children. Although decision-making about access to intensive care will involve choices with immediate tragic implications, the ethical complexity of these choices is relatively modest (although decisions will not be easy): there are persuasive moral reasons for giving priority to patients who are expected to benefit most within the shortest time. Finally, in the last section I tentatively argue that constraints on people’s freedom, as necessary for an effective public health approach, may support giving somewhat more weight to saving the most lives, than to concerns of equity. (shrink)

In April 2019, Greta Thunberg made TIME Magazine’s 100 Most Influential People of 2019 list. The 16 year-old climate activist, who has also been nominated for a Nobel Peace Prize, started a movement that saw a multitude of student protests and school strikes around the world centred on action against climate change. TIME Magazine quoted her saying, “We can’t save the world by playing by the rules, because the rules have to be changed.” With her engagement, Thunberg inspired thousands of (...) youth activists to join her in her efforts and has thus put not only climate change on the political agenda but also the political participation and representation of the young. And this even though Thunberg and many of her fellow protesters do not yet enjoy voting rights in their respective countries. Just like the previous issue of the Intergenerational Justice Review, this one is also dedicated to the topic of the underrepresentation of younger people in political decision-making. The first two contributions in this issue pay particular attention to the existence – or lack thereof – of networks and contacts in politics that seem to be important for political representation. Daniel Stockemer and Aksel Sundström’s article titled “Youth’s underrepresentation in the European Parliament: Insights from interviews with young Members of the European Parliament ” reports results from qualitative interviews with 23 MEPs on the factors contributing to the success and failure of young people to enter the European Parliament. They find that, in general, three common themes or complaints amongst the successful young MEPs, irrespective of their party affiliation: “ a general reluctance within parties to nominate young candidates, young candidates lacking the necessary contacts in parties to get elected, and young candidates having too little experience to gain nomination for an electable seat.” Despite these heavy criticisms of established politicians and structures, the authors also summarise some more hopeful suggestions by respondents centring around the role of party youth organisations. The second contribution, by Emilien Paulis, also highlights the important role of networks and contacts, yet already at an earlier stage: when joining a political party. Drawing on social network and political participation theory and novel survey data from Belgium, Paulis explores what network patterns contribute to young people’s enrolment in a political party. He discovers strong social ties between young party members and suggests that this indicates “a certain exclusivity in recruitment patterns of political parties”. In addition, his analysis also points out that a highly homogenous network composition is a statistically significant predictor of joining a political party. Overall, Paulis, similar to Stockemer and Sundström, suggests a review of institutional processes and structures within established political organisations such as parties in order to promote a more diverse and above all younger profile of politically active citizens. The final contribution in this issue offers insights from an online survey conducted among young adults in Germany suggesting that these respondents were indeed politically interested and felt willing to assume responsibility through participation. As a consequence, Philipp Köbe concludes from his analysis that the supply-side of political organisations is the main problem in the underrepresentation and not so much young people’s lack of engagement. His four specific recommendations to political organisations follow very much from this conclusion: providing transparent and suitable information to meet young people’s interests and demands; lowering the electoral threshold for parties’ parliamentary representation to improve the representation of minority opinions; expanding youth-friendly opportunities for political participation such as video conferences and social media usages in order to reach out to the appropriate groups; improving the efficiency and impact of political decision-making to reward political engagement amongst young people. Köbe finally suggests a steering instrument for political organisations to help them achieve these goals. In the book review section, we continue the theme of political participation and representation of the young. Simon Pistor reviews the book Youthquake 2017: The Rise of Young Cosmopolitans in Britain by James Sloam and Matt Henn. The book investigates youth political participation in Britain around and after the Brexit referendum in 2016 and is built around the new notion a “youthquake” – a term initially introduced by British media to describe the surprising success of the movement behind the Labour Party but later on also becoming Oxford Dictionaries’ 2017 word of the year. Pistor writes that Sloam and Henn expand the concept of a youthquake in their book to “youthquake elections” – “ones in which dramatic changes in how many young people vote, who they vote for and how active they are in the campaign have, quite literally, shaken up the status quo”. Using this concept, the book’s central claim is that it was a youth movement based on a broader appeal to the needs of young people which spiked the higher voter turnout among young people. Pistor’s review of the book is unequivocal: using methods from comparative politics, the authors provide a “very interesting argument” and “a clear empirical case for the youthquake during the 2017 General Election in the UK”. Pistor also welcomes especially two implications of the book: many young British people are not as politically disenfranchised as general wisdom holds ; many of them are not only cosmopolitans but also British cosmopolitans interested and engaged in national politics. Overall, Simon Pistor concludes that Sloam and Henn’s book is “an empirically rich and informed study”, which might suggest that the key to future democratic successes does indeed lie with the young. Ann-Kristin Kölln Antony Mason Jörg Tremmel Markus Rutsche Maria Lenk. (shrink)

A continuing need for care for elderly, combined with looser family structures prompt the question what filial obligations are. Do adult children of elderly have a duty to care? Several theories of filial obligation are reviewed. The reciprocity argument is not sensitive to the parent–child relationship after childhood. A theory of friendship does not offer a correct parallel for the relationship between adult child and elderly parent. Arguments based on need or vulnerability run the risk of being unjust to those (...) on whom a needs-based claim is laid. To compare filial obligations with promises makes too much of parents’ expectations, however reasonable they may be. The good of being in an unchosen relationship seems the best basis for filial obligations, with an according duty to maintain the relationship when possible. We suggest this relationship should be maintained even if one of the parties is no longer capable of consciously contributing to it. We argue that this entails a duty to care about one’s parents, not for one’s parents. This implies that care for the elderly is not in the first place a task for adult children. (shrink)

In this article I investigate the nature and extent of filial obligations. The question what (adult) children owe their parents is not only philosophically interesting, but also of increasing relevance in ageing societies. Its answer matters to elderly people and their adult children, and is relevant to social policy issues in various ways. I present the strongest arguments for and against three models of filial obligations: the ‘past parental sacrifices’ model, the ‘special relationship’ model, and the conventionalist model. There is (...) something to be said—and after consideration of objections something remains to be said—for all three models. In other words: filial obligations have more than one source, and an adequate model of filial obligations should reflect this. On its own, each of the above models is one-sided. They also fail to show the connections between the question of filial obligations and various other issues, such as issues of gender justice, the extent of institutionalization of eldercare, and social conventions regarding filial responsibility. Therefore, I integrate what I think we should keep from the aforementioned models into a contextual, pluralist model, which places filial obligations in a broader social and cultural context and relates them to issues of social justice. The model also highlights the difference between general and specific filial obligations, and the factors that determine their nature and extent, thus enabling a deeper and more comprehensive understanding of filial obligations. (shrink)

Norman Daniels's new book, Just Health, brings together his decades of work on the problem of justice and health. It improves on earlier writings by discussing how we can meet health needs fairly when we cannot meet them all and by attending to the implications of the socioeconomic determinants of health. In this article I return to the core idea around which the entire theory is built: that the principle of equality of opportunity grounds a societal obligation to meet health (...) needs. I point, first, that nowhere does Daniels say just what version of that principle he accepts. I then proceed to construct a principle on his behalf, based on a faithful reading of Just Health. Once we actually nail down the principle, I argue, we will find that there are two problems: it is implausible in itself, and it fails to ground a societal obligation to meet health needs. (shrink)

An aging population is often taken to require a profound reorganization of the prevailing health care system. In particular, a more cost-effective care system is warranted and ICT-based home care is often considered a promising alternative. Modern health care devices admit a transfer of patients with rather complex care needs from institutions to the home care setting. With care recipients set up with health monitoring technologies at home, spouses and children are likely to become involved in the caring process and (...) informal caregivers may have to assist kin-persons with advanced care needs by means of sophisticated technology. This paper investigates some of the ethical implications of a near-future shift from institutional care to technology-assisted home care and the subsequent impact on the care recipient and formal- and informal care providers. (shrink)

In this paper, I offer a solution to the Capacity/Equality Puzzle. The puzzle holds that an account of the franchise may adequately capture at most two of the following: (1) a political equality-based account of the franchise, (2) a capacity-based account of disenfranchising children, and (3) universal adult enfranchisement. To resolve the puzzle, I provide a complex liberal egalitarian justification of a moral requirement to disenfranchise children. I show that disenfranchising children is permitted by both the proper political liberal and (...) the proper political egalitarian understandings of the relationship between cognitive capacity and the franchise. Further, I argue, disenfranchising children is required by a minimalistic, procedural principle of collective competence in political decision-making. At the same time, I show that political equality requires the enfranchisement of all adults, regardless of cognitive capacities, and that the collective competence principle does not ground adult disenfranchisement. This justifies the progressive legal trend that holds the capacity-based disenfranchisement of adults to be incompatible with liberal democratic principles. (shrink)

While different worries about population size are present in public debates, political philosophers often take population size as given. This paper is an attempt to formulate a Rawlsian liberal egalitarian approach to population size: does it make sense to speak of ‘too few’ or ‘too many’ people from the point of view of justice? It argues that, drawing on key features of liberal egalitarian theory, several clear constraints on demographic developments – to the extent that they are under our control (...) – can be formulated. Based on these claims, we can clarify both the grounds and content of our obligations to future generations. (shrink)

Nancy Jecker (2013) makes a compelling argument for using a capabilities approach to resolve the issue of the fair allocation of health care resources across various age groups. This question has b...

As individuals grow older, they usually require assistance with the daily tasks of self-care. This type of assistance, ancillary care, is essential to maintaining the health of those who need these services. In his prudential lifespan account, Norman Daniels includes access to such services making his account an attractive proposal given the current demographic shift. In this paper, I examine the prudential lifespan account through the lens of old age and I focus on the two concepts on which the lifespan (...) account relies. I show that these two concepts, normal species functioning and opportunity cannot buttress Daniels’s lifespan account; at least it cannot do so for older persons. The tensions that I identify in the prudential lifespan account in relation to aging are instructive for the more recent proposals to include aging in a theory of health and health justice. In addition, my analysis allows me to demonstrate that Daniels’s view of opportunity is irreconcilable to capabilities, the latter being more adaptable to the realities of aging. If capabilities appear more promising, it is nonetheless imperative that the specificities of extended care, such as the need for unpaid caregiving, be taken into consideration. (shrink)

The allocation of scarce health care resources such as flu treatment or organs for transplant presents stark problems of distributive justice. Persad, Wertheimer, and Emanuel have recently proposed a novel system for such allocation. Their “complete lives system” incorporates several principles, including ones that prescribe saving the most lives, preserving the most life-years, and giving priority to persons between 15 and 40 years old. This paper argues that the system lacks adequate moral foundations. Persad and colleagues' defense of giving priority (...) to those between 15 and 40 leaves them open to the charge that they discriminate unfairly against children. Second, the paper contends that the complete lives system fails to provide meaningful practical guidance in central cases, since it contains no method for balancing its principles when they conflict. Finally, the paper proposes a new method for balancing principles of saving the most lives and maximizing life-years. (shrink)

This paper argues that we can see our lives as a snapshot happening now or as a moving picture extending across time. These dual ways of seeing our lives inform how we conceive of the problem of age group justice. A snapshot view sees age group justice as an interpersonal problem between distinct age groups. A moving picture view sees age group justice as a first-person problem of prudential choice. This paper explores these different ways of thinking about age group (...) justice and illustrates them using a principle of respect for human dignity, understood in terms of reasonable support for floor level central human capabilities at each stage of life. I argue that different frames are suitable for different kinds of decisions, and each provides a true, but partial, picture of aging and age group justice. (shrink)

Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...) the implications of this critique for the prudential life span account and for the special case of age-group justice. The result is that age-based rationing based on the prudential life span approach is not supported, and that the prudential life span approach itself is not the best way to think about allocating health care between age groups. I propose an alternative approach that avoids the disability objection, and consider its implications for specific proposals for age-based rationing of health care. (shrink)

This collection features comprehensive overviews of the various ethical challenges in organ transplantation. International readings well-grounded in the latest developments in the life sciences are organized into systematic sections and engage with one another, offering complementary views. All core issues in the global ethical debate are covered: donating and procuring organs, allocating and receiving organs, as well as considering alternatives. Due to its systematic structure, the volume provides an excellent orientation for researchers, students, and practitioners alike to enable a deeper (...) understanding of some of the most controversial issues in modern medicine. (shrink)

What should maximin egalitarians think about seniority privileges? We contrast a good-specific and an all-things-considered perspective. As to the former, inertia and erasing effects of a seniority-based allocation of benefits from employment are identified, allowing us to spot the categories of workers and job-seekers made involuntarily worse off by such a practice. What matters however is to find out whether abolishing seniority privileges will bring about a society in which the all-things-considered worst off people are better off than in the (...) seniority rule's presence. An assessment of the latter's cost-reduction potential is thus needed, enabling us to bridge a practice taking place within a firm with its impact on who the least well off members of society are likely to be. Three accounts of the profitability of seniority privileges are discussed: the “(firm specific) human capital”, the “deferred compensation” and the “knowledge transfer” ones. The respective relevance of “good-specific” and “all-things-considered” analysis is discussed. It turns out that under certain circumstances, a maximin egalitarian case for seniority privileges could be made. Senior: Do you know that they are planning layoffs? Of course, it is only fair that they lay-off the newcomers first! After all, I have been loyal to the company for many years. Junior: Did I choose to be a newcomer? Footnotes1 Many thanks to two anonymous referees, to P.-M. Boulanger, B. Cockx, C. Fabre, L. Jacquet, E. Lazear, I. Robeyns, G. Vallée, Y. Vanderborght, Ph. Van Parijs, V. Vansteenberghe and J. de Wispelaere for their help and critical comments. Earlier versions of this paper were presented in Louvain-la-Neuve, Ghent, Montevideo and London. I am very grateful to these audiences. Special thanks to G. Brennan for his extensive and extremely valuable comments on earlier drafts of this paper. The usual disclaimers apply. (shrink)

This paper explores the debate between perfectionists and anti-perfectionists in the context of children. It suggests that the most influential and compelling arguments in favour of anti-perfectionism are adult-centric. It does this by considering four leading reasons given in favour of anti-perfectionism and shows that none apply in the case of children. In so doing, the paper defends a perfectionist account of upbringing from the attacks made against perfectionism more generally. Furthermore, because the refutation of the various anti-perfectionist arguments are (...) made exclusively dealing with children, the paper suggests that the perfectionist view of upbringing is compatible with anti-perfectionist restrictions on dealing with adults. This dual view combining perfectionism for children and anti-perfectionism for adults is referred to as restricted perfectionism. (shrink)

The issues are familiar to most in bioethics by now, through professional or personal experiences (or both). The rapidly expanding population of elderly persons who require care is raising critical...

The age-rationing debate of fifteen years ago will inevitably reemerge as health care costs escalate. All age-rationing proposals should be judged in light of the current system of rationing health care by price in the U.S., and the resulting pattern of excess and deprivation. Age-rationing should be rejected as public policy, but recognized as a personal virtue of stewardship among the elderly.

In this paper, I assess Peter Dabrock's “Drawing distinctions responsibly and concretely: A European Protestant perspective on foundational theological bioethics.” I explore the ways in which Dabrock announces nontraditional Christian assumptions to guide Christian bioethics, engages the secular bioethical agenda on the very terms set by and congenial to the field of secular bioethics, and searches for insights from philosophy and science through which to recast Christian moral judgments. For example, he cites approvingly, as if they were expressive of Christian (...) moral concerns: human rights, democracy, and state-based social redistribution of resources to satisfy welfare entitlements. In this short essay, I argue that Dabrock has unduly limited the role of Traditional Christian theology to guide bioethics and, consequently, has also wrongly characterized the Christian moral life and Christian social/political obligations. (shrink)

This paper reconstitutes and addresses critically the deontological and consequentialist arguments given by the French government to justify the denial of the national guaranteed minimum income support to young people under 25 years old. The deontological arguments express a concern for distributive justice and suggest that young people do not deserve income support. The consequentialist arguments; on the other hand; emphasise social efficiency: they draw on the alleged negative outcomes that the extension of income support to young people would bring (...) about. After analysing each argument; this paper concludes that the denial of RSA to young people is an illegitimate discrimination. It then proposes that we understand our duties towards young people through an account of prudence that reconciles both concerns of distributive justice with concerns for social efficiency and concerns for inter- and intragenerational justices. (shrink)

Swedish welfare has for decades served as a role model foruniversalistic welfare. When the economic recession hit Swedish economyin the beginning of the 1990s, a period of more than 50 years ofcontinuous expansion and reforms in the welfare sector came to an end.Summing up the past decade, we can see that the economic downturnenforced rationing measures in most parts of the welfare state, althoughmost of this took place in the beginning of the decade. Today, most ofthe retrenchment has stopped and (...) in some areas we can see tendencies ofrestoration – but more so in financial benefits than in the caringsectors. In the article this process is discussed as a process ofreallocation where general principles of solidarity become manifest.Various levels of decision making are discussed within the context ofsocio-political action. Current transitions in Swedish health care aredescribed with respect to coverage rates, content, marketisation anddistribution. Basic principles of distribution are highlighted in orderto analyse the meaning of social solidarity in a concrete allocativesetting. The significance of popular opinion – it's shifts anddeterminants – is also considered. The article concludes with adiscussion of how the (once salient) features of universalism inwelfare and health care provision have been affected by the developmentsin the past decade in Sweden. (shrink)

In recent literature, there has been much debate about whether and how luck egalitarianism, given its focus on personal responsibility, can justify universal health care. In this paper we argue that, whether or not this is so, and in fact whether or not egalitarianism should be sensitive to responsibility at all, the question of personal responsibilization for health is not settled. This is the case because whether or not individuals are responsible for their own health condition is not all that (...) is relevant when considering whether we should somehow hold them responsible for their own health condition, e.g. cost-wise. There may also be efficiency-based reasons to hold them responsible, and there may even be egalitarian reasons. Defining universal health care as an insurance system where everyone’s deductible and premium is 0, we will argue that efficiency-based reasons for cost-responsibilization are not convincing, but that there are egalitarian reasons for cost-responsibilization. Luck egalitarianism, therefore, cannot, at least not on its own term, justify universal health care. (shrink)

Ultimately this book provides a theory of intergenerational justice that is both intellectually robust and practical with wide applicability to law and policy.

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 (...) liberal egalitarians prioritise is plausible and avoids problems that would otherwise arise with other candidates, most notably leisure. Retirement as free time is an essential feature of liberal egalitarian societies by (re)distributing the means to pursue any life project, and especially valuable for the poor who work and contribute the longest. The second part makes a case for 'libertirement', a proposal to increase the freedom to enjoy free time across life, as a matter of justice between those who live long and those who die early. Specifically, I propose adding reverse pensions and sabbaticals on top of old-age retirement. Besides showing the importance of longevity for age-group justice, I also draw implications for distributing unconditional basic income and income taxes across life, which I suggest may offer alternative paths to libertirement. Finally, the third part discusses the cases of pension inequality between genders and generations, pushing us to refine our account further. I conclude that there is often a mismatch between liberal egalitarian justice and the design of retirement schemes. The solution is often but not always to reform these systems. Sometimes, we have reasons to revise our very own principles of justice. (shrink)

In this article, I put forward an instrumental justification for the introduction of youth quotas in parliaments on grounds of justice between coexisting generations. I provide a two-fold argument drawing on the distinction between “substantive representation” and “symbolic representation”. I argue that these jointly provide a good basis for a “politics of youth presence” in parliaments. In the first section, I evaluate the impact that youth quotas can have on enhancing the chances of fair youth policies. In the second section, (...) I show that youth quotas can play an important symbolic role in the promotion of a community of political equals, with potential implications for youth political participation. (shrink)

Gender greatly impacts access to opportunities, potential, and success in corporate leadership roles. We begin with a general presentation of why such discussion is necessary for basic considerations of justice and fairness in gender equality and how the issues we raise must impact any ethical perspective on gender in the corporate workplace. We continue with a breakdown of the central categories affecting the success of women in corporate leadership roles. The first of these includes gender-influenced behavioral factors, such as the (...) requirements and expectations of gendered verbal and nonverbal communication styles as well as appearance. We move on to address the impact of family on corporate leadership opportunities and success, discussing the asymmetrical evaluation of an individual’s potential, authority, and competence based on gender stereotypes of familial obligations and expectations. Finally, we address how gender impacts access to networking and sponsorship opportunities and the long-term effects of systematic limitations on women’s inclusion in the upper echelons of corporate leadership. We conclude with a summary of the questions and issues raised by our discussion and direct individuals to consider how different ethical systems and moral requirements might influence their interpretations of gender and leadership in the corporate workplace. (shrink)