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)

Unintentional plagiarism abounds at universities. The literature offers several explanations for students’ difficulties with acquiring standards of good academic practice. In this paper, I propose an alternative account: unintentional plagiarism can only be understood in the context of implicit but irreconcilable forms of knowledge. While higher education institutions mainly operate within the framework of propositional epistemology, institutions of primary and secondary education tend to furnish students with encyclopedic epistemology. Accordingly, universities and institutions of pre-college education tend to propagate conflicting assumptions (...) regarding the nature of knowledge. Put simply, propositional epistemology is characterized by dialogue, agency and the exchange of ideas, which are ideally made explicit in academic writing. By contrast, encyclopedic epistemology tends to present knowledge monologically, leaving the scholarly conversation around it out. It is highly likely that the hardwired legacy of encyclopedic epistemology among students impedes the acquisition of the dialogism of academic inquiry at universities, resulting in cases of unintentional plagiarism. (shrink)

We thank the open peer commentators for their thoughtful responses to our article, "The Social Determinants of Health: Why Should We Care?" (Preda and Voigt 2015). Since space constraints prevent us from responding in detail to all the comments raised, we focus on two areas of concern that emerged from the commentaries. The first is our claim that avoidability is neither necessary nor sufficient for defining unjust or unfair health inequalities. The second area relates to the reasons we might give (...) for treating health inequalities as morally problematic. (shrink)

BackgroundCervical cancer disproportionately burdens disadvantaged women. Organised cervical screening aims to make cancer prevention available to all women in a population, yet screening uptake and cancer incidence and mortality are strongly correlated with socioeconomic status. Reaching underscreened populations is a stated priority in many screening programs, usually with an emphasis on something like ‘equity’. Equity is a poorly defined and understood concept. We aimed to explain experts’ perspectives on how cervical screening programs might justifiably respond to ‘the underscreened’.MethodsThis paper reports (...) on a grounded theory study of cervical screening experts involved in program organisation. Participants were 23 experts from several countries and a range of backgrounds: gynecology; epidemiology; public health; pathology; general practice; policy making. Data were gathered via semi-structured interview and concepts developed through transcript coding and memo writing.ResultsMost experts expressed an intuitive commitment to reducing systematic differences in screening participation or cancer outcomes. They took three different implicit positions, however, on what made organised programs justifiable with respect to underscreened populations. These were: 1) accepting that population screening is likely to miss certain disenfranchised groups for practical and cultural reasons, and focusing on maximising mainstream reach; 2) identifying and removing barriers to screening; and 3) providing parallel tailored screening services that attended to different cultural needs. Positions tended to fall along country of practice lines.ConclusionsExperts emphasised the provision of opportunity for underscreened populations to take up screening. A focus on opportunity appeared to rely on tacit premises not supported by evidence: that provision of meaningful opportunity leads to increased uptake, and that increased uptake of an initial screening test by disadvantaged populations would decrease cervical cancer incidence and mortality. There was little attention to anything other than the point of testing, or the difficulties disadvantaged women can have in accessing follow up care. The different approaches to ‘improving equity’ taken by participants are differently justified, and differently justifiable, but none attend directly to the broader conditions of disadvantage. (shrink)

Rationing is an unavoidable mechanism for reining in healthcare costs. It entails establishing cutoff points that distinguish between what is and is not offered or available to patients. When the resource to be distributed is defined by vague and indeterminate terms such as “beneficial,” “effective,” or even “futile,” the ability to draw meaningful boundary lines that are both ethically and medically sound is problematic. In this article, I draw a parallel between the challenges posed by this problem and the ancient (...) Greek philosophical conundrum known as the “sorites paradox.” I argue, like the paradox, that the dilemma is unsolvable by conventional means of logical analysis. However, I propose another approach that may offer a practical solution that could be applicable to real-life situations in which cutoffs must be decided (such as rationing). (shrink)