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)

In the luck egalitarian literature, one influential formulation of luck egalitarianism does not specify whether equalities that do not reflect people’s equivalent exercises of responsibility are bad with regard to inequality. This equivocation gives rise to two competing versions of luck egalitarianism: asymmetrical and symmetrical luck egalitarianism. According to the former, while inequalities due to luck are unjust, equalities due to luck are not necessarily so. The latter view, by contrast, affirms the undesirability of equalities as well as inequalities insofar (...) as they are due to luck. The symmetrical view, we argue, is by far the more compelling, both by internal luck egalitarian standards and in light of the external rightist emphasis on choice and responsibility to which luck egalitarianism may partly be seen as a response. Our main case for the symmetrical view is that when some people, against a background of equal opportunities, do not exercise their responsibility to the same degree as others, they cannot justifiably call for equalizing measures to be put in place. Indeed, such measures would be positively unfair. The symmetrical view, accordingly, rejects compensation in such cases, whereas the asymmetrical view, implausibly, enjoins it. We also examine two objections to this argument. First, that this view fails to qualify as genuinely egalitarian, instead collapsing the notion of equality into the notion of desert. Second, that the opposing asymmetrical view, in contrast to the symmetrical view, can draw support from its compatibility with sufficientarian concerns. Both objections are rebutted. We conclude that luck egalitarians are best served by endorsing the symmetrical, luck-neutralizing stance. (shrink)

Luck egalitarianism is a family of egalitarian theories of distributive justice that aim to counteract the distributive effects of luck. This article explains luck egalitarianism's main ideas, and the debates that have accompanied its rise to prominence. There are two main parts to the discussion. The first part sets out three key moves in the influential early statements of Dworkin, Arneson, and Cohen: the brute luck/option luck distinction, the specification of brute luck in everyday or theoretical terms and the specification (...) of advantage as resources, welfare, or some combination of these. The second part covers three later developments: the democratic egalitarian critique of luck egalitarianism, the luck egalitarian acceptance of pluralism, and luck egalitarian doubts about the significance of the brute luck/option luck distinction. (shrink)

The work of prominent analytical Marxist G. A. Cohen provides a vision of socialism which has distributive justice and community at its core. While Cohen's view of distributive justice has been hugely influential, much less has been said about community. This article argues that community plays three distinct roles in Cohen's socialism. One is as an independent value, the second is as a necessary adjacent counterpart to justice, which serves both to restrict and facilitate distributive equality, and the third is (...) as a critique of the liberal contractualist view of humanity. We argue that each of these are distinct and valuable elements in Cohen's thought, each of which must be recognized to understand the range and implications of Cohen's socialism. (shrink)

The late G.A. Cohen is routinely considered a founding father of luck egalitarianism, a prominent responsibility-sensitive theory of distributive justice. David Miller argues that Cohen’s considered beliefs on distributive justice are not best understood as luck egalitarian. While the relationship between distributive justice and personal responsibility plays an important part in Cohen’s work, Miller maintains that it should be considered an isolated theme confined to Cohen’s exchange with Dworkin. We should not understand the view Cohen defends in this exchange as (...) Cohen’s considered view. Accepting this thesis would change both our understanding of Cohen’s political philosophy and many recent luck egalitarian contributions. Miller’s argument offers an opportunity to reassess Cohen’s writings as a whole. Ultimately, however, the textual evidence against Miller’s argument is overwhelming. Cohen clearly considers the exchange with Dworkin to be about egalitarianism as such rather than about the best responsibility-sensitive version of egalitarianism. Furthermore, Cohen often offers luck egalitarian formulations of his own view outside of the exchange with Dworkin and uses luck egalitarianism as an independent yardstick for evaluating principles and distributions. (shrink)

According to US law, insurance companies can lawfully differentiate individual health insurance premiums on the basis of non-genetic medical information, but not on the basis of genetic information. The article reviews the case for such genetic exceptionalism. First, I critically assess some standard justifications. Next, I scrutinize an argument appealing to the view that genetically based premium differentiation expresses that persons do not all merit equal concern and respect. In the final section, I argue that even if genetic exceptionalism is (...) unjustified, there is a forceful luck egalitarian argument against basing premiums on genetic risks, to wit, that this tends to make some individuals worse off than others as a result of the bad brute luck involved in having a genetically determined, above-average risk of developing health problems. (shrink)

This paper argues that there are good reasons to limit the scope of luck egalitarianism to co‐existing people. First, I outline reasons to be sceptical about how “luck” works intergenerationally and therefore the very grounding of luck egalitarianism between non‐overlapping generations. Second, I argue that what Kasper Lippert‐Rasmussen calls the “core luck egalitarian claim” allows significant intergenerational inequality which is a problem for those who object to such inequality. Third, luck egalitarianism cannot accommodate the intuition that it might be required (...) to leave future generations better off than we are, even if it would come at no cost to ourselves. Finally, I argue that following another, broader, version of luck egalitarianism would require us to level down future generations and possibly even ourselves, which is a problem for those persuaded by the levelling‐down objection. (shrink)

A disaster is an occurrence disrupting a community’s normal functioning and existence. The disruption may render it impossible to comply with principles and to respect, protect, and fulfill rights as it happens in ordinary times; it may induce an overwhelming shortage of resources and make tragic decisions unavoidable. From its very beginning, the COVID-19 pandemic evoked the scenario of disaster medicine, where triage is likely to imply not simply postponing a treatment but letting someone die. However, it is not only (...) the health care system that faces disruption risks. Lockdown measures and other restrictions were imposed to curb the pandemic, impinging upon individual freedom as well as economic activities. The proposal of mandatory vaccination implied a suspension of the principle of autonomy, which is a fundamental pillar of modern medicine. Out of the ordinary balancing efforts may be required, and two questions arise. Do such exceptional circumstances suggest reconsidering the criteria to apply, especially when essential, life-saving treatments are at stake? Who should decide? Science offers the premises to build on, but the last word does not belong to science. It remains the province of ethics and politics. (shrink)

In addition to having an institutional site or scope, a theory of distributive justice might also have an institutional ‘reach’ or currency. It has the first when it applies to only social phenomena. It has the second when it distributes only socially produced goods. One objection to luck egalitarianism is that it has absurd implications. In response, Tan has defended a luck egalitarian account that has a strictly institutional reach. I argue, first, that Tan’s view contains two fatal ambiguities and, (...) second, that, to be sound, it requires an institutional currency. This second argument implies that virtually all extant luck egalitarian currencies are incompatible with his approach. I argue, third, that the alleged absurd implications often have little to do with the extent of luck egalitarianism’s reach. (shrink)

Many distributive egalitarians do not endorse strict equality of goods. Rather, they treat an equal division as having a special status such that departures from equality must be justified. They claim, then, that an equal division is “presumptively” just. Though the idea that equality is presumptively just and that departures from it may be just has intuitive appeal, making a case for this idea proves difficult. I argue, first, that extant “presumption arguments” are unsound. Second, I distill two general philosophical (...) morals: luck egalitarians have not adequately defended the presumption of equality and they face serious obstacles in doing so; Rawls has defended it, but only indirectly via the contract apparatus. This approach narrows the presumption’s appeal. Third, I consider and reject two alternative ways of understanding the presumption of equality that might avoid the problems revealed by my examination of extant views. The first appeals to the idea of value pluralism. The second treats the presumption as a view about the burden of proof. I conclude, ultimately, that it is misleading to think of distributive egalitarianism as typically having the form of a presumption argument. (shrink)

În acest capitol îmi revine sarcina de a prezenta unul dintre cele mai influente și mai dinamice curente din filosofia politică actuală. Este vorba, desigur, despre curentul care dă titlul acestui capitol: egalitarianismul.

Luck egalitarianism is often taken to task for its alleged harsh implications. For example, it may seem to imply a policy of nonassistance toward uninsured reckless drivers who suffer injuries. Luck egalitarians respond to such objections partly by pointing to a number of factors pertaining to the cases being debated, which suggests that their stance is less inattentive to the plight of the victims than it might seem at first. However, the strategy leaves some cases in which the attribution of (...) individual responsibility is appropriate . One such case is oral health or significant aspects of this. It is appropriate, the paper argues, to hold people responsible for a number of factors that affect their oral health. A luck egalitarian approach inspired by John Roemer can assess whether people have acted responsibly by comparing their choices to those of their peers. A luck egalitarian approach to oral health would recommend prioritizing scarce resources in a responsibility-weighted queuing system and include copayment and general taxation among its measures of financing. (shrink)

A standard formulation of luck-egalitarianism says that ‘it is [in itself] bad – unjust and unfair – for some to be worse off than others [through no fault or choice of their own]’, where ‘fault or choice’ means substantive responsibility-generating fault or choice. This formulation is ambiguous: one ambiguity concerns the possible existence of a gap between what is true of each worse-off individual and what is true of the group of worse-off individuals, fault or choice-wise, the other concerns the (...) notion of fault. I show that certain ways of resolving these ambiguities lead to counterintuitive results; and that the most plausible way of resolving them leads to a theory of distributive justice in which responsibility plays a role significantly different from that in standard luck-egalitarian thinking. My main conclusion here is that luck-egalitarianism is best formulated as the view that it is [in itself] bad – unjust and unfair – for an individual to be worse off than others if, and only if, her being worse off does not fit the degree to which she is at fault in a not purely prudential sense. (shrink)

Luck egalitarianism is an approach within current distributive justice theory which aims to focus redistributive efforts solely upon disadvantages that ensue from bad luck. This article considers how central assumptions and themes of both luck egalitarianism and its critics parallel those of providence theology and share some of their concerns. These relate to problems such as the basis of equality, the extent and nature of our knowledge, and of course, the paternalism that assessing people’s responsibility over their own disadvantages involves. (...) I highlight the similarity of luck egalitarianism to the role of providence and providence theory thinking, and particularly the tension between egalitarianism as a theological concept and the condescension inherent to imitatio Dei ethics. I approach these issues by analyzing standard criticisms of the luck egalitarian project, espoused by Susan Hurley and Elizabeth Anderson. I then proceed to assess the values of luck egalitarianism itself and consider different models of providence, and the meaning of this analysis for normative ethics. The subject matter of this article is part of a wider comparison of distributive justice and providence theory, within which luck egalitarianism affords a very fruitful and highly relevant case study. (shrink)

The luck egalitarian view famously maintains that inequalities in individuals’ circumstances are unfair or unjust, whereas inequalities traceable to individuals’ own responsible choices are fair or just. On this basis, the distinction between so-called brute luck and option luck has been seen as central to luck egalitarianism. Luck egalitarianism is interpreted, by advocates and opponents alike, as a view that condemns inequalities in brute luck but permits inequalities in option luck. It is also thought to be expressed in terms of (...) the view that no individual ought to be worse off other than because of a fault or choice of his or her own. I argue that these two characterizations of luck egalitarianism are not equivalent and that, properly understood, luck egalitarianism is compatible with widespread, potentially radical, inequalities in brute luck. (shrink)

L’un des objectifs centraux du livre de Kyle Johannsen,A Conceptual Investigation of Justice, consiste à défendre l’idée selon laquelle nous devrions concevoir la justice comme une valeur fondamentale pouvant entrer en conflit avec d’autres valeurs fondamentales. Ce type de pluralisme est principalement associé aux travaux de G.A. Cohen et à sa critique de la théorie de la justice de John Rawls. Dans le cadre ce commentaire, je propose une esquisse des implications du pluralisme de Cohen et de ce à quoi (...) pourrait ressembler un ethos de justice à la Cohen. (shrink)

In the article ‘Equality and Desert,’ Shelly Kagan rejects the principle of equality as an arbiter of distributive justice. He claims instead that all of our intuitions about distributive justice that are thought to support some principle of equality can be captured under the principle of desert. I argue that Kagan's claim fails because, in cashing out his notion of desert, Kagan makes tacit appeal to the principle of equality.

Can outcome equality (say, in welfare) ever be unjust? Despite the extensive inquiry into the nature of luck egalitarianism in recent years, this question is curiously under-explored. Leading luck egalitarians pay little attention to the issue of unjust equalities, and when they do, they appear not to speak in one voice. To facilitate the inquiry into the potential injustice of equalities, the paper introduces two rival interpretations of egalitarianism: the responsibility view, which may condemn equalities as unjust (when they reflect (...) unequal levels of personal responsibility); and, the non-responsibility view, which does not. It then teases out the implications of these two views, in the hope of establishing that the latter is at least as plausible as the former. The paper thus establishes that the egalitarian ideal can be plausibly formulated in a way that condemns only (certain) inequalities but never equalities, and that this formulation is both coherent and attractive. (shrink)

Luck egalitarians contend that, while each person starts out with a claim to an equal quantity of advantage, she can forfeit this claim by making certain choices. The appeal of luck egalitarianism is that it seems to satisfy what this paper calls the moral tyranny constraint. According to this constraint, any acceptable theory of justice must preclude the possibility of an agent unilaterally, discretionarily, and foreseeably leaving others with less advantage under conditions of full compliance with the theory. This paper (...) argues that claim forfeiture is built into luck egalitarianism specifically to preclude such moral tyranny. However, it contends that the dominant interpretation of luck egalitarianism fails to fully satisfy the moral tyranny constraint. It offers an alternative interpretation that both eliminates the possibility of moral tyranny and rescues the position from two other prominent objections that have been directed against luck egalitarianism. (shrink)

Recent literature on responsibility-sensitive egalitarianism has suggested that an opposition to unchosen inequality on the grounds of unfairness is compatible with a range of accounts as to which inequalities are fair. I argue that forms of responsibility-sensitive egalitarianism face a challenge in the construction of such accounts; namely to explain the fairness of such inequalities specifically, as opposed to their being merely justified in a broader sense. I illustrate the nature of this challenge through an interesting parallel with an issue (...) in value theory in the form of the so-called ‘wrong kind of reason’ problem. (shrink)

In a little noted passage in A Theory of Justice, John Rawls argued that genetic intervention in the traits of offspring may be morally required as a matter of distributive justice. Given that the “greater natural assets” of each “enables him to pursue a preferred plan of life[,]” Rawls wrote, the parties to the original position “want to insure for their descendents the best genetic endowment.…Thus over time a society is to take steps at least to preserve the general level (...) of natural abilities and to prevent the diffusion of serious defects.…The pursuit of reasonable policies in this regard is something that earlier generations owe to later ones.” Whether biological enhancement actually is a moral obligation we owe to future generations is a question that I have taken up elsewhere, but which lies beyond my scope here. If we agree with Rawls that some measure of safe and effective genetic intervention may be required as a matter of justice, it stands to ask how the distribution of genetic goods – that is, the hereditary basis of human traits – should be carried out. (shrink)

This paper explores the role individual responsibility plays in contemporary political theory. It argues that the standard luck egalitarian view—the view according to which distributive justice is ensured by holding people accountable for their exercise of responsibility in the distribution of benefits and burdens—obscures the more fundamental value of being responsible. The paper, then, introduces an account of ‘self-creative responsibility’ as an alternative to the standard view and shows how central elements on which this account is founded has been prominently (...) defended in the history of Western political thought but are comparatively neglected in contemporary political theory. Relying on this account, the paper argues that society should hold persons responsible when, and only when, doing so enables them to lead responsible lives, and only on the condition that doing so does not infringe other persons’ equivalently valuable ability to lead responsible lives. The account of self-creative responsibility, the paper concludes, plausibly captures the intuitive attraction of holding responsible while respecting the value of being responsible. (shrink)

Imagine a two-person distributive case in which Ernest's choices yield X and Bertie's choices yield X + Y, producing an income gap between them of Y. Neither Ernest nor Bertie is responsible for this gap of Y, since neither of them has any control over what the other agent chooses. This is what Susan Hurley calls the “Boring Problem” for luck egalitarianism. Contrary to Hurley's relatively dismissive treatment of it, it is contended that the Boring Problem poses a deep problem (...) for standard luck egalitarianism. To counter it, luck egalitarianism needs to be recast as a baseline-relative theory. This new version of luck egalitarianism is then put to work against some significant problems that have been encountered by luck egalitarianism: Saul Smilansky's “Paradox of the Baseline,” the “Partiality Worry,” and the “Pluralism Worry.” But baseline-relative luck egalitarianism is not without problems of its own. (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)

This paper argues that the philosophy of explanation can help inform core debates in value theory. Specifically, it argues that there is a consistent parallelism between the properties of explanation and the properties of justification such that one can reasonably infer that any property of explanation has a counterpart property of justification. Thus, by appealing to facts about the nature of explanation, one can derive various conclusions about the justifications offered by normative theorists. The paper illustrates this point by considering (...) a debate within political philosophy over whether inequality requires justification in a way that equality does not. Egalitarians typically presume an affirmative answer to this question. However, libertarian critics note that this justificatory asymmetry cannot be simply assumed without argument. This paper argues that, by appealing to the explanation-justification parallelism, one can resolve this debate in favor of the egalitarians, as there are two properties of explanation, the justificatory analogs of which vindicate the egalitarian presumption. (shrink)

This essay is an attempt to piece together the elements of G. A. Cohen’s thought on the theory of socialism during his long intellectual voyage from Marxism to political philosophy. It begins from his theory of the maldistribution of freedom under capitalism, moves onto his critique of libertarian property rights, to his diagnosis of the “deep inegalitarian” structure of John Rawls’ theory and concludes with his rejection of the “cheap” fraternity promulgated by liberal egalitarianism. The paper’s exegetical contention is that (...) Cohen’s work in political philosophy is best understood in the background of lifelong commitment to a form of democratic, non-market, socialism realizing the values of freedom, equality and community, as he conceived them. The first part of the essay is therefore an attempt to retrieve core socialism-related arguments by chronologically examining the development of Cohen’s views, using his books as thematic signposts. The second part brings these arguments together with an eye to reconstructing his vision of socialism. It turns out that Cohen’s political philosophy offers a rich conception of objective and subjective freedom, an original understanding of justice as satisfaction of genuine need, and a substantive ideal of fraternity as justificatory community with others. If properly united, these values can suggest a full-bloodied account of the just polity, and give us a glimpse into what it means, for Cohen, to treat people as equals. (shrink)

One question that has sometimes cropped up in the debate on triage and the management of scarce healthcare resources concerns patients’ merits, demerits, and responsibility with regard to their own medical condition. During the current pandemic, some have wondered, when it comes to accessing healthcare, whether patients who have refused vaccination—despite the availability of vaccines and pressure to get vaccinated from the health authorities—should be given the same priority as patients who have diligently undergone vaccination in accordance with the authorities’ (...) recommendations. The issue of patients’ merits and demerits is not new, and it did not emerge with the pandemic for the first time. In the past, the question was often posed whether terrorists have the right to receive the same treatment as their victims, with the same degree of priority, all clinical conditions being equal. Another issue that has been raised concerns patients suffering from diseases caused by unhealthy lifestyles that they have freely adopted: drinking, smoking, eating fatty foods, practising extreme sports, etc. The conclusion reached in the present article is that it is indeed possible to identify certain general rules for cases of this sort, as is shown by the literature on the topic. However, slavishly following these rules, even in exceptional cases for which it is impossible to make detailed provisions, can lead to disastrous consequences. Therefore, following Aristotle, the article seeks to take account both of the rule of justice and of equity, which is a form of “situational justice” capable of filling the gaps of general norms in the light of concrete cases. (shrink)