I argue that Harry Frankfurt’s doctrine of sufficiency, properly understood, presents a plausible alternative to egalitarianism. My position may be more general than Frankfurt’s, insofar as he limits himself to economic sufficiency; on my view, insufficiency is a generic reason for the rejection of principles governing permissible behavior. By situating sufficiency within a contractualist framework of moral permissibility, I provide an alternative to common (and, I think, mistaken) characterizations of the doctrine of sufficiency as either subordinate to equality or primarily (...) concerned with maximizing cases of sufficiency. (shrink)

Carl Knight argues that lexical sufficientarianism, which holds that sufficientarian concerns should have lexical priority over other distributive goals, is ‘excessive’ in many distinct ways and that sufficientarians should either defend weighted sufficientarianism or become prioritarians. In this article, I distinguish three types of weighted sufficientarianism and propose a weighted sufficientarian view that meets the excessiveness objection and is preferable to both Knight’s proposal and prioritarianism. More specifically, I defend a multi-threshold view which gives weighted priority to benefits directly above (...) and below its thresholds, but gives benefits below the lowest threshold lexical priority over benefits above the highest threshold. (shrink)

In this article, I propose a novel characterization of sufficientarianism. I argue that sufficientarianism combines three claims: a priority claim that we have non-instrumental reasons to prioritize benefits in certain ranges over benefits in other ranges; a continuum claim that at least two of those ranges are on one continuum; and a deficiency claim that the lower a range on a continuum, the more priority benefits in that range have. This characterization of sufficientarianism sheds new light on two long-standing philosophical (...) debates, namely about the distinctiveness of sufficientarianism as a distributive principle and about the common objections to sufficientarianism. (shrink)

Journal of Political Philosophy, Volume 30, Issue 2, Page 249-270, June 2022.

A common objection to sufficientarianism is that it allows large inequalities above the threshold. A sharpened form of this objection highlights that this indifference also encompasses large inequalities in the distribution of burdens. Consider the burdens that follow from climate change. A theory that does not rule out placing these burdens on the worst off (of the sufficiently well off) will appear implausible to many. This paper assesses ways of addressing this objection and defends a revised conception of sufficientarianism that (...) can demand fair distribution of burdens (and benefits) above the sufficiency threshold, without giving up core sufficientarian theoretical commitments. (shrink)

Why should we care about global health? What obligations do we have to improve global health? How can we work towards establishing a health industry that is better equipped to deal with the most significant global health challenges? In her impressive and ambitious book, Global Health Impact: Extending Access to Essential Medicine (Hassoun, 2020), Nicole Hassoun attempts to answer these questions, by drawing on contemporary research in political philosophy, global justice, health economics and business ethics. In this symposium, Timothy Campbell, (...) Yukiko Asada and Andreas Albertsen explore three dimensions of Hassoun’s proposal: the relation between measuring global health impact and conceptions of the minimally good life, different metrics used to measure the global health burden and democratic consumption and social justice. In a response paper, Hassoun responds to the critical remarks.In her book, Hassoun presents a theoretical framework that explains why we ought to care about global health, develops a way of measuring the global health impact of health technologies and argues that individuals should be guided by this in their consumption. The book presents an ambitious proposal for how one in a very practical way can use the measuring tool in order to promote global health by labeling and certifying different market products so that consumers and investors get incentivizing information that can change their behavior in a way that promotes global health. (shrink)

This paper argues that cost-effectiveness analysis in the healthcare sector introduces a discrimination risk that has thus far been underappreciated and outlines some approaches one can take toward this. It is argued that appropriate standards used in cost-effectiveness analysis in the healthcare sector fail to always fully determine an optimal option, which entails that cost-effectiveness analysis often leaves decision makers with large sets of permissible options. Larger sets of permissible options increase the role of decision makers’ biases, whims, and prejudices, (...) which means that the discrimination risk increases. Two ways of mitigating this are identified: tinkering with standards used in the cost-effectiveness analysis and outlining anti-discrimination guidelines for decision makers. (shrink)

What, if anything, do we owe others as a basic minimum? Sufficiency theorists claim that we must provide everyone with enough – but, to date, few well-worked-out accounts of the sufficiency threshold exist, so it is difficult to evaluate this proposition. Previous theories do not provide plausible, independent accounts of resources, capabilities, or welfare that might play the requisite role. Moreover, I believe existing accounts do not provide nearly enough guidance for policymakers. So, this article sketches a mechanism for arriving (...) at an account of the minimally good life that can help locate the sufficiency threshold. (shrink)

A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns the two–way relationship (...) between health and other social goods: deficits in health typically undermine one's abilities to secure advantage in other areas, which in turn often have further negative effects on health. This paper outlines the degree to which this latter relationship between health and other social goods exacerbates an existing problem for proponents of responsibilisation (the ‘harshness objection’) in ways that standard responses to this objection cannot address. Placing significant conditions on healthcare access because of a person's prior responsibility risks trapping them in, or worsening, negative cycles where poor health and associated lack of opportunity reinforce one another, making further poor yet ultimately responsible choices more likely. It ends by considering three possible solutions to this problem. (shrink)

The idea of using responsibility in the allocation of healthcare resources has been criticized for, among other things, too readily abandoning people who are responsible for being very badly off. One response to this problem is that while responsibility can play a role in resource allocation, it cannot do so if it will leave those who are responsible below a “sufficiency” threshold. This paper considers first whether a view can be both distinctively sufficientarian and allow responsibility to play a role (...) even for those who will be left with very poor health. It then draws several further distinctions that may affect the application of responsibility at this level. We conclude that a more plausible version of the sufficientarian view is to allow a role for responsibility where failure to do so will leave someone else who is not responsible below the sufficiency threshold. However, we suggest that individuals must exhibit “sufficient responsibility” in order for this to apply, involving both a sufficient level of control and an avoidable failure to respond adequately to reasons for action. (shrink)

Nicole Hassoun’s book Global Health Impact: Extending Access to Essential Medicines has three parts. Part 1 is about the right to health, Part 2 offers a concrete proposal for how to promote the ability of people in the developing world to live minimally good lives and Part 3 is concerned with consumer responsibility as it relates to global health. I argue that there is a philosophical tension between the respective projects of Parts 1 and 2. The project of Part 1 (...) reflects a sufficientarian ideal, namely ensuring that each person in our global community has the ability to live a minimally good life. But, the concrete proposal offered in Part 2 reflects a different ideal, namely maximizing global health benefit. While these two ideals may often converge on a set of feasible health outcomes that we should aim to bring about, they can also diverge. The extent to which they diverge depends on our specification of the minimally good life. It is therefore crucial that we have a criterion for distinguishing lives that are at least minimally good from those that are not. Unfortunately, Hassoun’s proposed criterion is problematic in that no life satisfies it. (shrink)

According to the sufficiency principle, distributive justice requires that everyone have some sufficient level of resources or well-being, but inequalities above this threshold have no moral significance. This paper defends a version of the sufficiency principle as the appropriate response to moral uncertainty about distributive justice. Assuming that the appropriate response to moral uncertainty is to maximize expected choiceworthiness, and given a reasonable distribution of credence in some familiar views about distributive justice, a version of the sufficiency principle strikes the (...) optimal balance between the competing moral risks posed by implementing these views. In particular, it avoids the moral risk posed by views like Nozick’s libertarianism, which forbid redistributive taxation even for the sake of helping to provide for people’s basic needs: failing to do the latter, if it turns out that justice does require it, would be very morally wrong. This “uncertainty argument” has the advantage of minimizing reliance on controversial intuitions about distributive justice, helps to specifying a non-arbitrary threshold for sufficiency, and shows that the substantive moral implications of moral uncertainty are not limited to high-stakes applied ethics issues such as abortion and vegetarianism but instead extend to an issue at the heart of political philosophy. (shrink)

Relational egalitarianism is a theory of justice according to which people must relate as equals. In this article, we develop relational sufficientarianism – a view of justice according to which people must relate as sufficients. We distinguish between three versions of this ideal, one that is incompatible with relational egalitarianism and two that are not. Building on this, we argue that relational theorists have good reason to support a pluralist view that is both egalitarian and sufficientarian.

From a nonideal justice perspective, this article investigates liability and compensation intheir wider theoretical context to better understand the governance of climate loss anddamage under the United Nations Framework Convention on Climate Change(UNFCCC). The usual rationale for considering compensation takes a backward-looking understanding of responsibility. It links those causing harm directly to its remedy. Thisarticle shows that, under current political circumstances, it is more reasonable to understandresponsibility as a forward-looking concept and thus to differentiate responsibilitieson grounds of capacity and solidarity. (...) The article argues that loss and damage entitlementsinUNFCCCgovernance should be understood as entitlements to a threshold of capabilitiesfor resilience. While compensation merely means redressing the situation ex ante a threat,entitlements to capabilities for resilience can entail more demanding responsibilities ofsupport. This means that Article 8 of the Paris Agreement has much more demandingimplications than it might at first appear. (shrink)

Despite the prominence of thresholds and limits in theories of distributive justice, there is no general account of their role within such theories. This has allowed an ongoing lack of clarity and misunderstanding around threshold views in distributive justice. In this thesis, I develop an account of the conceptual structure of such views. Such an account helps understand and characterize threshold views, can subsume what may seem to be different debates about such views under one conceptual header, and can be (...) used to further examine and develop patterns of justice that draw on thresholds. In light of this account, I propose a novel characterization of sufficientarianism which sheds new light on the distinctiveness of sufficientarianism as a distributive principle and on the common objections to sufficientarianism. Moreover, I examine and defend limitarianism, which is the view that people should not have more than a certain amount of wealth. In particular, I argue in favour of limitarianism as a midlevel principle for guiding institutional design and individual actions and, furthermore, as a specification of what a just allocation of wealth requires under epistemic constraints. (shrink)