The exposure of doctors, nurses and other medical professionals to risks in the context of epidemics is significant. While traditional medical ethics offers the thought that these dangers may limit the extent to which a duty to care is applicable in such situations, it has less to say about what we might owe to medical professionals who are disadvantaged in these contexts. Luck egalitarianism, a responsibility-sensitive theory of distributive justice, appears to fare particularly badly in that regard. If we want (...) to maintain that medical professionals are responsible for their decisions to help, cure and care for the vulnerable, luck egalitarianism seems to imply that their claim of justice to medical attention in case of infection is weak or non-existent. The article demonstrates how a recent interpretation of luck egalitarianism offers a solution to this problem. Redefining luck egalitarianism as concerned with responsibility for creating disadvantages, rather than for incurring disadvantage as such, makes it possible to maintain that medical professionals are responsible for their choices and that those infected because of their choice to help fight epidemics have a full claim of justice to medical attention. (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)

One way to think about capitalism-versus-socialism is to examine the extent to which capitalist economic institutions are compatible with the fulfillment of socialist ideals. The late G. A. Cohen has urged that the two are strongly incompatible. He imagines how it would make sense for friends to organize a camping trip, distills the socialist moral principles that he sees fulfilled in the camping trip model, and observes that these principles conflict with a capitalist organization of the economy. He adds that (...) these principles are ethically attractive, so if it is feasible to organize the economy on the camping trip model, we ought to do so. This essay argues to the contrary that for all that has been said, capitalist economic arrangements might be in the set of institutional arrangements that overall would best fulfill the camping trip principles, and anyway, the principles themselves ought to be rejected, so the question whether or not a capitalist set-up might satisfy these principles should not interest us. The grounds for rejecting the camping trip principles support a form of welfarist consequentialism that denies that equality of distribution of any sort is per se ethically desirable and also denies that liberal freedoms to live as one chooses are per se morally desirable. Equality and freedom should rather be regarded as in the light of possible means (or hindrances) to advancing good for people, fairly distributed. (shrink)

What does it take for an individual to be personally responsible for behaviors that lead to increased risk of disease? We examine three approaches to responsibility that cover the most important aspects of the discussion of responsibility and spell out what it takes, according to each of them, to be responsible for behaviors leading to increased risk of disease. We show that only what we call the causal approach can adequately accommodate widely shared intuitions to the effect that certain causal (...) influences—such as genetic make-up or certain social circumstances—diminish, or undermine personal responsibility. However, accepting the causal approach most likely makes personal responsibility impossible. We therefore need either to reject these widely shared intuitions about what counts as responsibility-softening or undermining or to accept that personal responsibility for behaviors leading to increased risk of disease rests on premises so shaky that personal responsibility is probably impossible. (shrink)

Two clusters of essays in this issue of The Journal of Medicine and Philosophy provide a critical gaze through which to explore central moral, phenomenological, ontological, and political concerns regarding human moral agency and personal responsibility. The first cluster challenges common assumptions in bioethics regarding the voluntariness of human actions. The second set turns the debate towards morally responsible choice within the requirements of distributive justice. The force of their collective analysis leaves us with a well-founded basis critically to approach (...) any account of bioethics or health policy that is insufficiently attentive to the central challenges of human freedom and responsible free choice. (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)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in distributive (...) justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

Should we grant a fresh start to those who come to regret their past lifestyle choices? A negative response to this question can be located in the luck egalitarian literature. As a responsibility-sensitive theory of justice, luck egalitarianism considers it just that people’s relative positions reflect their past choices, including those they regret. In a recent article, Vansteenkiste, Devooght and Schokkaert argue against the luck egalitarian view, maintaining instead that those who regret their past choices in health are disadvantaged in (...) a relevant way and should receive compensation. Employing the ideal that people should be made equal as measured by equivalent resources, they purport to show the fairness of such an arrangement through a hypothetical scenario. Relaxing the implicit assumptions of this scenario brings forth several unattractive consequences of the fresh-start idea. The main problem is that in striving to ensure that people’s past choices do not affect their own opportunities, the authors must accept that these choices put heavy strains on the opportunities available to other people. Furthermore, the luck egalitarian position is more compelling than they admit. (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)

Critics of luck egalitarianism have claimed that, far from providing a justification for the public insurance functions of a welfare state as its proponents claim, the view objectionably abandons those who are deemed responsible for their dire straits. This article considers seven arguments that can be made in response to this ‘abandonment objection’. Four of these arguments are found wanting, with a recurrent problem being their reliance on a dubious sufficientarian or quasi-sufficientarian commitment to provide a threshold of goods unconditionally. (...) Three arguments succeed, showing that luck egalitarians have good reasons for assisting ‘negligent victims’ on account of changes that may occur in an individual between the time of their choice and their subsequent disadvantage, bad option luck, and doubts about free will and responsibility. Luck egalitarianism is therefore shown to offer strong support for public insurance. (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)

Emissions grandfathering holds that a history of emissions strengthens an agent’s claim for future emission entitlements. Though grandfathering appears to have been influential in actual emission control frameworks, it is rarely taken seriously by philosophers. This article presents an argument for thinking this an oversight. The core of the argument is that members of countries with higher historical emissions are typically burdened with higher costs when transitioning to a given lower level of emissions. According to several appealing views in political (...) philosophy (utilitarianism, egalitarianism, prioritarianism, and sufficientarianism) they are therefore entitled to greater resources, including emission entitlements, than those in similar positions but with lower emissions. This grandfathering may play an especially important role in allocating emission entitlements among rich countries. (shrink)

Discrimination might be considered unjust on account of the comparative disadvantage it imposes, the absolute disadvantage it imposes, the disrespect it shows, or the prejudice it shows. This article argues that each of these accounts overlooks some cases of unjust discrimination. In response to this state of affairs we might combine two or more of these accounts. A promising approach combines the comparative disadvantage and absolute disadvantage accounts.

According to all-luck egalitarianism, the differential distributive effects of both brute luck, which defines the outcome of risks which are not deliberately taken, and option luck, which defines the outcome of deliberate gambles, are unjust. Exactly how to correct the effects of option luck is, however, a complex issue. This article argues that (a) option luck should be neutralized not just by correcting luck among gamblers, but among the community as a whole, because it would be unfair for gamblers as (...) a group to be disadvantaged relative to non-gamblers by bad option luck; (b) individuals should receive the warranted expected results of their gambles, except insofar as individuals blamelessly lacked the ability to ascertain which expectations were warranted; and (c) where societal resources are insufficient to deliver expected results to gamblers, gamblers should receive a lesser distributive share which is in proportion to the expected results. Where all-luck egalitarianism is understood in this way, it allows risk-takers to impose externalities on non-risk-takers, which seems counterintuitive. This may, however, be an advantage as it provides a luck egalitarian rationale for assisting ‘negligent victims’. (shrink)

In this article I review Jonathan Wolff and Avner de‐Shalit’s recent book Disadvantage (2007), highlighting its many contributions to egalitarian theory and practice. These contributions build to the authors’ central prescription: that policy‐makers work to create a society of equals by reducing the tendency for disadvantages to cluster around certain individuals or groups. From there, I discuss the idea of declustering disadvantage in an American context, and consider its implications for the politically salient ideal of equality of opportunity. The purpose (...) of this discussion is not to posit Wolff and de‐Shalit’s theory of disadvantage as a theory of justice as equal opportunity. Instead, I illustrate their approach by reference to an influential theory of justice, whose proponents include those taken to affirm the authors’ consensual starting point. (shrink)

This article explores the Rawlsian goal of ensuring that distributions are not influenced by the morally arbitrary. It does so by bringing discussions of distributive justice into contact with the debate over moral luck initiated by Williams and Nagel. Rawls’ own justice as fairness appears to be incompatible with the arbitrariness commitment, as it creates some equalities arbitrarily. A major rival, Dworkin’s version of brute luck egalitarianism, aims to be continuous with ordinary ethics, and so is (a) sensitive to non-philosophical (...) beliefs about free will and responsibility, and (b) allows inequalities to arise on the basis of option luck. But Dworkin does not present convincing reasons in support of continuity, and there are compelling moral reasons for justice to be sensitive to the best philosophical account of free will and responsibility, as is proposed by the revised brute luck egalitarianism of Arneson and Cohen. While Dworkinian brute luck egalitarianism admits three sorts of morally arbitrary disadvantaging which correspond to three forms of moral luck (constitutive, circumstantial, and option luck), revised brute luck egalitarianism does not disadvantage on the basis of constitutive or circumstantial luck. But it is not as sensitive to responsibility as it needs to be to fully extinguish the influence of the morally arbitrary, for persons under it may exercise their responsibility equivalently yet end up with different outcomes on account of option luck. It is concluded that egalitarians should deny the existence of distributive luck, which is luck in the levels of advantage that individuals are due. (shrink)

Traditional outcome-orientated egalitarian principles require access to information about the size of individual holdings. Recent egalitarian political theory has sought to accommodate considerations of responsibility. Such a move may seem problematic, in that a new informational burden is thereby introduced, with no apparent decrease in the existing burden. This article uses a simple model with simulated data to examine the extent to which outcome egalitarianism and responsibility-sensitive egalitarianism (‘luck egalitarianism’) can be accurately applied where information is incomplete or erroneous. It (...) is found that, while outcome egalitarianism tends to be more accurately applied, its advantage is not overwhelming, and in many prima facie plausible circumstances luck egalitarianism would be more accurately applied. This suggests that luck egalitarianism cannot be rejected as utopian. Furthermore, while some argue that, in practice, luck egalitarianism is best realized indirectly, by securing equality of outcome, our evidence suggests that a luck egalitarian rule of regulation offers a far more accurate implementation of the luck egalitarian ideal than does an outcome egalitarian rule of regulation. (shrink)

David Miller has objected to the cosmopolitan argument that it is arbitrary and hence unfair to treat individuals differently on account of things for which they are not responsible. Such a view seems to require, implausibly, that individuals be treated identically even where (unchosen) needs differ. The objection is, however, inapplicable where the focus of cosmopolitan concern is arbitrary disadvantage rather than arbitrary treatment. This 'unfair disadvantage argument' supports a form of global luck egalitarianism. Miller also objects that cosmopolitanism is (...) unable to accommodate special obligations generated by national membership. Cosmopolitanism can, however, accommodate many special obligations to compatriots. Those which it cannot accommodate are only morally compelling if we assume what the objection claims to prove - that cosmopolitanism is mistaken. Cosmopolitanism construed as global luck egalitarianism is therefore able to withstand both of Miller's objections, and has significant independent appeal on account of the unfair disadvantage argument. (shrink)

This essay argues that David Miller's criticisms of global egalitarianism do not undermine the view where it is stated in one of its stronger, luck egalitarian forms. The claim that global egalitarianism cannot specify a metric of justice which is broad enough to exclude spurious claims for redistribution, but precise enough to appropriately value different kinds of advantage, implicitly assumes that cultural understandings are the only legitimate way of identifying what counts as advantage. But that is an assumption always or (...) almost always rejected by global egalitarianism. The claim that global egalitarianism demands either too little redistribution, leaving the unborn and dissenters burdened with their societies' imprudent choices, or too much redistribution, creating perverse incentives by punishing prudent decisions, only presents a problem for global luck egalitarianism on the assumption that nations can legitimately inherit assets from earlier generations – again, an assumption very much at odds with global egalitarian assumptions. (shrink)

This review article of Shlomi Segall's Health, Luck, and Justice (Princeton University Press, 2010) addresses three issues: first, Segall’s claim that luck egalitarianism, properly construed, does not object to brute luck equality; second, Segall’s claim that brute luck is properly construed as the outcome of actions that it would have been unreasonable to expect the agent to avoid; and third, Segall’s account of healthcare and criticism of rival views. On the first two issues, a more conventional form of luck egalitarianism (...) – that is, one which objects to brute luck even if it creates equality, and which construes brute luck as the inverse of agent responsibility – is defended. On the third issue, strengths and weaknesses in Segall’s criticism of Rawlsian, democratic egalitarian, and all-luck egalitarian approaches to healthcare, and in his own luck egalitarian approach, are identified. (shrink)

Even where an act appears to be responsible, and satisfies all the conditions for responsibility laid down by society, the response to it may be unjust where that appearance is false, and where those conditions are insufficient. This paper argues that those who want to place considerations of responsibility at the centre of distributive and criminal justice ought to take this concern seriously. The common strategy of relying on what Susan Hurley describes as a 'black box of responsibility' has the (...) advantage of not taking responsibility considerations to be irrelevant merely because some specific account of responsibility is mistaken. It can, furthermore, cope perfectly well with an absence of responsibility, even of the global sort implied by hard determinism and other strongly sceptical accounts. Problems for the black box view come in where responsibility is present, but in a form that is curtailed in one significant regard or another. The trick, then, is to open the box of responsibility just enough that its contents can be the basis for judgements of justice. I identify three 'moderately sceptical' forms of compatibilism that cannot ground judgements of justice, and are therefore expunged by the strongest 'grey box' view. (shrink)

Discussions of where the costs of climate change adaptation and mitigation should fall often focus on the 'polluter pays principle' or the 'ability to pay principle'. Simon Caney has recently defended a 'hybrid view', which includes versions of both of these principles. This article argues that Caney's view succeeds in overcoming several shortfalls of both principles, but is nevertheless subject to three important objections: first, it does not distinguish between those emissions which are hard to avoid and those which are (...) easy to avoid; second, its only partial reference to all-things-considered justice means it cannot provide a full account even of climate justice; and third, it assigns to the poor very limited duties to meet climate change costs, even where they have created those costs, which may incentivise them to increase emissions. An alternative pluralistic account which avoids these objections is presented. (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)

The liberal-egalitarian concept formulated by John Rawls in his book A Theory of Justice is still vehemently debated today. Critics of this concept include, among others, Rodion Belkovich and Sergei Vinogradov, according to whom Rawlsians inevitably face a dilemma: they need to reject either the difference principle or luck egalitarianism, and each of these solutions leads to the erosion of the basic foundations of Rawls’s theory. The article presents a detailed analysis of the arguments put forward by Belkovich and Vinogradov (...) and demonstrates that the dilemma they identified is flawed for three reasons. First, it blurs the distinction between luck egalitarianism and “straight egalitarianism,” which assumes the complete equality of income and wealth in society. Luck egalitarians do not support the idea of absolute equality in distribution and consider inequality that reflects people’s responsibility for their own choices fair. Second, Rawlsian egalitarianism is essentially equated with luck egalitarianism, while they represent two clearly distinguishable approaches. Third, the kidnapper’s argument, which proves that the difference principle is incompatible with luck egalitarianism, does not provide solid reasoning against the difference principle. The argument is only applicable under limited conditions, when the difference principle is embedded as an assumption in the “argument from incentives,” which in turn is put forward by the potential beneficiaries of this incentive. According to the author’s conclusion, the above mentioned considerations clearly indicate that Rawlsians do not face any dilemma of choosing between luck egalitarianism and the difference principle, and the criticism of Rawls’s theory proposed by Belkovich and Vinogradov should be considered groundless. (shrink)

Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding (...) harm, it is very plausible to consider the policies harmful but much less reasonable to consider those responsible for their health disadvantages a socially salient group. Drawing on the disrespect literature, where social salience is typically not required for something to be discrimination, the policies are a form of discrimination. They are, however, not disrespectful. The upshot of this first assessment of the discrimination objection to luck egalitarianism in health is, thus, that it fails. (shrink)

Journal of Political Philosophy, EarlyView.

Rare diseases pose a particular priority setting problem. The UK gives rare diseases special priority in healthcare priority setting. Effectively, the National Health Service is willing to pay much more to gain a quality-adjusted life-year related to a very rare disease than one related to a more common condition. But should rare diseases receive priority in the allocation of scarce healthcare resources? This article develops and evaluates four arguments in favour of such a priority. These pertain to public values, luck (...) egalitarian distributive justice the epistemic difficulties of obtaining knowledge about rare diseases and the incentives created by a higher willingness to pay. The first is at odds with our knowledge regarding popular opinion. The three other arguments may provide a reason to fund rare diseases generously. However, they are either overinclusive because they would also justify funding for many non-rare diseases or underinclusive in the sense of justifying priority for only some rare diseases. The arguments thus fail to provide a justification that tracks rareness as such. There are no data in this work. (shrink)

The harshness objection is the most important challenge to luck egalitarianism. Very recently, Andreas Albertsen and Lasse Nielsen provided a scrupulous analysis of the harshness objection and claim that only the inconsistency objection—the objection that luck egalitarianism is incompatible with the ideal of basic moral equality—has real bite. I argue that the relevantly construed incoherence objection is not as strong as Albertsen and Nielsen believe. In doing so, first, I show that the deontological luck egalitarian conception of equal treatment does (...) not endorse harsh policies such as excessive responsibility-sensitive healthcare that would be disrespectful to the imprudent. Second, I demonstrate that deontological luck egalitarianism is not troubled by the case that involves a lack of respect for the prudent, which vexes Anderson’s relational egalitarianism that Kasper Lippert-Rasmussen’s argument highlights. I thus claim that the harshness objection is not a truly decisive objection against the luck egalitarian project. (shrink)

A recurring concern about luck egalitarianism is that its implementation would make some individuals, in particular those who lack marketable talents, experience shame. This, the objection goes, undermines individuals’ self-respect, which, in turn, may also lead to unequal respect between individuals. Loss of (self-)respect is a concern for any egalitarian, including distributive egalitarians, inasmuch as it is non-compensable. This paper responds to this concern by clarifying the relationship between shame and (self-)respect. We argue, first, a luck egalitarian society and ethos (...) would be radically different from the current one and incompatible with shame over lack of talent, and, second, that while shame may still occur in a less than ideal luck egalitarian society, this kind of shame does not undermine egalitarian commitments. (shrink)

Journal of Political Philosophy, EarlyView.

According to relational egalitarians, equality is not primarily about the distribution of some good but about people relating to one another as equals. However, compared with other theorists in political philosophy – including other egalitarians – relational egalitarians have said relatively little on what role personal responsibility should play in their theories. For example, is equality compatible with responsibility? Should economic distributions be responsibility-sensitive? This article fills this gap. I develop a relational egalitarian framework for personal responsibility and show that (...) relational equality commits us to responsibility. I develop two sets of arguments. First, I draw on relational theories of moral responsibility – particularly Strawsonian views – to show that valuable egalitarian relationships require responsibility. Second, I show why relational equality sometimes requires that economic distributions be sensitive to responsibility and choice. I also defend a seemingly paradoxical result: being committed to responsibility, relational egalitarianism not only justifies some distributive inequalities but some relational inequalities too. Overall, relational egalitarianism gives a nuanced and coherent answer as to why and how responsibility matters from within egalitarianism. That it does should be an important argument in its favour. (shrink)

The standard version of sufficientarianism maintains that providing people with enough, or as close to enough as is possible, is lexically prior to other distributive goals. This article argues that this is excessive – more than distributive justice allows – in four distinct ways. These concern the magnitude of advantage, the number of beneficiaries, responsibility and desert, and above-threshold distribution. Sufficientarians can respond by accepting that providing enough unconditionally is more than distributive justice allows, instead balancing sufficiency against other considerations.

In recent years, insurance companies have begun tracking their customers’ behaviors and price premiums accordingly. Based on the Market-Failures Approach as well as the Justice-Failures Approach, I provide an ethical analysis of the use of tracking technologies in the insurance industry. I focus on the use of telematics in car insurance and on the use of fitness tracking in life insurance. The use of tracking has some important benefits to policyholders and insurers alike: it reduces moral hazard and fraud, increases (...) actuarial fairness, and incentivizes safe behavior. These benefits, however, are outweighed by significant moral objections. First, the use of tracking technologies significantly undermines the fairness of the interaction between insurance companies and policyholders. Specifically, the use of tracking eliminates information asymmetries, but in such a way that favors insurers exclusively. Furthermore, tracked behaviors and the ability to choose to behave safely are highly correlated with other variables such as income. Therefore, tracking-based insurance relies on and exacerbates existing inequalities and injustices, which undermines the benefits that tracking is supposed to introduce. (shrink)

Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...) lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)

The objective of this article is to explore people’s attitudes toward responsibility in the allocation of public health care resources. Special attention is paid to conceptualizations of responsibility involving blame and sanctions. A representative sample of the Norwegian population was asked about various responsibility mechanisms that have been proposed in the theoretical literature on health care and personal responsibility, from denial of treatment to a tax on unhealthy consumer goods. Survey experiments were employed to study treatment effects, such as whether (...) fairness considerations affect attitudes about responsibility. We find that, overall, a substantial minority of the respondents find it fair to let the health care system sanction people—in one way or another—for voluntary behaviors that increase the risk of becoming ill. Quite surprisingly, we find that people are more prone to report that they should themselves be held responsible for unhealthy lifestyles than others. (shrink)

A recent movement within political philosophy called luck egalitarianism has attempted to synthesize the right’s regard for responsibility with the left’s concern for equality. The original motivation for subscribing to luck egalitarianism stems from the belief that one’s success in life ought to reflect one’s own choices and not brute luck. Luck egalitarian theorists differ in the decision procedures that they propose, but they share in common the general approach that we ought to equalize individuals with respect to brute luck (...) so that differences in distribution are only a consequence of the responsible choices that individuals make. I intend to show that through the application of its own distributive procedures, the interpersonal luck egalitarian approach actually undermines its original motivation by making the lives of individuals subject to brute luck. I propose two alternative methods that the luck egalitarian could use to prevent the problems suffered by the interpersonal luck egalitarian standard. (shrink)

An adequate theory of rights ought to forbid the harming of animals to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible with recognizing the (...) inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

This article carves out a new path between the two dominant wings of contemporary egalitarianism. The luck egalitarian emphasis on choice and personal responsibility is misplaced because individuals differ so deeply, and arbitrarily, in their choice-making capacities. Allowing inequalities to result from ‘choice’ is akin to allowing inequalities to stem from the possession of any other morally arbitrary factor – such as skin colour or gender. The move towards relational egalitarianism has been a case of two-steps forward, one-step back. While (...) the shift away from the focus on choice is salutary, the concurrent rejection of luck is problematic, given the prevalence and importance of luck-based discrepancies in opportunities to lead a good life. A new conceptual framework is presented: good life egalitarianism. The guiding idea is that given the unavoidable arbitrariness of human capacities, the foundation for a good life should be assured for people regardless of the actual choices that they make. The essential goods necessary for leading a good life – such as the opportunities to self-determine and to enjoy non-dominating social relationships – should be guaranteed to all. (shrink)

According to luck egalitarianism, it is unjust if some are worse off than others through no fault or choice of their own. The most common criticism of luck egalitarianism is the ‘harshness objection’, which states that luck egalitarianism allows for too harsh consequences, as it fails to provide justification for why those responsible for their bad fate can be entitled to society's assistance. It has largely gone unnoticed that the harshness objection is open to a number of very different interpretations. (...) We present four different interpretations of the harshness objection in which the problem pertains to counterintuitive implications, badness of outcome, disproportionality, or inconsistency, respectively. We analyse and discuss appropriate luck egalitarian replies. Disentangling these different versions clarifies what is at the heart of this dispute and reveals the point of the harshness objection. We conclude that only the inconsistency version involves a durable problem for luck egalitarianism. (shrink)

An adequate theory of rights ought to forbid the harming of animals (human or nonhuman) to promote trivial interests of humans, as is often done in the animal-user industries. But what should the rights view say about situations in which harming some animals is necessary to prevent intolerable injustices to other animals? I develop an account of respectful treatment on which, under certain conditions, it’s justified to intentionally harm some individuals to prevent serious harm to others. This can be compatible (...) with recognizing the inherent value of the ones who are harmed. My theory has important implications for contemporary moral issues in nonhuman animal ethics, such as the development of cultured meat and animal research. (shrink)

This book develops a novel approach to distributive justice by building a theory based on a concept of desert. As a work of applied political theory, it presents a simple but powerful theoretical argument and a detailed proposal to eliminate unmerited inequality, poverty, and economic immobility, speaking to the underlying moral principles of both progressives who already support egalitarian measures and also conservatives who have previously rejected egalitarianism on the grounds of individual freedom, personal responsibility, hard work, or economic efficiency. (...) By using an agnostic, flexible, data-driven approach to isolate luck and ultimately measure desert, this proposal makes equal opportunity initiatives both more accurate and effective as it adapts to a changing economy. It grants to each individual the freedom to genuinely choose their place in the distribution. It provides two policy variations that are perfectly economically efficient, and two others that are conditionally so. It straightforwardly aligns outcomes with widely shared, fundamental moral intuitions. Lastly, it demonstrates much of the above by modeling four policy variations using 40 years of survey data from the Panel Study of Income Dynamics. (shrink)

Ian Carter has recently argued in a series of articles that a certain form of respect, called ‘opacity respect’, gives a moral grounding to people’s equality. This type of respect involves abstaining from making or acting on judgements about others. Aside from arguing for its justificatory role, Carter also argues that, in this role, it has a series of implications for our thinking about liberal politics. I argue, first, that the theoretical implications of the view that opacity respect grounds equality (...) are narrower than they first appear. This is because, in order to put the view into action, one must make a certain kind of empirical claim. Second, I show that this point reveals an important structural aspect of Carter’s view, concerning the way that principles can be limited in practice. Third, I argue that the practical implications of the view are potentially much broader than they first appear, threatening absurdity. This is because the position’s repercussions naturally extend into day-to-day transactions. (shrink)

In recent years, bariatric surgery has become an increasingly popular treatment of obesity. The amount of resources spent on this kind of surgery has led to a heated debate among health care professionals and the general public, as each procedure costs at minimum $14,500 and thousands of patients undergo surgery every year. So far, no substantial argument for or against giving this treatment a high priority has, however, been presented. In this article, I argue that regardless which moral perspective we (...) consider—greatest need, utility or personal responsibility—the conclusion is that we should give bariatric surgery a high priority when allocating scarce resources in health care. (shrink)

This paper discusses what implications global luck egalitarianism (GLE) has for border control. Some authors suggest that an open‐borders policy follows from GLE. The idea is that various unchosen inequalities inevitably follow from differences in birthplace, such that GLE will always have principled reason to condemn closed borders. Others are skeptical of the assumption that GLE will have liberal implications for border control, because open borders may have other, adverse effects that outweigh the reductions in unjust inequality. Against such skeptics, (...) we argue that GLE will (typically) have quite liberal implications for border control. However, this connection is not a principled one: Whether (and to what extent) GLE favors opening or closing borders will depend upon empirical circumstances. (shrink)

The issue of distributive justice receives substantial amount of attention in our society. On the one hand, we are sensitive to whether and the extent to which people are responsible for being worse off. On the other hand, we are mindful of society’s worst-off members. There has been a debate over luck egalitarianism, which relates to the former concern, and relational egalitarianism, which echoes the latter. By investigating the psychological processes of these two concerns, this paper examines the reliability of (...) the argument that Elizabeth Anderson, a renowned relational egalitarian, presents against luck egalitarianism and for relational egalitarianism. It also considers whether it is possible to support luck egalitarianism and relational egalitarianism simultaneously, using an online experiment. The results of the experiment show that, first, for ordinary people, the luck consideration is as important as the basic capabilities consideration. Second, while real people consider the degree of compensation through the factors of causality and responsibility, the lack of basic capabilities directs them to determine how much victims of bad luck should be compensated. This suggests that pluralist egalitarianism is on the right track. (shrink)