The revisionist critique of conventional just war theory has undoubtedly scored some important victories. Walzer’s elegantly unified defense of combatant legal equality and noncombatant immunity has been seriously undermined. This critical success has not, however, been matched by positive arguments, which when applied to the messy reality of war would deprive states and soldiers of the permission to fight wars that are plausibly thought to be justified. The appeal to law that is sought to resolve this objection by casting it (...) as a practical concern, a pragmatic worry about implementation, which while germane to debates over the laws of war, need not undermine our convictions in the fundamental principles the revisionists advocate. This response is inadequate. Revisionists have not shown that soldiers should obey the laws of war, in practice, when they conflict with their other moral reasons – our worries about application remain intact. Moreover, a theory of war that offers only an account of the laws of war, and a set of fundamental principles developed in abstraction from feasibility constraints, is radically incomplete. We need to know how to apply those fundamental principles, and whether, when applied, they lead to defensible conclusions. Only two options seem to remain. Perhaps the revisionists’ arguments for their chosen fundamental principles are sufficiently compelling that we should stick with them, and accept their troubling conclusions – in other words, accept pacifism. Alternatively, we need to revise our fundamental principles, so that when applied they yield conclusions that we can more confidently endorse. -/- Though it does not save the revisionist view from the responsibility dilemma and cognate objections, the appeal to law does raise an important, and previously inadequately theorized, question – or, rather, resurrects a neglected topic, discussed in depth by historical just war theorists such as Grotius and Vattel. There are good grounds for distinguishing the laws of war from the morality of war, and for adjusting the former to accommodate predictable noncompliance, that should not impact on our account of the latter. Nonetheless, I have argued that there are some profound moral insights underlying both combatant legal equality and noncombatant immunity: specifically, we cannot infer from a combatant’s side having not satisfied jus ad bellum that he may not justifiably use lethal force; and other things equal, it is more wrongful to harm a nonliable noncombatant than to harm a nonliable combatant. (shrink)

Proportionality is widely accepted as a necessary condition of justified self-defense. What gives rise to this particular condition and what role it plays in the justification of self-defense seldom receive focused critical attention. In this paper I address the standard of proportionality applicable to personal self-defense and the role that proportionality plays in justifying the use of harmful force in self-defense. I argue against an equivalent harm view of proportionality in self-defense, and in favor of a standard of proportionality in (...) self-defense that requires comparable seriousness and takes into account the wrong, as opposed simply to the harm that the victim is fending off. I distinguish the standard of proportionality in self-defense from proportionality in circumstances of necessity, and I discuss whether proportionality is an internal or an external constraint on the right of self-defense. (shrink)

This article analyzes the moral and political implications of strong moral character for political action. The treatment provides reason to hold that strong moral character should play a role in a robust normative account of political leadership. The case is supported by empirical findings on character dispositions and the political viability of the account’s normative prescriptions.

A variety of ethical objections have been raised against the military employment of uninhabited aerial vehicles (UAVs, drones). Some of these objections are technological concerns over UAVs abilities’ to function on par with their inhabited counterparts. This paper sets such concerns aside and instead focuses on supposed objections to the use of UAVs in principle. I examine several such objections currently on offer and show them all to be wanting. Indeed, I argue that we have a duty to protect an (...) agent engaged in a justified act from harm to the greatest extent possible, so long as that protection does not interfere with the agent's ability to act justly. UAVs afford precisely such protection. Therefore, we are obligated to employ UAV weapon systems if it can be shown that their use does not significantly reduce a warfighter's operational capability. Of course, if a given military action is unjustified to begin with, then carrying out that act via UAVs is wrong, just as it would be with any weapon. But the point of this paper is to show that there is nothing wrong in principle with using a UAV and that, other things being equal, using such technology is, in fact, obligatory. (shrink)

According to the dominant position in the just war tradition from Augustine to Anscombe and beyond, there is no "moral equality of combatants." That is, on the traditional view the combatants participating in a justified war may kill their enemy combatants participating in an unjustified war - but not vice versa (barring certain qualifications). I shall argue here, however, that in the large number of wars (and in practically all modern wars) where the combatants on the justified side violate the (...) rights of innocent people ("collateral damage"), these combatants are in fact liable to attack by the combatants on the unjustified side. I will support this view with a rights-based account of liability to attack and then defend it against a number of objections raised in particular by Jeff McMahan. The result is that the thesis of the moral equality of combatants holds good for a large range of armed conflicts while the opposing thesis is of very limited practical relevance. (shrink)

The focus of this paper is an influential family of views in the ethics of self-defense and war: views that ground the agent’s liability to be attacked in self-defense in the agent’s moral responsibility for the threat posed. I critically examine the concept of responsibility employed by such views, by looking at potential connections with the contemporary literature on moral responsibility. I start by uncovering some of the key assumptions that Responsibility Views make about the relevant concept of responsibility, and (...) by scrutinizing those assumptions under the lens of more general theorizing about responsibility. I identify an important conflict that arises at that point. The problem is that the concept presupposed by Responsibility Views is in tension with the standard way of understanding the connection between the neutral and non-neutral forms of moral responsibility. I draw attention to a particular strategy that could be used to address this challenge, but I also identify some important obstacles that stand in the way. (shrink)

This paper defends the heretical view that, at least in some cases, we ought to assign legal liability based on purely statistical evidence. The argument draws on prominent civil law litigation concerning pharmaceutical negligence and asbestos-poisoning. The overall aim is to illustrate moral pitfalls that result from supposing that it is never appropriate to rely on bare statistics when settling a legal dispute.

Recent work in the ethics of war has done much to challenge the collectivism of the convention-based, Walzerian just war theory. In doing so, it raises the question of when it is permissible for soldiers to resort to force. This article considers this issue and, in doing so, argues that the rejection of collectivism in just war should go further still. More specifically, it defends the ‘Individual-Centric Approach’ to the deep morality of war, which asserts that the justifiability of an (...) individual’s contribution to the war, rather than the justifiability of the war more generally, determines the moral acceptability of their participation. It then goes on to present five implications of the Individual-Centric Approach, including for individual liability to attack in war. (shrink)

This article presents a novel theory of noncombatant immunity that can serve as a practical guide for soldiers in the field. It improves on existing theories by justifying why and when an innocent...

Recent debates in just war theory have been concerned with the status of combatants during war. Unfortunately, however, the debate has, up to now, focused on self-defensive wars. The present article changes the focus slightly by exploring the status of combatants during military humanitarian intervention (MHI). It begins by arguing that MHI poses a number of challenges to our thinking about the status of combatants. To solve these it draws on Jeff McMahan's theory of combatant liability. On this basis, the (...) article contends that, first, combatants engaged in atrocities lack the same set of rights and liberties held by intervening combatants. Second, and more controversially, drawing on McMahan's theory as well as the notion of complicity, it suggests that the same applies to those combatants who do not perpetrate atrocities but are merely ordered to defend the target state against the intervening state. (shrink)

Soldiers sign contracts to obey lawful orders; they also swear oaths to this end. The enlistment contract for the Armed Forces of the United States combines both elements: -/- '9a. My enlistment is more than an employment agreement. As a member of the Armed Forces of the United States, I will be: (1) Required to obey all lawful orders and perform all assigned duties … (4) Required upon order to serve in combat or other hazardous situations.' -/- We standardly think (...) that these oaths and contracts give soldiers new moral reasons to fight. Many also think that soldiers who are ordered to fight by legitimate states have moral reasons to obey those orders, just in virtue of their provenance. -/- We generate these reasons through our voluntary decisions—to sign the contract or swear the oath; to form the institutions and give the orders. They are therefore additional moral reasons, on top of the reasons that we have prior to those voluntary decisions. Simply because they are additional, these reasons seem limited in force and scope. In particular, they arguably cannot override pre-existing commitments. For example, if I already have a duty not to kill an innocent person, my promising to breach that duty seems irrelevant to whether doing so is permissible. Similarly for orders issued by legitimate states: the citizens of a legitimate state have pre-existing moral reasons not to kill the innocent; by what alchemy could their state's orders allow combatants to override those reasons? If additional reasons could make prohibited acts permissible, as Sidgwick observed, ‘we could evade any moral obligation by promising not to fulfil it, which is clearly absurd’ (Sidgwick 1981). -/- We might conclude that the contracts soldiers sign, the oaths they take and the orders they receive have weight only when they pertain to acts that soldiers are already allowed to do. Perhaps these additional reasons can require actions that would otherwise be merely permissible, but they cannot license otherwise prohibited actions. If this is right, then it radically limits the relevance of contracts, oaths and authority to the ethics of war, since almost all conflicts involve soldiers breaching some pre-existing moral duties. -/- This is obviously true for soldiers fighting on the unjust side in a war, since almost all the killing they do is unjust. But in all actual wars soldiers on the just side also kill at least some innocent victims, whether as part of an unjust subordinate aim, as ‘collateral damage’, or simply because their adversaries are not sufficiently responsible for unjustified threats to be liable to be killed. If additional reasons cannot make otherwise prohibited acts permissible, then they are practically irrelevant to the ethics of killing in war, at least in this sense: if fighting is impermissible without regard to the contract, oath and authority of their state, then fighting is simply impermissible. -/- This is a tempting conclusion. In this paper, however, I argue that even if it is true at the level of objective permissibility, it is false for subjective permissibility. And since subjective permissibility is where (at least some of) the action is in the ethics of war, this is a significant result. I explain first why additional reasons can make otherwise subjectively prohibited acts permissible, then why just war theorists should care more than they seem to about subjective permissibility. Although I focus throughout on the ethics of war, my arguments generalise to all kinds of additional reasons. (shrink)

Why does it matter that those who fight wars be authorized by the communities on whose behalf they claim to fight? I argue that lacking authorization generates a moral cost, which counts against a war's proportionality, and that having authorization allows the transfer of reasons from the members of the community to those who fight, which makes the war more likely to be proportionate. If democratic states are better able than non-democratic states and sub-state groups to gain their community's authorization, (...) this means that some wars will be proportionate if fought by democracies, disproportionate if not. (shrink)

Theories of self-defence tend to invest heavily in ‘liability justifications’: if the Attacker is liable to have defensive violence deployed against him by the Defender, then he will not be wronged by such violence, and selfdefence becomes, as a result, morally unproblematic. This paper contends that liability justifications are overrated. The deeper contribution to an explanation of why defensive permissions exist is made by the Defender’s non-liability. Drawing on both canonical cases of self-defence, featuring Culpable Attackers, and more penumbral cases (...) of self-defence, involving Non-Responsible Threats, a case is assembled for the ‘Non-Liability First Account’ of self-defence. (shrink)

This paper examines the legitimacy of the US government’s argument that it must “balance liberty and security” with regard to its policy of trying enemy belligerents in military commissions rather than federal courts. I distinguish between three senses of “balance,” and argue that the policy is ambiguous between the second (internal) and third (emergency external) senses of balance. Neither line of reasoning justifies the policy, however. On the second sense, it is unjustified because it constitutes an arbitrary limitation of the (...) rights of some for the sake of the security of others. It thus violates the government’s duty to decide questions of policy in accordance with accepted legal procedures. Alternately, if the policy is intended to be an exercise of emergency powers, then it violates what I call the government’s juridical duty to serve as a guardian of justice. I offer an alternative justification for emergency measures, one that is based on the model of self-defense. I conclude that although the exercise of military commissions in times of emergency can be justified, the current exercise is illegitimate. (shrink)

Oppressive governments that use violence against citizens, e.g. murder and torture, are usually thought of as liable to armed revolutionary attack by the oppressed population. But oppression may be non-violent. A government may greatly restrict political rights and personal autonomy by using surveillance, propaganda, manipulation, strategic detention and similar techniques without ever resorting to overt violence. Can such regimes be liable to revolutionary attack? A widespread view is that the answer is ‘no’. On this view, unless a government is or (...) is likely to turn violent, revolution against it is disproportional. After all, revolution would involve launching potentially lethal attacks against oppressors who do not threaten the lives and bodily integrity of their subjects but pose only lesser threats. I argue that this claim of disproportionality is false. Armed revolution against Stably Non-violent Oppressive Regimes can be proportional under some circumstances, thus they may be liable to revolutionary attack. My argument relies on the Responsibility-Sensitive Account of Proportionality. This account holds that responsibility for posing threats renders agents liable to greater defensive harms than the harms with which they threaten. Even if non-violent oppressive regimes do not threaten citizens with murder, serious physical injury, or enslavement, their responsibility for creating an environment in which citizens’ political rights and personal autonomy are extremely restricted may loosen the proportionality requirement of inflicting defensive harm and render them liable to revolutionary attack. (shrink)

Theories of recognition have largely neglected the question of whether “struggles for recognition” might permissibly use violent means. In this article I explore the question of whether and how it is possible to show proper respect for the victim of one’s violence. Focusing on self-defense as the paradigmatic case of justified violence, two questions arise: (1) What renders an agent liable to violent action? (2) If she is liable, what is the appropriate, i.e., proportionate, degree of defensive violence that still (...) expresses respect for her? I claim that – in order to answer these questions – three dimensions of what is defended must be distinguished: goods, rights and one’s moral status. Clarifying their relationship allows me to argue that persons become liable to defensive violence if they directly pose (or intentionally and significantly contribute to) an unjustified threat to important goods protected by the rights of another person, even if they, as “attackers “or “threats “are innocent, i.e., do not display disrespect. I argue that those accounts which claim a moral symmetry between innocent attackers or threats on the one hand and innocent bystanders on the other hand, misunderstand the role of (dis) respect in a theory of justified violence. Moreover, when it comes to considerations of proportionality the dimension of (dis) respect has to be taken much more seriously than is usually the case. Here, instead of focusing mainly on the importance of goods we should pay more attention to (especially political) relationships of intersubjective (dis) respect. (shrink)

A provocateur does not pose a threat of harm. Hence, a forceful response to provocation is generally considered wrongful. And yet, a provocateur is often denied recourse to a self-defence justification if she defends herself against such a violent response. In recent work, Kimberly Ferzan argues that a provocateur forfeits defensive rights but this forfeiture cannot be explained in the same way as an aggressor’s rights forfeiture. Ordinarily, one forfeits the right not to be harmed and to self-defend against harm (...) by threatening to violate another person’s rights. But provocateurs forfeit their defensive rights because they bring about the situation in which defence becomes necessary. As I argue here, positing these two types of forfeiture justifications is neither desirable nor necessary. I suggest a unified rights forfeiture account that grounds rights forfeiture in moral responsibility for an unjust threat. My account offers clearer distinctions than alternative unified accounts, which I briefly discuss. Furthermore, the account can provide better explanations of intuitively plausible judgements. A provocateur will have less extensive defensive rights than an innocent victim, but will not lose all her defensive rights simply because ‘she started it.’. (shrink)

Targeted killings have traditionally been viewed as a dirty tactic, even within war. However, I argue that just combatants actually have a prima facie duty to use targeted strikes against military and political leadership rather than conventional methods of fighting. This is because the leaders of a military engaging in aggression are typically responsible for the wrongful harms they threaten, whereas significant numbers of their solders usually will not be. Conventional warfare imposes significant risks on soldiers who are not liable (...) to be killed, violating their rights. Narrowly targeted strikes frequently provide a less-wrongful alternative. Consequently, there is a prima facie duty to conduct such strikes, and to exercise “due care” if engagement with conventional forces becomes necessary. (shrink)

A person drives her well‐maintained car cautiously and alertly to the movies. Freak circumstances send the car out of control. It veers in the direction of a pedestrian whom it will kill unless she, or a third party, blows it up with a grenade. Whether the driver is liable to be thusly killed polarizes debates about the ethics of self‐defense. But debaters frequently conflate the questions of whether and by what means the driver is liable to be killed. The paper (...) separates these questions: it argues the driver's liability to lethal harm need not entail her liability to the grenade. (shrink)

The conventional view of Just War thinking holds that militaries operate under “special” moral rules in war. Conventional Just War thinking establishes a principled approach to such moral exceptionalism in order to prevent arbitrary or capricious uses of military force. It relies on the notion that soldiers are instruments of the state, which is a view that has been critiqued by the Revisionist movement. The Revisionist critique rightly puts greater emphasis on the moral agency of individual soldiers: they are not (...) mere instruments of the state. Although Revisionism has something particularly important to contribute when applied to cases that are short-of-war, where an individual agent’s moral culpability plays a greater role, soldiers fighting wars are not wholly autonomous moral agents. An Institutionalist approach that responds to Revisionist criticisms is a plausible alternative to the conventional Just War account for grounding the moral exceptionalism of war. For the Institutionalist, soldiers are moral agents with state-imposed obligations whose fundamental responsibility is the performance of the proper moral ends of the military institution they serve. If this is true, then soldiers have a moral obligation to be attentive to the moral corruption of the military institution of which they are a part. (shrink)

Philosophy and Phenomenological Research, Volume 103, Issue 2, Page 441-461, September 2021.

Over the past 20 years, there has been a huge amount of work on which things you can kill in self‐defense and why. This paper surveys that work.

This paper examines whether an agent becomes liable to defensive harm by engaging in a morally permissible but foreseeably risk-imposing activity that subsequently threatens objectively unjustified harm. It first clarifies the notion of a foreseeably risk-imposing activity by proposing that an activity should count as foreseeably risk-imposing if an agent may morally permissibly perform it only if she abides by certain duties of care. Those who argue that engaging in such an activity can render an agent liable to defensive harm (...) ground this liability in the luck egalitarian thought that we may justly hold individuals responsible for the consequences of their voluntary choices. Against this, I argue that a luck egalitarian commitment to holding people responsible cannot, by itself, ground liability to defensive harm. It can help ground such liability only against the backdrop of a distributively just society, and only if further considerations speak morally in favour of attaching certain well-defined costs to individuals’ risk-imposing choices. I conclude by suggesting that if an account of liability applies robustly across distributively just and unjust contexts alike, then what grounds an agent’s liability is plausibly not her responsibility for threatening objectively unjustified harm, but her culpability for doing so. (shrink)

Some, but not all, of the mistakes a person makes when acting in apparently necessary self-defense are reasonable: we take them not to violate the rights of the apparent aggressor. I argue that this is explained by duties grounded in agents' entitlements to a fair distribution of the risk of suffering unjust harm. I suggest that the content of these duties is filled in by a social signaling norm, and offer some moral constraints on the form such a norm can (...) take. (shrink)

One motivation for adopting a justice-based view of the right to self-defense is that it seems to solve the puzzle of how a victim may kill her attacker even when doing so is not predicted to protect her from the threat imposed upon her. The paper shows (a) that this view leads to unacceptable results and (b) that its solution to cases of futile self-defense is unsatisfactory. This failure makes the interest-based theory of self-defense look more attractive, both in the (...) context of futile self-defense and in general. To understand how a victim might use force in this context, one need only point to some interest of hers that is threatened, and the best candidate for such interest in cases of futile self-defense is her honor. (shrink)

I address a foundational problem with accounts of the morality of war that are derived from the Just War Tradition. Such accounts problematically focus on ‘the moment of crisis’: i.e. when a state is considering a resort to war. This is problematic because sometimes the state considering the resort to war is partly responsible for wrongly creating the conditions in which the resort to war becomes necessary. By ignoring this possibility, JWT effectively ignores, in its moral evaluation of wars, certain (...) types of past wrongdoing. I argue that we can address this problem by incorporating an account of compensatory liability into an account of the morality of war. Doing so yields the view that, if we have culpably failed to compensate victims for past wrongs, we might be morally required to weigh the well-being of those victims more heavily in our calculation of proportionality when determining the permissibility of a defensive act that harms the victim as a side-effect. This, in turn, makes satisfying t. (shrink)

this paper advances a novel account of part of what justifies killing in war, grounded in the duties we owe to our loved ones to protect them from the severe harms with which war threatens them. It discusses the foundations of associative duties, then identifies the sorts of relationships, and the specific duties that they ground, which can be relevant to the ethics of war. It explains how those associa- tive duties can justify killing in theory—in particular how they can (...) justify overrid- ing the rights to life of some of those who must be killed to win a war. It then shows how these duties can be operationalised in practice: first, showing how soldiers who fight on behalf of their community can act on reasons that apply to the members of that community; second, showing that the argument from associative duties does not prove too much—in particular, that it does not license the intentional killing of noncombatants in war. (shrink)

This thesis takes up a rights-based perspective to discuss a number of issues related to the problem of permissible harm. It appeals to a person’s capacity to shape her life in accordance with her own ideas of the good to explain why her death can be bad for her, and why each of us should have primary say over what may be done to her. The thesis begins with an investigation of the badness of death for the person who dies. (...) If death is bad for us, this helps explain the wrongness of killing. The thesis defends the deprivation account—i.e. the idea that death is bad for us when and because it deprives us of good life—against two Epicurean challenges. It adds that death is also bad when and because it thwarts our agency. Next, the thesis deals with the logic of our moral rights to non-interference. It proposes a conception of rights according to which the stringency of our rights derives from and is justified by the rational aspect of our human nature. It argues that this conception of moral rights solves the paradox of deontology. While our rights to non-interference are stringent, they are not absolute. The thesis considers two possible exceptions to the general rule that it is impermissible to harm an innocent person against her consent. First, using an actual case from WWII, it investigates the circumstances under which a government may expose some parts of its population to an increased risk of harm in order to decrease the risk to others. Second, it considers the permissibility of self-defence against an innocent threat. It argues that the potential victim of an innocent threat has a justice-based reason to treat her own interests as on a par with those of the threat. (shrink)

This is a collection of four papers about the All-Affected Principle (AAP): the view that every person whose morally weighty interests are affected by a democratic decision has the right to participate in that decision. -/- The first paper (“Narrow Possibilism about Democratic Enfranchisement”) examines how we should distribute democratic participation rights: a plausible version of AAP must avoid treating unlike cases alike, which would be procedurally unfair. The solution is to distribute participation rights proportionately to the risk that a (...) person’s interests will be affected. AAP thus implies an account of political equality that requires adherence to the ‘one person—one vote’ model only if interests are indeed equally affected. -/- The second paper (“Economic Participation Rights and the AAP”) argues that AAP supporters have paid insufficient attention to economic participation rights. The exercise of such rights raises unique worries about democratic accountability, which is why their exercise is constrained by a number of duties. -/- The third paper (“What AAP Is, and How (Not) to Fight It”) explores how AAP fares in light of possible objections from desirability and feasibility. Unlike crude versions of AAP, a plausibly restricted version of AAP cannot be dismissed as easily as many AAP sceptics may have thought. My reflections here are useful for AAP supporters and sceptics alike: this paper helps clarify what kind of objection can cast serious doubt on AAP. -/- The fourth paper (“Criminal Disenfranchisement, Political Wrongdoing, and Affected Interests”) asks: is AAP compatible with criminal disenfranchisement? AAP, when endorsed in combination with a plausible theory of punishment, is compatible with disenfranchising a narrow set of criminal wrongdoers only: those guilty of ‘political wrongdoing’, which is wrong primarily because it undermines democratic procedures and institutions for private gain. The upshot is that current blanket policies of criminal disenfranchisement are incompatible with AAP. (shrink)

Modern analytical just war theory starts with Michael Walzer's defense of key tenets of the laws of war in his Just and Unjust Wars. Walzer advocates noncombatant immunity, proportionality, and combatant equality: combatants in war must target only combatants; unintentional harms that they inflict on noncombatants must be proportionate to the military objective secured; and combatants who abide by these principles fight permissibly, regardless of their aims. In recent years, the revisionist school of just war theory, led by Jeff McMahan, (...) has radically undermined Walzer's defense of these principles. This essay situates Walzer's and the revisionists’ arguments, before illustrating the disturbing vision of the morality of war that results from revisionist premises. It concludes by showing how broadly Walzerian conclusions can be defended using more reliable foundations. (shrink)

New biotechnologies have the potential to both dramatically improve human well-being and dramatically widen inequalities in well-being. This paper addresses a question that lies squarely on the fault line of these two claims: When as a matter of justice are societies obligated to include a new biotechnology in a national healthcare system? This question is approached from the standpoint of a twin aim theory of justice, in which social structures, including nation-states, have double-barreled theoretical objectives with regard to human well-being. (...) The first aim is to achieve a sufficient level of well-being in each of six core dimensions. In the special case of healthcare systems, this aim is focally but not exclusively attentive to achieving health sufficiency as one of the core dimensions. The second aim is to combat the emergence and persistence of densely woven patterns of systematic disadvantage that tend to undermine the achievement of a sufficient level of health and the other core elements of well-being of some persons and groups. Judgments about entitlements to health related resources, including new biotechnologies, are made in light of a threshold notion of health sufficiency. What is enough or sufficient health? The answer that is defended here is that sufficient health is enough health for a decent human life, understood as enough health to live a full life course without preventable, significant functional disability or decrement in health, or treatable pain or suffering. When a state must include a new biotechnology in its national healthcare system is also influenced by ancillary concerns about the connection between health and other core dimensions of well-being. What counts as a significant functional impairment or health decrement is thus explicated, in part, in relation to the theory’s sufficiency aim for the other essential dimensions of well-being, and thus for a decent life, overall. Those elements of health that play a critical role in the experience of sufficient reasoning, affiliation, security, respect and self determination are especially important; any loss of health function or capacity that threatens the individual’s prospects for sufficiency in these other dimensions, including the relational egalitiarian concerns they entail, constitutes a significant functional impairment. Within national borders, individuals are thus entitled to those health-related goods and services that are essential for a sufficiency of each of the dimensions of well-being; with regard to self determination and respect, what is sufficient by way of guaranteed access to specific goods and services is going to depend on the implications of such access for where an individual stands in relation to her co-nationals. The content of any entitlement to health-related goods and services is also necessarily dynamic. What can be done for health and the other core dimensions of well-being as a function of technological innovation and diffusion is in constant flux. The paper concludes by considering the implications of this analysis for the conditions under which states are obligated to include access in their healthcare systems to one biotechnology, deep brain stimulation. (shrink)