Societal aging raises challenging ethical questions regarding the just distribution of health care between young and old. This article considers a proposal for age-based rationing of health care, which is based on the prudential life span account of justice between age groups. While important objections have been raised against the prudential life span account, it continues to dominate scholarly debates. This article introduces a new objection, one that develops out of the well-established disability critique of social contract theories. I show (...) the implications of this critique for the prudential life span account and for the special case of age-group justice. The result is that age-based rationing based on the prudential life span approach is not supported, and that the prudential life span approach itself is not the best way to think about allocating health care between age groups. I propose an alternative approach that avoids the disability objection, and consider its implications for specific proposals for age-based rationing of health care. (shrink)

While there is a substantial conceptual literature on equality in education, there has been little clarificatory discussion on the term equity, despite its frequent use in policy and planning documents. The article draws out some different ways in which equity can be understood in education. It distinguishes three forms of equity, looking at the social context when major shifts in the meaning of the term took place in English—the fourteenth century, the sixteenth century and the eighteenth century. Terming these equity (...) from below, equity from above, and equity from the middle, the analysis highlights how each helps clarify aspects of the concern with diversity within the capability approach. The conclusion drawn is that all three forms of equity need to be placed in articulation to expand capabilities in education. (shrink)

A society is said to age when its number of older members increases in relation to its number of younger members. The societies in most of the world’s industrialized nations have been aging since at least 1800. In 1800 the demographic makeup of developed countries was similar to that of many Third World countries in the early 1990s with roughly half the population under the age of 16 and very few people living beyond age of 60. Since that time, increases (...) in life expectancy, combined with declines in fertility rates, have dramatically increased the proportion of older persons in developed nations. The rapid increase in the number of older persons relative to younger ones carries important societal implications. In the domain of healthcare, societal aging will increase costs and exert greater pressure to ration services. It will, thus, bring to the fore questions, regarding a just distribution of healthcare between young and old age groups. This paper considers some of the most influential arguments to date for age-based rationing of health care. I show that these arguments fall short, and that the theoretical assumptions underlying them do not withstand careful scrutiny. (shrink)

How do social norms influence our choices? And does the presence of biased norms affect what we owe to each other? Looking at empirical research relating to PrEP rollout in HIV prevention policy, a...

Thomas Pogge answers the question if the capability approach can be justified with a firm ‘no’. Amongst others, he ridicules capability theorists for demanding compensation for each and every possible natural difference between people, including hair types. Not only does Pogge, so this paper argues, misconstrue the difference between the capability approach and Rawlsian resourcism. Even worse: he is actually implicitly relying on the idea of capabilities in his defence of the latter. According to him the resourcist holds that the (...) institutional order should not be biased towards the average person or the needs of some. Yet, as his own case of blind people and traffic lights can illustrate, whether or not this is the case is impossible to assess without resorting to some concept like people’s capabilities. Secondly, it is argued that the real issue at stake is not at all the best metric of justice—primary goods or capabilities—but rather the scope of theories of justice. On the surface the difference of opinion seems to be how to deal with so-called “personal heterogeneities”, yet the discussed case of interpersonal differences in metabolism and communal land-use choices hints at something else; Whereas Pogge insists that questions of justice only concern the institutional structure of society, many capability theorists support the inclusion of culture and social practices as possible sources of injustice. Unfortunately Pogge does not properly acknowledge this, as right from the start of his paper he frames the debate between both approaches in terms of institutions only. (shrink)

What people are realistically able to do and be in their lives, their capabilities, are of central moral importance according to the capability approach of Amartya Sen and Martha Nussbaum. Examples are the capabilities to be healthy or to be part of a community. The CA has become an influential normative framework for reflecting on justice, equality, well-being and development. In the past decades it has been successfully applied to areas such as education and health care. Only quite recently have (...) scholars started to use the CA to reflect on technology, for example on the contribution of ICT to development in the Global South. Much of this work is empirical. This dissertation contributes to the theoretical foundations for future empirical and ethical work by providing a philosophical exploration of how the CA can be brought to bear on technology. It discusses the applicability and added value of the CA for the design of technical artifacts, for the evaluation of technological development projects, and for the assessment of technology from the perspective of the good life. One main question addressed in this dissertation is which technology theories and design approaches could fruitfully supplement the CA, in order to ‘operationalize’ it in this new area. For this purpose participatory design, value sensitive design, the use plan account of technical artifacts, inclusive/universal design, actor-network theory, appropriate technology, pluralist theories of technology and the system/network view of technology are discussed. Another guiding question is what the exact nature is of human capabilities as discussed in the CA, and technology in the sense of technical artifacts, and how we can then conceptualize the relation between them. It is argued that we need to regularly move back and forth between ‘zooming in’ and ‘zooming out’. The former allows us to see the details of design of technical artifacts, the latter how exactly technical artifacts are embedded in broader socio-technical networks. Both, it is claimed, are crucial for the expansion of human capabilities. (shrink)