The interest in "social sustainability" has recently increased in the field of urban development. We want societies, cities, and neighborhoods to be economically and environmentally sustainable, but we also want urban areas that are safe, diverse, walkable, and relaxing, just to mention a few examples. Strikingly, however, there is no consensus regarding what definition of "social sustainability" should be employed. Additionally, some people are skeptical about the prospect of finding a useful definition at all and claim it is impossible to (...) satisfactorily define the concept for various reasons, such as its complexity. A potential first step towards navigating this conceptual maze is to provide desiderata for a definition of social sustainability. We defend a list of nine desiderata and thereby create a theoretical framework for analyzing and constructing a definition of "social sustainability". We also examine the skeptical arguments and find that it is premature to conclude that the goal of finding a useful definition is hopeless. With the criteria in place, the future debate can proceed by assessing definitions of "social sustainability" in a more structured and transparent manner. This activity is of upmost importance if we want to create just cities. Keywords: Social Sustainability, Definition, Purposes and Aims, Conditions of Adequacy. (shrink)

There is an ongoing increase in the use of mobile health technologies that patients can use to monitor health-related outcomes and behaviours. While the dominant narrative around mHealth focuses on patient empowerment, there is potential for mHealth to fit into a growing push for patients to take personal responsibility for their health. I call the first of these uses ‘medical monitoring’, and the second ‘personal health surveillance’. After outlining two problems which the use of mHealth might seem to enable us (...) to overcome—fairness of burdens and reliance on self-reporting—I note that these problems would only really be solved by unacceptably comprehensive forms of personal health surveillance which applies to all of us at all times. A more plausible model is to use personal health surveillance as a last resort for patients who would otherwise independently qualify for responsibility-based penalties. However, I note that there are still a number of ethical and practical problems that such a policy would need to overcome. The prospects of mHealth enabling a fair, genuinely cost-saving policy of patient responsibility are slim. (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)

What level of government subsidy of higher education is justified, in what form, and for what reasons? We answer these questions by applying the hypothetical insurance approach, originally developed by Ronald Dworkin in his work on distributive justice. On this approach, when asking how to fund and deliver public services in a particular domain, we should seek to model what would be the outcome of a hypothetical insurance market: we stipulate that participants lack knowledge about their specific resources and risks, (...) and ask what insurance contracts they would take out to secure different types of benefit and protection in the domain in question. The great benefit of the hypothetical insurance approach is that it allows us to take apparently intractable questions about interpersonal distribution and transform them into questions about intrapersonal distributions: that is, questions about how an individual would choose to distribute risks and resources across the various lives that they might end up living, in light of their individual ambitions and preferences. Applying this approach to higher education, we argue that the UK model of higher education funding in which the costs of an individual's higher education are shared between general taxation and the individual herself, with the latter element to be paid retrospectively through an income-contingent state-backed loan, is vindicated as just. In particular, we argue that it is more just than alternatives such as a graduate tax, full funding through general taxation, and full privatisation. (shrink)

Wealth and income are highly predictive of health and longevity. Egalitarians who maintain that this “socioeconomic-status gradient” in health is unjust are challenged by the fact that a significant component of it is owed to the higher prevalence of certain kinds of voluntary risk-taking among members of lower socioeconomic groups. Some egalitarians have argued that these apparently free personal choices are not genuinely free, and that those who make them should not be held morally responsible for the resulting harms to (...) their health. I argue to the contrary that such choices usually are fully free, and that those who make them are responsible for their consequences. This does not imply, however, that society cannot also be responsible for those consequences. It is responsible for them if they are statistically foreseeable and avoidable outcomes of unjust public institutions and policies. I show that many of the harms to health that contribute to the voluntary behavioral component of the SES health gradient satisfy that description. Society can therefore be morally responsible for those harms, even though the individuals who suffer them are also fully responsible for them. (shrink)

Individuals who become ill as a result of personal lifestyle choices often shift the monetary costs of their healthcare needs to the taxpaying public or to fellow members of a private insurance pool. Some argue that policies permitting such cost shifting are unfair. Arguments for this view may seem to draw support from luck egalitarian accounts of distributive justice. This essay argues that the luck egalitarian framework provides no such support. To allocate healthcare costs on the basis of personal responsibility (...) would arbitrarily and publicly burden socially detectable risk-takers while undetectable risk-takers continue to get a free ride. That problem is unavoidable even on the assumption that distributive institutions outside the healthcare sector are fully just. In actual, farfrom-just societies, imposing personal liability for the costs of voluntary risk taking would be wrong for an additional reason. Doing so would tend to magnify existing distributive injustices. These conclusions draw attention to two common ‘moral fallacies of the second best’ that can arise when applying ideal normative theory to matters of institutional design and in real-world policy contexts. (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)

If we want to make people more equal, what should we make them more equal in? For example, should it be resources, such as income, or should it be subjective well-being, such as preference satisfaction? The aim of this article is to critically examine the two main answers to this question within a luck egalitarian moral framework, which is a framework that aims to eliminate inequalities caused by non-responsibility factors, while preserving inequalities due to responsibility factors. I argue that the (...) arguments typically presented in favor of equalizing incomes rather than subjective well-being are weak and that within a luck egalitarian moral framework the claim that resources and not welfare should be considered the appropriate basis for interpersonal comparisons is in need of justification.The question of what society should equalize is applied to the issue of what should be the fair level of unemployment insurance compensation: Should we only compensate the involuntary unemployed for the income loss associated with unemployment, or also for the non-pecuniary costs associated with unemployment? The answer to this question, I argue, depends on where the cut between responsibility factors and non-responsibility factors is drawn. (shrink)

Genomics provides information on genetic susceptibility to diseases and new possibilities for interventions which can fundamentally alter the design of fair health policies. The aim of this paper is to explore implications of genomics from the perspective of equal opportunity ethics. The ideal of equal opportunity requires that individuals are held responsible for some, but not all, factors that affect their health. Informational problems, however, often make it difficult to implement the ideal of equal opportunity in the context of healthcare. (...) In this paper, examples are considered of how new genetic information may affect the way individual responsibility for choice is assigned. It is also argued that genomics may result in relocation of the responsibility cut by providing both new information and new technology. Finally, how genomics may affect healthcare policies and the market for health insurance is discussed. (shrink)

A liberal egalitarian theory of justice seeks to combine the values of equality, personal freedom, and personal responsibility. It is considered a much more promising position than strict egalitarianism, because it supposedly provides a fairness argument for inequalities reflecting differences in choice. However, we show that it is inherently difficult to fulfill this ambition. We present a liberal egalitarian paradox which shows that there does not exist any robust reward system that satisfies a minimal egalitarian and a minimal liberal requirement. (...) Moreover, we demonstrate how libertarianism may be justified in this framework if we drop the egalitarian condition. (shrink)

Combatting chronic, lifestyle-related disease has become a healthcare priority in the developed world. The role personal responsibility should play in healthcare provision has growing pertinence given the growing significance of individual lifestyle choices for health. Media reporting focussing on the ‘bad behaviour’ of individuals suffering lifestyle-related disease, and policies aimed at encouraging ‘responsibilisation’ in healthcare highlight the importance of understanding the scope of responsibility ascriptions in this context. Research into the social determinants of health and psychological mechanisms of health behaviour (...) could undermine some commonly held and tacit assumptions about the moral responsibility of agents for the sorts of lifestyles they adopt. I use Philip Petit's conception of freedom as ‘fitness to be held responsible’ to consider the significance of some of this evidence for assessing the moral responsibility of agents. I propose that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others. (shrink)

There is a large and growing body of empirical work on people's intuitions about distributive justice. In this paper, we investigate how well luck egalitarianism and desertism--the two normative approaches that appear to cohere well with people's intuitions--are supported by more fine-grained findings in the empirical literature. The time is ripe for a study of this sort, as the positive literature on justice has blossomed over the last three decades. The results of our investigation are surprising. In three different contexts (...) (good option luck, good brute luck, and bad brute luck) in which the demands of luck egalitarianism and those of a mainstream desert-based view come apart, the latter carries the day. One ramification of these findings is that people's intuitions about justice are moralized; that is, they appeal to particular conceptions of the good. Luck egalitarians must decide whether to embrace these moralized intuitions by adopting desertism--or to resist them. (shrink)

This paper begins with a simple illustration of the choice between individual and population strategies in population health policy. It describes the traditional approach on which the choice is to be made on the relative merits of the two strategies in each case. It continues by identifying two factors—our knowledge of the consequences of the epidemiological transition and the prevalence of responsibility-sensitive theories of distributive justice—that may distort our moral intuitions when we deliberate about the choice of appropriate risk-management strategies (...) in population health. It argues that the confluence of these two factors may lead us to place too much emphasis on personal responsibility in health policy. (shrink)

Lifestyle diseases constitute an increasing proportion of health problems and this trend is likely to continue. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge. Holding individuals accountable for their choices in the context of health care is, however, controversial. There are powerful arguments both for and against such policies. In this article the main arguments for and the traditional arguments against the use of individual responsibility as a criterion for (...) the distribution of scarce health resources will be briefly outlined. It is argued that one of the most prominent contemporary normative traditions, liberal egalitarianism, presents a way of holding individuals accountable for their choices that avoids most of the problems pointed out by the critics. The aim of the article is to propose a plausible interpretation of liberal egalitarianism with respect to responsibility and health care and assess it against reasonable counter-arguments. (shrink)

In recent years some moral philosophers and political theorists, who have come to be called “luck egalitarians,” have urged that the essence of social justice is the moral imperative to improve the condition of people who suffer from simple bad luck. Prominent theorists who have attracted the luck egalitarian label include Ronald Dworkin, G. A. Cohen, and John Roemer.1 Larry Temkin should also be included in this group, as should Thomas Nagel at the time that he wrote Equality and Partiality.2 (...) However, each of these theorists asserts a different position. The common ground, if any, is obscure. The idea of luck that is invoked is not transparently clear. Anyway, the term “luck egalitarianism” was coined by a critic of the doctrine, and tendentiously defined to denote an extreme version of the view that looks implausible from the start.3 With some justice Ronald Dworkin, perhaps the chief architect of the luck egalitarian position, has denied that he is a luck egalitarian. (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)

According to what we could call the "liberal" theory of distributive justice, people do not deserve the money they are able to make in the market for contributing to the economy. Yet the standard arguments for that view, which center on the fact that persons have very limited control over the size of their contributions, would also seem to imply that persons cannot deserve admiration, appreciation, esteem, praise and so on for these and other contributions. The control asymmetry is this: (...) the first conclusion of these arguments is acceptable but the second not. This paper is an effort to defend that claim, but without appeal to the notion of control. (shrink)

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

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

Should priority in the allocation of organs be given to those who have previously donated or declared their willingness to do so? This article examines the Israeli priority rule in light of two prominent critiques of priority rules, pertaining to failure to reciprocate and unfairness. The scope and content of these critiques are interpreted from the perspective of equality of opportunity. Because the Israeli priority rule may be reasonably criticized for unfairness and failing to reward certain behaviors, the article develops (...) an adjusted priority rule, which removes and adjust the elements in the Israeli priority rule deemed problematic. However, such a priority rule is complex to the extent that it may fail to increase donation rates and furthermore introduce new concerns of fairness, as the better off may be better able to navigate the complex adjusted priority rule. (shrink)

People’s health is hugely affected by where they live, their occupational status and their socio-economic position. It has been widely argued that the presence of such social determinants in health provides good reasons to reject luck egalitarianism as a theory of distributive justice in health. The literature provides different reasons why this responsibility-sensitive theory of distributive justice should not be applied to health. The critiques submit that the social circumstances undermine or remove people’s responsibility for their health; responsibility sensitive health (...) policies would adversely affect those who are worst off and; the luck egalitarian approach to health distracts from the important task of rectifying socio-economic influences on people's health and provides individualistic solutions to collective problems. But for each of these variants of the critique luck egalitarianism provides suitable answers. The literature on social determinants is no detriment to the project of applying luck egalitarianism to health. (shrink)

Eli Feiring has developed a concept of forward-looking responsibility in healthcare. On this account, what matters morally in the allocation of scarce healthcare resources is not people's past behaviours but rather their commitment to take on lifestyles that will increase the benefit acquired from received treatment. According to Feiring, this is to be preferred over the backward-looking concept of responsibility often associated with luck egalitarianism. The article critically scrutinises Feiring's position. It begins by spelling out the wider implications of Feiring's (...) view. Against this background, it shows that (i) Feiring's distinction between backward-looking and forward-looking responsibility is incompatible with the Scanlonian notion of responsibility she apparently endorses; (ii) her favoured forward-looking notion of responsibility is subject to the objections levelled against the luck egalitarian view (whatever the strength of such objections). (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)

Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should address distributions of health rather (...) than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. (shrink)

This chapter discusses how justice applies to public health. It begins by outlining three different metrics employed in discussions of justice: resources, capabilities, and welfare. It then discusses different accounts of justice in distribution, reviewing utilitarianism, egalitarianism, prioritarianism, and sufficientarianism, as well as desert-based theories, and applies these distributive approaches to public health examples. Next, it examines the interplay between distributive justice and individual rights, such as religious rights, property rights, and rights against discrimination, by discussing examples such as mandatory (...) treatment and screening. The chapter also examines the nexus between public health and debates concerning whose interests matter to justice (the “scope of justice”), including global justice, intergenerational justice, and environmental justice, as well as debates concerning whether justice applies to individual choices or only to institutional structures (the “site of justice”). The chapter closes with a discussion of strategies, including deliberative and aggregative democracy, for adjudicating disagreements about justice. (shrink)

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

This paper scrutinizes the tension between individuals’ rights and paternalism. I will argue that no normative account that includes rights of individuals can justify hard paternalism since the infringement of a right can only be justified with the right or interest of another person, which is never the case in hard paternalism. Justifications of hard paternalistic actions generally include a deviation from the very idea of having rights. The paper first introduces Tom Beauchamp as the most famous contemporary hard paternalist (...) by outlining his moral theory (principlism) and showing why it, as it stands, has to allow for hard paternalism. Secondly, the paper focuses on the notion of rights within principlism. I will employ traditional theories of rights to make sense of rights in principlism. Unfortunately, this attempt fails. In the third part, then, I claim that rights can only be limited with reference to the rights or interests of others. This structure is the very point of rights, it is their bite. I will argue for this claim and show its implications. The most important implication is that not only principlism, but every normative theory that includes rights of individuals, has to abolish hard paternalism. (shrink)

Nu cu foarte mult timp în urmă, grupul de teorie socială şi politică din cadrul proiectului POSDRU 89/1.5/S/56815 „Societatea bazată pe cunoaştere-cercetări, dezbateri, perspective”, a publicat, tot la editura Institutul European, lucrarea Concepte şi teorii social-politice. Volumul de faţă reprezintă un nou pas al grupului nostru de lucru în realizarea proiectului inaugurat prin publicarea acelei lucrări. Este vorba, reamintesc, despre proiectul elaborării unor volume care să-i ajute pe cei interesaţi în iniţierea (lor sau a altora) în teoria (şi în special (...) filosofia) politică, mai ales în dezvoltările sale conceptuale, argumentative şi problematologice recente. Desigur, nu am intenţionat în mod expres ca aceste volume să fie utile doar în această direcţie. Speranţa noastră a fost, dimpotrivă, ca ele să fie interesante şi pentru cercetătorii cu experienţă în investigarea şi dezbaterea temelor abordate în cadrul lor, mai ales pentru că unele capitole prezintă idei, argumente sau perspective originale, care, credem noi, merită atenţia critică a comunităţii cercetătorilor români. Menirea lor fundamentală rămâne totuşi, în intenţia noastră, cea introductivă. Aşa cum recunoşteam în cuvântul său înainte, Concepte şi teorii socialpolitice nu este deloc un volum exhaustiv. Teorii şi ideologii politice reprezintă, în bună măsură, şi o încercare de a compensa cumva acest „defect” al volumului în cauză. Desigur, nici publicarea lui nu ne permite să susţinem că am atins obiectivul oferirii unei introduceri cât mai complete în teoria/filosofia politică actuală. Deşi Teorii şi ideologii politice prezintă câteva dintre cele mai importante teorii sau ideologii politice contemporane, există multe altele care nu sunt prezentate (sau cel puţin nu sunt prezentate atât de detaliat pe cât ar fi meritat) între paginile sale. Mă refer aici, spre exemplu, la libertarianism, comunitarianism, cosmopolitism sau capabilism (ca teorie a dezvoltării umane). Ne consolăm însă în baza a trei argumente. Unul este acela că, aşa cum se poate observa cu uşurinţă din cuprinsul său, cartea de faţă prezintă totuşi un număr important dintre principalele teorii şi ideologii politice recente (unele dintre ele pentru prima dată în literatura românească de specialitate). Al doilea este acela că unele dintre teoriile sau ideologiile politice care nu sunt abordate aici au beneficiat deja de prezentări competente şi atente la noi (unele dintre ele chiar în Concepte şi teorii social-politice). În sfârşit, al treilea argument este acela că sperăm cu toţii că prezentul volum nu reprezintă ultimul nostru pas în realizarea obiectivului menţionat în debutul acestei intervenţii. Sperăm, altfel spus, să putem prezenta acele teorii sau ideologii politice care nu şi-au găsit locul între paginile lui sau ale celui precedent cu o altă ocazie. Ţin să precizez însă că volumul pe care îl introduc prin această intervenţie nu este întrutotul o continuare a celui precedent, deşi între ele există, desigur, destule afinităţi, relaţii şi continuităţi tematice. Mai exact, el nu ar putea fi descris totalmente neproblematic ca reprezentând „al doilea tom” al volumului Concepte şi teorii social-politice. Titlul său este menit să indice acest lucru. Dacă lucrarea anterioară era centrată pe prezentarea unora dintre principalele concepte ale teoriei/filosofiei social-politice contemporane, cartea de faţă prezintă câteva dintre principalele teorii sau ideologii dezvoltate şi apărate de politologii, filosofii, economiştii sau „ideologii” politici contemporani. Nici de această dată nu voi încerca să rezum principalele idei expuse sau metodologii utilizate de către autori în prezentarea teoriilor sau ideologiilor politice care se regăsesc între paginile ce urmează. Temeiul meu este acelaşi: acolo unde au considerat că este cazul, autorii capitolelor şi-au rezumat ei înşişi ideile prezentate sau/şi metodologiile utilizate. În plus, cititorul interesat să-şi facă o idee prealabilă despre conţinutul ideatic şi problematologic al cărţii dispune de un rezumat al ei (în limbile engleză şi franceză) în finalul său. În consecinţă, mă voi mulţumi să închei doar prin a exprima încă o dată speranţa noastră că această carte se va dovedi utilă celor cărora li se adresează cu preponderenţă. Sperăm, în alte cuvinte, ca ea să le fie de ajutor în înţelegerea şi evaluarea adecvată a teoriilor şi ideologiilor pe care le prezintă. Şi mai important, sperăm că ea îi va stimula să caute să aprofundeze cercetarea acestor teorii şi ideologii şi – mai ales – să iniţieze propriile investigaţii sistematice şi riguroase în această privinţă. Dezvoltarea politologiei şi a filosofiei politice în spaţiul românesc, ca să nu mai vorbim despre clarificarea şi fundamentarea cât mai completă şi adecvată a opţiunilor ideologice ale partidelor politice din România, au nevoie de acest lucru. (shrink)

Everyone wants to be healthy, but many of us decline to act in healthy ways. Should these choices have any bearing on the ethics of clinical practice and health policy? How may personal responsibility for health be manipulated in health policy debates.

In this paper I aim to examine some problematic implications of the fact that individuals are prone to making systematic reasoning errors, for resource egalitarianism. I begin by disentangling the concepts of preferences, choices and ambitions, which are sometimes used interchangeably by egalitarians. Subsequently, I claim that the most plausible interpretation of resource egalitarianism takes preferences, not choices, as the site of responsibility. This distinction is salient, since preference-sensitive resource egalitarianism is faced with an important objection when applied to situations (...) in which the empirically reasonable assumption that individuals have different degrees of computational abilities is introduced. I first show that this objection can be raised in cases involving individuals who have incomplete information, but that it ultimately fails for such cases since we can appeal to higher order insurance markets in order to mitigate any initial concerns. I further claim, however, that the objection is much more powerful in cases involving individuals who have different reasoning skills, since the appeal to higher order insurance markets is no longer tenable. Consequently, the ideal principle of justice proposed by Dworkin is met with a new feasibility challenge. Finally, I claim that the problem of reasoning errors and various forms of cognitive biases also affect Dworkin’s non-ideal principle of justice, skewing the outputs of the hypothetical insurance mechanism in an unjustifiable manner. (shrink)

Smoking is disproportionately common among the disadvantaged, both within many countries and globally; the burden associated with smoking is, therefore, borne to a great extent by the disadvantaged. In this paper, I argue that this should be regarded as a problem of social justice. Even though smokers do, in a sense, ‘choose’ to smoke, the extent to which these choices can legitimise the resulting inequalities is limited by the unequal circumstances in which they are made. An analysis of the empirical (...) literature reveals a variety of factors—such as targeted advertising, unequal dissemination of information about the health risks of smoking and inequalities in smoking norms—that make the disadvantaged more likely to become smokers and less likely to quit successfully. The paper then considers a range of common tobacco control policies from the perspective of social justice. The social justice perspective developed here poses a challenge for policy-makers: on the one hand, social justice concerns strengthen the case for tobacco control policies because such policies disproportionately benefit the health of the disadvantaged. At the same time, however, we must be particularly sensitive to any harms associated with such policies because such burdens, too, will fall largely on the disadvantaged. (shrink)

RESUMEN El igualitarismo de la suerte es una teoría de justicia distributiva que incluye con sideraciones de responsabilidad atributiva individual para definir las obligaciones distributivas. Se presenta como un intento de recomponer cierta consistencia in terna a la teoría rawlsiana y evitar algunas de sus consecuencias "inequitativas". El artículo defiende la consistencia interna del proyecto rawlsiano sin necesidad de incluir un criterio sensible a la responsabilidad atributiva individual, ya que la inclusión de tal criterio resultaría ilegítima desde el punto de (...) vista rawlsiano. ABSTRACT Luck egalitarianism is a theory of distributive justice that includes considerations of attributive responsibility when defining distributive obligations. It appears as an attempt to recompose the internal coherence of Rawlsian theory and avoid some of its "inequitable" consequences. The article defends the internal coherence of Rawls' theory, without the need to include a criterion sensitive to individual attributive responsibility, given that such criterion would be illegitimate from a Rawlsian point of view. (shrink)

In the old days, material egalitarians tended to favor equality of outcome advantage, on some suitable conception of advantage (happiness, resources, etc.). Under the influence of Dworkin’s seminal articles on equality[i], contemporary material egalitarians have tended to favor equality of brute luck advantage—on the grounds that this permits people to be held appropriately accountable for the benefits and burdens of their choices. I shall argue, however, that a plausible conception of egalitarian justice requires neither that brute luck advantage always be (...) equalized nor that people always bear the full cost of their voluntary choices. Instead, justice requires that initial opportunities for advantage be equalized—roughly along the lines suggested by Arneson and Cohen.[ii] Brute luck egalitarianism and initial opportunity egalitarianism are fairly similar in motivation, and as a result they have not been adequately distinguished. Once the two views are more clearly contrasted, equality of opportunity for advantage will, I claim, be seen to be a more plausible conception of equality. (shrink)

Amartya Sen and Martha Nussbaum have argued that justice is concerned, at least in part, with the distribution of capabilities (opportunities to function). Richard Arneson, G.A. Cohen, and John Roemer have argued that justice is concerned with something like the distribution of opportunities for well-being. I argue that, although some versions of the capability view are incompatible with some versions of the opportunity for well-being view, the most plausible version of the capability view is identical to a slight generalization of (...) the opportunity for well-being view. (shrink)

Lifestyle-induced diseases are becoming a burden on healthcare, actualizing the discussion on health responsibilities. Using data from the National Association for Heart and Lung Diseases ’s 2015 Health Survey, this study examined the public’s attitudes towards personal and social health responsibility in a Norwegian population. The questionnaires covered self-reported health and lifestyle, attitudes towards personal responsibility and the authorities’ responsibility for promoting health, resource-prioritisation and socio-demographic characteristics. Block-wise multiple linear regression assessed the association between attitudes towards health responsibilities and individual (...) lifestyle, political orientation and health condition. We found a moderate support for social responsibility across political views. Respondents reporting unhealthier eating habits, smokers and physically inactive were less supportive of health promotion policies. The idea that individuals are responsible for taking care of their health was widely accepted as an abstract ideal. Yet, only a third of the respondents agreed with introducing higher co-payments for treatment of ‘self-inflicted’ conditions and levels of support were patterned by health-related behaviour and left-right political orientation. Our study suggests that a significant support for social responsibility does not exclude a strong support for personal health responsibility. However, conditional access to healthcare based on personal lifestyle is still controversial. (shrink)

The formal theory of equality of opportunity emerged as a response – a friendly amendment – to Ronald Dworkin's (1981) characterization of resource egalitarianism, as defined by the allocation that would emerge from insurance contracts arrived at behind a thin veil of ignorance. This article compares several of the prominent versions of this response, put forth in the period 1993–2008. I argue that a generalization of Roemer's (1998) proposal is the most satisfactory approach. Inherent in that generalization is an indeterminism, (...) which reflects a philosophical problem: that we do not know what comprise the ethically correct rewards to effort. The indeterminism should be resolved, I propose, by an ancillary theory which limits the degree of inequality which is acceptable. (shrink)

Conceptions of desert and responsibility have had a powerful influence in justifying economic inequality. Currently, they are being reaffirmed in policies advocated by the centre left in Britain. In contrast, luck egalitarianism, one of the dominant theoretical positions in contemporary political philosophy, puts equality at the top of the agenda and notoriously undermines traditional notions of desert and rejects the conception of personal responsibility on which traditional ideas rely. Although luck egalitarians are sceptical about desert and redefine responsibility to reduce (...) its role in arguments for just distribution, they nevertheless retain a commitment to holding people responsible for the distributive consequences of what they freely choose to do. They attempt to demonstrate that equality can be reconciled with responsibility. I will argue that luck egalitarians have not gone far enough in eliminating desert and responsibility from the armoury of social justice, and that their own arguments should have led them to do so. My aim in this article is to push the ideas implicit in luck egalitarian's arguments to their logical conclusion. I argue that for practical and conceptual reasons, they should have formulated their theories as though hard determinism is true, or nearly true, even if it is not. Denying the pertinence of judgements of desert and responsibility to questions of distributive justice removes an obstacle to egalitarian aims by suggesting a more egalitarian distribution than one that is hostage to voluntary choice. It could be accepted that luck egalitarianism cannot accommodate the concept of personal responsibility without accepting the conclusion that considerations of responsibility should be abandoned. However, any plausible account of responsibility would demonstrate that existing inequalities are undeserved, and that these inequalities make a mockery of politicans current emphasis on personal responsibility. (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)

While libertarians affirm personal responsibility as a central moral and political value, libertarian theorists write relatively little about the theory and practice of this value. Focusing on the work of F. A. Hayek and David Schmidtz, this article identifies the core of a libertarian approach to personal responsibility and demonstrates the ways in which this approach entails a radical revision of the ethics and American politics of personal responsibility. Then, I highlight several central implications of this analysis in the American (...) political and economic status quo. First, this analysis makes a mockery of so-called libertarian/conservative ‘fusionism’, such that libertarian personal responsibility cannot partner with meritocratic conservative thought to provide a plural grounding for rejecting progressive or redistributive economic policy. Next, preferred libertarian policies threaten the status, esteem and social bases of self-respect of citizens who are worse-off through little or no fault of their own. Finally, these policies undermine the ethics of personal responsibility that Americans from across the ideological spectrum value and many conservatives and libertarians celebrate. In the American status quo, those who value personal responsibility must reserve a central place for policies that mitigate opportunity and distributive inequalities. (shrink)

This paper develops a conceptual framework, which can accommodate a wide range of value judgements used in ethical evaluations of extended social states and which can be used to differentiate different categories of value judgements by referring to the type of information on which they may be based. The notions of consequentialism, non-consequentialism, exclusive focus on personal well-being, exclusive focus on utility, etc. are conceptualized in operational ways in the framework. The framework and the discussion of different types of ethical (...) criteria that may be used in evaluating extended social states contribute to conceptual clarity about the ethical bases of public policies. (shrink)

Many theories of fairness distinguish between compensation factors and responsibility factors. Whereas the distinction between both types of factors is a matter of definition in theory, empirical work usually requires a sharp cut. All determinants of the outcome of interest have to be classified as either a compensation factor or a responsibility factor. We argue that the determinants are often hard to classify. A pragmatic solution to the problem at hand is to introduce a more general soft cut: determinants can (...) be partly compensation, partly responsibility. Still, in a first-best income tax framework, such a soft cut is possible only if the gross income function is additively separable. In case separability fits the data, a simple partial sharing rule emerges as a natural candidate for partial redistribution. This rule can be characterized on the basis of two simple properties, equal treatment of equals and partial solidarity. In case additive separability is rejected by the data, we propose two alternative solutions. (shrink)

If it is true, as suggested by Sir Michael Marmot and other researchers, that status impacts health and therefore accounts for some of the social gradient in health, then it seems to be the case that it would be possible to bring about more equality in health by equalizing status. The purpose of this article is to analyze this suggestion. First, we suggest a working definition of what status precisely is. Second, following a luck egalitarian approach to distributive justice, we (...) consider whether and to which extent individuals are responsible themselves for their position in a status hierarchy. Third, we consider the contours of a difficult question, namely which political measures are feasible in order to reduce health-affective inequalities in status and fourth, whether or to what extent such measures are legitimate. We argue that on the basis of these considerations, we have at least some prima facie reasons to counter (at least some) status inequalities in order to equalize health. (shrink)