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)

Many countries have imposed strict regulations on the genetic information to which insurers have access. Commentators have warned against the emerging body of legislation for different reasons. This paper demonstrates that, when confronted with the argument that genetic information should be available to insurers for health insurance underwriting purposes, one should avoid appeals to rights of genetic privacy and genetic ignorance. The principle of equality of opportunity may nevertheless warrant restrictions. A choice-based account of this principle implies that it is (...) unfair to hold people responsible for the consequences of the genetic lottery, since we have no choice in selecting our genotype or the expression of it. However appealing, this view does not take us all the way to an adequate justification of inaccessibility of genetic information. A contractarian account, suggesting that health is a condition of opportunity and that healthcare is an essential good, seems more promising. I conclude that if or when predictive medical tests (such as genetic tests) are developed with significant actuarial value, individuals have less reason to accept as fair institutions that limit access to healthcare on the grounds of risk status. Given the assumption that a division of risk pools in accordance with a rough estimate of people's level of (genetic) risk will occur, fairness and justice favour universal health insurance based on solidarity. (shrink)

Abstract:The distinction between brute luck and option luck is fundamental for luck egalitarianism. Many luck egalitarians write as if it could be used to specify which outcomes people should be held responsible for. In this paper, I argue that the distinction can’t be used this way. In fact, luck egalitarians tend to rely instead on rough intuitive judgements about individual responsibility. This makes their view vulnerable to what’s known as theneutrality objection. I show that attempts to avoid this objection are (...) unsuccessful. I conclude that until it provides a better account of attributing responsibility, luck egalitarianism remains incomplete. (shrink)

The luck egalitarian view famously maintains that inequalities in individuals’ circumstances are unfair or unjust, whereas inequalities traceable to individuals’ own responsible choices are fair or just. On this basis, the distinction between so-called brute luck and option luck has been seen as central to luck egalitarianism. Luck egalitarianism is interpreted, by advocates and opponents alike, as a view that condemns inequalities in brute luck but permits inequalities in option luck. It is also thought to be expressed in terms of (...) the view that no individual ought to be worse off other than because of a fault or choice of his or her own. I argue that these two characterizations of luck egalitarianism are not equivalent and that, properly understood, luck egalitarianism is compatible with widespread, potentially radical, inequalities in brute luck. (shrink)

Luck egalitarianism has been criticized for condoning some cases of oppression and condemning others for the wrong reason—namely, that the victims were not responsible for their oppression. Oppression is unjust, however, the criticism says, regardless of whether victims are responsible for it, simply because it is contrary to the equal moral standing of persons. I argue that four luck egalitarian responses to this critique are inadequate. Two address only the first part of the objection and do so in a way (...) that risks making luck egalitarianism inconsistent. A third severely dilutes the luck egalitarian doctrine. A fourth manages to denounce some instances of oppression for the right reason, but at the same time permits other instances of oppression and condemns yet others for the wrong reason. (shrink)

When is it fair that some people are less healthy than others due to their own individual choices and preferences? In this paper, I explore two alternative answers. The first is a luck-egalitarian account that holds people responsible for choices that society could have reasonably expected them to avoid. I argue that this account is indeterminate and go on to sketch an alternative proposal based on Rawls’s idea of a “social division of responsibility.” This latter approach connects the notion of (...) responsibility for health to the social conditions under which health-related behaviour is developed. (shrink)

This paper explores how luck egalitarianism fares in capturing our intuitions about the fairness of market-generated outcomes. Critics of luck egalitarianism have argued that it places no restrictions on what outcomes are acceptable, at least when all agents are equally situated before entering the market, and that this gives us a reason to reject it as an account of fairness. I will argue that luck egalitarianism does make specific judgements about which market-generated outcomes are compatible with maintaining a fair distribution. (...) In addition, I will argue that luck egalitarian prescriptions accord with our pre-theoretical intuitions about the (un)fairness of certain market-generated outcomes. Securing these points both speaks in favour of luck egalitarianism as an ethical principle and provides a framework within which to analyze the fairness of practical, real world cases. (shrink)

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)