Throughout the COVID-19 pandemic, shortages of scarce healthcare resources consistently presented significant moral and practical challenges. While the importance of vaccines as a key pharmaceutical intervention to stem pandemic scarcity was widely publicized, a sizable proportion of the population chose not to vaccinate. In response, some have defended the use of vaccination status as a criterion for the allocation of scarce medical resources. In this paper, we critically interpret this burgeoning literature, and describe a framework for thinking about vaccine-sensitive resource (...) allocation using the values of responsibility, reciprocity, and justice. Although our aim here is not to defend a single view of vaccine-sensitive resource allocation, we believe that attending critically with the diversity of arguments in favor (and against) vaccine-sensitivity reveals a number of questions that a vaccine-sensitive approach to allocation should answer in future pandemics. (shrink)

This is an interview by the Erasmus Journal for Philosophy and Economics with Ian Carter. The interview covers Carter's intellectual biography; his extensive writings on the measurement and value of freedom; his reflections on the use of formal methods in philosophical work on freedom and in political philosophy more broadly; his more recent work on basic equality and respect for persons; and, finally, his advice to young scholars.

Luck egalitarians contend that, while each person starts out with a claim to an equal quantity of advantage, she can forfeit this claim by making certain choices. The appeal of luck egalitarianism is that it seems to satisfy what this paper calls the moral tyranny constraint. According to this constraint, any acceptable theory of justice must preclude the possibility of an agent unilaterally, discretionarily, and foreseeably leaving others with less advantage under conditions of full compliance with the theory. This paper (...) argues that claim forfeiture is built into luck egalitarianism specifically to preclude such moral tyranny. However, it contends that the dominant interpretation of luck egalitarianism fails to fully satisfy the moral tyranny constraint. It offers an alternative interpretation that both eliminates the possibility of moral tyranny and rescues the position from two other prominent objections that have been directed against luck egalitarianism. (shrink)

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

Over the last few decades, there have been intense debates concerning the effects of markets on the morality of individuals’ behaviour. On the one hand, several authors argue that markets’ ongoing expansion tends to undermine individuals’ intentions for mutual benefit and virtuous character traits and actions. On the other hand, leading economists and philosophers characterize markets as a domain of intentional cooperation for mutual benefit that promotes many of the character traits and actions that traditional virtue ethics accounts classify as (...) virtuous. In this paper, I join this debate and argue for three claims of general interest to philosophers, economists and policy makers. First, market transactions do not reliably promote individuals’ intentions for mutual benefit, and often select against such intentions. Second, the set of so-called market virtues lacks a substantial overlap with the set of character traits that traditional virtue ethics accounts classify as virtuous. And third, many seemingly virtuous actions observed in market contexts are merely actions in accordance with virtue rather than genuine actions from virtue. These three claims do not license opposition to markets, but challenge the main empirical and theoretical presuppositions of leading virtue ethics defences of markets. (shrink)

Recent literature on responsibility-sensitive egalitarianism has suggested that an opposition to unchosen inequality on the grounds of unfairness is compatible with a range of accounts as to which inequalities are fair. I argue that forms of responsibility-sensitive egalitarianism face a challenge in the construction of such accounts; namely to explain the fairness of such inequalities specifically, as opposed to their being merely justified in a broader sense. I illustrate the nature of this challenge through an interesting parallel with an issue (...) in value theory in the form of the so-called ‘wrong kind of reason’ problem. (shrink)

Many philosophers believe that luck egalitarianism captures “desert-like” intuitions about justice. Some even think that luck egalitariansm distributes goods in accordance with desert. In this paper, we argue that this is wrong. Desertism conflicts with luck egalitarianism in three important contexts, and, in these contexts, desertism renders the proper moral judgment. First, compared to desertism, luck egalitarianism is sometimes too stingy: it fails to justly compensate people for their socially valuable contributions—when those contributions arose from “option luck”. Second, luck egalitarianism (...) is sometimes too restrictive: it fails to justly compensate people who make a social contribution when that contribution arose from “brute luck”. Third, luck egalitarianism is too limited in scope: it cannot diagnose economic injustice arising independently of comparative levels of justice. The lesson of this paper is that luck egalitarians should consider supplementing their theory with desert considerations. Or, even better, consider desertism as a superior alternative to their theory. (shrink)

According to luck egalitarianism, inequalities are justified if and only if they arise from choices for which it is reasonable to hold agents responsible. This position has been criticised for its purported harshness in responding to the plight of individuals who, through their own choices, end up destitute. This paper aims to assess the Harshness Objection. I put forward a version of the objection that has been qualified to take into account some of the more subtle elements of the luck (...) egalitarian approach. Revising the objection in this way suggests that the Harshness Objection has been overstated by its proponents: because luck egalitarians are sensitive to the influence of unequal brute luck on individuals’ choices, it is unlikely that there will be any real world cases in which the luck egalitarian would not have to provide at least partial compensation. However, the Harshness Objection still poses problems for the luck egalitarian. First, it is not clear that partial compensation will be sufficient to avoid catastrophic outcomes. Second, the Harshness Objection raises a theoretical problem in that a consistent luck egalitarian will have to regard it as unjust if any assistance is provided to the victim of pure option luck, even if such assistance could be provided at no cost. I consider three strategies the luck egalitarian could pursue to accommodate these concerns and conclude that none of these strategies can be maintained without either violating basic luck egalitarian principles or infringing upon individual liberty. (shrink)

Suppose that you must make choices that may influence the well-being and the identities of the people who will exist, though not the number of people who will exist. How ought you to choose? This paper answers this question. It argues that the currency of distributive ethics in such cases is a combination of an individual’s final well-being and her expected well-being conditional on her existence. It also argues that this currency should be distributed in an egalitarian, rather than a (...) prioritarian, manner. (shrink)

Luck egalitarianism is a family of egalitarian theories of distributive justice that aim to counteract the distributive effects of luck. This article explains luck egalitarianism's main ideas, and the debates that have accompanied its rise to prominence. There are two main parts to the discussion. The first part sets out three key moves in the influential early statements of Dworkin, Arneson, and Cohen: the brute luck/option luck distinction, the specification of brute luck in everyday or theoretical terms and the specification (...) of advantage as resources, welfare, or some combination of these. The second part covers three later developments: the democratic egalitarian critique of luck egalitarianism, the luck egalitarian acceptance of pluralism, and luck egalitarian doubts about the significance of the brute luck/option luck distinction. (shrink)

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

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)

Oppression can be unjust from a luck egalitarian point of view even when it is the consequence of choices for which it is reasonable to hold persons responsible. This is for two reasons. First, people who have not been oppressed are unlikely to anticipate the ways in which their choices may lead them into oppressive conditions. Facts about systematic phenomena (like oppression) are often beyond the epistemic reach of persons who are not currently subject to such conditions, even when they (...) possess adequate information about the particular consequences of their choices. Second, people may be (much) less responsible for remaining in oppressive conditions, even if they are responsible for entering circumstances of oppression. Oppression that results from a person’s choice may cause or contribute to dramatic changes in that person, and these changes may be sufficient to undermine the person’s responsibility for the results of her earlier choice. (shrink)

Contemporary egalitarian theories of justice constrain the demands of equality by responsibility, and do not view as unjust inequalities that are traceable to individuals' choices. This paper argues that, in order to make non-arbitrary determinate judgements of responsibility, any theory of justice needs a principle of stakes , that is, an account of what consequences choices should have. The paper also argues that the principles of stakes seemingly presupposed by egalitarians are implausible, and that adopting alternative principles of stakes amounts (...) to fleshing out the demands of responsibility rather than imposing limits on them. (shrink)

Park and Davies have laid out an illuminating map of major arguments bearing on whether vaccination status should affect access to scarce healthcare resources during a pandemic. Notably, they sugge...

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)

This article considers the implications of luck egalitarianism for a range of issues relating to international, South-North migration. More specifically, the implications of luck egalitarianism for the question of whether receiving societies are justified in extending to immigrants a less comprehensive set of rights than that enjoyed by other members of society are considered. First, are voluntary migrants responsible for their migration in such a way that receiving societies are justified in extending to them a less comprehensive set of rights (...) than if, say, they had been involuntary migrants, or citizens of the destination country? Since luck egalitarianism aims to redistribute only for inequalities for which individuals are not responsible, there is an issue of whether it will hold individuals responsible for their choice of migration in such a way that it may justify asymmetrical sets of rights between voluntary immigrants and other members of society. Second, it may be possible to allow access for a larger number of disadvantaged migrants if they are granted access to a less extensive package of rights when they reach the destination country than if they were granted access to a more extensive such package. If so, may not the less extensive package of rights turn out to have a greater positive impact on global equality? Both these arguments are critically discussed and it is concluded that neither justifies extending to immigrants a less comprehensive set of rights. (shrink)

Aggregation in moral philosophy calls for the summing or averaging of values or utilities as a guide to individual behavior. But morality, it is argued, needs to be individualistic, in view of the evident separateness of persons, especially given the great disparities among individuals who nevertheless interact with each other in social life. The most plausible general moral program is the classical liberal (or “libertarian”) one calling for mutual noninterference rather than treating others as equal to oneself in point of (...) demands on our action. Why, then, would we ever aggregate? The reason is that we are affected by behavior that has general effects, especially unintended side effects, on all sorts of people among whom we ourselves are often to be found. When we are randomly situated among such groups—as we sometimes are and often are not—minimizing aggregate harm is the plausible strategy, and sometimes promoting aggregate benefit as well. (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)

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 the luck egalitarian literature, one influential formulation of luck egalitarianism does not specify whether equalities that do not reflect people’s equivalent exercises of responsibility are bad with regard to inequality. This equivocation gives rise to two competing versions of luck egalitarianism: asymmetrical and symmetrical luck egalitarianism. According to the former, while inequalities due to luck are unjust, equalities due to luck are not necessarily so. The latter view, by contrast, affirms the undesirability of equalities as well as inequalities insofar (...) as they are due to luck. The symmetrical view, we argue, is by far the more compelling, both by internal luck egalitarian standards and in light of the external rightist emphasis on choice and responsibility to which luck egalitarianism may partly be seen as a response. Our main case for the symmetrical view is that when some people, against a background of equal opportunities, do not exercise their responsibility to the same degree as others, they cannot justifiably call for equalizing measures to be put in place. Indeed, such measures would be positively unfair. The symmetrical view, accordingly, rejects compensation in such cases, whereas the asymmetrical view, implausibly, enjoins it. We also examine two objections to this argument. First, that this view fails to qualify as genuinely egalitarian, instead collapsing the notion of equality into the notion of desert. Second, that the opposing asymmetrical view, in contrast to the symmetrical view, can draw support from its compatibility with sufficientarian concerns. Both objections are rebutted. We conclude that luck egalitarians are best served by endorsing the symmetrical, luck-neutralizing stance. (shrink)

One prominent criticism of luck egalitarianism is that it requires either shameful revelations or otherwise problematic declarations by the state toward those who have had bad brute luck. Relational egalitarianism, by contrast, is portrayed as an alternative that requires no such revelations or declarations. I argue that this is false. Relational equality requires the state to draft anti-discrimination laws for both state and private action. The ideal of relational egalitarianism requires these laws to be asymmetric, that is to allow affirmative (...) action for disadvantaged groups while prohibiting affirmative action for advantaged groups. Hence, the state needs to make a public declaration on which groups are privileged and which are underprivileged; and individuals need to reveal whether they belong to groups officially declared underprivileged. These declarations are no more problematic in this case than in the case of luck egalitarianism. (shrink)

Forced choices between rescuing imperilled persons are subject to a presumption of equality. Unless we can point to a morally relevant difference between these persons' imperilments, each should get an equal chance of rescue. Sometimes, this presumption is overturned. For example, when one imperilled person has wrongfully caused the forced choice, most think that this person (rather than an innocent person) should bear the harm. The converse scenario, in which a forced choice resulted from the supererogatory action of one of (...) the imperilled people, has received little attention in distributive ethics. I argue that, sometimes, we need not offer equal chances in these cases either. When the supererogatory act places the initially imperilled person under a reciprocal duty to bear risks for the supererogatory agent's sake in the forced choice, we may fulfil this duty for them if they are unable to do it themselves, by favouring the supererogatory agent. (shrink)

A standard formulation of luck-egalitarianism says that ‘it is [in itself] bad – unjust and unfair – for some to be worse off than others [through no fault or choice of their own]’, where ‘fault or choice’ means substantive responsibility-generating fault or choice. This formulation is ambiguous: one ambiguity concerns the possible existence of a gap between what is true of each worse-off individual and what is true of the group of worse-off individuals, fault or choice-wise, the other concerns the (...) notion of fault. I show that certain ways of resolving these ambiguities lead to counterintuitive results; and that the most plausible way of resolving them leads to a theory of distributive justice in which responsibility plays a role significantly different from that in standard luck-egalitarian thinking. My main conclusion here is that luck-egalitarianism is best formulated as the view that it is [in itself] bad – unjust and unfair – for an individual to be worse off than others if, and only if, her being worse off does not fit the degree to which she is at fault in a not purely prudential sense. (shrink)

I assess G. A. Cohen's claim, which is central to his luck egalitarian account of distributive justice, that forcing others to pay for people's expensive indulgence is inegalitarian because it amounts to their exploitation. I argue that the forced subsidy of such indulgence may well be unfair, but any such unfairness fails to ground an egalitarian complaint. I conclude that Cohen's account of distributive justice has a non-egalitarian as well as an egalitarian aspect. Each impulse arises from an underlying commitment (...) to fairness. Cohen's account of distributive justice is therefore one of justice as fairness. (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)

Only women can bear the burdens of gestating fetuses. That fact, I suggest, bears on the morality of abortion. To illustrate and explain this point, I frame my discussion around Judith Jarvis Thomson's classic defense of abortion and Gina Schouten's recent feminist challenge to Thomson's defense. Thomson argued that, even assuming that fetuses are morally equivalent to persons, abortions are typically morally permissible. According to Schouten's feminist challenge to Thomson, however, if fetuses are morally equivalent to persons, then abortions are (...) typically morally impermissible because there is a collective moral obligation to care for the vulnerable. The consideration that is my topic, however, poses a problem for that feminist challenge to Thomson. There is reason to believe, I argue, that it is unfair that only women can bear the burdens of gestating fetuses. And, if that is unfair, it would undermine that feminist challenge to Thomson. I show, in other words, that there is a plausible and well‐motivated basis for believing that, even if fetuses are morally equivalent to persons and there is a collective obligation to care for the vulnerable, then abortions are nevertheless typically morally permissible. That is how fairness bears on the morality of abortion. (shrink)

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

Social egalitarians hold that one fundamental requirement of the ideal of social equality is that people should stand in relations of non-domination to one another. In the light of this, they reject luck egalitarian principles of justice as incompatible with a society of equals, because the former violate the non-domination requirement. I call this the domination objection. In this paper I examine its force against Dworkinian resource egalitarianism. There are two reasons why equality of resources might be thought to be (...) vulnerable to it. First, Dworkin has been interpreted to maintain that as long as people’s preferences are authentic, people should be consequentially responsible for the choices that flow from such preferences. However, Dworkin’s view on when people’s choices should be considered to be authentic does not rule out that the latter are sometimes influenced by norms and processes that are the outcome of domination and oppression, and so holding people fully consequentially responsible for choices that are the outcome of such preferences is itself unjust. Second, equality of resources objectionably permits bad-option-luck victims to become vulnerable to domination. I argue that Dworkinian egalitarianism is not susceptible to either of the two parts of the domination objection and defend the view that it is—contrary to the social egalitarian criticism—faithful to the social egalitarian demand for non-domination. (shrink)

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

Rawls intended the difference principle to be a liberal egalitarian principle of justice. By that I mean he intended it to provide a moral justification for a moderate amount of redistribution of income from the most advantaged members of society to the least. But since the difference principle was introduced, economic inequality has increased dramatically, reaching levels now not seen since just before the Great Depression, levels that Rawls surely would have thought perverse. Many blame this increase on the rise (...) of supply-side economics and the dramatic cuts in marginal tax rates enacted by the supply-siders for corporations and those already at the top of the income distribution. But I contend that the difference principle, or at least the ethos that the difference principle embodies and represents, is also partially to blame. Accordingly, the purpose of this paper is to explain how the difference principle, the ideas and arguments of the supply-siders, and this dramatic rise in inequality are connected, to identify where the difference principle went wrong, and to discuss what those who remain committed to the liberal egalitarian ideals that the difference principle was thought to represent might do about it. (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)

Imagine a two-person distributive case in which Ernest's choices yield X and Bertie's choices yield X + Y, producing an income gap between them of Y. Neither Ernest nor Bertie is responsible for this gap of Y, since neither of them has any control over what the other agent chooses. This is what Susan Hurley calls the “Boring Problem” for luck egalitarianism. Contrary to Hurley's relatively dismissive treatment of it, it is contended that the Boring Problem poses a deep problem (...) for standard luck egalitarianism. To counter it, luck egalitarianism needs to be recast as a baseline-relative theory. This new version of luck egalitarianism is then put to work against some significant problems that have been encountered by luck egalitarianism: Saul Smilansky's “Paradox of the Baseline,” the “Partiality Worry,” and the “Pluralism Worry.” But baseline-relative luck egalitarianism is not without problems of its own. (shrink)

Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, (...) and lower priority treatment, but not typically full exclusion from the healthcare system. We also note two important restrictions on this argument. First, failures of solidary obligations can only be assumed under conditions that are conducive to sufficiently autonomous choice, which occur when patients are given ‘Golden Opportunities’ to improve their health. Second, because poor health does not occur in a social vacuum, an insistence on solidarity as part of healthcare is legitimate only if all members of society are held to similar standards of solidarity. We cannot insist upon, and penalise failures of, solidarity only for those who are unwell, and who cannot afford to evade the terms of public health. (shrink)

Recent health legislation in Norway significantly increases access to specialist care within a legally binding time frame. The paper describes the contents of the new legislation and introduces some of the challenges with proliferations of rights to health care. The paper describes some of the challenges associated with the proliferation of legal rights to health care. It explains the benefits of assessing the new law in the light of a rights framework. It then analyses the problematic aspects of establishing additional (...) priority rules as solutions to rights conflicts. It then defends adequacy criteria for acceptable priority rules when such rules are unavoidable. It finally defends our proposed method and explores concrete applications. (shrink)