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Justice, Socioeconomic Status, and Responsibility for Health

In Sudhir Anand (ed.), Public Health, Ethics, and Equity. Oxford University Press UK (2004)

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  1. Discrimination Based on Personal Responsibility: Luck Egalitarianism and Healthcare Priority Setting.Andreas Albertsen - 2024 - Cambridge Quarterly of Healthcare Ethics 33 (1):23-34.
    Luck egalitarianism is a responsibility-sensitive theory of distributive justice. Its application to health and healthcare is controversial. This article addresses a novel critique of luck egalitarianism, namely, that it wrongfully discriminates against those responsible for their health disadvantage when allocating scarce healthcare resources. The philosophical literature about discrimination offers two primary reasons for what makes discrimination wrong (when it is): harm and disrespect. These two approaches are employed to analyze whether luck egalitarian healthcare prioritization should be considered wrongful discrimination. Regarding (...)
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  • A social division of responsibility for health.Johannes Kniess - 2018 - Les Ateliers de l'Éthique / the Ethics Forum 13 (3):105-122.
    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 (...)
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  • Shrinking Poor White Life Spans: Class, Race, and Health Justice.Erika Blacksher - 2018 - American Journal of Bioethics 18 (10):3-14.
    An absolute decline in US life expectancy in low education whites has alarmed policy makers and attracted media attention. Depending on which studies are correct, low education white women have lost between 3 and 5 years of lifespan; men, between 6 months and 3 years. Although absolute declines in life expectancy are relatively rare, some commentators see the public alarm as reflecting a racist concern for white lives over black ones. How ought we ethically to evaluate this lifespan contraction in (...)
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  • Health, Luck and Moral Fallacies of the Second Best.Eric Cavallero - 2011 - The Journal of Ethics 15 (4):387-403.
    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 (...)
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  • Responsibility as an Obstacle to Good Policy: The Case of Lifestyle Related Disease.Neil Levy - 2018 - Journal of Bioethical Inquiry 15 (3):459-468.
    There is a lively debate over who is to blame for the harms arising from unhealthy behaviours, like overeating and excessive drinking. In this paper, I argue that given how demanding the conditions required for moral responsibility actually are, we cannot be highly confident that anyone is ever morally responsible. I also adduce evidence that holding people responsible for their unhealthy behaviours has costs: it undermines public support for the measures that are likely to have the most impact on these (...)
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  • Should We Punish Responsible Drinkers? Prevention, Paternalism and Categorization in Public Health.Stephen John - 2018 - Public Health Ethics 11 (1):35-44.
    Many public debates over policies aimed at curbing alcohol consumption start from an assumption that policies should not affect ‘responsible’ drinkers. In this article, I examine this normative claim, which I call prudentialism. In the first part of the article, I argue that prudentialism is both a demanding and distinctive doctrine, which philosophers should consider seriously. In the middle sections, I examine the relationship between prudentialism and two familiar topics in public health ethics: the prevention paradox and the relationship between (...)
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