This paper explores the relationship between dignity and robot care for older people. It highlights the disquiet that is often expressed about failures to maintain the dignity of vulnerable older people, but points out some of the contradictory uses of the word ‘dignity’. Certain authors have resolved these contradictions by identifying different senses of dignity; contrasting the inviolable dignity inherent in human life to other forms of dignity which can be present to varying degrees. The Capability Approach (CA) is introduced (...) as a different but tangible account of what it means to live a life worthy of human dignity. It is used here as a framework for the assessment of the possible effects of eldercare robots on human dignity. The CA enables the identification of circumstances in which robots could enhance dignity by expanding the set of capabilities that are accessible to frail older people. At the same time, it is also possible within its framework to identify ways in which robots could have a negative impact, by impeding the access of older people to essential capabilities. It is concluded that the CA has some advantages over other accounts of dignity, but that further work and empirical study is needed in order to adapt it to the particular circumstances and concerns of those in the latter part of their lives. (shrink)

Implicit biases involve associations outside conscious awareness that lead to a negative evaluation of a person on the basis of irrelevant characteristics such as race or gender. This review examines the evidence that healthcare professionals display implicit biases towards patients. PubMed, PsychINFO, PsychARTICLE and CINAHL were searched for peer-reviewed articles published between 1st March 2003 and 31st March 2013. Two reviewers assessed the eligibility of the identified papers based on precise content and quality criteria. The references of eligible papers were (...) examined to identify further eligible studies. Forty two articles were identified as eligible. Seventeen used an implicit measure, to test the biases of healthcare professionals. Twenty five articles employed a between-subjects design, using vignettes to examine the influence of patient characteristics on healthcare professionals’ attitudes, diagnoses, and treatment decisions. The second method was included although it does not isolate implicit attitudes because it is recognised by psychologists who specialise in implicit cognition as a way of detecting the possible presence of implicit bias. Twenty seven studies examined racial/ethnic biases; ten other biases were investigated, including gender, age and weight. Thirty five articles found evidence of implicit bias in healthcare professionals; all the studies that investigated correlations found a significant positive relationship between level of implicit bias and lower quality of care. The evidence indicates that healthcare professionals exhibit the same levels of implicit bias as the wider population. The interactions between multiple patient characteristics and between healthcare professional and patient characteristics reveal the complexity of the phenomenon of implicit bias and its influence on clinician-patient interaction. The most convincing studies from our review are those that combine the IAT and a method measuring the quality of treatment in the actual world. Correlational evidence indicates that biases are likely to influence diagnosis and treatment decisions and levels of care in some circumstances and need to be further investigated. Our review also indicates that there may sometimes be a gap between the norm of impartiality and the extent to which it is embraced by healthcare professionals for some of the tested characteristics. Our findings highlight the need for the healthcare profession to address the role of implicit biases in disparities in healthcare. More research in actual care settings and a greater homogeneity in methods employed to test implicit biases in healthcare is needed. (shrink)

Is equality a distributive value or does it rather point to the quality of social relationships? This article criticizes the distributive character of luck egalitarian theories of justice and fleshes out the central characteristics of an alternative, relational approach to equality. It examines a central objection to distributive theories: that such theories cannot account for the significance of how institutions treat people (as opposed to the outcomes they bring about). I discuss two variants of this objection: first, that distributive theories (...) fail to account for the importance of how institutions cause good shortfalls and, second, that they fail to account for the normative attitude of social and political institutions expressed in different ways of treating people. The article argues that the causal variant of the objection has only very limited reach, and endorses the expressive variant: the attitudes expressed by institutions in their treatment of persons, such as contempt or neglect, generate potentially unjust social relationships and hierarchies. This should be the focus of a relational egalitarian approach to social justice. The article proceeds to explain how it is possible that artificial agents such as institutions have attitudes and how these attitudes are not reducible to those of the individuals that sustain them, and argues that distributive theories cannot be so modified as to account for such attitudes. It concludes by indicating several directions for the development of more worked-out conceptions of relational equality on this basis. (shrink)

I defend the proposal that certain forms of work—specifically forms that are socially necessary but involve the imposition of considerable burdens—be shared between citizens. I argue that sharing burdensome work would achieve several goals, including a more equal distribution of the benefits and burdens of work, a greater appreciation of each other's labour contributions, and an amelioration of problematic inequalities of status. I conclude by considering three objections: that sharing burdensome work would (1) involve morally unacceptable constraints on freedom, (2) (...) be prohibitively inefficient, and (3) forbid mutually advantageous trades. I argue that none of these objections succeed. (shrink)

This paper surveys the current philosophical discussion of the ethics of risk imposition, placing it in the context of relevant work in psychology, economics and social theory. The central philosophical problem starts from the observation that it is not practically possible to assign people individual rights not to be exposed to risk, as virtually all activity imposes some risk on others. This is the ‘problem of paralysis’. However, the obvious alternative theory that exposure to risk is justified when its total (...) benefits exceed its total costs faces the standard distributional challenges of consequentialism. Forms of contractualism have been proposed as a solution, but how exactly such theories can be formulated remains problematic, especially when confronted with the difficult cases of mass, novel, risk such as climate change. (shrink)

According to relational egalitarians, equality is not primarily about the distribution of some good but about people relating to one another as equals. However, compared with other theorists in political philosophy – including other egalitarians – relational egalitarians have said relatively little on what role personal responsibility should play in their theories. For example, is equality compatible with responsibility? Should economic distributions be responsibility-sensitive? This article fills this gap. I develop a relational egalitarian framework for personal responsibility and show that (...) relational equality commits us to responsibility. I develop two sets of arguments. First, I draw on relational theories of moral responsibility – particularly Strawsonian views – to show that valuable egalitarian relationships require responsibility. Second, I show why relational equality sometimes requires that economic distributions be sensitive to responsibility and choice. I also defend a seemingly paradoxical result: being committed to responsibility, relational egalitarianism not only justifies some distributive inequalities but some relational inequalities too. Overall, relational egalitarianism gives a nuanced and coherent answer as to why and how responsibility matters from within egalitarianism. That it does should be an important argument in its favour. (shrink)

In this article, I propose a novel characterization of sufficientarianism. I argue that sufficientarianism combines three claims: a priority claim that we have non-instrumental reasons to prioritize benefits in certain ranges over benefits in other ranges; a continuum claim that at least two of those ranges are on one continuum; and a deficiency claim that the lower a range on a continuum, the more priority benefits in that range have. This characterization of sufficientarianism sheds new light on two long-standing philosophical (...) debates, namely about the distinctiveness of sufficientarianism as a distributive principle and about the common objections to sufficientarianism. (shrink)

This open access book provides the first explicit case study for an application of the method of reflective equilibrium (RE), using it to develop and defend a precautionary principle. It thereby makes an important and original contribution to questions of philosophical method and methodology. The book shows step-by-step how RE is applied, and develops a methodological framework which will be useful for everyone who wishes to use reflective equilibrium. With respect to precautionary principles, the book demonstrates how a rights-based precautionary (...) principle can be constructed and defended. The case study succeeds in demonstrating that RE can be successfully applied and puts real constraints on the justification process. This is all the more remarkable as the case study was designed as an open-ended process, without presupposing any specific results. This book will be highly relevant both to people interested in philosophical methodology and epistemology, as well as to researchers who are interested in using philosophical methods and tools and applying them to practical problems. (shrink)

This paper reconsiders some themes and arguments from my earlier paper “Fairness, Respect and the Egalitarian Ethos.” That work is often considered to be part of a cluster of papers attacking “luck egalitarianism” on the grounds that insisting on luck egalitarianism's standards of fairness undermines relations of mutual respect among citizens. While this is an accurate reading, the earlier paper did not make its motivations clear, and the current paper attempts to explain the reasons that led me to write the (...) earlier paper, assesses the force of its arguments, and locates it in respect to work of Richard Arneson and Elizabeth Anderson. The paper concludes by bringing out what now appears to be the main message of the earlier paper: that the attempt to implement an “ideal” theory of equality can harm the very people that the theory is designed to help. (shrink)

Three claims about love and justice cannot be simultaneously true and therefore entail a paradox: (1) Love is a matter of justice. (2) There cannot be a duty to love. (3) All matters of justice are matters of duty. The first claim is more controversial. To defend it, I show why the extent to which we enjoy the good of love is relevant to distributive justice. To defend (2) I explain the empirical, conceptual and axiological arguments in its favour. Although (...) (3) is the most generally endorsed claim of the three, I conclude we should reject it in order to avoid the paradox. (shrink)

Recent epidemiological reports of associations between socioeconomic status and epigenetic markers that predict vulnerability to diseases are bringing to light substantial biological effects of social inequalities. Here, we start the discussion of the moral consequences of these findings. We firstly highlight their explanatory importance in the context of the research program on the Developmental Origins of Health and Disease (DOHaD) and the social determinants of health. In the second section, we review some theories of the moral status of health inequalities. (...) Rather than a complete outline of the debate, we single out those theories that rest on the principle of equality of opportunity and analyze the consequences of DOHaD and epigenetics for these particular conceptions of justice. We argue that DOHaD and epigenetics reshape the conceptual distinction between natural and acquired traits on which these theories rely and might provide important policy tools to tackle unjust distributions of health. (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)

This article presents the framework Capability Sensitive Design (CSD), which consists of merging the design methodology Value Sensitive Design (VSD) with Martha Nussbaum's capability theory. CSD aims to normatively assess technology design in general, and technology design for health and wellbeing in particular. Unique to CSD is its ability to account for human diversity and to counter (structural) injustices that manifest in technology design. The basic framework of CSD is demonstrated by applying it to the hypothetical design case of a (...) therapy chatbot for mental health. By applying CSD to a design case, the merits of this new framework over the standard VSD approach become apparent. Also, the application demonstrates what a technology design would look like when attention is paid to capabilities right from the start of the design process. (shrink)

Research involving human subjects is much more stringently regulated than many other nonresearch activities that appear to be at least as risky. A number of prominent figures now argue that research is overregulated. We argue that the reasons typically offered to justify the present system of research regulation fail to show that research should be subject to more stringent regulation than other equally risky activities. However, there are three often overlooked reasons for thinking that research should be treated as a (...) special case. First, research typically involves the imposition of risk on people who do not benefit from this risk imposition. Second, research depends on public trust. Third, the complexity of the moral decision making required favors ethics committees as a regulative solution for research. (shrink)

A key question in disability studies, philosophy, and bioethics concerns the relationship between disability and well-being. The mere difference view, endorsed by Elizabeth Barnes, claims that physical and sensory disabilities by themselves do not make a person worse off overall—any negative impacts on welfare are due to social injustice. This article argues that Barnes’s Value Neutral Model does not extend to intellectual disability. Intellectual disability is (1) intrinsically bad—by itself it makes a person worse off, apart from a non-accommodating environment; (...) (2) universally bad—it lowers quality of life for every intellectually disabled person; and (3) globally bad—it reduces a person’s overall well-being. While people with intellectual disabilities are functionally disadvantaged, this does not imply that they are morally inferior—lower quality of life does not mean lesser moral status. No clinical implications concerning disability-based selective abortion, denial of life-saving treatment, or rationing of scarce resources follow from the claim that intellectual disability is bad difference. (shrink)

There are various reasons why efforts to promote “support for self-management” have rarely delivered the kinds of sustainable improvements in healthcare experiences, health and wellbeing that policy leaders internationally have hoped for. This paper explains how the basis of failure is in some respects built into the ideas that underpin many of these efforts. When support for self-management is narrowly oriented towards educating and motivating patients to adopt the behaviours recommended for disease control, it implicitly reflects and perpetuates limited and (...) somewhat instrumental views of patients. It tends to: restrict the pursuit of respectful and enabling ‘partnership working’; run the risk of undermining patients’ self-evaluative attitudes ; limit recognition of the supportive value of clinician-patient relationships; and obscure the practical and ethical tensions that clinicians face in the delivery of support for self-management. We suggest that a focus on enabling people to live well with their long-term conditions is a promising starting point for a more adequate conception of support for self-management. We then outline the theoretical advantages that a capabilities approach to thinking about living well can bring to the development of an account of support for self-management, explaining, for example, how it can accommodate the range of what matters to people for living well, help keep the importance of disease control in perspective, recognize social influences on people’s values, behaviours and wellbeing, and illuminate more of the rich potential and practical and ethical challenges of supporting self-management in practice. (shrink)

Most people have a clear sense of what they mean by disability, and have little trouble identifying conditions they consider disabling. Yet providing a clear and consistent definition of disability is far from straightforward. Standardly, disability is understood as the restriction in our abilities to perform tasks, as a result of an impairment of normal physical or cognitive human functioning. However, which inabilities matter? We are all restricted by our bodies, and are all incapable of performing some tasks, but most (...) of these inabilities are not considered disabilities. If, then, we are to avoid the category of disability becoming overly broad—and thus politically and practically useless—we need some way of picking out the specific inabilities that are disabling. I argue that our answer should be informed by an account of the opportunities individuals are entitled to be able to perform as a matter of justice. Thus, to be disabled is to have these opportunities restricted, and not to deviate from the species norm or lack any ability that might improve our well-being. (shrink)

Child poverty is one of the biggest challenges of today, harming millions of children. In this book, it is investigated from a philosophical social justice perspective, primarily in the context of modern welfare states. Based on both normative theory (particularly the capability approach) and empirical evidence, the authors identify the injustices of child poverty, showing how it negatively affects the well-being of children as well as their whole life course. But child poverty is not 'given by nature'. It is avoidable (...) and there is certainly the moral duty to alleviate it. Therefore, Graf and Schweiger develop a normative theory of responsibilities, which clarifies the moral role of different agents in the poor child's environment: the family, the state and many others, that have so far been neglected in philosophical theories. They conclude their book by sketching how their theory can be extended to global child poverty and what it means to show equal respect and concern for every child - no matter where and in which context they were born. (shrink)

This paper develops a recognition-theoretical analysis of human dignity. I argue that a life with dignity requires social esteem (recognition for one’s contribution to socially shared goals) as well as respect (recognition of one’s equal status). I illustrate this through an empirically informed discussion of three aspects of the current social organization of labour which threaten human dignity: unemployment, precarity and low pay. I also argue that in class societies the assertion of dignity as a positional good can undermine its (...) general progressive appeal. (shrink)

Comprehensive Biomedical Research Centre and Centre for Philosophy, Justice and Health, UCL, First Floor, Charles Bell House, 67–73 Riding House Street, London W1W 7EJ, UK. Tel.: +44 (0)20 7679 9417; Fax: +44 (0)20 7679 9426; Email: james-gs.wilson{at}ucl.ac.uk ' + u + '@' + d + ' '//--> . Abstract This paper aims to shed some light on the difficulties we face in constructing a generally acceptable normative framework for thinking about public health. It argues that there are three factors that (...) combine to make theorising about public health difficult, and which when taken together defeat simplistic top-down and bottom-up approaches to the design of public health policies. The first factor is the problem of complex systems, namely that the distribution of health both affects and is affected by the distribution of other goods. The second is the difficulty of defining the goals of public health: we still need to get clear about what we should mean by health in this context, and what the goals of public health should be. The third is that we stand in need of an account of how important health is relative to the importance of other goods that a just society should be trying to secure for its citizens. The paper argues that these problems should lead us to abandon the search for a ‘one-size fits all’ normative framework for thinking about public health. Rather, different approaches will be appropriate at different levels of abstraction. CiteULike Connotea Del.icio.us What's this? (shrink)

Must a society aim indefinitely for continued economic growth? Proponents of economic growth advance three central challenges to the idea that a society, having attained high levels of income and wealth, may justly cease to pursue further economic growth: if environmentally sustainable and the gains fairly distributed, first, continued economic growth could make everyone within a society and globally, and especially the worst off, progressively better off; second, the pursuit of economic growth spurs ongoing innovation, which enhances people’s opportunities and (...) protects a society against future risks; and third, continued economic growth fosters attitudes of openness, tolerance, and generosity, which are essential to the functioning of a liberal democratic society. This article grants these challenges’ normative foundations, to show that, even if one accepts their underlying premises as requirements of justice, a society may still justly cease to aim for economic growth, so long as it continues to aim for and realize gains on other dimensions. I argue that, while continued economic growth might instrumentally serve valuable ends, it is not necessary for their realization, as a society can achieve these ends through other means. (shrink)

Various authors hold that what is wrong with risk imposition is that being at risk diminishes the opportunities available to an agent. Arguably, even when risk does not result in material or psychological damages, it still represents a setback in terms of some legitimate interests. However, it remains to be specified what those interests are. This article argues that risk imposition represents a diminishment of overall freedom. Freedom will be characterized in empirical terms, as the range of unimpeded actions available (...) to an agent. After briefly outlining the main characteristics of overall freedom as defended by Hillel Steiner and Ian Carter, the article shows that this notion is able to capture many of our intuitions about when and how risk imposition disadvantages an agent, without reference to welfare indicators. The article argues that if this non-welfarist perspective can be defended, then it would be easier to approach a number of applied questions about risk, including the questions of when risk imposition is permissible or legitimate, in which ways risk can be an object of distributive justice and how one can be compensated for being subject to a risk. (shrink)

The paper describes a project in which the thesis of the social determinants of health is used in order to help identify groups that will be among the least advantaged members of society, when disadvantage is understood in terms of lack of genuine opportunity for secure functioning. The analysis is derived from the author's work with Avner de-Shalit in Disadvantage (Oxford University Press, 2007).

This paper uncovers a distinctively social type of injustice that lies in the kinds of wrongs we can do to each other specifically as social beings. In this paper, social injustice is not principally about unfair distributions of socio-economic goods among citizens. Instead, it is about the ways we can violate each other’s fundamental rights to lead socially integrated lives in close proximity and relationship with other people. This paper homes in on a particular type of social injustice, which we (...) can call social contribution injustice. The paper identifies two distinct forms of social contribution injustice. The first form involves compromising a person’s social resources so as to deny her adequate scope to contribute socially. The second form involves unjustly misvaluing a person as a social contributor, usually by not taking her seriously as a social contributor. (shrink)

The harms of climate change are deeply uncertain. Though climate change will render most individuals more vulnerable to harm, many individuals will not actually suffer climate-related harms. In this paper, I argue that vulnerability to harms is itself a harm, because it undermines our enjoyment of the good of security. After some brief remarks on the concept of security, I give three reasons for thinking that depriving an individual of the security of basic goods harms them: it has a strong (...) contingent connection to fear and anxiety, it directly undermines their ability to make reasonable plans, and security may reasonably be valued as an end in itself. This suggests that one of our goals in determining climate policy ought to be mechanisms which ensure the security of basic goods. (shrink)

There has recently been much debate about the idea of levying a tax on particular transactions on international financial markets. Economists have argued about how much revenue such an international financial transaction tax would raise and they disagree about what effects it would have on trade volumes, financial stability, and overall growth. Politicians have argued about the feasibility of introducing such a tax internationally and they disagree on its adequacy as a policy response to the current financial and economic crisis. (...) This article contributes to the debate about international financial transaction taxation by bringing the perspective of political philosophy to bear on the politicians’ and economists’ arguments about policy. I shall outline a framework for thinking about justice in finance, and defend the idea of an international financial transaction tax as an instrument for making the international financial system more just. (shrink)

Recent articles published in this journal have highlighted the shortcomings of individualistic approaches to health promotion, and the potential contributions of relational analyses of autonomy to public health ethics. I argue that the latter helps to elucidate the former, by showing that an inadequate analysis of autonomy leads to misassignment of both forward-looking and backward-looking responsibility for health outcomes. Health promotion programmes predicated on such inadequate analyses are then ineffective, because they assign responsibility to agents whose social environment inhibits their (...) ability to act on such responsibilities; inequitable, because the social barriers to autonomous agency display a socio-economic gradient; and stigmatizing, because they license blaming of individuals for their own poor health without taking into account how reasonable it is to hold these individuals responsible, given the social barriers to autonomy they face. I further sketch how incorporating a relational understanding of autonomy could help to produce health promotion programmes that do not succumb to these difficulties, while avoiding coercive paternalism, exploring potential applications in ecological approaches to health promotion. (shrink)

This paper proposes the notion of evaluative injustice as a distinct kind of injustice. Evaluative injustice occurs when someone is evaluated with regard to whether one satisfies the ideal associated with a social role one occupies, and the evaluation is characterized by an unjust failure of appraisal respect. This kind of injustice is importantly distinct from other kinds of injustice recently theorized, in particular epistemic injustice (Fricker 2007) and ontological injustice (Jenkins 2023). It is distinct insofar as it is how (...) one is evaluated with respect to a given ideal that accounts for the injustice in question. After analyzing the nature of the phenomenon of evaluative injustice (section 2), this paper discusses the multiple different forms it can take (section 3) and argues that the wrong of all instances of evaluative injustice can be understood in terms of appraisal respect (Darwall 1977) (section 4). Throughout, the paper highlights various theoretical benefits the notion of evaluative injustice affords us. (shrink)

Realists and supporters of ‘democratic underlabouring’ have recently challenged the traditional separation between political theory and practice. Although both attack Jürgen Habermas for being an idealist whose philosophy is too removed from politics, I argue that this interpretation is inaccurate. While Habermas’s social and political theory is indeed oriented to truth and understanding, he has sought realize his communicative conception of democracy by increasing the quality of political debate as a public intellectual. Building on his approach, I argue that giving (...) the theorist a direct role in public policy undermines theory as an enterprise oriented towards truth while overlooking the contingency, participatory nature and complicated internal logics of social and political practice. My basic thesis is that Habermas’s understanding of the relationship between theory and practice overcomes these difficulties by providing an account of theory that is independent but simultaneously also allows philosophers to participate in politics as public intellectuals. (shrink)

Hierarchy is a difficulty for theories of equality, and especially those that define equality in relational or social terms. In ideal egalitarian circumstances it seems that hierarchies should not exist. However, a liberal egalitarian defence of some types of hierarchies is common. Hierarchies of esteem have no further consequences than praise or admiration for valued individual features. Hierarchies of status, with differential reward, can, it is often argued, also be justified when they serve a justified social purpose and meet conditions (...) of genuine equality of opportunity. However, group hierarchies remain problematic, and evidence suggests that they are pervasive in human societies above a subsistence level of production. It has also been argued that group hierarchies are impossible to eliminate, and enormous cost is associated with attempting, and failing, to remove them. However, the perspective of ‘real-world’ political philosophy suggests measures to mitigate group hierarchy, starting with those that are either the easiest to address, the most damaging, or the most consequential. (shrink)

What is wrong with imposing pure risks, that is, risks that don’t materialize into harm? According to a popular response, imposing pure risks is pro tanto wrong, when and because risk itself is harmful. Call this the Harm View. Defenders of this view make one of the following two claims. On the Constitutive Claim, pure risk imposition is pro tanto wrong when and because risk constitutes diminishing one’s well-being viz. preference-frustration or setting-back their legitimate interest in autonomy. On the Contingent (...) Claim, pure risk imposition is pro tanto wrong when and because risk has harmful consequences for the risk-bearers, such as psychological distress. This paper argues that the Harm View is plausible only on the Contingent Claim, but fails on the Constitutive Claim. In discussing the latter, I argue that both the preference and autonomy account fail to show that risk itself is constitutively harmful and thereby wrong. In discussing the former, I argue that risk itself is contingently harmful and thereby wrong but only in a narrow range of cases. I conclude that while the Harm View can sometimes explain the wrong of imposing risk when risk itself is contingently harmful, it is unsuccessful as a general, exhaustive account of what makes pure imposition wrong. (shrink)

While some trust theorists have adverted to the vulnerabilities involved in trust, especially vulnerability to betrayal, the literature on trust has not engaged with recent work on the ethics of vulnerability. This paper initiates a dialogue between these literatures, and in doing so begins to explore the complex interrelations between vulnerability and trust. More specifically, it aims to show how trust can both mitigate and compound vulnerability. Through a discussion of two examples drawn from literary sources, the paper also investigates (...) the effects of pathogenic vulnerability on the psychic economies of trust and distrust. (shrink)

in recent years, policy makers have shown increasing interest in implementing policies aimed at promoting individual well-being. But how should policy makers choose their well-being policies? a seemingly reasonable first step is to settle on an agreed-upon definition of well-being. yet there currently is significant disagreement on how well-being ought to be characterized, and agreement on the correct view of well-being does not appear to be forthcoming. Nevertheless, i argue in this paper that there are several reasons to think that (...) the domain of well-being in the public policy context is narrower than that of well-being in general, which makes agreement on how to understand well-being in the public policy context more likely. (shrink)

Many normative theorists want to contribute to making the world a better place. In recent years, it has been suggested that to realise this ambition one must start with an adequate description of real-life practices. To determine what should be done, however, one must also fundamentally criticise existing moral beliefs. The method of reflective equilibrium offers a way of doing both. Yet, its practical usefulness has been doubted and it has been largely ignored in the recent practical turn of normative (...) theorising. This paper offers a complementary methodology to the method of reflective equilibrium, referred to as Rawlsian constructivism, which brings forth its practical merits. With the support of Rawlsian constructivism, the method of reflective equilibrium becomes a tool for public reasoning about practical problems which aims to facilitate shared solutions. The process of reflective scrutiny is used, not in the search of moral truth, but rather to highlight what stands in the way of solutions to problems agents face in different domains of social life. The practical value lies in scrutinising reasons for action that are taken for granted, explicating new rationales for action and highlighting neglected points of agreement. The paper exemplifies this approach with a process of justifying individual obligations to combat climate change. Normative theorists who share the practical agenda have correctly noted the importance of bottom-up investigations of subject domains. This paper argues that the next step should be to utilise this version of the method of reflective equilibrium to explore the potential for morally progressive solutions to these problems. (shrink)

Care drain brings the traditional problem of carers' choice between paid work and family at a new level. Taking care drain from Romania as a case study, I analyse the consequences of parents' migration within a normative framework committed to meeting the needs of vulnerable individuals. The temporary migration of parents who cannot take their children with them involves moral harm, particularly the frustration of children's developmental and emotional needs. I use recent feminist work on justice and care in the (...) economy to address the question whose responsibility it is to fill the void of care created by temporary migration. I argue that the moral issues raised by care drain are also issues of social justice and therefore call for rectification by the states involved. (shrink)

In controlled human infection (CHI) studies, investigators deliberately infect healthy individuals with pathogens in order to study mechanisms of disease or obtain preliminary efficacy data on investigational vaccines and medicines. CHI studies offer a fast and cost‐effective way of generating new scientific insights, prioritizing investigational products for clinical testing, and reducing the risk that large numbers of people are exposed to ineffective or harmful substances in research or in practice. Yet depending on the pathogen, CHI studies can involve significant risks (...) or burdens for participants, pose risks to individuals or communities not involved in the research, and lead to public controversy. It is therefore essential to ensure that the risks of CHI studies are justified by their social value—that is, their potential to generate benefits for society—and that public trust can be maintained. In this paper, we aim to clarify how research sponsors, research ethics committees and other reviewers should judge the social value of CHI studies. We develop a list of relevant considerations for making social value judgments based on the standard view of social value. We then use this list to discuss the example of potentially conducting dengue virus CHI studies in endemic settings. We argue that dengue virus CHI studies in endemic settings would fall on the higher end of the spectrum of social value, mostly because of their potential to redirect all fields of future dengue research. Drawing on this discussion, we derive several general recommendations for how reviewers should judge the social value of CHI studies. (shrink)

Despite the prominence of thresholds and limits in theories of distributive justice, there is no general account of their role within such theories. This has allowed an ongoing lack of clarity and misunderstanding around threshold views in distributive justice. In this thesis, I develop an account of the conceptual structure of such views. Such an account helps understand and characterize threshold views, can subsume what may seem to be different debates about such views under one conceptual header, and can be (...) used to further examine and develop patterns of justice that draw on thresholds. In light of this account, I propose a novel characterization of sufficientarianism which sheds new light on the distinctiveness of sufficientarianism as a distributive principle and on the common objections to sufficientarianism. Moreover, I examine and defend limitarianism, which is the view that people should not have more than a certain amount of wealth. In particular, I argue in favour of limitarianism as a midlevel principle for guiding institutional design and individual actions and, furthermore, as a specification of what a just allocation of wealth requires under epistemic constraints. (shrink)

It often appears that the most appropriate form of addressing disadvantage related to disability is through policies that can be called “status enhancements”: changes to the social, cultural and material environment so that the difficulties experienced by those with impairments are reduced, even eradicated. However, status enhancements can also have their limitations. This paper compares the relative merits of policies of status enhancement and “personal enhancement”: changes to the disabled person. It then takes up the question of how to assess (...) the priority of the claims of disabled people in the face of scarcity of resources for which there can be many competing social claims, arguing for the theory of “declustering disadvantage”. (shrink)

Relational egalitarians claim that a situation is just only if everyone it involves relates to one another as equals. It implies that relational egalitarians believe the ideal of “living as equals” (for short) is desirable, and furthermore, necessary for justice. In this paper, I distinguish three accounts of the desirability of the ideal: the instrumental value account, the non‐instrumental value account, and the non‐consequentialist account. I argue that the former two accounts cannot provide satisfying reasons for being a relational egalitarian. (...) Instead, the ideal of “living as equals” ought to be understood as fundamentally a moral requirement in a non‐consequentialist sense. In addition, a pluralist (though fundamentally non‐consequentialist) approach is welcome. (shrink)

When it comes to improving the health of the general population, mHealth technologies with self-monitoring and intervention components hold a lot of promise. We argue, however, that due to various factors such as access, targeting, personal resources or incentives, self-monitoring applications run the risk of increasing health inequalities, thereby creating a problem of social justice. We review empirical evidence for “intervention-generated” inequalities, present arguments that self-monitoring applications are still morally acceptable, and develop approaches to avoid the promotion of health inequalities (...) through self-monitoring applications. (shrink)

This paper considers the range of possible policy options that are available if we wish to attempt to treat people with cognitive disabilities as equal members of society. It is suggested that the goal of policy should be allow each disabled person to establish a worthwhile place in the world and sets out four policy options: cash compensation, personal enhancement, status enhancement and targeted resource enhancement. The paper argues for the social policy of targeted resource enhancement for individuals with cognitive (...) disabilities, in the form of providing cash with some limits on its use. Taking the example from the UK of ‘self-directed support’ it is argued that such policies can be cost-effective and advance the autonomy of people with cognitive disabilities, especially when compared with current policies of centrally provided services. (shrink)

This paper concerns what if any obligations a “society of equals” has to criminal offenders after legal punishment ends. In the United States, when people leave prisons, they are confronted with a wide range of federal, state, and local laws that burden their ability to secure welfare benefits, public housing, employment opportunities, and student loans. Since the 1980s, these legal consequences of criminal convictions have steadily increased in their number, severity, and scope. The central question I want to ask is (...) whether the infliction of these burdensome legal consequences for those who have already been punished by the state is consistent with the ideal of equality. I argue that these collateral legal consequences violate relational egalitarian principles of justice and are thus objectionable. I conclude by examining possible objections to my argument. (shrink)

In this article, we argue that apart from evaluating the causes and the social determinants of health inequalities, an evaluation of the effects of health inequalities is due. For this, we propose the ideal of relational equality as an evaluative framework, and test to what extent health inequalities threaten this ideal of a society of equals. We identify three ways in which they do and argue that these risks are especially great for those lower down the socio-economic strata. We thus (...) conclude that equality in health is instrumental to social justice, and that socio-economic inequalities in health are not only unjust due to their causes but also due to their consequences. We continue to argue that our instrumental approach opens a perspective to mitigate the identified injustices by changing society, rather than reducing inequalities in health, and argue that this is an advantage in the light of the realistic assumption that of the socio-economic health inequalities will persist. The article thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socio-economic inequalities in health. (shrink)

The issue of whether biological and psychological properties associated with disability can be harmful, beneficial, or neutral brings up an important philosophical question about how we evaluate disability, and disability’s impact on well-being. The debate is usually characterized as between those who argue disability is intrinsically harmful, and disability rights advocates who argue that disability is just another way of being different, in part, because disability can also provide important benefits. I argue that this debate is a false one, as (...) neither view can capture the more complicated relationship between disability and well-being. I argue that many disabilities are best understood as a kind of pro-tanto extrinsic harm that is characterized in counterfactual terms. This means that our judgments concerning disability and harm must be context-sensitive. (shrink)

This book offers an original account of a distinctly republican theory of social and global justice. The book starts by exploring the nature and value of Hegelian recognition theory. It shows the importance of that theory for grounding a normative account of free and autonomous agency. It is this normative account of free agency which provides the groundwork for a republican conception of social and global justice, based on the core-ideas of freedom as non-domination and autonomy as non-alienation. As the (...) author argues, republicans should endorse a sufficientarian account of social justice, which focuses on the nature of social relationships and their effects on people's ability to act freely and realize their fundamental interests. On the global level, the book argues for the cosmopolitan extension of the republican principles of non-domination and non-alienation within a multi-level democratic system. In so doing, the book addresses a major gap in the existing literature, presenting an original theory of justice, which combines Hegelian recognition theory and republican ideas of freedom, and applying this hybrid theory to the global domain. Fabian Schuppert creates a grand synthesis uniting neo-republican insights on freedom with Hegelian recognition theory. The result is an account of agency that arises from the idea of non-domination whose aim it is to safeguard individual freedom. When combined with Hegelian recognition theory a social focus also emerges. This amalgam comments on many of the major disputes concerning global justice from a cosmopolitan perspective. Because of the broad scope and the many contemporary discussions engaged this book will be of keen interest to scholars as well as a welcome addition to the classroom. (shrink)