Typically, philosophers analysing well-being’s nature maintain three claims. First, that well-being has essential properties. Second, that the concept of well-being circumscribes those properties. Third, that well-being theories should capture them exhaustively and exclusively. This predominant position is called well-being monism. In opposition, contextualists argue that no overarching concept of well-being referring to a universally applicable well-being standard exists. Such a standard would describe what is good, bad, and neutral, for us without qualification. Instead, well-being research is putatively about several central (...) phenomena. If several phenomena are central, a proliferation of concurrently acceptable well-being theories and operationalisations is expected. However, contextualists are challenged to explain how those analysing well-being are not systematically talking past each other. In this paper, I address that challenge. The upshot is that contextualist well-being theories can be justifiably context-sensitive and applied to tailor-made policy-making efforts. I illustrate the benefits by connecting contextualism to the capability approach. (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)

Cornell realism (CR), a prominent meta-ethical position that has emerged since the last decades of the twentieth century, proposes a non-reductionist naturalistic account of moral properties and facts. This paper argues that the best version of CR’s chosen methodology for arriving at justified moral beliefs must be seen as a variant of reflective equilibrium. In comparison to the traditional versions, our proposal offers a ‘social’ reinterpretation of reflective equilibrium in delineating CR’s epistemology. We argue that it satisfactorily accounts for objectivity (...) and calls for the inclusion of the social nature of both moral and scientific inquiries. Emphasising the social dimension of their epistemological account also nudges debates in metaethics into incorporating the much-needed social dimension while dealing with questions of moral beliefs and facts that have been of CR’s concern. (shrink)

The news media is a critical source of information for the public. However, it neglects the interests of the poor. In this paper, we explore why this happens, why it matters, and what might be done about it. As to why this happens, we identify two main reasons: because of the way that media is funded and because of the composition of its journalists and its sources. As to why this matters, we argue that this neglect is problematic for three (...) main reasons: it deprives the poor of vital information; it contributes to public support for or acceptance of policies that harm the interests of the poor; and it undermines political equality. And as to what might be done about it, we suggest two proposals: proposals that change the composition of who makes the news and proposals that change how the media is funded. (shrink)

What does it mean to treat people as equals when the legacies of feudalism, religious persecution, authoritarian and oligarchic government have shaped the landscape within which we must construct something better? This question has come to dominate much constitutional practice as well as philosophical inquiry in the past 50 years. The combination of Second Wave Feminism with the continuing struggle for racial equality in the 1970s brought into sharp relief the variety of ways in which people can be treated unequally, (...) while respecting the formalities of constitutional government. Most obviously, the content of laws can mistreat them by wrongfully assuming that they are either threats to others, or that, like children, they need to be protected from harm through paternalistic limitations on their freedom of action. Or, as those concerned with class inequality have long noted, formal equality can create legal requirements, permissions, and prohibitions whose burdens fall predictably, and often solely, on groups who are already marginalised, and most in need of state protection. (Kairys, David 1990) Above all, what these two great political movements made plain, is that a concern for group inequality and, specifically, group injustice must figure in the formulation and adjudication of individual rights, if legal protections for equality are adequately to combat the causes of inequality. Getting to grips with that challenge, it became obvious, required going beyond the familiar analyses of inequality inherited from Liberalism and Marxism, given the many different ways in which people can be equal or unequal.(Hackett and Haslanger 2006, 3 - 15) In the first part of this chapter, I will seek to illustrate these claims, by focusing on efforts to reframe the theory and practice of constitutional equality given demands for sexual and racial equality. I will then show that analytic philosophy has also come to recognise the various non-reducible dimensions of equality in ways that reinforce the claims of critical legal theory, even as philosophers highlight their disconcerting consequences. If equality has multiple irreducible dimensions, conflicts between the legitimate demands of equality are unavoidable features of law and politics, even in the best possible world, and are likely to be particularly painful when set against a background of historical injustice. The chapter concludes with the challenges to democratic constitutionalism, and the scope for constructive responses to those challenges, which the rapprochement between critical and analytic thinking on equality suggests. (shrink)

Freedom and security are often portrayed as things that have to be traded off against one another, but this view does not capture the full complexity of the freedom-security relationship. Rather, there seem to be four different ways in which freedom and security connect to each other: freedom can come at the cost of security, security can come at the cost of freedom, freedom can work to the benefit of security, and security can work to the benefit of freedom. This (...) paper analyses each of these connections in turn. It shows that particular understandings of freedom can help us to see particular connections between freedom and security. The practical examples used to illustrate these connections are drawn from the context of the COVID-19 pandemic. It will be suggested that, in the face of challenges such as this one, taking into account all four connections between freedom and security can ultimately help decision-makers in upholding both. (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)

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)

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)

Philosophy Compass, Volume 17, Issue 4, April 2022.

This paper analyses how security affects well-being. Security is understood as someone’s sureness of enjoying some good in the future; well-being is treated as a matter of human flourishing. Security can contribute to our well-being in various ways: if we are in fact bound to enjoy a good, in principle this is positive for our flourishing in the future; if we also believe that we will enjoy this good, we can be more efficient in pursuing our well-being; if we also (...) feel secure, this supports our enjoyment of our physical and mental capacities. For some of these benefits to obtain fully, however, it is important that our beliefs and feelings align with the facts. Furthermore, mirroring security’s upsides, there are also ways in which security can hamper our flourishing: it can obstruct the change, surprise, and pleasurable fear that are sometimes required for a good life too. (shrink)

How do social norms influence our choices? And does the presence of biased norms affect what we owe to each other? Looking at empirical research relating to PrEP rollout in HIV prevention policy, a...

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)

Much research has studied the importance of play for children’s development. However, questions of its political importance and our public institutions’ duties to protect it have been largely neglected. This article argues that childhood play is politically important due to having both intrinsic and instrumental value, and it suggests that the duty to protect the capability for play in childhood falls especially on the public health system. If this argument succeeds, it follows that we have stronger duties toward our children (...) than we currently believe. (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 chapter describes a philosophical approach to theorizing justice, mapping out some main strands of the tradition leading up to contemporary political philosophy. We first briefly discuss what distinguishes a philosophical approach to justice from other possible approaches to justice, by explaining the normative focus of philosophical theories of justice – that is, a focus on questions not about how things actually are, but about how things ought to be. Next, we explain what sorts of methods philosophers use to justify (...) theories of justice. Following this, in the longest section, we highlight major questions about justice that have drawn the attention of philosophers, and indicate how competing conceptions of justice have arisen from differing answers to these questions. The goal here is not to answer but to elucidate some of the larger questions about justice, as well as to establish a framework for understanding and distinguishing different kinds of claims about justice and some of the relations between them. (shrink)

This chapter describes how philosophical theorizing about justice can be connected with empirical research in the social sciences. We begin by drawing on some received distinctions between ideal and non-ideal approaches to theorizing justice along several different dimensions, showing how non-ideal approaches are needed to address normative aspects of real-world problems and to provide practical guidance. We argue that there are advantages to a transitional approach to justice focusing on manifest injustices, including the fact that it enables us to set (...) aside some reasonable disagreements about justice. The ‘bottom-up’ approach we advocate, for which we borrow Wolff’s term ‘real-world political philosophy’, is an empirically-informed normative analysis that attends to specific, identifiable injustices, and thus is partial, though not isolationist. We illustrate our approach by considering how different models of the nature of disability suggest different kinds of remedy for injustices faced by persons living with disabilities. We reflect on the nature and significance of vulnerabilities, and we assess the role of public opinion in normative theorizing, suggesting a particular significance for the opinions and experiences of marginalized groups. We finally reflect on the relevance of European legal and institutional frameworks for theorizing justice in Europe. (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)

: Accidents will survive the outbreak of driverless cars, but their moral implications will suffer substantial changes. The decision made today by a human in a fraction of a second will eventually be replaced by an algorithm subject to moral scrutiny. This not only raises the question of how the algorithm should work, or whether alternatives solutions are indeed comparable, but also changes the essence of the problem: from ascertaining liability to defining desired outcomes. In this paper, I first contest (...) two possible approaches to resolving the driverless car dilemma – which I call statistical and nominal – to conclude that neither is morally sound. I then propose an alternative solution based on “time-relative equality”, or always sparing younger people. This follows from seeking an egalitarian solution, that is the least intrusive – a position I defend from a possible ageist critique. Keywords: Driverless Cars; Accident; Algorithm; Age-relative Equality Condotti verso un incidente morale Riassunto: Vi saranno incidenti anche dopo la diffusione delle auto a guida autonoma, ma le loro implicazioni morali subiranno mutamenti sostanziali. Le decisioni prese oggi in una frazione di secondo dagli esseri umani saranno alla fine sostituite da un algoritmo soggetto a controllo morale. Sorge non solo il problema di come dovrebbe funzionare questo algoritmo – o se vi siano soluzioni alternative comparabili –, ma cambia anche la sostanza del problema: dall’accertamento dell’imputabilità alla definizione dell’esito auspicato. In questo lavoro discuterò due possibili approcci per risolvere il dilemma – che chiamerò “statistico” e “nominale” –, per concluderne che non sono moralmente corretti. Proporrò quindi una soluzione alternativa, basata sulla “eguaglianza tempo-relativa”, il principio per cui bisogna sempre salvare il più giovane. Questo segue dal cercare una soluzione egalitarista, che sia la meno intrusiva – una posizione che difenderò da una possibile critica che la vede come discriminatoria verso gli anziani. Parole chiave: Automobili a guida automatica; Incidenti; Algoritmo; Eguaglianza relativa all’età. (shrink)

This article carves out a new path between the two dominant wings of contemporary egalitarianism. The luck egalitarian emphasis on choice and personal responsibility is misplaced because individuals differ so deeply, and arbitrarily, in their choice-making capacities. Allowing inequalities to result from ‘choice’ is akin to allowing inequalities to stem from the possession of any other morally arbitrary factor – such as skin colour or gender. The move towards relational egalitarianism has been a case of two-steps forward, one-step back. While (...) the shift away from the focus on choice is salutary, the concurrent rejection of luck is problematic, given the prevalence and importance of luck-based discrepancies in opportunities to lead a good life. A new conceptual framework is presented: good life egalitarianism. The guiding idea is that given the unavoidable arbitrariness of human capacities, the foundation for a good life should be assured for people regardless of the actual choices that they make. The essential goods necessary for leading a good life – such as the opportunities to self-determine and to enjoy non-dominating social relationships – should be guaranteed to all. (shrink)

Progressive family policy regimes typically aim to promote and protect women’s opportunities to participate in the workforce. These policies offer significant benefits to affluent, two-parent households. A disproportionate number of low-income and impoverished families, however, are headed by single mothers. How responsive are such policies to the objectives of these mothers and the needs of their children? This chapter argues that one-size-fits-all family policy regimes often fail the most vulnerable household and contribute to intergenerational poverty in two ways: by denying (...) at-risk children adequate parenting, and by undermining their mothers’ legitimate interest in nurturing and caring for their own children. The capabilities of these mothers and the well-being of their children are better served by policies which recognise maternal caregiving as a productive and valuable occupation meriting equal respect and social support. (shrink)

As we enter the 2020s, global poverty is still a grave and persistent problem. Alleviating and eradicating poverty within and across the world’s societies requires a thorough understanding of its nature and extent. Although economists still standardly measure absolute and relative poverty in monetary terms, a consensus is emerging that poverty is a socially relational problem involving deprivations in multiple dimensions, including health, standard of living, education and political participation. The anthology Dimensions of Poverty advances the interdisciplinary debate on multidimensional (...) poverty, and features contributions from leading international experts and early career researchers (including from the Global South). This introductory chapter gives an overview of formative debates, central concepts and key findings. While monetary poverty measures are still dominant in public and academic debate, their explanatory power has been drawn into question. We discuss relevant criticisms before outlining the normative concepts that can inform both multidimensional poverty and monetary measures, including basic capabilities, basic needs and social primary goods. Next, we introduce several influential multidimensional poverty indices, including the Human Development Index and the Multidimensional Poverty Index. The anthology shows in detail how such measures can be improved, from a variety of disciplinary perspectives. It shows that there are different methods of poverty research that require further investigation, including participatory studies, (value) surveys, public consensus building, the constitutional approach, and financial diaries. Finally, we show that there is an ongoing problem of epistemic asymmetries in global poverty research, and discuss responsibility for addressing poverty, including the responsibilities of academics. The remainder of the chapter is dedicated to a more detailed preview of the volume’s 20 contributions, which are assembled along the following five themes: (I) poverty as a social relation; (II) epistemic injustices in poverty research; (III) the social context of poverty; (IV) measuring multidimensional poverty; and (V) country cases. (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)

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)

Effective altruism is purportedly ecumenical towards different moral views, charitable causes, and evidentiary methods. I argue that effective altruists’ criticisms of purportedly less effective charities are inconsistent with their commitment to ecumenicity. Individuals may justifiably support charities other than those recommended by effective altruism. If effective altruists take their commitment to ecumenicity seriously, they will have to revise their criticisms of many of these charities.

Over the last 30 years the Indian philosopher-economist Amartya Sen has developed an original normative approach to the evaluation of individual and social well-being. The foundational concern of this ‘capability approach’ is the real freedom of individuals to achieve the kind of lives they have reason to value. This freedom is analysed in terms of an individual’s ‘capability’ to achieve combinations of such intrinsically valuable ‘beings and doings’ (‘functionings’) as being sufficiently nourished and freely expressing one’s political views. In this (...) account, ‘development’ is conceived as the expansion of individuals’ capability, and thus as a concept that goes beyond the economic growth of third world countries. My thesis is a philosophical examination of Sen’s capability approach. In the first part (chapters 1-3) I present and defend my interpretation of Sen’s work. (shrink)

In Minimal Morality, Michael Moehler justifies what he calls the weak principle of universalization as a principle of pure instrumental morality. This article addresses the application of this principle and problems associated with it. Specifically, the article focuses on the principle’s ability to protect the interests of the most vulnerable members of society: agents without primary moral standing, specifically non-human animals; and the weakest members of society, either as a result of their diminished relative bargaining power in certain cases of (...) conflict, or because of their present standing in society, made worse off by historical injustices. To this end, the article considers, respectively, the problems of moral standing, indivisible goods and historical injustice. (shrink)

Policy-making must always pay attention to race. That is the central claim of this chapter. Regardless of whether some particular policy debate is ostensibly “racial”, policy-makers must attend to questions of race, because race is a ubiquitous, but frequently unnoticed, feature of our world. I examine the type of philosophical question about race that I think philosophers and policy-makers would do well to examine and consider how the question “What is race?” is pertinent to policy debate. Examples will be drawn (...) from Australia, the United States, and Britain to illustrate these abstract arguments. (shrink)

We sought to assess formally the extent to which different control and elimination strategies for human African trypanosomiasis Trypanosoma brucei gambiense would exacerbate or alleviate experiences of societal disadvantage that traditional economic evaluation does not take into account. Justice-enhanced cost-effectiveness analysis is a normative approach under development to address social justice considerations in public health decision-making alongside other types of analyses. It aims to assess how public health interventions under analysis in comparative evaluation would be expected to influence the clustering (...) of disadvantage across three core dimensions of well-being: agency, association and respect. As a case study to test the approach, we applied it to five strategies for Gambiense HAT control and elimination, in combination with two different other evaluations: a cost-effectiveness analysis and a probability of elimination analysis. We have demonstrated how JE-CEA highlights the ethical importance of adverse social justice impacts of otherwise attractive options and how it indicates specific modifications to policy options to mitigate such impacts. JE-CEA holds promise as an approach to help decision makers and other stakeholders consider social justice more fully, explicitly and systematically in evaluating public health programs. (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)

The unfairness of health inequalities depends on the more fundamental question of the relationship between justice in health and distributive justice more generally. In this article, I discuss some constraints on how health should be incorporated in a theory of justice and their implications for when health inequalities can be considered to be unfair. I argue against adopting separate distributive principles for health, and in favour of conceiving justice in health as interrelated with, and contingent on, justice in the distribution (...) of other important social goods and resources, in particular income. Accordingly, health inequalities are unfair when they are the result of an unfair distribution of resources. (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)

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)

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

Our concern is with the ethical issues related to girlhood and bodily integrity—the right to be free from physical harm and harassment and to experience freedom and security in relation to the body. We defend agency, positive self-relations, and health as basic elements of bodily integrity and we advocate that this normative concept be used as a conceptual tool for the protection of the rights of girls. We assume the capability approach developed by Martha Nussbaum as an ethical framework that (...) enables us to evaluate girls’ well-being and well-becoming in relation to the potential, and often subtle, threats they face. The capability approach can be understood as a theory of justice, and, therefore, as an ethical and political approach. An enriched concept of bodily integrity can help in the design of better policies to address gender biases against girls because it could contribute to seeing them as active agents and valid participants. (shrink)

Non-communicable diseases now account for the majority of the global burden of disease and an international campaign has emerged to raise their priority on the post-2015 development agenda. We argue, to the contrary, that there remain strong reasons to prioritize maternal and child health. Policy-makers ought to assign highest priority to the health conditions that afflict the worst off. In virtue of how little healthy life they have had, children who die young are among the globally worst off. Moreover, many (...) interventions to deal with the conditions that cause mortality in the young are low-cost and provide great benefits to their recipients. Consistent with the original Millennium Development Goals, the international community should continue to prioritize reductions in communicable diseases, neonatal conditions, and maternal health despite the shifts in the global burden of disease. (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)

The purpose of this paper is to show that conscientious objection to military service is essentially not a dilemma of freedom of conscience versus the duty to obey the law, but above all a dilemma between two conflicting patriotic moral obligations. Furthermore, the paper demonstrates that CO is justifiable on the basis of what is known as moderate patriotism, that is, out of a patriotism which is committed simultaneously to universal and particular values. The paper begins with a critical discussion (...) of theoretical weaknesses in liberal thought of CO. Then, the concept of moderate patriotism is presented, followed by a discussion of the notion of patriotic CO. The next stage presents a step Towards A Theory of PCO to Military Service and shows how it differs from other liberal theories of disobedience. The conclusion is that if CO on patriotic grounds is morally justifiable, it follows that this is an act committed within the framework of legitimate political discourse. Therefore, PCO is politically legitimate even if it is not always legal. In other words, the discussion of PCO offers a theoretical distinction between politicallegitimacy and legality. (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)

One of the most frequently voiced criticisms of free will skepticism is that it is unable to adequately deal with criminal behavior and that the responses it would permit as justified are insufficient for acceptable social policy. This concern is fueled by two factors. The first is that one of the most prominent justifications for punishing criminals, retributivism, is incompatible with free will skepticism. The second concern is that alternative justifications that are not ruled out by the skeptical view per (...) se face significant independent moral objections. Yet despite these concerns, I maintain that free will skepticism leaves intact other ways to respond to criminal behavior—in particular preventive detention, rehabilitation, and alteration of relevant social conditions—and that these methods are both morally justifiable and sufficient for good social policy. The position I defend is similar to Derk Pereboom’s, taking as its starting point his quarantine analogy, but it sets out to develop the quarantine model within a broader justificatory framework drawn from public health ethics. The resulting model—which I call the public health -quarantine model—provides a framework for justifying quarantine and criminal sanctions that is more humane than retributivism and preferable to other non-retributive alternatives. It also provides a broader approach to criminal behavior than Pereboom’s quarantine analogy does on its own. (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 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)

Worldwide, many impoverished parents migrate, leaving their children behind. As a result children are deprived of continuity in care and, sometimes, suffer from other forms of emotional and developmental harms. I explain why coercive responses to care drain are illegitimate and likely to be inefficient. Poor parents have a moral right to migrate without their children and restricting their migration would violate the human right to freedom of movement and create a new form of gender injustice. I propose and defend (...) an institutional solution. Taxes levied on the remittances sent by temporary migrants ought to be used to provide migrants' children with psychological counselling in order to mitigate the harm resulted from discontinuity in care. (shrink)

In this article I review Jonathan Wolff and Avner de‐Shalit’s recent book Disadvantage (2007), highlighting its many contributions to egalitarian theory and practice. These contributions build to the authors’ central prescription: that policy‐makers work to create a society of equals by reducing the tendency for disadvantages to cluster around certain individuals or groups. From there, I discuss the idea of declustering disadvantage in an American context, and consider its implications for the politically salient ideal of equality of opportunity. The purpose (...) of this discussion is not to posit Wolff and de‐Shalit’s theory of disadvantage as a theory of justice as equal opportunity. Instead, I illustrate their approach by reference to an influential theory of justice, whose proponents include those taken to affirm the authors’ consensual starting point. (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)

Ethicists of care have objected to traditional moral philosophy's reliance upon abstract universal principles. They claim that the use of abstraction renders traditional theories incapable of capturing morally relevant, particular features of situations. I argue that this objection sometimes conflates two different levels of moral thinking: the level of justification and the level of deliberation. Specifically, I claim that abstraction or attention to context at the level of justification does not entail, as some critics seem to think, a commitment to (...) abstraction or attention to context at the level of deliberation. It follows that critics who reject a theory's use of abstraction at the level of justification have not shown that the theory recommends abstraction at the level of deliberation and that it, therefore, compels the deliberating agent to overlook morally salient details. (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)