Most theories of justice rest on the idea that emotions need to be contained or set aside and that rationality serves as the best, if not exclusive, criterion for identifying the principles of a fair distribution. In recent years, however, two important claims have been made. One is that rationality and emotions are not in conflict with one another, but should be conceived of as strictly interconnected; the other is that social justice is not just about distribution, but also – (...) or especially – about social relations. This paper aims to bridge these claims and argues that (a) the role of emotions should be recognised by theories of justice, as it is compatible with the importance such theories attribute to rationality, and (b) an inquiry into emotions is particularly important to investigate the socio-relational dimension of justice. Moreover, the paper claims that (c) in order to adequately investigate the role of emotions in social justice, it is important to acknowledge that emotions are structurally mediated and shaped by powerful transformative forces, among which technologies – especially so-called socially disruptive technologies (SDTs) – prove to be particularly relevant. The paper argues that SDTs have a fundamental role in shaping social relations, shared commitments, and the emotions that follow from them or enable them. (shrink)

The strong correlation between people’s socioeconomic position and health within high income countries is a well-documented fact. A person’s occupation, income and education level tell us a lot about that person’s prospects on a long and healthy life, such that we can speak of a ‘social gradient in health’, or a ‘socioeconomic health gap’. This association is often perceived to be unjust. Therefore, it is generally thought that governments should aim to reduce socioeconomic health inequalities. However, this idea needs ethical (...) justification, for it is not evident if and why exactly these inequalities are unjust. For instance, are inequalities in health unjust per se? Or because the underlying socioeconomic inequalities are unjust? And does justice require equal health levels, or a minimum level of health? What complicates the issue, is that the width of the health gap, or the steepness of the social gradient, depends on what health measures are used. Overall, the more subjective the measure, the greater the inequalities appear to be. But are all these measures equally morally relevant? This dissertation aims to give a better understanding of these philosophical questions. It does so by investigating the question of what we should understand by health in the first part, after which it addresses the question of how to evaluate socioeconomic health inequalities in the light of justice. The introduction begins with a description of the phenomenon of socioeconomic health inequalities, and how it has been addressed by politicians, epidemiologists and philosophers in the past and today. The chapter continues by formulating the central question of the dissertation – that of which health inequalities should be focused in the light of a concern with social justice. It explicates how this dissertation contributes to answering that question, by discussing the potential relation between the conceptualisation of health and justice evaluations, and by discussing which questions are addressed in each of the following chapters. The chapter 2 addresses the question of how health is conceptualised in the philosophical and public heath literature, and how theoretical concepts of health differ. It proposes to approach health concepts as a Wittgensteinian family of thick concepts and argues that while theories on health generally argue in favour of one specific concept, a comparison of concepts shows that we may need different concepts of health given the variety of health practices. By explicating the differences between five concepts of health, this chapter argues that each captures aspects of health that all seem relevant when we talk and think about health. Classifying these concepts based on their distinctions reveals them as members of a conceptual family: each of the discussed concepts differs from the others in at least one respect and resembles the others in several respects. Moreover, the discussion of the concepts shows that ‘health’ always both describes a condition and values that condition at the same time. Having both descriptive and evaluative dimensions, we can see health concepts as ‘thick concepts’. Given this evaluative dimension, it is important to reflect on the question of what understanding of health guides specific practices. Moreover, the distinctions revealed by the classification can serve as a conceptual toolbox for reflection on the assumptions and purposes of health practices. How such reflection could work is illustrated by a brief exploration of what health aspects are focused upon in three specific health practices. Chapter 3 presents a study into the question of how health is conceptualised by ordinary citizens and to what extent conceptualisations of health differ between socioeconomic groups. By making use of the method of concept mapping, this study analyses how different socioeconomic groups formulate their own answers regarding the question ‘what does health mean to you?’. It presents concept maps of health for three different socioeconomic groups living in the city of Utrecht that reveal that all groups have a multidimensional understanding of health. An interpretation of the concept maps reveals nuanced differences between groups. The multiple aspects of health were also ranked by importance. It appears that each group assigned most importance to mental health. All in all, the study shows that people in lower socioeconomic groups are more likely to show a conceptualisation of health that refers to 1) the absence of health threats, 2) a person within his/her circumstances, 3) the value of functional notions, and 4) an accepting attitude towards life. Chapter 4 addresses the question of what the theoretical and empirical study to concepts of health could imply for health equity practices. It does so by exploring further the suggestions made in chapters 2 and 3. Regarding the question of which health aspects should guide health equity policies, this chapter discusses the question of whether we should primarily look at subjective or objective health measures, and whether a universal or relative standard of health should be central. While justice-related concerns of impartiality and equal treatment may seem to favour an objective perspective and a universal health standard, it appears that we have good reason to account for the subjective perspective as well. It is also argued that a concern for recognition and participatory parity gives room for relative health standards. Th room for relative health standards confronts us with the question of how to deal with mechanisms like adaptive preferences that the concept maps reveal. It proposes a way out, by arguing for society-relative health standards. Chapter 5 examines the question of whether inequalities in health should be evaluated ‘directly’, thus independently of a distribution of their social determinants. It proposes a sufficientarian perspective, such that the central question of evaluation is that of whether everyone is – or can be – healthy enough. By discussing two sufficientarian approaches to health and social justice – by Powers & Faden and by Nussbaum – this chapter distinguishes two ways of setting a threshold level for health. Both approaches appear to provide an unsatisfactory basis for justice evaluations and lead us away from direct evaluation if we try to settle health minima that are less arbitrary. In anticipation to chapters 6 and 7, it is argued that the perspective of sufficient health for relational equality escapes this arbitrariness: compared to that of a decent human life, it better helps to answer both the question of what socioeconomic health inequalities a society is due to avoid, and the question of when socioeconomic health inequalities are unjust considering their consequences. Chapter 6 discusses to what extent Daniels’s theory of health justice provides a satisfactory answer to the question of what health inequalities a society is due to avoid. Daniels proposes an indirect evaluative approach by arguing that we should evaluate socioeconomic health inequalities in the light of Rawls’s principles of justice as fairness. That is, if socioeconomic inequalities are in accordance with fair equality of opportunity and with the difference principle, the corresponding health inequalities would be just. It is shown that the suggestion that Rawls’s principles regulate the social determinants of health neglects that not all social determinants of health belong to society’s basic structure as conceived of by Rawls and are thereby not subjected to the principles of justice. To acknowledge the social mechanisms leading to socioeconomic health inequalities in their full complexity, it is argued that we should broaden our understanding of society’s structure in accordance with Young’s notion of social structural processes. This renders the question of what health inequalities a society is due to avoid into a question of what we can expect from the side of the various actors that uphold the social structures that produce socioeconomic health inequalities. Lastly, it is discussed how a shift to Young’s theory completes the shift to non-ideal theorising that seem already initiated by Daniels, and that with this, the distinction between direct and indirect evaluation dissolves. Chapter 7 discusses to what extent equality in health is of instrumental value for a society of free and equals. It thus takes up the idea proposed in chapter 5, that an evaluation of the consequences of health inequalities is also due. Taking relational equality as an evaluative framework reveals three ways in which inequalities in life expectancy threaten this ideal. That is, via unequal risks to stigmatisation, unequal risks to unemployment and the risk of unequal pension enjoyments. It is thereby shown that these risks are especially great for those lower down the socioeconomic strata. It thus concludes that equality in health is of instrumental value to relational equality. The chapter continues to argue that our instrumental approach opens a new perspective: to mitigate the identified injustices by changing society, rather than by reducing inequalities in health. This is argued to be an advantage in the light of the realistic assumption that of the socioeconomic health inequalities will persist. The paper thus offers a complementary approach to both the evaluation and the mitigation of the injustice of socioeconomic inequalities in health. The discussion chapter summarises the central findings of the analyses of health concepts and discusses questions regarding the philosophical and practical merits of comparing theoretical health concepts, the need for developing new health measures or concepts and the importance or nonsense of studying citizen’s views on health. Repeating this for the dissertation’s second part, the central findings of the chapters on justice evaluation are summarised and followed by a discussion of questions and issues that have remained unaddressed so far. Here, central points of discussion are my take on rules of distribution, the distinction of direct and indirect evaluation, the role of ideal and non-ideal theory, the idea of relational equality, and personal responsibility for health. The chapter concludes by noting that also in the light of justice evaluations, all commonly used health measures are relevant for justice. Therefore, my recommendations for policy and further research entail that inequalities in each of these measures deserve attention by both policymakers and researchers. Specifically, policymakers and researchers should give attention to how exactly each of these health inequalities come about, in such a way that a discussion about the question of who can be assigned responsibility to alleviate them is well-informed; and both should give attention to the effects of health inequalities on the opportunities for people to live on equal standing, in such a way that when these opportunities are diminished, actions can be considered to aim to restore relational equality. (shrink)

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

Resumen: Este artículo analiza la fundamentación normativa de un tipo de políticas de alivio contra la pobreza comunes durante los últimos años en Latinoamérica, a saber, las transferencias monetarias condicionadas. Se mostrará que la justificación típica de las transferencias monetarias condicionadas es ilegítima en una comunidad política democrática. A través de la indagación de las razones por las que la carga de la prueba se coloca del lado de las transferencias incondicionadas, se mostrará que se apela a una noción controvertida (...) de responsabilidad individual que cristaliza relaciones desiguales y que se basa en un diagnóstico empírico cuestionable.: This paper analyzes the normative foundations of conditional cash transfers, a kind of poverty relief policy which has been massively implemented during recent years in Latin America. I intend to show that the conditional cash transfer’s typical justification is illegitimate for a democratic political community. After reviewing the reasons why the burden of proof falls on unconditional transfers, I argue that the typical justification appeals to a controversial conception of individual responsibility that crystallizes unequal interpersonal relations and is based on a shaky empirical diagnosis. (shrink)

There is a deep divide amongst political philosophers of an egalitarian stripe. On the one hand, there are so-called distributive egalitarians, who hold that equality obtains within a political community when each of its members enjoys an equal share of the community’s resources. On the other hand, there are so-called social egalitarians, who instead hold that equality obtains within a political community when each of its members stands in certain relations to other members of the community, such non-domination and lack (...) of oppression, for example. In this paper, we have three aims. Our first aim is to cast doubt on the helpfulness of characterizing the debate in this way. Our second aim is to reconstruct this debate in alternative and more precise terms, so that disagreements between advocates of either side are easier to evaluate. Our third aim is to advance a hybrid account that integrates element from both views. (shrink)

The needs principle—that certain goods should be distributed according to need—has been central to much socialist and egalitarian thought. It is the principle which Marx famously takes to be that which is to govern the distribution of goods in the higher phase of communism. The principle is one that Marx himself took from the Blanquists. It had wider currency in the radical traditions of the nineteenth century. In the twentieth century it remained central to the mutualist form of socialism defended (...) by Tawney and Titmuss. The principle underlay the development and justification of the modern welfare state—thus the National Health Service is still founded upon the idea that the distribution of medical resources should be determined by medical need, not by ability to pay. One source of the power of the needs principle lies in the fact that it appears to be both a principle of justice and a principle of community or social solidarity. As a principle of justice it is offered as a corrective to the particular forms of unequal distributions of goods that can result from market transactions, and as a principle of community or social solidarity as a corrective to the possessive individualism taken to be the corollary of a market order. (shrink)

Ian Carter has recently argued in a series of articles that a certain form of respect, called ‘opacity respect’, gives a moral grounding to people’s equality. This type of respect involves abstaining from making or acting on judgements about others. Aside from arguing for its justificatory role, Carter also argues that, in this role, it has a series of implications for our thinking about liberal politics. I argue, first, that the theoretical implications of the view that opacity respect grounds equality (...) are narrower than they first appear. This is because, in order to put the view into action, one must make a certain kind of empirical claim. Second, I show that this point reveals an important structural aspect of Carter’s view, concerning the way that principles can be limited in practice. Third, I argue that the practical implications of the view are potentially much broader than they first appear, threatening absurdity. This is because the position’s repercussions naturally extend into day-to-day transactions. (shrink)

Cet article propose une réponse critique à quelques thèmes du livre de Kyle Johannsen,A Conceptual Investigation of Justice. La discussion se penche sur l’analyse du pluralisme fondamental de la valeur proposée par Johannsen et met en cause cette même analyse. Je soutiens que l’analyse proposée par Johannsen ne parvient pas à expliquer comment des conflits entre des valeurs fondamentales peuvent être résolus et qu’il y a davantage de convergence entre des valeurs fondamentales que ne le reconnaît Johannsen.

Public insurance is commonly assimilated with redistributive tools mobilized by the welfare state in the pursuit of an egalitarian ideal. This view contains some truth, since the result of insurance, at a given moment, is the redistribution of resources from the lucky to unlucky. However, Joseph Heath considers that the principle of efficiency provides a better normative explanation and justification of public insurance than the egalitarian account. According to this view, the fact that the state is involved in the provision (...) of specific insurance is explained and justified by the greater efficiency of the state, in comparison with markets, in addressing market failures such as moral hazard or adverse selection. Our argument is that while insurance, intrinsically and idealistically, may diverge from a redistributive scheme, it is nevertheless difficult to deny that insurance has nothing to do with equality. More precisely, we argue that insurance may be understood as an egalitarian tool if our understanding of equality is broadened to include relational equality. Our paper aims to briefly recap the debates surrounding public insurance as a redistributive tool, advancing the idea that public insurance may be a relational egalitarian tool. It then presents a number of relational arguments in favor of the involvement of the state in the provision of specific forms of insurance, arguments that have been overlooked given the domination of luck egalitarian approaches in these debates. (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)

A prominent feature of the ongoing politics of welfare state restructuring is the development of workfare policies, defined as the attachment of a work condition to entitlement to basic income support. Workfare rejects unconditional rights of social citizenship, which formed the basis of social democratic political reforms and advocacy throughout the twentieth century. Nevertheless, workfare has received notable theoretical justification from egalitarian political theorists. This paper addresses four egalitarian arguments for workfare: the arguments from recipient self-respect, rational paternalism, fair reciprocity, (...) and equal opportunity for active citizenship. It attempts to demonstrate the tensions between each and egalitarian justification, and it is argued that none of the arguments successfully ground workfare policies in an egalitarian framework. (shrink)

Journal of Social Philosophy, EarlyView.

The concept of the ‘benefit cheat’ plays a critical role in political rhetoric and public policy and it has been deployed to justify changes to the benefit system that have had a very negative impact on well being and justice. The authors argue that the concept is dangerous, adding to the existing burdens of poverty and exclusion and that it must be eradicated by a reorganisation of the welfare system. Dignity and a spirit of equality must be the starting point (...) for any system of welfare that aims to promote universal well being. (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)

This paper argues that the best interpretation of Ronald Dworkin’s hypothetical insurance scheme is a holistic one that allows the parties to make choices between the policies that are available. This interpretation contrasts with the hypothecated and insurance-focused aspects that are traditionally understood as part of the procedure. The paper argues that the holistic interpretation better fits with the ideal of resource egalitarianism that people should have as much choice as possible from an equal starting point. It does so by (...) allowing people a choice over the policies that will be used to achieve their insurance preferences. (shrink)

In their celebrated essay “The Right to Privacy,” legal scholars Samuel Warren and Louis Brandeis identified as the generic privacy value “the right to be let alone.” This same phrase occurs in Justice Brandeis's dissent inOlmstead v. U.S.(1927). This characterization of privacy has been found objectionable by philosophers acting as conceptual police. For example, moral philosopher William Parent asserts that one can wrongfully fail to let another person alone in all sorts of ways—such as assault—that intuitively do not qualify as (...) violations of privacy and thus cannot be violations of the right to privacy. (shrink)