This study uses techniques from economics to illuminate fundamental questions in ethics, particularly in the foundations of utilitarianism. Topics considered include the nature of teleological ethics, the foundations of decision theory, the value of equality and the moral significance of a person's continuing identity through time.

Two principles form the basis for much priority setting in health. According to the greater benefit principle, resources should be directed toward the intervention with the greater health benefit. According to the worse off principle, resources should be directed toward the intervention benefiting those initially worse off. Jointly, these principles accord with so-called prioritarianism. Crucial for its operationalisation is the specification of the worse off. In this paper, we examine how the worse off can be defined as those with the (...) fewer lifetime Quality-Adjusted Life Years (QALYs). We contrast this proposal with several alternative specifications. (shrink)

This article discusses the relation between prioritarian and egalitarian principles, whether and why we need to appeal to both kinds of principle, how prioritarians can answer various objections, especially those put forward by Michael Otsuka and Alex Voorhoeve, the moral difference between cases in which our acts could affect only one person or two or more people, veil of ignorance contractualism and utilitarianism, what prioritarians should claim about cases in which the effects of our acts are uncertain, the relative moral (...) importance of actual and expectable benefits, whether people should sometimes be given various chances of receiving benefits, and principles that appeal to competing claims. (shrink)

Some of us believe in giving priority to people who are badly off in designing social policies and in acting ourselves to help others. As Thomas Nagel puts it, the badly off should be first in the queue when benefits are distributed. This idea is one way of explaining moral views that are called ‘egalitarian.’ Egalitarian moral views can depend either on the idea of valuing equality itself or on the idea of giving priority to the interests of the badly (...) off. This paper is concerned with the second kind of egalitarianism.The purest form of the idea explains the priority in this way: a benefit for someone badly off can be more important morally, or can have more value, than a benefit of the same size for someone better off. This is to suppose that the priority in question cannot be explained by thinking in utilitarian terms and accepting the principle of diminishing marginal utility. (shrink)

We argue that there is a marked shift in the moral weight of an increment in a person's well-being when one moves from a case involving only intra-personal trade-offs to a case involving only inter-personal trads-offs. This shift, we propose, is required by the separateness of persons. We also argue that the Priority View put forward by Parfit cannot account for such a shift. We also outline two alternative views, an egalitarian view and a claims-based view, that can account for (...) this shift. (shrink)

In "Equality, Priority, and Compassion," Roger Crisp rejects both egalitarianism and prioritarianism. Crisp contends that our concern for those who are badly off is best accounted for by appealing to "a sufficiency principle" based -- indirectly, via the notion of an impartial spectator -- on compassion for those who are badly off" (p. 745). A key example of Crisp's is the Beverly Hills case (discussed below). This example is directed against prioritarianism, but it also threatens egalitarianism. In this article, I (...) respond to the Beverly Hills case. I also challenge the wide person-affecting principle and Crisp's welfarist restriction, which some believe underlie the Levelling Down Objection against egalitarianism. My aim in this article is to defend egalitarianism by illuminating both its nature and appeal. (shrink)

A natural view in distributive ethics is that everyone's interests matter, but the interests of the relatively worse off matter more than the interests of the relatively better off. I provide a new argument for this view. The argument takes as its starting point the proposal, due to Harsanyi and Rawls, that facts about distributive ethics are discerned from individual preferences in the "original position." I draw on recent work in decision theory, along with an intuitive principle about risk-taking, to (...) derive the view. (shrink)

How should we choose between uncertain prospects in which different possible people might exist at different levels of wellbeing? Alex Voorhoeve and Marc Fleurbaey offer an egalitarian answer to this question. I give some reasons to reject their answer and then sketch an alternative, which I call person-affecting prioritarianism.

This article distinguishes between a telic and a deontic version of Derek Parfit's influential Priority View. Employing the distinction, it shows that the existence of variations in how intrapersonal and interpersonal conflicts should be resolved fails to provide a compelling case in favour of relational egalitarianism and against all pure versions of the Priority View. In addition, the article argues that those variations are better understood as providing counterevidence to certain distribution-sensitive versions of consequentialism.

This paper introduces a condition for rational choice that states that accepting decision methods and normative theories that sometimes entail that the act of choosing a maximal alternative renders this alternative non-maximal is irrational. The paper illustrates how certain distributive theories that ascribe importance to what the status quo is violate this condition and argues that they thereby should be rejected.

Prioritarianism is a moral view that ranks outcomes according to the sum of a strictly increasing and strictly concave transformation of individual well-being. Prioritarianism is ‘welfarist’ (namel...

The priority view has become very popular in moral philosophy, but there is a serious question about how it should be formalized. The most natural formalization leads to ex post prioritarianism, which results from adding expected utility theory to the main ideas of the priority view. But ex post prioritarianism entails a claim which is too implausible for it to be a serious competitor to utilitarianism. In fact, ex post prioritarianism was probably never a genuine alternative to utilitarianism in the (...) first place. By contrast, ex ante prioritarianism is defensible. But its motivation is very different from the usual rationales offered for the priority view. Given the untenability of ex post prioritarianism, it is more natural for most friends of the priority view to revert to utilitarianism. (shrink)

A natural formalization of the priority view is presented which results from adding expected utility theory to the main ideas of the priority view. The result is ex post prioritarianism. But ex post prioritarianism entails that in a world containing just one person, it is sometimes better for that person to do what is strictly worse for herself. This claim may appear to be implausible. But the deepest objection to ex post prioritarianism has to do with meaning: ex post prioritarianism (...) is not a genuine alternative to utilitarianism in the first place. By contrast, ex ante prioritarianism is defensible. But its motivation is very different from the usual rationales offered for the priority view. Given their hostility to egalitarianism, most supporters of the priority view have not provided reasons to reject utilitarianism. (shrink)

Lifetime quality-adjusted life-year (QALY) prioritarianism has recently been defended as a reasonable specification of the prioritarian view that benefits to the worse off should be given priority in health-related priority setting. This paper argues against this view with reference to how it relies on implausible assumptions. By referring to lifetime QALY as the basis for judgments about who is worse off lifetime QALY prioritarianism relies on assumptions of strict additivity, atomism and intertemporal separability of sublifetime attributes. These assumptions entail that (...) a health state at some period in time contributes with the same amount to how well off someone is regardless of intrapersonal and interpersonal distributions of health states. The paper argues that this is implausible and that prioritarians should take both intrapersonal and interpersonal distributions of goods into account when they establish who is worse off. They should therefore not accept that lifetime QALY is a reasonable ground for ascribing priority and reject lifetime QALY prioritarianism. (shrink)