One of the central debates within contemporary Anglo-American political philosophy concerns how to formulate an egalitarian theory of distributive justice which gives coherent expression to egalitarian convictions and withstands the most powerful anti-egalitarian objections. This book brings together many of the key contributions to that debate by some of the world’s leading political philosophers: Richard Arneson, G.A. Cohen, Ronald Dworkin, Thomas Nagel, Derek Parfit, John Rawls, T.M. Scanlon, and Larry Temkin.

As part of an effort to look at for bioethicists interested in clinical decisionmaking, Erik Parens, the editor of this special section, asked us to look at social class. When we began our research for this paper, we were surprised to find that although bioethicists have written much on social class and such macrolevel issues as access to healthcare and the distribution of scarce resources, and have paid some attention to the effects of class on patient-provider relationships, bioethicists have written (...) little specifically that looks at the implications of social class for medical decisions in individual cases. (shrink)

Richard Brandt is one of the most eminent and influential of contemporary moral philosophers. His work has been concerned with how to justify what is good or right not by reliance on intuitions or theories about what moral words mean but by the explanation of moral psychology and the description of what it is to value something, or to think it immoral. His approach thus stands in marked contrast to the influential theories of John Rawls. The essays reprinted in this (...) collection span a period of almost 30 years and include many classic pieces in metaethical and normative ethical theory. The collection is aimed at both those moral philosophers familiar with Brandt's work and at those philosophers who may be largely unfamiliar with his work. The latter group will be struck by the lucid unpretentious style and the cumulative weight of Brandt's contributions to topics that remain at the forefront of moral philosophy. (shrink)

Persons of low socioeconomic status generallyexperience worse health and shorter lives thantheir better off counterparts. They alsosuffer a greater incidence of adversepsychosocial characteristics, such as lowself-esteem, self-efficacy, and self-masteryand increased cynicism and hostility. Thesepopulation data suggest another category ofharm to persons: diminished moral agency. Chronic socioeconomic deprivation can createenvironments that undermine the development ofself and capacities constitutive to moralagency – i.e., the capacity forself-determination and crafting a life of one''sown. The harm affects not only the choicesa person makes, but the (...) chooser herself. Thismoral harm is particularly salient in modernWestern societies, especially in the UnitedStates, where success and failure is attributedto the individual, with little notice of thelarger social and political realities thatinform an individual''s circumstances and choices. (shrink)

The patient's right to informed consent is grudgingly acknowledged by medical professionals, firmly established in law, and brandished as a shibboleth by most bioethicists. But questions remain concerning genuine patient autonomy, and the doctrine of informed consent offers inadequate answers. In addition to the continuing controversy over what counts as “informed,” the passive acquiescence implied by “consent” seems a pale shadow of genuine autonomy.

Moral egalitarianism will depend on one of two basic ideas. The first is the idea of equality itself. We might believe that it is a good thing if different people have equal shares of resources, or if their lives score equally well in terms of whatever makes lives valuable, at least if there is no reason based on some other moral value for one person to do better than the other. Equality is a relationship between the lives of different people. (...) This version of egalitarianism claims that the existence of the relationship makes an outcome better. It attributes value to relations between lives rather than to the content of lives. (shrink)

The principle of informed consent is now well established within the National Health Service (NHS) in relation to any type of medical treatment. However, this ethical principle appears to be far less well established in relation to medical screening programmes such as Britain's national cervical screening programme. This article will critically examine the case for health care providers vigorously pursuing women to accept an invitation to be screened. It will discuss the type of information which women would need in order (...) to make an informed decision about whether or not to be screened. The lack of such information in current patient leaflets on the "smear test" will then be documented. Finally, the article will explore possible ways of maximising women's autonomy in relation to the cervical screening programme without sacrificing any of its main benefits. (shrink)