Though the revised edition of A Theory of Justice, published in 1999, is the definitive statement of Rawls's view, so much of the extensive literature on Rawls's theory refers to the first edition. This reissue makes the first edition once again available for scholars and serious students of Rawls's work.

This paper argues that the medical conception of health as absence of disease is a value-free theoretical notion. Its main elements are biological function and statistical normality, in contrast to various other ideas prominent in the literature on health. Apart from universal environmental injuries, diseases are internal states that depress a functional ability below species-typical levels. Health as freedom from disease is then statistical normality of function, i.e., the ability to perform all typical physiological functions with at least typical efficiency. (...) This conception of health is as value-free as statements of biological function. The view that health is essentially value-laden, held by most writers on the topic, seems to have one of two sources: an assumption that health judgments must be practical judgments about the treatment of patients, or a commitment to "positive" health beyond the absence of disease. I suggest that the assumption is mistaken, the commitment possibly misdescribed. (shrink)

In the course of the last 30 years, feminist theories of gender have shifted from quasi-Marxist, labor-centered conceptions to putatively ‘post-Marxist’ culture-and identity-based conceptions. Reflecting a broader political move from redistribution to recognition, this shift has been double edged. On the one hand, it has broadened feminist politics to encompass legitimate issues of representation, identity and difference. Yet, in the context of an ascendant neoliberalism, feminist struggles for recognition may be serving less to enrich struggles for redistribution than to displace (...) the latter. Thus, instead of arriving at a broader, richer paradigm that could encompass both redistribution and recognition, feminists appear to have traded one truncated paradigm for another – a truncated economism for a truncated culturalism. This article aims to resist that trend. I propose an anaysis of gender that is broad enough to house the full range of feminist concerns, those central to the old socialist-feminism as well as those rooted in the cultural turn. I also propose a correspondingly broad conception of justice, capable of encompassing both distribution and recognition, and a non-identitarian account of recognition, capable of synergizing with redistribution. I conclude by examining some practical problems that arise when we try to envision institutional reforms that could redress gender maldistribution and gender misrecognition simultaneously. (shrink)

In this article, we explore the implications of a Rawlsian theory for intergenerational issues. First, we confront Rawls's way of locating his `just savings' principle in his Theory of Justice with an alternative way of doing so. We argue that both sides of his intergenerational principle, as they apply to the accumulation phase and the steady-state stage, can be dealt with on the bases, respectively, of the principle of equal liberty and of the difference principle. We then proceed by focusing (...) on the implications of applying maximin to his steady-state stage. One central claim is that, in principle, Rawlsians should consider not only generational dissavings, but also generational savings, as unfair. This principle suffers a series of exceptions on which we focus in the fourth section of the article. In some cases, growth can be maximin compatible. (shrink)

The purpose of this article is to argue for a position holding that epigenetic responsibility primarily should be a political and not an individual responsibility. Epigenetic is a rapidly growing research field studying regulations of gene expression that do not change the DNA sequence. Knowledge about these mechanisms is still uncertain in many respects, but main presumptions are that they are triggered by environmental factors and life style and, to a certain extent, heritable to subsequent generations, thereby reminding of aspects (...) of Lamarckism. Epigenetic research advances give rise to intriguing challenges for responsibility relations between the society and the individual. Responsibility is commonly understood in a backwards-looking manner, identifying causally responsible actors to blame for a bad outcome. If only a backwards-looking responsibility model is applied, epigenetics might give rise to arduous responsibility ascriptions to individuals for their health and the health of their future descendants. This would put heavy responsibility burdens on actors constrained by unequal social and economic structures. In contrast, a forward-looking responsibility notion takes account of structural conditions and pay attention to who is best placed to do something about conditions contributing to bad outcomes. A forward-looking responsibility notion would partly free disadvantaged individuals from responsibility, and identify actors with power and capacity to do something about structural factors constraining genuine choice. (shrink)

A rich literature in public health has demonstrated that health is strongly influenced by a host of environmental factors that can vary according to social, economic, geographic, cultural or physical contexts. Bioethicists should, we argue, recognize this and – where appropriate – work to integrate environmental concerns into their field of study and their ethical deliberations. In this article, we present an argument grounded in scientific research at the molecular level that will be familiar to – and so hopefully more (...) persuasive for – the biomedically-inclined in the bioethics community. Specifically, we argue that the relatively new field of molecular epigenetics provides novel information that should serve as additional justification for expanding the scope of bioethics to include environmental and public health concerns. We begin by presenting two distinct visions of bioethics: the individualistic and rights-oriented and the communitarian and responsibility-oriented. We follow with a description of biochemical characteristics distinguishing epigenetics from genetics, in order to emphasize the very close relationship that exists between the environment and gene expression. This then leads to a discussion of the importance of the environment in determining individual and population health, which, we argue, should shift bioethics towards a Potterian view that promotes a communitarian-based sense of responsibility for the environment, in order to fully account for justice considerations and improve public health. (shrink)

In this article, we explore the implications of a Rawlsian theory for intergenerational issues. First, we confront Rawls's way of locating his `just savings' principle in his Theory of Justice with an alternative way of doing so. We argue that both sides of his intergenerational principle, as they apply to the accumulation phase and the steady-state stage, can be dealt with on the bases, respectively, of the principle of equal liberty (and its priority) and of the difference principle. We then (...) proceed by focusing on the implications of applying maximin to his steady-state stage. One central claim is that, in principle, Rawlsians should consider not only generational dissavings, but also generational savings, as unfair. This principle suffers a series of exceptions on which we focus in the fourth section of the article. In some cases, growth can be maximin compatible. Key Words: generations • egalitarianism • maximin • sustainability • growth • difference principle • John Rawls. (shrink)

La possibilité d’une définition naturaliste de la santé et d’une distinction entre le normal et le pathologique qui ne repose pas sur des normes culturelles, sociales ou subjectives est au cœur des débats en philosophie de la médecine. Or le concept statistique de la normalité, fondamental pour une définition objective de la santé, soulève d’importantes difficultés. Christopher Boorse défend une « théorie bio-statistique » qui, en articulant ce concept à une notion non normative de fonction biologique, résoudrait ces difficultés. L’identification (...) de la santé et de la normalité au sens statistique demeure toutefois centrale dans sa définition. Après avoir précisé le rôle que joue la normalité statistique dans la BST, nous dégageons, à partir de l’épidémiologie contemporaine, un certain nombre de problèmes et questions que cette définition naturaliste soulève.The liability for a naturalist definition of health and for a value-free distinction between the normal and the pathological is at the core of discussions on health and disease in philosophy of medicine. But the statistical concept of normality, a central one for any objective definition of health, raises numerous problems. Christopher Boorse argues for a « biostatistical theory » which aims at solving these difficulties by articulating a statistical concept of normality and a non-normative concept of biological function. However the BST is still based on identifying normality and health with the most frequent. After analyzing in details the true role of statistical normality in BST, I will show how results and data from modern epidemiology can be mobilized to reveal several limits and difficulties with respect to this naturalist definition of health and disease. (shrink)