Healthcare (including public health) is special because it protects normal functioning, which in turn protects the range of opportunities open to individuals. I extend this account in two ways. First, since the distribution of goods other than healthcare affect population health and its distribution, I claim that Rawls's principles of justice describe a fair distribution of the social determinants of health, giving a partial account of when health inequalities are unjust. Second, I supplement a principled account of justice for health (...) and healthcare with an account of fair process for setting limits or rationing care. This account is provided by three conditions that comprise "accountability for reasonableness.". (shrink)

In contemporary society, private debt has substituted for other ways of financing the consumption of basic social goods like housing, education, and medical care. This is at least partially due to increased inequality, which has allowed costs to rise faster than median incomes, as well as due to stagnating public provisions. Debt-financed access to basic goods is problematic because it creates new kinds of unfreedom and undermines the value of the freedoms that the indebted do manage to keep or acquire. (...) Debt-financing qualifies freedom in this way by placing certain kinds of conditions on our acquisition and consumption of the goods that we buy. These conditions compromise the very freedom that we seek and value when acquiring and consuming these goods. It does so, first, by transferring the burden of providing basic goods from the public to private individuals, thereby further constraining those who already face the most constraints in accessing basic goods. And, second, the conditional character of debt-financed consumption undermines the value that we attach to having basic social goods. At the very least, this gives us strong reasons to want to regulate the conditions that creditors can place on debtors, at least with respect to basic social goods. Further, at best, the most desirable alternative to debt-financed consumption is the unconditional public provision of basic goods like housing, education, and medical care. (shrink)

This paper considers four institutional models for funding higher education in the light of principles of fairness and meritocracy, with particular reference to the debate in the UK over ‘top-up fees’. It concludes that, under certain plausible but unproven assumptions, the model the UK government has adopted is fairer and more meritocratic than alternatives, including, surprisingly, the Graduate Tax.

Opposition to university fees is often framed as a defence of higher education as a 'right' rather than a 'privilege'. However, the basis and nature of this right is unclear. This article presents a conceptual exploration of the question, drawing on an initial analysis of international law. An argument is put forward for a right to higher education seen as one of a number of possible forms of post-school education, restricted only by a requirement for a minimum level of academic (...) preparation. (shrink)

Current debates regarding justice in university admissions most often approach the question of access to university from a technical, policy-focussed perspective. Despite the attention that access to university receives in the press and policy literature, ethical discussion tends to focus on technical matters such as who should pay for university or which schemes of selection are allowable, not the question of who should go to university in the first place. We address the question of university admissions—the question of who should (...) go to university—from an ethical perspective. We find that most discussions draw on a generic conception of what the university is good for that is too thin to provide deliberative guidance and hold that a full account of the ethics of admissions needs to take into account the distinctive good that the university provides—knowledge and understanding. This view, we hold, does not imply that measures should not be taken to widen access to university; however, the basis for such measures should be grounded in that distinctive good in the first instance. (shrink)

John White has recently defended a national curriculum which aims to promote children's well-being and personal autonomy. I argue that there is a sense in which the state can remain neutral between diirferent conceptions of the good life and that White has not established that the state should aim to promote particular conceptions. I contend that the arguments which White offers in defence of his view of well-being are inadequate and that he has failed to justifi the promotion of everyone's (...) personal autonomy. (shrink)

Current debates regarding justice in university admissions most often approach the question of access to university from a technical, policy-focussed perspective. Despite the attention that access to university receives in the press and policy literature, ethical discussion tends to focus on technical matters such as who should pay for university or which schemes of selection are allowable, not the question of who should go to university in the first place. We address the question of university admissions—the question of who should (...) go to university—from an ethical perspective. We find that most discussions draw on a generic conception of what the university is good for that is too thin to provide deliberative guidance and hold that a full account of the ethics of admissions needs to take into account the distinctive good that the university provides—knowledge and understanding. This view, we hold, does not imply that measures should not be taken to widen access to university; however, the basis for such measures should be grounded in that distinctive good in the first instance. (shrink)