Since it appeared in 1971, John Rawls's A Theory of Justice has become a classic. The author has now revised the original edition to clear up a number of difficulties he and others have found in the original book. Rawls aims to express an essential part of the common core of the democratic tradition--justice as fairness--and to provide an alternative to utilitarianism, which had dominated the Anglo-Saxon tradition of political thought since the nineteenth century. Rawls substitutes the ideal of the (...) social contract as a more satisfactory account of the basic rights and liberties of citizens as free and equal persons. "Each person," writes Rawls, "possesses an inviolability founded on justice that even the welfare of society as a whole cannot override." Advancing the ideas of Rousseau, Kant, Emerson, and Lincoln, Rawls's theory is as powerful today as it was when first published. (shrink)

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.

According to the Repugnant Conclusion: Compared with the existence of many people who would all have some very high quality of life, there is some much larger number of people whose existence would be better, even though these people would all have lives that were barely worth living. I suggest some ways in which we might be able to avoid this conclusion. I try to defend a strong form of lexical superiority.

Derek Parfit has famously pointed out that ‘total’ utilitarian views, such as classical hedonistic utilitarianism, lead to the conclusion that, to each population of quite happy persons there corresponds a more extensive population with people living lives just worth living, which is better. In particular, for any possible population of at least ten billion people, all with a very high quality of life, there must be some much larger imaginable population whose existence, if other things are equal, would be better, (...) even though its members have lives that are barely worth living. This world is better if the sum total of well-being is great enough, and it is great enough if only enough sentient beings inhabit it. This conclusion has been considered by Parfit and others to be ‘repugnant’. (shrink)

Total utilitarianism implies Parfit's repugnant conclusion. For any world containing ten billion very happy people, there is a better world where a vast number of people have lives barely worth living. One common response is to claim that life in Parfit's Z is better than he suggests, and thus that his conclusion is not repugnant. This paper shows that this strategy cannot succeeed. Total utilitarianism also implies a reverse repugnant conclusion. For any world where ten billion people have lives of (...) excruciating agony, there is a worse world where a vast number of people have lives almost worth living. This reverse repugnant conclusion is at least as repugnant as Parfit's original. If we avoid the latter by raising the zero level, then the former becomes more repugnant. We cannot save total utilitarianism by tinkering with the zero level. (shrink)

With much of the world's population facing restricted access to adequate medical care, how to allocate scarce health-care resources is a pressing question for governments, hospitals, and individuals. How do we decide where funding for health-care programs should go? Tannsjo here approaches the subject from a philosophical perspective, balancing theoretical treatments of distributive ethics with real-world examples of how health-care is administered around the world today. Tannsjo begins by laying out several popular ethical theories-utilitarianism, which recommends maximizing the best overall (...) outcome; egalitarianism, which recommends smoothing out the differences between people as much as possible; and the maximin/leximin theory, which urges people to give absolute priority to those who are worst off. Tannsjo shows how, in abstract thought experiments, these theories come into conflict with each other and reveal puzzling implications. He goes on to argue, however, that when we consider health-care in the real-world, these theories all agree on a central point: in a well-ordered welfare state, more resources should be directed to the care and cure of people suffering from mental illness, and less to the marginal life extension of elderly patients. Tannsjo's book thus recommends a shift in spending to increase fairness and overall utility-while also recognizing that this kind of dispassionate suggestion, with its purely economic foundation, is unlikely to take hold in policy. Tannsjo's analysis is a case study in how ethical theories can sometimes lead to rational conclusions and recommendations that we are not prepared to accept. (shrink)