Several attempts have been made to apply the choice-sensitive theory of distributive justice, luck egalitarianism, in the context of health and healthcare. This article presents a framework for this discussion by highlighting different normative decisions to be made in such an application, some of the objections to which luck egalitarians must provide answers and some of the practical implications associated with applying such an approach in the real world. It is argued that luck egalitarians should (...) address distributions of health rather than healthcare, endorse an integrationist theory that combines health concerns with general distributive concerns and be pluralist in their approach. It further suggests that choice-sensitive policies need not be the result of applying luck egalitarianism in this context. (shrink)

People’s health is hugely affected by where they live, their occupational status and their socio-economic position. It has been widely argued that the presence of such social determinants in health provides good reasons to reject luck egalitarianism as a theory of distributive justice in health. The literature provides different reasons why this responsibility-sensitive theory of distributive justice should not be applied to health. The critiques submit that the social circumstances undermine or remove people’s responsibility (...) for their health; responsibility sensitive health policies would adversely affect those who are worst off and; the luck egalitarian approach to health distracts from the important task of rectifying socio-economic influences on people's health and provides individualistic solutions to collective problems. But for each of these variants of the critique luck egalitarianism provides suitable answers. The literature on social determinants is no detriment to the project of applying luck egalitarianism to health. (shrink)

Luck egalitarianism is often taken to task for its alleged harsh implications. For example, it may seem to imply a policy of nonassistance toward uninsured reckless drivers who suffer injuries. Luck egalitarians respond to such objections partly by pointing to a number of factors pertaining to the cases being debated, which suggests that their stance is less inattentive to the plight of the victims than it might seem at first. However, the strategy leaves some cases in which (...) the attribution of individual responsibility is appropriate . One such case is oral health or significant aspects of this. It is appropriate, the paper argues, to hold people responsible for a number of factors that affect their oral health. A luck egalitarian approach inspired by John Roemer can assess whether people have acted responsibly by comparing their choices to those of their peers. A luck egalitarian approach to oral health would recommend prioritizing scarce resources in a responsibility-weighted queuing system and include copayment and general taxation among its measures of financing. (shrink)

The scarcity of livers available for transplants forces tough choices upon us. Lives for those not receiving a transplant are likely to be short. One large group of potential recipients needs a new liver because of alcohol consumption, while others suffer for reasons unrelated to their own behaviour. Should the former group receive lower priority when scarce livers are allocated? This discussion connects with one of the most pertinent issues in contemporary political philosophy; the role of personal responsibility in distributive (...) justice. One prominent theory of distributive justice, luck egalitarianism, assesses distributions as just if, and only if, people's relative positions reflect their exercises of responsibility. There is a principled luck egalitarian case for giving lower priority to those who are responsible for their need. Compared to the existing literature favouring such differentiation, luck egalitarianism provides a clearer rationale of fairness, acknowledges the need for individual assessments of responsibility, and requires initiatives both inside and outside of the allocation systems aimed at mitigating the influence from social circumstances. Furthermore, the concrete policies that luck egalitarians can recommend are neither too harsh on those who make imprudent choices nor excessively intrusive towards those whose exercises of responsibility are assessed. (shrink)

Much of the philosophical literature on health inequalities seeks to establish the superiority of one or another conception of luck egalitarianism. In recent years, however, an increasing number of self-avowed egalitarian philosophers have proposed replacing luck egalitarianism with alternatives that stress the moral relevance of distinct relationships, rather than the moral relevance of good or bad luck. After briefly explaining why I am not attracted to luck egalitarianism, I seek in this chapter (...) to distinguish and clarify three views that have been characterized in the philosophical literature as forms of relational egalitarianism. I call these three relational views equality of treatment, equality of concern, and social egalitarianism. I will explain why each claims to be a form of egalitarianism and why these three views should not be seen as competitors. I will argue that each brand of relational egalitarianism describes a plausible plank of distributive justice that bears on the evaluation of health inequalities and on the political institutions that create, sustain, or exacerbate them. To illustrate this pluralistic relational egalitarian approach, I will draw on a case study by Horton and Barker (this volume) to discuss how each of the three planks might be brought to bear on the evaluation of oral health disparities among the children of migrant Latino farmworkers in California. (shrink)

Rare diseases pose a particular priority setting problem. The UK gives rare diseases special priority in healthcare priority setting. Effectively, the National Health Service is willing to pay much more to gain a quality-adjusted life-year related to a very rare disease than one related to a more common condition. But should rare diseases receive priority in the allocation of scarce healthcare resources? This article develops and evaluates four arguments in favour of such a priority. These pertain to public values, (...) luck egalitarian distributive justice the epistemic difficulties of obtaining knowledge about rare diseases and the incentives created by a higher willingness to pay. The first is at odds with our knowledge regarding popular opinion. The three other arguments may provide a reason to fund rare diseases generously. However, they are either overinclusive because they would also justify funding for many non-rare diseases or underinclusive in the sense of justifying priority for only some rare diseases. The arguments thus fail to provide a justification that tracks rareness as such. There are no data in this work. (shrink)

Should we grant a fresh start to those who come to regret their past lifestyle choices? A negative response to this question can be located in the luck egalitarian literature. As a responsibility-sensitive theory of justice, luck egalitarianism considers it just that people’s relative positions reflect their past choices, including those they regret. In a recent article, Vansteenkiste, Devooght and Schokkaert argue against the luck egalitarian view, maintaining instead that those who regret their past choices in (...) health are disadvantaged in a relevant way and should receive compensation. Employing the ideal that people should be made equal as measured by equivalent resources, they purport to show the fairness of such an arrangement through a hypothetical scenario. Relaxing the implicit assumptions of this scenario brings forth several unattractive consequences of the fresh-start idea. The main problem is that in striving to ensure that people’s past choices do not affect their own opportunities, the authors must accept that these choices put heavy strains on the opportunities available to other people. Furthermore, the luck egalitarian position is more compelling than they admit. (shrink)

Luck egalitarianism provides a reason to object to conditionality in health incentive programmes in some cases when conditionality undermines political values such as solidarity or inclusiveness. This is the case with incentive programmes that aim to restrict access to essential healthcare services. Such programmes undermine solidarity. Yet, most people's lives are objectively worse, in one respect, in non-solidary societies, because solidarity contributes both instrumentally and directly to individuals' well-being. Because solidarity is non-excludable, undermining it will deprive both (...) the prudent and the imprudent citizens of its goods. Thereby, undermining solidarity can make prudent citizens worse off than they would have otherwise been, out of no fault or choice of their own, but rather as a result of somebody else's imprudent choice. This goes against the spirit of luck egalitarianism. Therefore (luck egalitarian) justice can require us to save the imprudent and avoid conditionality in access to essential healthcare services. (shrink)

I outline and defend two egalitarian theories, which yield distinctive and, I argue, complementary answers to why health-related inequalities matter: a brute luck egalitarian view, according to which inequalities due to unchosen, differential luck are bad because unfair, and a social egalitarian view, according to which inequalities are bad when and because they undermine people’s status as equal citizens. These views identify different objects of egalitarian concern: the brute luck egalitarian view directs attention to health-related (...) well-being, while social egalitarianism focuses on health-related capabilities that are central to a person’s status as a citizen. I argue that both views are correct and should jointly guide priority-setting in health. (shrink)

Eli Feiring has developed a concept of forward-looking responsibility in healthcare. On this account, what matters morally in the allocation of scarce healthcare resources is not people's past behaviours but rather their commitment to take on lifestyles that will increase the benefit acquired from received treatment. According to Feiring, this is to be preferred over the backward-looking concept of responsibility often associated with luck egalitarianism. The article critically scrutinises Feiring's position. It begins by spelling out the wider implications (...) of Feiring's view. Against this background, it shows that (i) Feiring's distinction between backward-looking and forward-looking responsibility is incompatible with the Scanlonian notion of responsibility she apparently endorses; (ii) her favoured forward-looking notion of responsibility is subject to the objections levelled against the luck egalitarian view (whatever the strength of such objections). (shrink)

Luck egalitarianism has been criticized for condoning some cases of oppression and condemning others for the wrong reason—namely, that the victims were not responsible for their oppression. Oppression is unjust, however, the criticism says, regardless of whether victims are responsible for it, simply because it is contrary to the equal moral standing of persons. I argue that four luck egalitarian responses to this critique are inadequate. Two address only the first part of the objection and do so (...) in a way that risks making luck egalitarianism inconsistent. A third severely dilutes the luck egalitarian doctrine. A fourth manages to denounce some instances of oppression for the right reason, but at the same time permits other instances of oppression and condemns yet others for the wrong reason. (shrink)

A considerable literature has emerged around the idea of using ‘personal responsibility’ as an allocation criterion in healthcare distribution, where a person's being suitably responsible for their health needs may justify additional conditions on receiving healthcare, and perhaps even limiting access entirely, sometimes known as ‘responsibilisation’. This discussion focuses most prominently, but not exclusively, on ‘luck egalitarianism’, the view that deviations from equality are justified only by suitably free choices. A superficially separate issue in distributive justice concerns (...) the two–way relationship between health and other social goods: deficits in health typically undermine one's abilities to secure advantage in other areas, which in turn often have further negative effects on health. This paper outlines the degree to which this latter relationship between health and other social goods exacerbates an existing problem for proponents of responsibilisation (the ‘harshness objection’) in ways that standard responses to this objection cannot address. Placing significant conditions on healthcare access because of a person's prior responsibility risks trapping them in, or worsening, negative cycles where poor health and associated lack of opportunity reinforce one another, making further poor yet ultimately responsible choices more likely. It ends by considering three possible solutions to this problem. (shrink)

Luck egalitarianism is a family of egalitarian theories of distributive justice that aim to counteract the distributive effects of luck. This article explains luck egalitarianism's main ideas, and the debates that have accompanied its rise to prominence. There are two main parts to the discussion. The first part sets out three key moves in the influential early statements of Dworkin, Arneson, and Cohen: the brute luck/option luck distinction, the specification of brute luck (...) in everyday or theoretical terms and the specification of advantage as resources, welfare, or some combination of these. The second part covers three later developments: the democratic egalitarian critique of luck egalitarianism, the luck egalitarian acceptance of pluralism, and luck egalitarian doubts about the significance of the brute luck/option luck distinction. (shrink)

The article has two aims. First, to show that a version of luck egalitarianism that includes relational goods amongst its distribuenda can, as a matter of internal logic, account for one of the core beliefs of relational egalitarianism. Therefore, there will be important extensional overlap, at the level of domestic justice, between luck egalitarianism and relational egalitarianism. This is an important consideration in assessing the merits of and relationship between the two rival views. Second, (...) to provide some support for including relational goods, including those advocated by relational egalitarianism, on the distribuenda of justice and therefore to put in a good word for the overall plausibility of this conception of justice. I show why relational egalitarians, too, have reason to sympathise with this proposal. (shrink)

Christian Munthe, David Fumagalli and Erik Malmqvist argue that well-known healthcare resource allocation principles, such as need, prognosis, equal treatment and cost-effectiveness, should be supplemented with a principle of sustainability.1 Employing such a principle would entail that the allocation of healthcare resources should take into account whether a specific allocation causes negative dynamics, which would limit the amount of resources available in the future. As examples of allocation decisions, which may have such negative dynamics, they mention those who cause a (...) lack of vaccines, anti-bioethics resistance and drug shortages. Thus, the overall thought is that we can spend and allocate healthcare resources in a certain way at t1, which means that we will have fewer resources available at a later point, t2. The authors argue that we should include a principle of sustainability to justify allocations, which avoids or diminishes the negative dynamics. The authors argue that existing principles cannot sufficiently include proper regard for how our current decisions affect future allocation decisions and, therefore, the people who need healthcare resources in the future. I am sympathetic to the developed argument and believe that the authors are correct that negative dynamics provide reasons to take our ability to meet future health needs …. (shrink)

Luck egalitarianism is a family of egalitarian theories of distributive justice that give a special place to luck, choice, and responsibility. These theories can be understood as responding to perceived weaknesses in influential earlier theories of both the left – in particular Rawls’ liberal egalitarianism (1971) – and the right – Nozick’s libertarianism (1974) stands out here. Rawls put great emphasis on the continuity of his theory with the great social contract theories of modern political thought, (...) particularly emphasising its Kantian character, while Nozick overtly develops his theory as an elaboration of John Locke’s account of property. By contrast, how luck egalitarianism is related to the history of political thought or philosophy more generally has been left unexplored by its proponents. Perhaps this is because they see luck egalitarianism, with its focus on individual choice and association with such contemporary concerns as equality of opportunity, as without significant predecessors in the canon. My purpose in this chapter is to make the tentative first steps towards identifying some historical antecedents of luck egalitarianism among the main works of Western political thought, in particular Aristotle, Machiavelli, and Locke. (shrink)

Luck egalitarians think that considerations of responsibility can excuse departures from strict equality. However critics argue that allowing responsibility to play this role has objectionably harsh consequences. Luck egalitarians usually respond either by explaining why that harshness is not excessive, or by identifying allegedly legitimate exclusions from the default responsibility-tracking rule to tone down that harshness. And in response, critics respectively deny that this harshness is not excessive, or they argue that those exclusions would be ineffective or lacking (...) in justification. Rather than taking sides, after criticizing both positions I also argue that this way of carrying on the debate – i.e. as a debate about whether the harsh demands of responsibility outweigh other considerations, and about whether exclusions to responsibility-tracking would be effective and/or justified – is deeply problematic. On my account, the demands of responsibility do not – in fact, they can not – conflict with the demands of other normative considerations, because responsibility only provides a formal structure within which those other considerations determine how people may be treated, but it does not generate its own practical demands. (shrink)

Luck egalitarians argue that distributive justice should be understood in terms of our capacity to be responsible for our choices. Both proponents and critics assume that the theory must rely on a comprehensive conception of responsibility. I respond to luck egalitarianism’s critics by developing a political conception of responsibility that remains agnostic on the metaphysics of free choice. I construct this political conception by developing a novel reading of John Rawls’ distinction between the political and the comprehensive. (...) A surprising consequence is that many responsibility-based objections to luck egalitarianism turn out to be objections to Rawls’ political liberalism as well. (shrink)

The late G.A. Cohen is routinely considered a founding father of luck egalitarianism, a prominent responsibility-sensitive theory of distributive justice. David Miller argues that Cohen’s considered beliefs on distributive justice are not best understood as luck egalitarian. While the relationship between distributive justice and personal responsibility plays an important part in Cohen’s work, Miller maintains that it should be considered an isolated theme confined to Cohen’s exchange with Dworkin. We should not understand the view Cohen defends in (...) this exchange as Cohen’s considered view. Accepting this thesis would change both our understanding of Cohen’s political philosophy and many recent luck egalitarian contributions. Miller’s argument offers an opportunity to reassess Cohen’s writings as a whole. Ultimately, however, the textual evidence against Miller’s argument is overwhelming. Cohen clearly considers the exchange with Dworkin to be about egalitarianism as such rather than about the best responsibility-sensitive version of egalitarianism. Furthermore, Cohen often offers luck egalitarian formulations of his own view outside of the exchange with Dworkin and uses luck egalitarianism as an independent yardstick for evaluating principles and distributions. (shrink)

This paper considers issues raised by Elizabeth Anderson’s recent critique of the position she terms ‘luck egalitarianism’. It is maintained that luck egalitarianism, once clarified and elaborated in certain regards, remains the strongest egalitarian stance. Anderson’s arguments that luck egalitarians abandon both the negligent and prudent dependent caretakers fails to account for the moderate positions open to luck egalitarians and overemphasizes their commitment to unregulated market choices. The claim that luck egalitarianism insults (...) citizens by redistributing on the grounds of paternalistic beliefs, pity and envy, and by making intrusive and stigmatizing judgments of responsibility, fails accurately to characterize the luck egalitarian’s rationale for redistribution and relies upon luck egalitarians being insensitive to the danger of stigmatization. The luck egalitarian position is reinforced by the fact that Anderson’s favoured conception of equality, ‘democratic equality’, is counterintuitively indifferent to all unchosen inequalities, including intergenerational inequalities, once bare social minima are met. (shrink)

This brilliant and challenging book provides an overview and defence of 'luck egalitarianism', one that helpfully connects debates on luck egalitarianism to debates on what aspects of our lives egalitarians should try equalise (the 'equality of what?' debate/the debate on the 'metric' of equality) and on what respect, if any, it makes sense to see each other as equals. The book illuminates different conceptions of luck, as found in the philosophical literature, clarifies the difference between (...) telic and deontic equality, and explains the 'levelling down' problem and the way that this affects luck egalitarians, and egalitarians more generally. For these reasons, the book provides a handy introduction to a range of philosophical debates about equality amongst analytic philosophers, whether or not one is particularly interested in luck egalitarianism. However, this is not an easy book to read, and while it is advertised as suitable for advanced undergraduates, I find it hard to imagine using it in any undergraduate course I have taught in the United States, England, France or Switzerland. But this is definitely a book that masters and doctoral students should be able to read by themselves and that will be helpful for teachers preparing classes on luck egalitarianism or on equality more generally. (shrink)

Many philosophers believe that luck egalitarianism captures “desert-like” intuitions about justice. Some even think that luck egalitariansm distributes goods in accordance with desert. In this paper, we argue that this is wrong. Desertism conflicts with luck egalitarianism in three important contexts, and, in these contexts, desertism renders the proper moral judgment. First, compared to desertism, luck egalitarianism is sometimes too stingy: it fails to justly compensate people for their socially valuable contributions—when those contributions (...) arose from “option luck”. Second, luck egalitarianism is sometimes too restrictive: it fails to justly compensate people who make a social contribution when that contribution arose from “brute luck”. Third, luck egalitarianism is too limited in scope: it cannot diagnose economic injustice arising independently of comparative levels of justice. The lesson of this paper is that luck egalitarians should consider supplementing their theory with desert considerations. Or, even better, consider desertism as a superior alternative to their theory. (shrink)

Luck egalitarianism makes a fundamental distinction between inequalities for which agents are responsible and inequalities stemming from luck. I give several reasons to find luck egalitarianism a compelling view of distributive justice. I then argue that it is an incomplete theory of equality. Luck egalitarianism lacks the normative resources to achieve its ends. It is unable to specify the prior conditions under which persons are situated equivalently such that their choices can bear this (...) tremendous weight. This means that luck egalitarians need to become pluralists who understand equality not merely in terms of choice, luck, and responsibility. After developing my critical argument that luck egalitarianism is incomplete, I sketch a strategy for rehabilitating and filling out the theory. (shrink)

Kok-Chor Tan has recently defended a novel theory of egalitarian distributive justice, institutional luck egalitarianism (ILE). On this theory, it is unjust for institutions to favor some individuals over others based on matters of luck. Tan takes his theory to preserve the intuitive appeal of luck egalitarianism while avoiding what he regards as absurd implications that face other versions of luck egalitarianism. Despite the centrality of the concept of institutional influence to his theory, (...) Tan never spells out precisely what it means for an inequality to be produced by an institution. In this paper, I consider different conceptions of institutional influence that ILE might employ. It appears that however this concept is construed, ILE has serious problems. On some conceptions, the luck egalitarian character of the theory is undermined. On others, the theory gives rise to precisely the sorts of absurd implications facing other versions of luck egalitarianism that Tan takes his theory to avoid. (shrink)

Some critics of luck egalitarianism have suggested that its reference to responsibility leaves it either assuming metaphysical libertarianism or (in the inevitable absence of a resolution of the free will problem) practically impotent. This paper argues that luck egalitarianism need not fall into either trap. It may in fact be sensitive to the possibility that libertarianism is false, and would not be undermined were this the case. Here luck egalitarianism actually fares better than outcome (...) egalitarianism, which assumes, in just the way luck egalitarianism allegedly does, a controversial metaphysical position. There is, moreover, little difficulty in applying luck egalitarianism in practical contexts on the basis of our best guess about the relevant metaphysical questions. This solution is, of course, non-ideal, but appears preferable to the alternatives, such as simply assuming that metaphysical account of responsibility that offers the best fit with our favored theory of distributive justice. (shrink)

ABSTRACT: In his A Conceptual Investigation of Justice, Kyle Johannsen suggests a theory of disability that holds that to have a disability just is to be worse off, sometimes referred to as the ‘medical’ or ‘individual’ model of disability. I argue that Johannsen’s understanding of disability might force some of his key claims into an uncomfortable position. In particular, for his theory to avoid the thrust of Elizabeth Anderson’s criticisms of luck egalitarianism, the assumption of the medical model (...) of disability must be dropped, but this comes at the cost of his criticism of John Rawls’ difference principle. -/- RÉSUMÉ : Dans son livre, A Conceptual Investigation of Justice, Kyle Johannsen semble invoquer une théorie du handicap selon laquelle le fait d’avoir un handicap, c’est être pire qu’une autre personne, un modèle parfois appelé le modèle de handicap «médical» ou «individuel». Je soutiens que la compréhension de Johannsen en matière d’invalidité peut mettre sa theorie dans une position difficile. En particulier, pour que sa théorie évite les critiques d’Elizabeth Anderson sur l’égalitarisme de la chance, l’hypothèse du modèle médical du handicap doit être abandonnée. Cependant, cela se fait au détriment de la critique du principe de différence de John Rawls formulée par Johannsen. (shrink)

G. A. Cohen conceptualizes socialism as luck egalitarianism constrained by a community principle. The latter mitigates certain inequalities to achieve a shared common life. This article explores the plausibility of the community constraint on inequality in light of two related problems. First, if it is voluntary, it fails as a response to “the abandonment objection” to luck egalitarianism, as it would not guarantee imprudent people sufficient resources to avoid deprivation and to function as equal citizens in (...) a democratic society. Contra Cohenite socialism, this appears unjust. Second, if it is instead enforced, coercive equalization beyond sufficiency-constrained luck egalitarianism, which is possibly necessary to achieve a shared common life, seems to require unjustified restrictions on liberty. I therefore argue that the constraint is most plausibly specified as requiring enforcement of sufficiency and only voluntary equalization thereafter. I also note, skeptically, why this constraint might be morally preferable to a purely sufficientarian alternative. (shrink)

This review article of Shlomi Segall's Health, Luck, and Justice (Princeton University Press, 2010) addresses three issues: first, Segall’s claim that luck egalitarianism, properly construed, does not object to brute luck equality; second, Segall’s claim that brute luck is properly construed as the outcome of actions that it would have been unreasonable to expect the agent to avoid; and third, Segall’s account of healthcare and criticism of rival views. On the first two issues, a (...) more conventional form of luck egalitarianism – that is, one which objects to brute luck even if it creates equality, and which construes brute luck as the inverse of agent responsibility – is defended. On the third issue, strengths and weaknesses in Segall’s criticism of Rawlsian, democratic egalitarian, and all-luck egalitarian approaches to healthcare, and in his own luck egalitarian approach, are identified. (shrink)

Kymlicka has offered an influential luck egalitarian justification for a catalogue of polyethnic rights addressing cultural disadvantages of immigrant minorities. In response, Quong argues that while the items on the list are justified, in the light of the fact that the relevant disadvantages of immigrants result from their choice to immigrate, (i) these rights cannot be derived from luck egalitarianism and (ii) that this casts doubt on luck egalitarianism as a theory of cultural justice. As (...) an alternative to Kymlicka’s argument, Quong offers his own justification of polyethnic rights based on a Rawlsian ideal of fair equality of opportunity. I defend luck egalitarianism against Quong’s objection arguing that if choice ever matters, it matters in relation to cultural disadvantages too. Also, the Rawlsian ideal of fair equality of opportunity cannot justify the sort of polyethnic rights that Quong wants it to justify, once we set aside an unwarranted statist focus in Quong’s conception of fair equality of opportunity. Whatever the weaknesses of luck egalitarianism are, the inadequacy of the position in relation to accommodating cultural disadvantages of immigrants is not among them. (shrink)

My intention in this paper is to reframe the practice of veiling as an embodied practice of self-development and self- transformation. I argue that practices like these cannot be handled by the choice/chance distinction relied on by those who would restrict religious minority accommodations. Embodied self- transformation necessarily means a change in personal identity and this means the religious believer cannot know if they will need religious accommodation when they begin their journey of piety. Even some luck egalitarians would (...) find leaning exclusively on preference and choice to find who should be burdened with paying the full costs of certain choices in one’s life too morally harsh to be justifiable. I end by briefly illustrating an alternative way to think about religious accommodation that does not rely on the choice/chance distinction. (shrink)

I review Shlomi Segall's book 'Why Inequality Matters'. I argue that it conclusively establishes that alongside egalitarians, prioritarians and sufficientarians must sometimes regard a prospect as better (in at least one respect) when it is not better (in terms of well-being) for anyone. Sufficientarians and prioritarians must therefore relinquish a treasured anti-egalitarian argument. It also makes a powerful case that among these three views, egalitarians are in the best position to explain such departures from what is in each person’s prudential (...) interest. For egalitarians can point to the natural idea that it is unfair when, due to pure chance, some fare much better than others. By contrast, it remains unclear what value, if any, sufficientarians or prioritarians can appeal to in order to justify their departures from what best promotes people’s well-being. (shrink)

The liberal-egalitarian concept formulated by John Rawls in his book A Theory of Justice is still vehemently debated today. Critics of this concept include, among others, Rodion Belkovich and Sergei Vinogradov, according to whom Rawlsians inevitably face a dilemma: they need to reject either the difference principle or luck egalitarianism, and each of these solutions leads to the erosion of the basic foundations of Rawls’s theory. The article presents a detailed analysis of the arguments put forward by Belkovich (...) and Vinogradov and demonstrates that the dilemma they identified is flawed for three reasons. First, it blurs the distinction between luck egalitarianism and “straight egalitarianism,” which assumes the complete equality of income and wealth in society. Luck egalitarians do not support the idea of absolute equality in distribution and consider inequality that reflects people’s responsibility for their own choices fair. Second, Rawlsian egalitarianism is essentially equated with luck egalitarianism, while they represent two clearly distinguishable approaches. Third, the kidnapper’s argument, which proves that the difference principle is incompatible with luck egalitarianism, does not provide solid reasoning against the difference principle. The argument is only applicable under limited conditions, when the difference principle is embedded as an assumption in the “argument from incentives,” which in turn is put forward by the potential beneficiaries of this incentive. According to the author’s conclusion, the above mentioned considerations clearly indicate that Rawlsians do not face any dilemma of choosing between luck egalitarianism and the difference principle, and the criticism of Rawls’s theory proposed by Belkovich and Vinogradov should be considered groundless. (shrink)

Critics of luck egalitarianism have claimed that, far from providing a justification for the public insurance functions of a welfare state as its proponents claim, the view objectionably abandons those who are deemed responsible for their dire straits. This article considers seven arguments that can be made in response to this ‘abandonment objection’. Four of these arguments are found wanting, with a recurrent problem being their reliance on a dubious sufficientarian or quasi-sufficientarian commitment to provide a threshold of (...) goods unconditionally. Three arguments succeed, showing that luck egalitarians have good reasons for assisting ‘negligent victims’ on account of changes that may occur in an individual between the time of their choice and their subsequent disadvantage, bad option luck, and doubts about free will and responsibility. Luck egalitarianism is therefore shown to offer strong support for public insurance. (shrink)

This paper argues that luck egalitarianism, especially in the guise of equality of opportunity for welfare, is in tension with the ideal of fair equality of opportunity in three ways. First, equal opportunity for welfare is compatible with a caste system in employment that is inconsistent with open competition for positions. Second, luck egalitarianism does not support hiring on the basis of qualifications. Third, amending luck egalitarianism to repair this problem requires abandoning fair access (...) to qualifications. Insofar as luck egalitarianism cannot support fair equality of opportunity, it cannot do justice to the claims of the disabled. Indeed, in the absence of fair equality of opportunity, disabled people are likely to be marginalized. (shrink)

One prominent criticism of luck egalitarianism is that it requires either shameful revelations or otherwise problematic declarations by the state toward those who have had bad brute luck. Relational egalitarianism, by contrast, is portrayed as an alternative that requires no such revelations or declarations. I argue that this is false. Relational equality requires the state to draft anti-discrimination laws for both state and private action. The ideal of relational egalitarianism requires these laws to be asymmetric, (...) that is to allow affirmative action for disadvantaged groups while prohibiting affirmative action for advantaged groups. Hence, the state needs to make a public declaration on which groups are privileged and which are underprivileged; and individuals need to reveal whether they belong to groups officially declared underprivileged. These declarations are no more problematic in this case than in the case of luck egalitarianism. (shrink)

Politics, Philosophy & Economics, Volume 21, Issue 2, Page 165-189, May 2022. It is generally acknowledged that a certain amount of state intervention in health and health care is needed to address the significant market failures in these sectors; however, it is also thought that the primary rationale for state involvement in health must lie elsewhere, for example in an egalitarian commitment to equalizing access to health care for all citizens. This paper argues that a complete (...) theory of justice in health can be derived from a commitment to correcting market failure, or in other words promoting Pareto-efficiency, in the domain of health. This approach can address familiar problems around access to care, as well as problems related to resource allocation and rationing, the control of health care costs, and the foundations of public health. Egalitarian theories of justice in health cannot make sense of the depth and pervasiveness of state involvement in health and health care; only a theory rooted in the need to correct market failure can. (shrink)

Recent epidemiological reports of associations between socioeconomic status and epigenetic markers that predict vulnerability to diseases are bringing to light substantial biological effects of social inequalities. Here, we start the discussion of the moral consequences of these findings. We firstly highlight their explanatory importance in the context of the research program on the Developmental Origins of Health and Disease (DOHaD) and the social determinants of health. In the second section, we review some theories of the moral status of (...) health inequalities. Rather than a complete outline of the debate, we single out those theories that rest on the principle of equality of opportunity and analyze the consequences of DOHaD and epigenetics for these particular conceptions of justice. We argue that DOHaD and epigenetics reshape the conceptual distinction between natural and acquired traits on which these theories rely and might provide important policy tools to tackle unjust distributions of health. (shrink)

In addition to having an institutional site or scope, a theory of distributive justice might also have an institutional ‘reach’ or currency. It has the first when it applies to only social phenomena. It has the second when it distributes only socially produced goods. One objection to luck egalitarianism is that it has absurd implications. In response, Tan has defended a luck egalitarian account that has a strictly institutional reach. I argue, first, that Tan’s view contains two (...) fatal ambiguities and, second, that, to be sound, it requires an institutional currency. This second argument implies that virtually all extant luck egalitarian currencies are incompatible with his approach. I argue, third, that the alleged absurd implications often have little to do with the extent of luck egalitarianism’s reach. (shrink)

This essay argues that David Miller's criticisms of global egalitarianism do not undermine the view where it is stated in one of its stronger, luck egalitarian forms. The claim that global egalitarianism cannot specify a metric of justice which is broad enough to exclude spurious claims for redistribution, but precise enough to appropriately value different kinds of advantage, implicitly assumes that cultural understandings are the only legitimate way of identifying what counts as advantage. But that is an (...) assumption always or almost always rejected by global egalitarianism. The claim that global egalitarianism demands either too little redistribution, leaving the unborn and dissenters burdened with their societies' imprudent choices, or too much redistribution, creating perverse incentives by punishing prudent decisions, only presents a problem for global luck egalitarianism on the assumption that nations can legitimately inherit assets from earlier generations – again, an assumption very much at odds with global egalitarian assumptions. (shrink)

In this paper I describe how Kant’s idea about the impossibility of moral luck has come to influence, via Rawls, recent writings in egalitarian theory. I argue that this influence has been detrimental for the study of equality. Further, I claim that the major deficiencies of this post-Rawlsian egalitarianism (nicely described by Elizabeth Anderson’s title “luck egalitarianism) are both effectively critiqued and corrected by the understanding of equality and its value located in John Dewey’s writings.

Luck egalitarianism provides one powerful way of defending global egalitarianism. The basic luck egalitarian idea that persons ought not to be disadvantaged compared to others on account of his or her bad luck seems to extend naturally to the global arena, where random factors such as persons’ place of birth and the natural distribution of the world’s resources do affect differentially their life chances. Yet luck egalitarianism as an ideal, as well as its (...) global application, has come under severe criticisms in recent debate. My aim in this article is to restore plausibility to the luck egalitarian idea, and to suggest how it could then provide a plausible grounding for global egalitarianism. To do this, I will propose a more modest but also more defensible conception of luck egalitarianism that can also strengthen the case for global distributive justice. (shrink)

My aim in this chapter is to place John Stuart Mill’s distinctive utilitarian political philosophy in the context of the debate about luck, responsibility, and equality. I hope it will reveal the extent to which his utilitarianism provides a helpful framework for synthesizing the competing claims of luck and relational egalitarianism. I attempt to show that when Mill’s distributive justice commitments are not decided by direct appeal to overall happiness, they are guided by three main public principles: (...) an impartiality principle, a sufficiency principle, and a merit principle. The question then becomes how luck and relational considerations figure into his articulation of these public principles. I argue that relational egalitarianism is more fundamental than considerations of luck and responsibility in Mill’s thought, but I also hope to show that any fleshed out picture of Mill’s reform proposals must recognize his condemnation of the role luck plays in determining the distribution of opportunities and outcomes. (shrink)

Oppression can be unjust from a luck egalitarian point of view even when it is the consequence of choices for which it is reasonable to hold persons responsible. This is for two reasons. First, people who have not been oppressed are unlikely to anticipate the ways in which their choices may lead them into oppressive conditions. Facts about systematic phenomena (like oppression) are often beyond the epistemic reach of persons who are not currently subject to such conditions, even when (...) they possess adequate information about the particular consequences of their choices. Second, people may be (much) less responsible for remaining in oppressive conditions, even if they are responsible for entering circumstances of oppression. Oppression that results from a person’s choice may cause or contribute to dramatic changes in that person, and these changes may be sufficient to undermine the person’s responsibility for the results of her earlier choice. (shrink)

Paternalistic interventions restrict individuals’ liberty or autonomy so as to guide their decisions towards options that are more beneficial for them than the ones they would choose in the absence of such interventions. Although some philosophers have emphasised that there is a case for justifiable paternalism in certain circumstances, much of contemporary moral and political philosophy works from a strong presumption against paternalistic interventions. However, Richard Arneson has argued that there are egalitarian reasons that support the case for paternalism: paternalistic (...) interventions can protect poor decision-makers from making ‘bad’ choices, thus preventing inequalities between them and those with better decision-making skills. This paper seeks to clarify and advance our understanding of the egalitarian argument for paternalism. Arneson’s argument adds an important and often neglected dimension to the debate about paternalism but also raises a number of questions about equality, paternalism and the relationship between the two. (shrink)

In recent years, interest in desert-based theories of justice has increased, and this seems to represent a challenge to equality-based theories of justice.[i] The best distribution of outcomeadvantage with respect to desert, after all, need not be the most equal distribution of outcomeadvantage. Some individuals may deserve more than others. Outcome egalitarianism is, however, implausible, and so the conflict of outcome desert with outcome equality is of little significance.[ii] Most contemporary versions of egalitarianism are concerned with neutralizing the (...) differential effects of brute luck and not with equality of outcome. I shall argue that, in order to be plausible, a desert-based theory of justice can and must be compatible with this form of egalitarianism. There is, however, a stronger form of brute luck egalitarianism, which, as I shall explain, is concerned with equalizing the advantages from brute luck—and not merely with neutralizing the differential effects thereof. Under idealized conditions in which agents have perfect information about the outcomes that their choices generate, even this stronger form of egalitarianism, I shall show, is compatible with pure desert theory. Under conditions of incomplete information, however, strong brute luck egalitarianism is incompatible with a pure desert theory that appeals, as I shall explain, to moral, rather than prudential, desert. (shrink)

Many widely divergent accounts of luck have been offered or employed in discussing an equally wide range of philosophical topics. We should, then, expect to find some unified philosophical conception of luck of which moral luck, epistemic luck, and luck egalitarianism are species. One of the attempts to provide such an account is that offered by Duncan Pritchard, which he refers to as the modal account. This view commits us to calling an event lucky (...) when it obtains in this world, but fails to obtain in a wide class of nearby possible worlds. In support of this account, Pritchard argues that a theory of luck ought to capture the fact that luck comes in degrees and that luck is closely associated with risk. I argue against this claim by suggesting that an understanding of luck grounded in considerations of probability is better able to satisfy these demands, and that the probability theory better explains exemplary cases of luck like those brought up by Pritchard. (shrink)

This article explores the Rawlsian goal of ensuring that distributions are not influenced by the morally arbitrary. It does so by bringing discussions of distributive justice into contact with the debate over moral luck initiated by Williams and Nagel. Rawls’ own justice as fairness appears to be incompatible with the arbitrariness commitment, as it creates some equalities arbitrarily. A major rival, Dworkin’s version of brute luck egalitarianism, aims to be continuous with ordinary ethics, and so is (a) (...) sensitive to non-philosophical beliefs about free will and responsibility, and (b) allows inequalities to arise on the basis of option luck. But Dworkin does not present convincing reasons in support of continuity, and there are compelling moral reasons for justice to be sensitive to the best philosophical account of free will and responsibility, as is proposed by the revised brute luck egalitarianism of Arneson and Cohen. While Dworkinian brute luck egalitarianism admits three sorts of morally arbitrary disadvantaging which correspond to three forms of moral luck (constitutive, circumstantial, and option luck), revised brute luck egalitarianism does not disadvantage on the basis of constitutive or circumstantial luck. But it is not as sensitive to responsibility as it needs to be to fully extinguish the influence of the morally arbitrary, for persons under it may exercise their responsibility equivalently yet end up with different outcomes on account of option luck. It is concluded that egalitarians should deny the existence of distributive luck, which is luck in the levels of advantage that individuals are due. (shrink)

According to luck egalitarianism, it is unjust if some are worse off than others through no fault or choice of their own. The most common criticism of luck egalitarianism is the ‘harshness objection’, which states that luck egalitarianism allows for too harsh consequences, as it fails to provide justification for why those responsible for their bad fate can be entitled to society's assistance. It has largely gone unnoticed that the harshness objection is open to (...) a number of very different interpretations. We present four different interpretations of the harshness objection in which the problem pertains to counterintuitive implications, badness of outcome, disproportionality, or inconsistency, respectively. We analyse and discuss appropriate luck egalitarian replies. Disentangling these different versions clarifies what is at the heart of this dispute and reveals the point of the harshness objection. We conclude that only the inconsistency version involves a durable problem for luck egalitarianism. (shrink)

In the luck egalitarian literature, one influential formulation of luck egalitarianism does not specify whether equalities that do not reflect people’s equivalent exercises of responsibility are bad with regard to inequality. This equivocation gives rise to two competing versions of luck egalitarianism: asymmetrical and symmetrical luck egalitarianism. According to the former, while inequalities due to luck are unjust, equalities due to luck are not necessarily so. The latter view, by contrast, affirms (...) the undesirability of equalities as well as inequalities insofar as they are due to luck. The symmetrical view, we argue, is by far the more compelling, both by internal luck egalitarian standards and in light of the external rightist emphasis on choice and responsibility to which luck egalitarianism may partly be seen as a response. Our main case for the symmetrical view is that when some people, against a background of equal opportunities, do not exercise their responsibility to the same degree as others, they cannot justifiably call for equalizing measures to be put in place. Indeed, such measures would be positively unfair. The symmetrical view, accordingly, rejects compensation in such cases, whereas the asymmetrical view, implausibly, enjoins it. We also examine two objections to this argument. First, that this view fails to qualify as genuinely egalitarian, instead collapsing the notion of equality into the notion of desert. Second, that the opposing asymmetrical view, in contrast to the symmetrical view, can draw support from its compatibility with sufficientarian concerns. Both objections are rebutted. We conclude that luck egalitarians are best served by endorsing the symmetrical, luck-neutralizing stance. (shrink)

According to all-luck egalitarianism, the differential distributive effects of both brute luck, which defines the outcome of risks which are not deliberately taken, and option luck, which defines the outcome of deliberate gambles, are unjust. Exactly how to correct the effects of option luck is, however, a complex issue. This article argues that (a) option luck should be neutralized not just by correcting luck among gamblers, but among the community as a whole, because (...) it would be unfair for gamblers as a group to be disadvantaged relative to non-gamblers by bad option luck; (b) individuals should receive the warranted expected results of their gambles, except insofar as individuals blamelessly lacked the ability to ascertain which expectations were warranted; and (c) where societal resources are insufficient to deliver expected results to gamblers, gamblers should receive a lesser distributive share which is in proportion to the expected results. Where all-luck egalitarianism is understood in this way, it allows risk-takers to impose externalities on non-risk-takers, which seems counterintuitive. This may, however, be an advantage as it provides a luck egalitarian rationale for assisting ‘negligent victims’. (shrink)