Rawls offers three arguments for the priority of liberty in Theory, two of which share a common error: the belief that once we have shown the instrumental value of the basic liberties for some essential purpose (e.g., securing self-respect), we have automatically shown the reason for their lexical priority. The third argument, however, does not share this error and can be reconstructed along Kantian lines: beginning with the Kantian conception of autonomy endorsed by Rawls in section 40 of (...) Theory, we can explain our highest-order interest in rationality, justify the lexical priority of all basic liberties, and reinterpret Rawls’ threshold condition for the application of the priority of liberty. Perhaps unsurprisingly, this Kantian reconstruction will not work within the radically different framework of Political Liberalism. (shrink)

I will defend two claims. First, Schaffer's priority monism is in tension with many research programs in quantum gravity. Second, priority monism can be modified into a view more amenable to this physics. The first claim is grounded in the fact that promising approaches to quantum gravity such as loop quantum gravity or string theory deny the fundamental reality of spacetime. Since fundamental spacetime plays an important role in Schaffer's priority monism by being identified with the fundamental (...) structure, namely the cosmos, the disappearance of spacetime in these views might undermine classical priority monism. My second claim is that priority monism can avoid this issue with two moves: first, in dropping one of its core assumptions, namely that the fundamental structure is spatio-temporal, second, by identifying the connection between the non-spatio-temporal structure and the derivative spatio-temporal structure with mereological composition. (shrink)

Priority monism is the view that the cosmos is the only independent concrete object. The paper argues that, pace its proponents, Priority monism is in conflict with the dependence of any whole on any of its parts: if the cosmos does not depend on its parts, neither does any smaller composite.

In this paper, I introduce a version of perdurantism called Priority Perdurantism, according to which perduring, four-dimensional objects are ontologically fundamental and the temporal parts of those objects are ontologically derivative, depending for their existence and their identity on the four-dimensional wholes of which they are parts. I argue that by switching the order of the priority relations this opens up new solutions to the too-many-thinkers problem and the personite problem – solutions that are more ontologically robust than (...) standard maximality solutions. I then consider and respond to two initial objections to the view: that it no longer counts as a perdurantist theory and that it reintroduces the problem of temporary intrinsics. I conclude by offering two further advantages of priority perdurantism: that it is consistent with hunky time and with the existence of irreducibly temporally-extended actions, such as those pertaining to deliberative agency. (shrink)

According to the priority view, or prioritarianism, it matters more to benefit people the worse off they are. But how exactly should the priority view be defined? This article argues for a highly general characterization which essentially involves risk, but makes no use of evaluative measurements or the expected utility axioms. A representation theorem is provided, and when further assumptions are added, common accounts of the priority view are recovered. A defense of the key idea behind the (...) priority view, the priority principle, is provided. But it is argued that the priority view fails on both ethical and conceptual grounds. (shrink)

Michail Peramatzis presents a new interpretation of Aristotle's view of the priority relations between fundamental and derivative parts of reality, following ...

This book explores the relation between agape (or Christian charity) and social justice. Timothy Jackson defines agape as the central virtue in Christian ethical thought and action and applies his insights to three concrete issues: political violence, forgiveness, and abortion. Taking his primary cue from the New Testament while drawing extensively from contemporary theology and philosophy, Jackson identifies three features of Christian charity: unconditional commitment to the good of others, equal regard for others' well-being, and passionate service open to self-sacrifice (...) for the sake of others. Charity, prescribed by Jesus for his disciples and named by Saint Paul as the "greatest" theological virtue, is contrasted with various accounts of justice. Jackson argues that agape is not trumped by justice or other goods. Rather, agape precedes justice: without the work of love, society would not produce persons capable of merit, demerit, and contract, the elements of most modern conceptions of justice. Jackson then considers the implications of his ideas for several questions: the nature of God, the relation between Christian love and political violence, the place of forgiveness, and the morality of abortion. Arguing that agapic love is to be construed as a gift of grace as well as a divine commandment, Jackson concludes that love is the "eternal life" that makes temporal existence possible and thus the "first" Christian virtue. Though foremost a contribution to Christian ethics, Jackson's arguments and the issues he takes up will find a broader readership. (shrink)

This paper motivates and develops a new theory of time: priority presentism. Priority presentism is the view according to which (i) only present entities exist fundamentally and (ii) past and future entities exist, but they are grounded in the present. The articulation of priority presentism is an exercise in applied grounding: it draws on concepts from the recent literature on ontological dependence and applies those concepts in a new way, to the philosophy of time. The result, as (...) I will argue, is an attractive position that can do much of the same work in satisfying our intuitions about time as presentism, but without the ontological cost. (shrink)

Priority monism is roughly the view that the universe is the only fundamental object, that is, a concrete object that does not depend on any other concrete object. Schaffer, the main advocate of PM, claims that PM is compatible with dependence having two different directions: from parts to wholes for subcosmic wholes, and from whole to parts for the cosmic whole. Recently it has been argued that this position is untenable. Given plausible assumptions about dependence, PM entails that dependence (...) has only one direction, it always goes from wholes to parts. One such plausible assumption is a principle of Isolation. I argue that, given all extant accounts of dependence on the market, PM entails No Isolation. The argument depends upon a particular feature of the dependence relation, namely, necessitation and its direction. In the light of this, I contend that the argument is important, insofar as it suggests that we should distinguish dependence from other cognate notions, e.g. grounding. Once this distinction is made, I suggest we should also distinguish between two different notions of fundamentality that might turn out to be not-coextensive. (shrink)

In The Priority of the Person, world-class philosopher David Walsh advances the argument set forth in his highly original philosophic meditation Politics of the Person as the Politics of Being (2015), that "person" is the central category of modern political thought and philosophy. This book is divided into three main parts. Beginning with the political discovery of the inexhaustibility of persons, it then explores the philosophic differentiation of the idea of the "person," and finally traces its historical emergence through (...) art, science, and faith. Walsh argues that, although the roots of the idea of "person" are found in the Greek concept of the mind and in the Christian conception of the soul, this notion is ultimately a distinctly modern achievement, because it is only the modern turn toward interiority that illuminated the unique nature of persons as each being a world unto him or herself. As Walsh shows, it is precisely this feature of persons that makes it possible for us to know and communicate with others, for we can only give and receive one another as persons. In this way alone can we became friends and, in friendship, build community. In showing how the person is modernity's central preoccupation, and in demonstrating how it is only as persons that we can truly give ourselves to others and thus develop real community, David Walsh's The Priority of the Person makes an important contribution to current discussions in both political theory and philosophy. It will also appeal to students and scholars of theology and literature, and any groups interested in the person and personalism. (shrink)

In this article, I address concerns that the ontological priority claims definitive of ontic structural realism are as they stand unclear, and I do so by placing these claims on a more rigorous formal footing than they typically have been hitherto. I first of all argue that Kit Fine’s analysis of ontological dependence furnishes us with an ontological priority relation that is particularly apt for structuralism. With that in place, and with reference to two case studies prominent within (...) the structuralist literature, I consider whether any of structuralism’s distinctive priority claims may be regarded as warranted. The discussion as a whole has largely negative implications for the radical structuralism of French and Ladyman (including their ‘eliminativist’ interpretation of it), largely positive implications for the moderate structuralism primarily advocated by Esfeld and Lam, and some broad lessons for contemporary fundamentalist metaphysics as a whole. 1 Introduction2 The Right Priority Relation for Structuralism: Supervenience or Dependence?3 Introducing Ontological Dependence4 Fine’s System5 The Priority of Structure 1: Entangled Quantum Particles6 The Priority of Structure 2: The Group-Theoretic Conception of Elementary Particles7 Concluding Remarks. (shrink)

Many moral theories are committed to the idea that some kinds of moral considerations should be respected, whatever the cost to ‘lesser’ types of considerations. A person's life, for instance, should not be sacrificed for the trivial pleasures of others, no matter how many would benefit. However, according to the decision-theoretic critique of lexical priority theories, accepting lexical priorities inevitably leads us to make unacceptable decisions in risky situations. It seems that to operate in a risky world, we must (...) reject lexical priorities altogether. This paper argues that lexical priority theories can, in fact, offer satisfactory guidance in risky situations. It does so by equipping lexical priority theories with overlooked resources from decision theory. (shrink)

The combination of panpsychism and priority monism leads to priority cosmopsychism, the view that the consciousness of individual sentient creatures is derivative of an underlying cosmic consciousness. It has been suggested that contemporary priority cosmopsychism parallels central ideas in the Advaita Vedānta tradition. The paper offers a critical evaluation of this claim. It argues that the Advaitic account of consciousness cannot be characterized as an instance of priority cosmopsychism, points out the differences between the two views, (...) and suggests an alternative positioning of the Advaitic canon within the contemporary debate on monism and panpsychism. (shrink)

In recent years there has been a good deal of discussion of equality’s place in the best account of distribution or distributive justice. One central question has been whether egalitarianism should give way to a principle requiring us to give priority to the worse off. In this article, I shall begin by arguing that the grounding of equality is indeed insecure and that the priority principle appears to have certain advantages over egalitarianism. But I shall then claim that (...) the priority principle itself is ungrounded and that the priority principle should itself give way to a sufficiency principle based — indirectly, via the notion of an impartial spectator — on compassion for those who are badly off. (shrink)

This paper offers a critique of the “democratic state of education” proposed by Amy Gutmann in her influential book Democratic Education. In the democratic state of education, educational authority is shared among the state, parents and educational professionals; and educational objectives are geared toward equipping future citizens to participate in what Gutmann calls “conscious social reproduction”—the collective shaping of the future of society through democratic deliberation. Although I agree with some of Gutmann’s broad recommendations for civic education, I have misgivings (...) about the centrality that she gives to conscious social reproduction in her theory of education. I argue that in focusing so intently on the facilitation of conscious social reproduction, Gutmann’s theory makes insufficient room for the basic interests of individual children, and in particular, their prospective interest in autonomy. Gutmann’s considered position on sex education policy—specifically, her willingness to allow local communities to deny their children access to sex education—exemplifies the shortcomings of her theory. Ultimately, her democratic state of education fails to acknowledge the fundamental moral importance of individual flourishing, and the contribution that education can and should make to it. (shrink)

This book presents a unifying framework for using priority arguments to prove theorems in computability. Priority arguments provide the most powerful theorem-proving technique in the field, but most of the applications of this technique are ad hoc, masking the unifying principles used in the proofs. The proposed framework presented isolates many of these unifying combinatorial principles and uses them to give shorter and easier-to-follow proofs of computability-theoretic theorems. Standard theorems of priority levels 1, 2, and 3 are (...) chosen to demonstrate the framework's use, with all proofs following the same pattern. The last section features a new example requiring priority at all finite levels. The book will serve as a resource and reference for researchers in logic and computability, helping them to prove theorems in a shorter and more transparent manner"--Provided by publisher. (shrink)

Michael Otsuka, Alex Voorhoeve and Marc Fleurbaey have challenged the priority view in favour of a theory based on competing claims. The present paper shows how their argument can be used to recast the priority view. All desert claims in distributive justice are comparative. The stronger a party’s claims to a given benefit, the greater is the value of her receiving it. Ceteris paribus, the worse-off have stronger claims on welfare, and benefits to them matter more. This can (...) account for intuitions that at first appear egalitarian, as the analysis of an example of Larry Temkin’s shows. The priority view, properly understood, is desert-adjusted utilitarianism under the assumption that no other claims pertain. (shrink)

In recent work, Louis deRosset (Philosophical Studies 149:73–97, 2010) has argued that priority theorists, who hold that truths about macroscopic objects can be metaphysically explained without reference to such things, cannot meet an independently motivated constraint upon good explanation. By clarifying the nature of the priority theorist’s project, I argue that deRosset’s argument fails to establish its conclusion.

In this article, I examine Leibniz’s criticism of Spinoza’s notion of priority by nature based on the first proposition in Spinoza’s Ethics. Leibniz provides two counterexamples: first, the number 10’s being 6+3+1 is prior by nature to its being 6+4; second, a triangle’s property that two internal angles are equal to the exterior angle of the third is prior by nature to its property that the three internal angles equal two right angles. Leibniz argues that Spinoza’s notion cannot capture (...) these priority relations. Although this text has received some scholarly attention, Leibniz’s objection in this text has not been fully explained yet. I argue that evaluating Leibniz’s objection relies on how to understand Spinoza’s notion of conception: first, whether conception is co-extensive with inherence and causation; second, whether conception is mental. (shrink)

Argument that priority monism is best understood as being a contingent thesis.

Consider the kinds of macroscopic concrete objects that common sense and the sciences allege to exist: tables, raindrops, tectonic plates, galaxies, and the rest. Are there any such things? Opinions differ. Ontological liberals say they do; ontological radicals say they don't. Liberalism seems favored by its plausible acquiescence to the dictates of common sense abetted by science; radicalism by its ontological parsimony. Priority theorists claim we can have the virtues of both views. They hold that tables, raindrops, etc., exist, (...) but they aren't fundamental. The ontological liberal's ontology provides the correct inventory of existent individuals. The ontological radical's more restricted ontology provides the correct inventory of fundamental individuals. The priority theorist claims that the derivative individuals are "no addition in being" to the fundamental ones, so we can have our cake and eat it too. It would be nice if priority theorists were right. In this paper I argue, with regret, that they are not. One upshot is that the sort of explanations which underwrite the priority theorist's distinction between fundamental and derivative individuals do not mitigate our ontological commitments. Another is that we still have to choose between the charms of liberalism and radicalism. (shrink)

I introduce and argue for a Priority Principle, according to which we exemplify certain of our mental properties in the primary or non-derivative sense. I then apply this principle to several debates in the metaphysics and philosophy of mind.

In recent work, the interrelated questions of whether there is a fundamental level to reality, whether ontological dependence must have an ultimate ground, and whether the monist thesis should be endorsed that the whole universe is ontologically prior to its parts have been explored with renewed interest. Jonathan Schaffer has provided arguments in favour of 'priority monism' in a series of articles (2003, 2004, 2007a, 2007b, forthcoming). In this paper, these arguments are analysed, and it is claimed that they (...) are not compelling: in particular, the possibility that there is no ultimate level of basic entities that compose everything else is on a par with the possibility of infinite 'upward' complexity. The idea that we must, at any rate, postulate an ontologically fundamental level for methodological reasons ( Cameron 2008 ) is also discussed and found unconvincing: all things considered, there may be good reasons for endorsing 'metaphysical infinitism'. In any event, a higher degree of caution in formulating metaphysical claims than found in the extant literature appears advisable. (shrink)

Derek Parfit has argued that (Teleological) Egalitarianism is objectionable by breaking a person-affecting claim to the effect that an outcome cannot be better in any respect - such as that of equality - if it is better for nobody. So, he presents the Priorty View, i.e., the policy of giving priority to benefiting the worse-off, which avoids this objection. But it is here argued, first, that there is another person-affecting claim that this view violates. Secondly, Egalitarianism can be construed (...) as person-affecting in a weaker sense. Thirdly, it is possible to construct a Relational version of the Priority View which incorporates the Egalitarian value of just equality in this sense. Two reasons are given for why this Relational View and Egalitarianism are superior to the Parfitian Absolute Priority View. However, no attempt is made to abjudicate between the first two views, the main point being that they both accept the value of just equality in the same sense. (shrink)

Should priority in the allocation of organs be given to those who have previously donated or declared their willingness to do so? This article examines the Israeli priority rule in light of two prominent critiques of priority rules, pertaining to failure to reciprocate and unfairness. The scope and content of these critiques are interpreted from the perspective of equality of opportunity. Because the Israeli priority rule may be reasonably criticized for unfairness and failing to reward certain (...) behaviors, the article develops an adjusted priority rule, which removes and adjust the elements in the Israeli priority rule deemed problematic. However, such a priority rule is complex to the extent that it may fail to increase donation rates and furthermore introduce new concerns of fairness, as the better off may be better able to navigate the complex adjusted priority rule. (shrink)

The priority rule in science has been interpreted as a behavior regulator for the scientific community, which benefits society by adequately structuring the distribution of intellectual labor across pre-existing research programs. Further, it has been lauded as part of society's "grand reward scheme" because it fairly rewards people for the benefits they produce. But considerations about how news of scientific developments spreads throughout a scientific community at large suggest that the priority rule is something else entirely, which can (...) disadvantage historically underrepresented or otherwise marginalized social groups. (shrink)

Background:The global COVID-19 pandemic has imposed challenges on healthcare systems and professionals worldwide and introduced a ´maelstrom´ of ethical dilemmas. How ethically demanding situations are handled affects employees’ moral stress and job satisfaction.Aim:Describe priority-setting dilemmas, moral distress and support experienced by nurses and physicians across medical specialties in the early phase of the COVID-19 pandemic in Western Norway.Research design:A cross-sectional hospital-based survey was conducted from 23 April to 11 May 2020.Ethical considerations:Ethical approval granted by the Regional Research Ethics Committee (...) in Western Norway (131421).Findings:Among the 1606 respondents, 67% had experienced priority-setting dilemmas the previous two weeks. Healthcare workers who were directly involved in COVID-19 care, were redeployed or worked in psychiatry/addiction medicine experienced it more often. Although 59% of the respondents had seen adverse consequences due to resource scarcity, severe consequences were rare. Moral distress levels were generally low (2.9 on a 0–10 scale), but higher in selected groups (redeployed, managers and working in psychiatry/addiction medicine). Backing from existing collegial and managerial structures and routines, such as discussions with colleagues and receiving updates and information from managers that listened and acted upon feedback, were found more helpful than external support mechanisms. Priority-setting guidelines were also helpful.Discussion:By including all medical specialties, nurses and physicians, and various institutions, the study provides information on how the COVID-19 mitigation also influenced those not directly involved in the COVID-19 treatment of patients. In the next stages of the pandemic response, support for healthcare professionals directly involved in outbreak-affected patients, those redeployed or those most impacted by mitigation strategies must be a priority.Conclusion:Empirical research of healthcare workers experiences under a pandemic are important to identify groups at risks and useful support mechanisms. (shrink)

This book develops an empirically informed normative theory of need-based justice, summarizing core findings of the DFG research group FOR2104 “Need-based Justice and Distributive Procedures”. In eleven chapters scholars from the fields of economics, political science, philosophy, psychology, and sociology cover the identification and rationale of needs, the recognition and legitimacy of needs, the dynamics and stability of procedures of distributions according to needs, and the consequences and sustainability of need-based distributions. These four areas are studied from the perspective of (...) two mechanisms of need objectification, the social objectification by the discursive generation of mutual understanding (transparency) and the factual objectification by the transfer of decisions to uninvolved experts (expertise). The volume addresses academics in the fields of justice research, ethics, political theory, social choice and welfare, framing, individual and group decision making, inequality and redistribution, as well as advanced students in the contributing disciplines. (shrink)

John Rawls’s thesis that a certain package of basic liberties should be given lexical priority is of great interest for legal and political philosophy, but it has received relatively little defense from Rawls or his supporters. In this paper, I examine three arguments for the thesis: the first is based on the two ‘moral powers’; the second, on the social bases of self-respect; and the third, on a Kantian notion of autonomy. I argue none of these accounts successfully establishes (...) 1) the distinct claim of lexical priority, 2) for the complete package of basic liberties, on the basis of reasons that are appropriately public. In turn, I propose an alternative argument, in support of those two claims, based on the social or ‘relational’ conception of equality. (shrink)

Steinberg has recently proposed an argument against Schaffer’s priority monism. The argument assumes the principle of Necessity of Monism, which states that if priority monism is true, then it is necessarily true. In this paper, I argue that Steinberg’s objection can be eluded by giving up Necessity of Monism for an alternative principle, that I call Essentiality of Fundamentality, and that such a principle is to be preferred to Necessity of Monism on other grounds as well.

Truthmaker monism is the view that the one and only truthmaker is the world. Despite its unpopularity, this view has recently received an admirable defence by Schaffer :307–324, 2010b). Its main defect, I argue, is that it omits partial truthmakers. If we omit partial truthmakers, we lose the intimate connection between a truth and its truthmaker. I further argue that the notion of a minimal truthmaker should be the key notion that plays the role of constraining ontology and that truthmaker (...) monism is not necessary for an appropriate solution to the problem of finding truthmakers for negative truths. I conclude that we should reject truthmaker monism once and for all. (shrink)

Some philosophers and segments of the public think age is relevant to healthcare priority-setting. One argument for this is based in equity: “Old” patients have had either more of a relevant good than “young” patients or enough of that good and so have weaker claims to treatment. This article first notes that some discussions of age-based priority that focus in this way on old and young patients exhibit an ambiguity between two claims: that patients classified as old should (...) have a low priority, and that patients classified as young should have high priority. The author next argues, drawing on a problem raised by Christine Overall, that equity cannot justify giving “old” patients low priority, since there is wide variety in the total lifetime experiences of older people, partly influenced by gender, race, class, and disability injustice. Finally, the author suggests that there might be a limited role for age-based prioritization in the context of infant and childhood death, since those who die in childhood are always and uncontroversially among the worst-off. (shrink)

Is the mind just a by-product of the brain? Or is mind the fundamental reality, which creates matter? This book is a defense of mind as prior to matter. It is a philosophical work, written in an accessible style, which explains idealism as the teaching of most classical philosophers, and as most consistent with modern science"-- Back cover.

One‐third of all human deaths are due to poverty‐related causes, to malnutrition and to diseases that can be prevented or cured cheaply. Yet our politicians, academics, and mass media show little concern for how such poverty might be reduced. They are more interested in possible military interventions to stop human rights violations in developing countries, even though such interventions – at best – produce smaller benefits at greater cost. This Western priority may be rooted in self‐interest. But it engenders, (...) and is sustained by, a deeply flawed moral presentation of global economic cooperation. The new global economic order we impose aggravates global inequality and reproduces severe poverty on a massive scale. On any plausible understanding of our moral values, the prevention of such poverty is our foremost responsibility. (shrink)

Prioritized bases, i.e., weakly ordered sets of sentences, have been used for specifying an agent’s ‘basic’ or ‘explicit’ beliefs, or alternatively for compactly encoding an agent’s belief state without the claim that the elements of a base are in any sense basic. This paper focuses on the second interpretation and shows how a shifting of priorities in prioritized bases can be used for a simple, constructive and intuitive way of representing a large variety of methods for the change of belief (...) states—methods that have usually been characterized semantically by a system-of-spheres modeling. Among the methods represented are ‘radical’, ‘conservative’ and ‘moderate’ revision, ‘revision by comparison’ in its raising and lowering variants, as well as various constructions for belief expansion and contraction. Importantly, none of these methods makes any use of numbers. (shrink)

Priority setting in health care is ubiquitous and health authorities are increasingly recognising the need for priority setting guidelines to ensure efficient, fair, and equitable resource allocation. While cost-effectiveness concerns seem to dominate many policies, the tension between utilitarian and deontological concerns is salient to many, and various severity criteria appear to fill this gap. Severity, then, must be subjected to rigorous ethical and philosophical analysis. Here we first give a brief history of the path to today’s severity (...) criteria in Norway and Sweden. The Scandinavian perspective on severity might be conducive to the international discussion, given its long-standing use as a priority setting criterion, despite having reached rather different conclusions so far. We then argue that severity can be viewed as a multidimensional concept, drawing on accounts of need, urgency, fairness, duty to save lives, and human dignity. Such concerns will often be relative to local mores, and the weighting placed on the various dimensions cannot be expected to be fixed. Thirdly, we present what we think are the most pertinent questions to answer about severity in order to facilitate decision making in the coming years of increased scarcity, and to further the understanding of underlying assumptions and values that go into these decisions. We conclude that severity is poorly understood, and that the topic needs substantial further inquiry; thus we hope this article may set a challenging and important research agenda. (shrink)

This paper aims to illuminate some issues in the equality, priority, or what debate. I characterize egalitarianism and prioritarianism, respond to the view that we should care about sufficiency or compassion rather than equality or priority, discuss the levelling down objection, and illustrate the significance of the distinction between prioritarianism and egalitarianism, establishing that the former is no substitute for the latter. In addition, I respond to Bertil Tungodden's views regarding the Slogan, the levelling down objection, the Pareto (...) Principle, leximin, the principle of personal good, strict moderate egalitarianism, the Hammond Equity Condition, the intersection approach, and non-aggregative reasoning. (shrink)

The coronavirus disease 2019 (COVID-19) pandemic has motivated medical ethicists and several task forces to revisit or issue new guidelines on allocating scarce medical resources. Such guidelines are relevant for the allocation of scarce therapeutics and vaccines and for allocation of ICU beds, ventilators, and other life-sustaining treatments or potentially scarce interventions. Principles underlying these guidelines, like saving the most lives, mitigating disparities, reciprocity to those who assume additional risk (eg, essential workers and clinical trial participants), and equal access may (...) compete with one another. We propose the use of a “categorized priority system” (also known as a “reserve system”) as an improvement over existing allocation methods, particularly because it may be able to achieve disparity mitigation better than other methods. (shrink)

There has been much discussion about how to obtain legitimacy at macro-level priority setting in health care by use of fair procedures, but how should we consider priority setting by individual clinicians or health workers at the micro-level? Despite the fact that just health care totally hinges upon their decisions, surprisingly little attention seems being paid to the legitimacy of these decisions. This paper addresses the following question: what are the conditions that have to be met in order (...) to ensure that individual claims on health care are well aligned with an overall concept of just health care? Drawing upon a distinction between individual and aggregated needs, I argue that even though we assume the legitimacy of macro-level guidelines, this legitimacy is not directly transferable to decisions at micro-level simply by adherence to the guidelines’ recommendation. Further, I argue that individual claims are subject to the formal principle of equality and the demands of vertical and horizontal equity in a way that gives context- and patient-related equity concerns precedence over equity concerns captured at the macro-level. I conclude that if we aim to achieve just health care, we need to develop a complementary framework for legitimising individual judgment of patients’ claims on health care resources. Moreover, I suggest the basic structure of such a framework. (shrink)

The purpose of this paper is to discuss the accountability for reasonableness and its four conditions. This explains the priority setting and resource allocation for scarce resources. In this article it is discussed that how the scarce resources in a developing country like Pakistan be allocated in health care. This is explained with the help of case scenario.

Some theories of practical reasons incorporate a lexical priority structure, according to which some practical reasons have infinitely greater weight than others. This includes absolute deontological theories and axiological theories that take some goods to be categorically superior to others. These theories face problems involving cases in which there is a non-extreme probability that a given reason applies. In view of such cases, lexical-priority theories are in danger of becoming irrelevant to decision-making, becoming absurdly demanding, or generating paradoxical (...) cases in which each of a pair of actions is permissible yet the pair is impermissible. (shrink)