This article introduces a symposium on Daniel Hausman’s Valuing Health: Well-Being, Suffering and Freedom. The symposium contains papers by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Erik Nord, Alex Voorhoeve and James Wilson, with replies by Daniel Hausman. In Valuing Health, Hausman argues that, despite apparently measuring health, projects such as the Global Burden of Disease Study in fact measure judgments about the value of health. Once this has been clarified, the key question is how the value of health should be (...) measured. Hausman argues that existing instruments measure the private value of health, that is, health’s ‘contribution to whatever the individual cares about or should care about’, whereas what should be measured for resource allocation purposes is the public value of health, that is, the value health should be accorded from the perspective of the liberal state. Hausman argues that the public value of health should be measured by the extent to which suffering and activity limitations are relieved. Each commentator engages with a different aspect of Hausman’s argument. (shrink)

Most non-consequentialists “let the numbers count” when one can save either a lesser or greater number from equal or similar harm. But they are wary of doing so when one can save either a small number from grave harm or instead a very large number from minor harm. Limited aggregation is an approach that reconciles these two commitments. It is motivated by a powerful idea: our decision whom to save should respect each person who has a claim to our help, (...) including those whom we fail to save. However, it has recently been argued that it is open to decisive objections. I develop a new limitedly aggregative view:Hybrid Balance Relevant Claims. This view is well grounded in the reasons we have to be skeptical of aggregation and resolves all recent challenges by paying careful attention to the rationale for limited aggregation. (shrink)

Ex ante contractualism holds that in situations involving risk we ought to act in accordance with principles that license the action that satisfies the strongest individual claim, where those claims are a function of the expected value that a given policy gives each person ex ante. I here challenge ex ante contractualism on contractualist grounds. I argue that adopting ex ante contractualism would have far reaching implications that contractualists, or many nonconsequentialist in general, would find very hard to accept. I (...) conclude that to block these implications, contractualists should adopt an ex post approach to deal with decisions under risk. (shrink)

Is there any number of people you should save from paralysis rather than saving one person from death? Is there any number of people you should save from a migraine rather than saving one person from death? Many people answer ‘yes’ and ‘no’, respectively. The aim of partially aggregative moral views is to capture and justify combinations of intuitions like these. These views contrast with fully aggregative moral views, which imply that the answer to both questions is ‘yes’, and with (...) non-aggregative moral views, which imply that the answer to both questions is ‘no’. In this paper, I review the most natural and influential ways of developing partially aggregative views and explain the main problems they face. (shrink)

This essay responds to the helpful criticisms of Valuing Health: Well-Being, Freedom, and Suffering, which have been offered by Elselijn Kingma, Adam Oliver, Anna Alexandrova, Alex Voorhoeve, Erik Nord and James Wilson. I am extremely grateful to Jonathan Wolf and especially James Wilson for arranging a one-day conference on my book, Valuing Health: Well-Being, Freedom, and Suffering [Hausman, D.. Valuing Health: Well-Being, Freedom, and Suffering. Oxford: Oxford University Press.], and for publishing this symposium. I am also grateful to the wonderful (...) six scholars who took the time to study my work and to offer perceptive and helpful criticisms. Without unduly trying the patience of readers, I cannot respond to all their remarks, but I hope that in what follows I have replied to the most important of their comments on the arguments and conclusions of Valuing Health. Before I begin these replies, a brief synopsis of Valuing Health may be helpful to the reader. (shrink)

Haecceitism is the thesis that, necessarily, in addition to its qualities, each thing has a haecceity or individual essence. The purpose of this paper is to expose a flaw in haecceitism: it entails that familiar cases of fission and fusion either admit of no explanation or else only admit of explanations too bizarre to warrant serious consideration. Because the explanatory problem we raise for haecceitism closely resembles the Euthyphro problem for divine command theory, we refer to our objection as the (...) haecceitic Euthyphro problem, or the Haecceitic Euthyphro for short. We conclude that the objection is decisive against haecceitism. (shrink)

There is a well-known moral quandary concerning how to account for the rightness or wrongness of acts that clearly contribute to some morally significant outcome – but which each seem too small, individually, to make any meaningful difference. One consequentialist-friendly response to this problem is to deny that there could ever be a case of this type. This paper pursues this general strategy, but in an unusual way. Existing arguments for the consequentialist-friendly position are sorites-style arguments. Such arguments imagine varying (...) a subject’s predicament bit by bit until it is clear that a relevant difference has been achieved. The arguments offered in this paper are structurally different, and do not rely on any sorites series. For this reason, they are not vulnerable to objections that have been leveled against the sorites-style arguments. (shrink)

This thesis is about the moral reasons we have to do less than best. It consists of six chapters. Part I of the thesis proposes, extends, and defends reasons to do less than best. In Chapter One (“The Conditional Obligation”) I outline and reject two recent arguments from Joe Horton and Theron Pummer for the claim that we have a conditional obligation to bring about the most good. In Chapter Two (“Agglomeration and Agent-Relative Costs”) I argue that agent-relative costs can (...) justify permissions to less than best in a far greater range of decisions contexts than we currently believe. In Chapter Three (“Risk and Aggregation”) I discuss how anti-aggregative moral theories deal with risk, whilst proposing an argument in favour of ex-post moral theories. -/- In Part II of the thesis, I discuss longtermism, presenting a series of reasons to believe we have both significant permissions and obligations to prioritise those in the short-term. In Chapter Four (“Listening to Future People”) I criticise a recent argument presented by Andreas Mogensen for the claim we cannot have obligations grounded in the wellbeing of future people. I then show that, even permitting the existence of obligations to future people, we still have significant reasons to resist longtermism on the grounds of partiality. In Chapter Five (“The Complaints of Future People”) I argue that scepticism about aggregation is inconsistent with an obligation, or indeed even a permission, to help far future people. In Chapter Six (“Leaving the Present Behind”) I explore the moral significance of “dooming”, whilst arguing that we have a pro tanto reason of fairness to prioritise aiding those currently in existence. (shrink)

A number of philosophers have argued that if you care about how much goodness your actions generate, or how good the state-of-affairs you actions bring about are, then your attention should be directed towards the very far future. But many don’t care about how much goodness their actions generate, nor do they care about things like “states-of-affairs”. Amongst a multitude of things, many people care about how their actions impact individuals. And they also care about the sorts of justifications they (...) are able to offer for those actions. One moral theory which captures this moral viewpoint is contractualism. In this chapter, I argue that contractualism is, in large part, incompatible with longtermism – the view that, in many contexts, we ought to do that which will most improve the prospects of future people. I then discuss what advice, if any at all, contractualism can offer to the longtermist. (shrink)

In the context of a global pandemic, there is good health-based reason for governments to impose various social distancing measures. However, such measures also cause economic and other harms to people at low risk from the virus. In this paper, I examine how to make such trade-offs in a way that is respectfully justifiable to their losers. I argue that existing proposals like using standard QALY (quality-adjusted life-year) valuations or WELLBYs (wellbeing-adjusted life-years) as the currency for trade-offs do not allow (...) such justification, because they give weight to utilities that are irrelevant in a life-and-death context. Drawing on work on restricted aggregation in ethics, I articulate an alternative framework for balancing claims arising from prospects of different kinds of harm and benefit, and show how it can be applied to reasoning about trade-offs in a pandemic context. (shrink)

Common principles for resource allocation in health care can prioritize the alleviation of small health burdens over lifesaving treatment. I argue that there is some evidence that these principles are at odds with a sizable share of public opinion, which holds that saving a life should take priority over any number of cures for minor ailments. I propose two possible explanations for this opinion, one debunking and one vindicatory. I also outline how well-designed surveys and moral inquiry could help decide (...) between them. Finally, I consider how priority-setting principles could be adjusted if the view that saving a life always trumps alleviating small burdens were vindicated. (shrink)