If You’re a Rawlsian, How Come You’re So Close to Utilitarianism and Intuitionism? A Critique of Daniels’s Accountability for Reasonableness

Health Care Analysis 26 (1):1-16 (2018)
Authors
Gabriele Badano
Cambridge University
Abstract
Norman Daniels’s theory of ‘accountability for reasonableness’ is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls’s general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls’s argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques. The important role that utilitarian-like cost-effectiveness calculations are allowed to play in resource allocation processes disregards the separateness of persons and is seriously unfair towards individuals whose interests are sacrificed for the sake of groups. Furthermore, the function played by intuitions in settling frequent value conflicts opens the door for sheer custom and vested interests to steer decision-making.
Keywords Accountability for reasonableness  Healthcare resource allocation  Public justification  John Rawls  Norman Daniels  Cost effectiveness analysis  Intuitionism  Utilitarism
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DOI 10.1007/s10728-017-0343-9
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References found in this work BETA

What We Owe to Each Other.Thomas Scanlon - 2000 - Mind 111 (442):323-354.
Political Liberalism.J. Rawls - 1995 - Tijdschrift Voor Filosofie 57 (3):596-598.
Contractualism and Utilitarianism.Thomas M. Scanlon - 1982 - In Amartya Kumar Sen & Bernard Arthur Owen Williams (eds.), Utilitarianism and Beyond. Cambridge University Press. pp. 103--128.

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