This essay explains the notion of luck in terms of risk. It starts by distinguishing two senses of risk, the risk that an event has of occurring and the risk at which an agent is with respect to an event. It cashes out the former in modal terms and the latter in terms of lack of control. It then argues that the presence or absence of event-relative risk marks a distinction between two types of luck or (...) fortune commonly overlooked in ordinary usage of the terms “luck” and “fortune.” After offering a detailed account of the notion of control, the essay advances a new version of the so-called lack of control account of luck: lucky events are events with respect to which one is at risk and hence events over which one lacks control in the specified way. Finally, it argues that its account steers clear of counterexamples to the lack of control account of luck. (shrink)

This essay explains the notion of luck in terms of risk. It starts by distinguishing two senses of risk, the risk that an event has of occurring and the risk at which an agent is with respect to an event. It cashes out the former in modal terms and the latter in terms of lack of control. It then argues that the presence or absence of event-relative risk marks a distinction between two types of luck or (...) fortune commonly overlooked in ordinary usage of the terms “luck” and “fortune.” After offering a detailed account of the notion of control, the essay advances a new version of the so-called lack of control account of luck: lucky events are events with respect to which one is at risk and hence events over which one lacks control in the specified way. Finally, it argues that its account steers clear of counterexamples to the lack of control account of luck. (shrink)

This essay offers a rearticulation and defence of the modal account of luck that the author developed in earlier work . In particular, the proposal is situated within a certain methodology, a component of which is paying due attention to the cognitive science literature on luck ascriptions. It is shown that with the modal account of luck properly articulated it can adequately deal with some of the problems that have recently been offered against it, and that the (...) view has a number of attractions over competing proposals, such as the lack of control account. (shrink)

This essay offers a rearticulation and defence of the modal account of luck that the author developed in earlier work (e.g., Pritchard ). In particular, the proposal is situated within a certain methodology, a component of which is paying due attention to the cognitive science literature on luck (and risk) ascriptions. It is shown that with the modal account of luck properly articulated it can adequately deal with some of the problems that have recently been offered against (...) it, and that the view has a number of attractions over competing proposals, such as the lack of control account. (shrink)

Moral luck, until recently, has been understood either explicitly or implicitly through using a lack of control account of luck. For example, a case of resultant moral luck is a case where an agent is morally blameworthy or more morally blameworthy or praiseworthy for an outcome despite that outcome being significantly beyond that agent's control (Nagel ). Due to a shift in understanding the concept of luck itself in terms of modal robustness, however, (...) other accounts of moral luck have surfaced. Both Duncan Pritchard () and Julia Driver () have offered an alternative way of understanding moral luck by employing versions of a modal account of luck. This essay considers some problems with these accounts and attempts to resolve them. (shrink)

Moral luck, until recently, has been understood either explicitly or implicitly through using a lack of control account of luck. For example, a case of resultant moral luck is a case where an agent is morally blameworthy or more morally blameworthy or praiseworthy for an outcome despite that outcome being significantly beyond that agent's control . Due to a shift in understanding the concept of luck itself in terms of modal robustness, however, other (...) accounts of moral luck have surfaced. Both Duncan Pritchard and Julia Driver have offered an alternative way of understanding moral luck by employing versions of a modal account of luck. This essay considers some problems with these accounts and attempts to resolve them. (shrink)

In recent years, philosophers have tended to think of luck as being a relation between an event and a subject; to give an account of luck is to fill in the right-hand side of the following biconditional: an event e is lucky for a subject S if and only if ____. We can call such accounts of luck subject-relative accounts of luck, since they attempt to spell out what it is for an event to (...) be lucky relative to a subject. This essay argues that we should understand subject-relative luck as a secondary phenomenon. What is of philosophical interest is giving an account of subject-involving luck, i.e., filling in the right-hand side of this biconditional: it is a matter of luck that S ϕs iff ____. The essay argues that one of the upshots of focusing on subject-involving luck is that lack of control accounts of luck become more attractive. In particular, a range of counterexamples to LCALs of subject-relative luck do not apply to LCALs of subject-involving luck. (shrink)

"First published as Metaphilosophy volume 45, nos. 4-5, except for 'Luck as risk and the lack of control account of luck,' first published in Metaphilosophy volume 46, no. 2 "--Title page vers.

In recent years, philosophers have tended to think of luck as being a relation between an event (taken in the broadest sense of the term) and a subject; to give an account of luck is to fill in the right‐hand side of the following biconditional: an event e is lucky for a subject S if and only if ——. We can call such accounts of luck subject‐relative accounts of luck, since they attempt to spell (...) out what it is for an event to be lucky relative to a subject. This essay argues that we should understand subject‐relative luck as a secondary phenomenon. What is of philosophical interest is giving an account of subject‐involving luck, i.e., filling in the right‐hand side of this biconditional: it is a matter of luck that Sφs iff ———. The essay argues that one of the upshots of focusing on subject‐involving luck is that lack of control accounts of luck (LCALs) become more attractive. In particular, a range of counterexamples to LCALs of subject‐relative luck do not apply to LCALs of subject‐involving luck. (shrink)

When Thomas Nagel originally coined the expression “moral luck,” he used the term “luck” to mean lack of control. This use was a matter of stipulation, as Nagel’s target had little to do with luck itself, but the question of how control is related to moral responsibility. Since then, we have seen several analyses of the concept of luck itself, and recent contributors to the moral luck literature have often assumed that any (...) serious contribution to the moral luck debate must begin with a robust concept of luck simpliciter. I argue here that this assumption is a mistake, on the basis of three reasons: the issue was originally conceived as an issue about responsibility and control, analyses of luck tend to distort and needlessly to complicate what is at issue when shoehorned into the moral luck debate, and these analyses have very little (if anything) to contribute to the discussion. (shrink)

Clare, the titular character of The Time Traveller's Wife, reflects that "Everything seems simple until you think about it." This might well be a mantra for the whole of philosophy, but a fair few terms tend to stick out. "Knowledge", "goodness" and "happiness" for example, are all pervasive everyday terms that undergo significant philosophical analysis. "Luck", I think, is another one of these terms. Wishing someone good luck in their projects, and cursing our bad luck when success (...) seems so close to our reach or failure could have so easily been otherwise, happens so often that we rarely stop to reflect on what we really mean. Philosophical reflection on the nature of luck has a rich tradition, that is by no stretch confined to the Western philosophical canon. However, it has only very recently become one of the goals of philosophy to provide a clear account of what luck actually amounts to. This, in part, is the goal of this thesis. The thesis has two primary motivations. The first is to offer and defend a general account of luck that overcomes the problems faced by the current accounts of luck that are available in the current philosophical literature. The second is to apply this general account of luck to the areas of metaethics and epistemology where luck has been a pervasive and problematic concept, and demonstrate how this account of luck may resolve or further illuminate some of the problems that the notion has generated. The thesis is roughly split into two parts. The first half of the thesis focuses on the former objective of offering an account of luck. Chapter 1 offers a selected history of the philosophy of luck that spans from the Ancient Greeks to the present day, so that we might properly situate the current work on luck as part of the broader historical importance of the concept. Chapter 2 will set out the major rival to the theory of luck that I will offer - the lack of control account of luck. LCAL has various iterations across the literature, but is most clearly articulated by Wayne Riggs and E.J. Coffman. Both Coffman and Riggs add and adapt their own conditions to LCAL specifically so that the account may overcome several problems that have been levied against it. These further conditions are not incompatible so, to provide the strongest lack of control account possible, I have combined them to form a lack of control account I have called Combined LCAL - LCAL. The latter part of the chapter pits LCAL against some of the problems that have been raised against LCAL. However, despite the efforts of both Riggs and Coffman, even LCAL fails to counter some of these objections. For these reasons I have rejected LCAL has a viable candidate for an account of luck. Chapter 3 sets out a modal account of luck, as argued for by Pritchard, where an event is lucky only if it occurs in the actual world, but not in a relevant set of nearby possible worlds. Here I further elaborate on how we should understand the modal distances using Lewisian possible world semantics, and what worlds should be taken into consideration when fixing the relevant set of nearby possible worlds. I argue that these relevant sets of worlds should be fixed according to the domain of inquiry of which the luck is being applied - this I call the type of luck. Examples of this is the current literature are resultant luck - the type of luck concerned with the results of our actions, and veritic luck - the type of luck concerned with the modal safety of our belief formation. Due to the multitude of types of luck across disciplinary areas, a general modal account of luck requires flexibility in what factors should fix the relevant sets of possible worlds. I achieve this by providing a [TYPE] function for the general modal account of luck, which is used as a mean of inserting the relevant fixing conditions for any domain of inquiry. Chapter 3, in a similar vein to Chapter 2, pits the general modal account of luck against some of the problems that have been levied against MAL, specifically the Buried Treasure problem raised by Lackey and the agent causation problem as raised by Levy. More successfully, the modal account offered stands up against these criticisms. For these reasons, the modal condition understood with the [TYPE] function and Lewisian semantics concerning modal distances, will be adopted to make up one half of the conditions for my account of luck. Chapter 4 will look at the second condition for an account of luck - the significance condition. The chapter will set out the reasons for adopting a significance condition at all, and some of the ways in which the condition has been articulated by Rescher, Pritchard and Ballantyne. All of these current views of the significance condition will be found wanting due to their inability to make sense of certain kinds of luck in specific normative domains. For example, Ballantyne's account of significance focuses on the interests of an agent, yet for certain types of moral luck, the interests of the agent are irrelevant. Instead, I propose a relativised significance condition, where the value of the event is relative to the value of the normative domain in which the luck is being ascribed. Epistemic luck requires a focus on the epistemic significance of the event for the agent, moral luck requires a focus on the moral or ethical significance of the event for the agent, and so on. This I call the kind of luck. Similar to the [TYPE] function for the modal condition for luck, the significance condition requires a [NORMATIVE DOMAIN] function where the relevant normative domain can be inserted depending on the kind of luck. This version of the significance condition will be conjoined with the modal condition as set out in Chapter 3 to form the correct general account of luck. Chapter 5 is the first chapter of the second half of the thesis that concerns applying the account of luck set out in part 1 to more specific domains of inquiry. Chapter 5 concerns moral luck, more specifically, resultant moral luck. Moral luck has traditionally been understood in terms of lack of control. This chapter looks at how Pritchard and Driver have attempted to understand moral luck using modal conditions. However, it is argued that these attempts would be more successful if we adopted the account of luck that I have offered in previous chapters. The chapter will go on to look at two possible problems that may be faced by this modal account of luck, and how it may resolve these problems. Chapter 6, the final chapter, looks at epistemic luck, specifically how the adoption of the modal account I have offered resolves a particular problem targeted at anti-luck epistemology by Ballantyne. The problem, Ballantyne argues, is that given that luck requires a significance condition, the degree of significance affects the degree of luck and that the degree of luck involved in our belief formation affects whether we are in a position to know the target proposition, that the result is that degree of significance affects our ability to know. For at least some instances of this - such as the aesthetic significance that we assign to the target proposition - the result will be that non-epistemic factors that have no relevance at all whether an agent is in a position to know will affect that agent's position to know. The resolution to this problem can be found in a two part solution. The first part is to demonstrate that any degree of veritic epistemic luck results in the agent failing to know. The second is that through the relativisation of the significance condition, any type of value will not affect an agent's position to know, only the epistemic value. With these two considerations in mind, the latter of which that can only be held through the adoption of the modal account of luck I have offered, the problem may be resolved. (shrink)

‘Constitutive luck’ refers to luck that affects the sort of person one is. This article demonstrates that it is a philosophically troubling sort of luck, causing problems in, at least, ethics and political philosophy. Some, notably Susan Hurley, Nicholas Rescher, and Daniel Statman, have argued that such trouble can be avoided, by pointing out that the notion of constitutive luck is incoherent. The article examines this claim by means of a discussion of the idea of (...) class='Hi'>luck in general, settling on an account of luck in terms of the notions of chance, value, and (lack of) control. This account is then used to show that the notion of constitutive luck is not incoherent. We are stuck with the problems made by constitutive luck. (shrink)

Libertarianism in all its varieties is widely taken to be vulnerable to a serious problem of present luck, inasmuch as it requires indeterminism somewhere in the causal chain leading to action. Genuine indeterminism entails luck, and lack of control over the ensuing action. Compatibilism, by contrast, is generally taken to be free of the problem of present luck, inasmuch as it does not require indeterminism in the causal chain. I argue that this view is false: (...) compatibilism is subject to a problem of present luck. Taken by itself, the compatibilist problem with present luck is less serious than the analogous problem confronting libertarianism. However, its effects are just as devastating for the entire account of freedom: the present luck confronting compatibilism is sufficient to undermine the compatibilist response to distant – constitutive – luck. (shrink)

In this paper, I critically examine the two dominant views of the concept of luck in the current literature: lack of control accounts and modal accounts. In particular, I argue that the conditions proposed by such views—that is, a lack of control and the absence of counterfactual robustness—are neither necessary nor sufficient for an event's being lucky. Hence, I conclude that the two main accounts in the current literature both fail to capture (...) what is distinctive of, and central to, the concept of luck. (shrink)

This thesis examines some of the legal philosophical issues that are implicated in the problem of outcome luck. In the context of criminal law, the problem asks whether we should hold agents criminally liable for the consequences of their actions given that those consequences are never wholly within anyone’s control. I conclude that outcomes should matter to an agent’s liability and punishment, and I make this argument indirectly by examining some of the foundational questions in legal theory. The (...) thesis begins by considering a current trend in some areas of philosophy. This trend involves attempts to address philosophical problems surrounding luck by doing conceptual analyses on the nature of luck. Chapter 1 critically examines modal theories, which conceptualize luck, as well as the related concept of risk, in terms of close possible worlds rather than probabilistic likelihood. I argue that not only are modal theories uninformative, but conceptual analyses on luck are unhelpful in addressing philosophical questions surrounding luck. Chapter 2 then returns to the traditional notion of luck as lack of control, and focuses on the relationship between luck, risk, and culpability. Some theorists argue that culpability, for any offence, is in part a function of the degree of risk the agent imposes on others. In the context of criminal law, degrees of luck and risk can both be understood in terms of degrees of control, so the suggestion that culpability is a function of the level of risk imposed (and thus of the degree of control an agent exercises) is attractive for insulating culpability judgments from luck. However, I argue that this view is mistaken because culpability is only sensitive to risk in reckless actions, but not in purposeful actions. The problem of outcome luck may raise different questions for reckless actions and purposeful actions. Chapter 3 looks at the mens rea element of criminal attempts, which is crucial for understanding the problem of luck in the context of purposeful actions. I discuss a variation of what are sometimes referred to as impossible attempts, which have helped shape current English law. I argue that the current doctrine is largely correct, and that perhaps with the exception of few paradigm sexual offences, the mens rea element for attempts should require a direct intention as to the consequence element of an offence, and knowledge or belief as to the circumstance element of that offence. Chapters 4 and 5 then look at normative justifications of criminal punishment. In order to understand whether outcomes should matter for punishment, we must first understand whether and why punishment is an appropriate response to criminal offending. Here, I defend a communicative theory, where punishment is a communicative process between the offender, the political community, and the victim. What punishment communicates is the appropriate degree of censure that is warranted in response to the offender’s wrongdoing. And in doing this, it publicly recognizes the wrong that has been committed by the offender. Chapter 4 offers a detailed explanation of this account, and argues that the political community’s recognition of wrongdoing is a valuable aim of communication. Chapter 5 then takes up a crucial challenge against communicative theories of punishment, which is that such theories fail to take crime prevention seriously. Against this criticism, I will show that general prevention can in fact be an essential part of communicative punishment. And I will show that it is specifically the political community’s recognition of wrongdoing that entails punishment’s preventive aims. (shrink)

The present paper poses a new problem for moral luck. Defenders of moral luck uncritically rely on a broader theory of luck known as the control theory or the lack of control theory. However, there are are two other analyses of luck in the literature that dominate discussion in epistemology, namely the probability and modal theories. However, moral luck is nonexistent under the probability and modal accounts, but the control theory (...) cannot explain epistemic luck. While some have posited that “luck” is ambiguous, so that one theory of luck is operative with epistemic luck and a different theory works for moral luck, there are both semantic and philosophical reasons to reject luck ambiguity. Defenders of moral luck must engage with the broader literature on luck and either provide a comprehensive defense of the control theory or concede that moral luck is not a genuine thing in its own right. (shrink)

The aim of this paper is to explore the hypothesis that luck is a risk-involving phenomenon. I start by explaining why this hypothesis is prima facie plausible in view of the parallelisms between luck and risk. I then distinguish three ways to spell it out: in probabilistic terms, in modal terms, and in terms of lack of control. Before evaluating the resulting accounts, I explain how the idea that luck involves risk is compatible with (...) the fact that risk concerns unwanted events whereas luck can concern both wanted and unwanted events. I turn to evaluating the modal and probabilistic views and argue, firstly, that they fail to account for the connection between risk and bad luck; secondly, that they also fail to account for the connection between risk and good luck. Finally, I defend the lack of control view. In particular, I argue that it can handle the objections to the probabilistic and modal accounts and that it can explain how degrees of luck and risk covary. (shrink)

A platitude in epistemology is that an individual’s belief does not qualify as knowledge if it is true by luck. Individuals, however, are not the only bearers of knowledge. Many epistemologists agree that groups can also possess knowledge in a way that is genuinely collective. If groups can know, it is natural to think that, just as true individual beliefs fall short of knowledge due to individual epistemic luck, true collective beliefs may fall short of knowledge because of (...) collective epistemic luck. This paper argues, first, that the dominant view of epistemic luck in the literature, the modal view, does not yield a satisfactory account of lucky collective beliefs. Second, it argues that collective epistemic luck is better explained in terms of groups lacking forms of control over collective belief formation that are specific to the different procedures for forming collective beliefs. One of the main implications of this, we will argue, is that groups whose beliefs are formed via internal deliberation are more vulnerable to knowledge-undermining collective luck than groups that form their beliefs via non-deliberative methods, such as non-deliberative anonymous voting. The bottom line is that the greater exposure to knowledge-undermining luck that deliberation gives rise to provides a reason for thinking that non-deliberative methods of group belief formation have greater epistemic value. (shrink)

This paper develops a normative account of epistemic luck, according to which the luckiness of epistemic luck is analyzed in terms of the expectations a subject is entitled to have when she satisfies the standards of epistemic justification. This account enables us to distinguish three types of epistemic luck—bad, good, and sheer—and to model the roles they play e.g. in Gettierization. One controversial aspect of the proposed account is that it is non‐reductive. While other approaches analyze epistemic (...) luck in non‐epistemic terms—either in modal terms (lack of safety) or in agential terms (lack of creditworthiness)—I argue that the non‐reductive nature of the normative account is actually a selling‐point relative to its competitors. (shrink)

According to Pettit, an account of freedom in terms of rational control fails to suffice, for he argues that such an account lacks the resources to rule out coerced actions as unfree. The crucial feature of a coerced action is that it leaves the agent with a choice to make, an apparently rational choice to make. To the extent that it does this, it would seem to leave the agent as free as he would be in any other case (...) where there is a choice to be made. However, we do not consider actions that are coerced to be on a par with actions that are not coerced, that are performed freely as we might say. We do not hold agents similarly responsible in the two sorts of cases. So it would seem that the rational control account fails, for it appears to fail to vindicate this differential practice. In this paper, I defend the rational control account. I outline two ways in which proponents of a rational control model, broadly understood, can respond to this criticism. (shrink)

Structural evil impacts persons’ experiences differently, a reality that feminist philosophers Claudia Card and Lisa Tessman have termed “moral luck.” As Christian ethicists grapple with privilege and oppression, we lack a satisfactory framework to describe how particular life circumstances impact moral lives. This essay develops a Christian virtue account of moral luck, drawing on Thomas Aquinas and womanist theologians including Melanie L. Harris and Rosita deAnn Mathews. Moral luck helps Christian ethicists attend to the impact of (...) difference on the moral life as well as to the common experience of contingency harming virtue, requiring dependence on God’s grace. (shrink)

Contemporary accounts of luck, though differing in pretty much everything, all agree that the concept of luck is descriptive as opposed to normative. This widespread agreement forms part of the framework in which debates in ethics and epistemology, where the concept of luck plays a central role, are carried out. The hypothesis put forward in the present paper is that luck attributions are sensitive to normative considerations. I report five experiments suggesting that luck attributions (...) are influenced by the normative features of the case, and not merely by descriptive notions like agential control or modal fragility. I discuss the implications of this effect for theories of luck and debates in ethics and epistemology. (shrink)

Control-based accounts of moral responsibility face a familiar problem. There are some actions which look like obvious cases of responsibility but which appear equally obviously to lack the requisite control. Drunk-driving cases are canonical instances. The familiar solution to this problem is to appeal to tracing. Though the drunk driver isn't in control at the time of the crash, this is because he previously drank to excess, an action over which he did plausibly exercise the (...) requisite control. Tracing seeks to show that an agent's responsibility for some outcome can be traced back to a prior exercise of control which caused the later lack of control. These and related cases have led many theorists to treat tracing as an indispensable component of any adequate theory of responsibility. This paper argues that tracing is in fact dispensable. I offer two strategies for explaining responsibility in drunk-driving cases : responsibility can either be exhaustively modeled on recklessness, or exhaustively modeled on negligence. Neither explanation, however, relies on tracing. If I'm right, the case for tracing is seriously weakened. (shrink)

Moral luck occurs when factors beyond an agent’s control positively affect how much praise or blame she deserves. Kinds of moral luck are differentiated by the source of lack of control such as the results of her actions, the circumstances in which she finds herself, and the way in which she is constituted. Many philosophers accept the existence of some of these kinds of moral luck but not others, because, in their view, the existence (...) of only some of them would make morality unfair. I, however, argue that this intermediary approach is unstable, because either morality is fair in ways that rule out resultant, circumstantial, and constitutive moral luck (and this leads to moral responsibility skepticism), or morality is unfair in ways that permit the existence of those kinds of moral luck. Thus, such intermediary approaches lack the motivation that their proponents have long taken them to have. In the appendix, I point to ways in which morality is unfair concerning the scope of moral responsibility, moral obligation, moral taint, being a good or bad person, and flourishing. (shrink)

The issue of whether and how we have the control necessary for freedom and moral responsibility is central to all control accounts of freedom and moral responsibility. The problem of luck for libertarians aims to show that indeterministic agents are ill‐equipped with the control required for freedom and moral responsibility. In view of this, we must either endorse scepticism about the possibility of free and morally responsible agents, or make some form of, possibly revisionary, compatibilism (...) work.In this paper, I shall offer a new solution to the problem of luck for libertarians. After outlining the problem of luck, I shall argue that, given a particular approach to mental causation, indeterminism can be viewed as an essential requirement of free and morally responsible action. After this, I shall distinguish between different types of inability and show how this provides us with a solution to the problem of luck. Finally, I shall consider some advantages and objections to the proposed solution. (shrink)

This essay aims to reorient current theorizing about luck as an aid to our discerning this concept's true philosophical significance. After introducing the literature's leading theories of luck, it presents and defends counterexamples to each of them. It then argues that recent luck theorists’ main target of analysis—the concept of an event's being lucky for a subject—is parasitic on the more fundamental notion of an event's being a stroke of luck for a subject, which thesis serves (...) as at least a partial diagnosis of the leading theories’ failure. Next, it develops an analysis of strokes of luck that utilizes insights from the recent luck literature. Finally, having set out a comprehensive new analysis of luck—the Enriched Strokes Account of lucky events—the essay revisits the initial counterexamples to the literature's leading theories and argues that the Enriched Strokes Account properly handles all of them. (shrink)

This essay aims to reorient current theorizing about luck as an aid to our discerning this concept's true philosophical significance. After introducing the literature's leading theories of luck, it presents and defends counterexamples to each of them. It then argues that recent luck theorists' main target of analysis—the concept of an event's being lucky for a subject—is parasitic on the more fundamental notion of an event's being a stroke of luck for a subject, which thesis serves (...) as at least a partial diagnosis of the leading theories' failure. Next, it develops an analysis of strokes of luck that utilizes insights from the recent luck literature. Finally, having set out a comprehensive new analysis of luck—the Enriched Strokes Account of lucky events—the essay revisits the initial counterexamples to the literature's leading theories and argues that the Enriched Strokes Account properly handles all of them. (shrink)

Many philosophers hold that luck excludes control-more precisely, that an event is lucky for you only if that event lies beyond your control. Call this the Lack of Control Requirement (LCR) on luck. Jennifer Lackey [2008] has recently argued that there is no such requirement on luck. Should such an argument succeed, it would (among other things) disable a main objection to the "libertarian" position in the free will debate. After clarifying the LCR, (...) I defend it against both Lackey's argument and a novel argument different in kind from Lackey's. I undermine each of these arguments by sketching a plausible error theory for its key intuition. For each argument, there's a natural reply available to its proponents. I show that these natural replies depend on certain mistaken general principles about luck. Neither Lackey's argument nor the novel argument I consider casts serious doubt on the LCR. [Word count: 147]. (shrink)

Necessarily, if S lacks the ability to exercise control, S is not an agent. If S is not an agent, S cannot act intentionally, responsibly, or rationally, nor can S possess or exercise free will. In spite of the obvious importance of control, however, no general account of control exists. In this paper I reflect on the nature of control itself. I develop accounts of control ’s exercise and control ’s possession that illuminate (...) what it is for degrees of control —that is, the degree of control an agent possesses or exercises in a given circumstance—to vary. Finally, I demonstrate the usefulness of the account on offer by showing how it generates a solution to a long-standing problem for causalist theories of action, namely, the problem of deviant causation. (shrink)

I argue against the Standard View of ignorance, according to which ignorance is defined as equivalent to lack of knowledge, that cases of environmental epistemic luck, though entailing lack of knowledge, do not necessarily entail ignorance. In support of my argument, I contend that in cases of environmental luck an agent retains what I call epistemic access to the relevant fact by successfully exercising her epistemic agency and that ignorance and non-ignorance, contrary to what the Standard (...) View predicts, are not modal in the sense that knowledge is. After responding to objections, I conclude by sketching an alternative account of ignorance centered on the notions of epistemic access and epistemic agency. (shrink)

On Jeff McMahan's influential ‘responsibility account’ of moral liability to defensive killing, one can forfeit one's right not be killed by engaging in an ordinary, morally permissible risk-imposing activity, such as driving a car. If, through no fault of hers, a driver's car veers out of control and toward a pedestrian, the account deems it no violation of the driver's right to save the pedestrian's life at the expense of the driver's life. Many critics reject the responsibility account on (...) the grounds that, first, it has draconian implications for threateners like the driver, and second, it contravenes the plausible principle that wronging one's victim is necessary for forfeiting one's rights. But I argue, drawing on the account's luck-egalitarian underpinnings, that the account lacks the draconian implications widely attributed to it, and contrary to what many assume, wrongdoing is unnecessary for rights-forfeiture. Via these arguments, I seek both to deepen our understanding of the responsibility account, and to reissue it in a more plausible and attractive form. (shrink)

Blame is multifarious. It can be passionate or dispassionate. It can be expressed or kept private. We blame both the living and the dead. And we blame ourselves as well as others. What’s more, we blame ourselves, not only for our moral failings, but also for our non-moral failings: for our aesthetic bad taste, gustatory self-indulgence, or poor athletic performance. And we blame ourselves both for things over which we exerted agential control (e.g., our voluntary acts) and for things (...) over which we lacked such control (e.g., our desires, beliefs, and intentions). I argue that, despite this manifest diversity in our blaming practices, it’s possible to provide comprehensive account of blame. Indeed, I propose a set of necessary and sufficient conditions that aims to specify blame’s extension in terms of its constitution as opposed to its function. And I argue that this proposal has a number of advantages beyond accounting for blame in all its disparate forms. For one, it can account for the fact that one’s having had control over whether one was to φ is a necessary condition for one’s being fittingly blamed for having φ-ed. For another, it can account for why, unlike fitting shame, fitting blame is always deserved, which in turn explains why there is something morally problematic about ridding oneself of one’s fitting self-blame (e.g., one’s fitting guilt). (shrink)

Findlay & Walker give voice to several common lines of thought regarding oculomotor control but do not provide sufficient detail for a critical evaluation of their theory. I argue that arbitrary spatial and temporal saccade metrics can be produced simply by manipulating the initial activation values in their model – values that the authors never specify. This lack of detail makes it difficult to anticipate the model's specific oculomotor behavior, or to compare this behavior to models opting for (...) a more quantitative framework. (shrink)

Intentional action is, in some sense, non-accidental, and one common way action theorists have attempted to explain this is with reference to control. The idea, in short, is that intentional action implicates control, and control precludes accidentality. But in virtue of what, exactly, would exercising control over an action suffice to make it non-accidental in whatever sense is required for the action to be intentional? One interesting and prima facie plausible idea that we wish to explore (...) in this paper is that control is non-accidental in virtue of requiring knowledge – either knowledge-that or knowledge-how (e.g., Beddor and Pavese 2021; cf., Setiya 2008; 2012 and Habgood-Coote 2018). We review in detail some key recent work defending such knowledge-centric theories of control, and we show that none of these accounts holds water. We conclude with some discussion about how control opposes the sort of luck intentional action excludes without doing so by requiring knowledge (that- or how). (shrink)

Some epistemologists hold that exploration and elaboration of the nature of luck will allow us to better understand knowledge. I argue this is a mistake.

This article proposes a new account of luck and how luck impacts attributions of credit for agents' actions. It proposes an analogy with the expected value of a series of wagers and argues that luck is the difference between actual outcomes and expected value. The upshot of the argument is that when considering the interplay of intention, chance, outcomes, skill, and actions, we ought to be more parsimonious in our attributions of credit when exercising a skill and (...) obtaining successful outcomes, and more generous in our attributions of credit when exercising a skill but obtaining unsuccessful outcomes. Furthermore, the article argues that when agents skillfully perform an action, they deserve the same amount of credit whether their action is successful or unsuccessful in achieving the goal. (shrink)

On the one hand, Kant seems to suggest that moral weakness is merely expressed at the level of following maxims. On the other hand, he addresses moral weakness as the first grade of our propensity to evil, which implies that moral weakness is also expressed at the level of adopting maxims. There is still a lack of clarity in the literature concerning how the relationship between these two aspects is to be understood, and a proper account of the nature (...) of the maxims of the morally weak has yet to be offered. Drawing on my earlier interpretation of moral strength, I shall propose a reading of Kant's account of moral weakness that consistently unifies both aspects. On my interpretation, the morally weak agent lacks the moral strength that he ought to acquire through the continuous exercise of his power of self‐control; he therefore fails both to set himself particular moral ends in adopting his maxims and to follow his maxims by realizing such ends. His intention to do what the moral law demands is overly general: It does not set a particular moral end, which is what virtue requires. (shrink)

The aim of this paper is to improve our understanding of the category of moral “luck”. In current debate most often only specific cases of moral “luck” are taken into account. Such restrictions, however, involving a fragmentary picture of moral "luck", are introduced without any rationale for them. In this paper I look for a formal comprehensiveness of the category of moral “luck”. I consider three factors each of which is developed in two scenarios. These are (...) (i) whether the agent’s action is nasty or nice, (ii) whether the agent’s intention is confirmed or contradicted by her action, and (iii) whether the agent’s action is preceded by her intention or the lack thereof. I explore eight scenarios which are a mark of the intricacy of the category of moral “luck” otherwise ignored in the literature. After an assessment of their structure I arrive at new distinctions. The upshot is a rather complex set of correlations between several cases of moral “luck” with a variety of kinds and shades. (shrink)

Intentional action is, in some sense, non-accidental, and one common way action theorists have attempted to explain this is with reference to control. The idea, in short, is that intentional action implicates control, and control precludes accidentality. But in virtue of what, exactly, would exercising control over an action suffice to make it non-accidental in whatever sense is required for the action to be intentional? One interesting and prima facie plausible idea that we wish to explore (...) in this paper is that control is non-accidental in virtue of requiring knowledge—either knowledge-that or knowledge-how (e.g., Beddor and Pavese 2021; cf., Setiya 2008; 2012 and Habgood-Coote 2018). We review in detail some key recent work defending such knowledge-centric theories of control, and we show that none of these accounts holds water. We conclude with some discussion about how control opposes the sort of luck intentional action excludes without doing so by requiring knowledge (that- or how). (shrink)

This article focuses on maternal-fetal surgery (MFS) and on the concept of clinical equipoise that is a widely accepted requirement for conducting randomized controlled trials (RCT). There are at least three reasons why equipoise is unsuitable for MFS. First, the concept is based on a misconception about the nature of clinical research and the status of research subjects. Second, given that it is not clear who the research subject/s in MFS is/are, if clinical equipoise is to be used as a (...) criterion to test the ethical appropriateness of RCT, its meaning should be unambiguous. Third, because of the multidisciplinary character of MFS, it is not clear who should be in equipoise. As a result, we lack an adequate criterion for the ethical review of MFS protocols. In our account, which is based on Chervenak and McCullough's seminal work in the field of obstetric ethics, equipoise is abandoned. and RCT involving MFS can be ethically initiated when a multidisciplinary ethics review board (ERB), having an evidence-based assessment of the risks involved, is convinced that the value of answering the research hypothesis, for the sake of the health interests of future pregnant women carrying fetuses with certain congenital birth defects, justifies the actual risks research participants might suffer within a set limit of low/manageable. (shrink)

The problem of epistemic luck arises when a person has a true belief that is only true by luck. Before Gettier, it was believed that the element of justification would be sufficient for knowledge; but he showed that it is possible to have a justified true belief that is not an example of knowledge because of the intrusion of luck. Duncan Pritchard has examined epistemic luck in an extensive and detailed manner. He offers a modal account (...) of luck based on two elements: a possible-worlds analysis of counterfactual conditions and a significance condition for the factors that make the truth of the belief lucky. Pritchard argues for the superiority of this account to those that focus on whether the truth of the belief is “accidental” and on whether the believer has sufficient control over the belief. Epistemic luck may be “reflective” or “veritic”. Both undermine knowledge claims, although Pritchard gives the central role to veritic luck in his anti-luck epistemology, which is based on two elements: a safety principle and a condition to ensure that the cognitive faculties of the agent are not impaired. In this article, we will describe, analyze, and subsequently, evaluate the viewpoint of Pritchard. In addition to the critiques offered by others, ambiguities in his counterfactual account of luck and other components of his theory detract from his theory. (shrink)

Assertive community treatment (ACT) is a widely propagated team approach to community mental health care that ‘assertively’ engages a subgroup of individuals with severe mental illness who continuously disengage from mental health services. It involves a number of interested parties – including clients, carers, clinicians and managers. Each operates according to perceived ethical principles related to their values, mores and principles. ACT condenses a dilemma that is common in psychiatry. ACT proffers social control whilst simultaneously holding therapeutic aspiration. The (...) clients’ perspective of this dilemma was studied in interviews with 12 clients using the ‘grounded theory’ approach. Results suggest that clients’ disengagement is as much a historical and cultural phenomenon as a result of lack of insight. Many clients had experienced rejection of early help–seeking behaviour and all had been subject to coercive interventions. These coercive interventions were experienced as an attack on identity. All felt that their voice had not been listened to in previous interactions with psychiatric services. Consequentially the clients had an increased level of arousal around issues of power, which needs to be incorporated when examining the ethics of community psychiatry. Traditional notions of the difference between persuasion and coercion – for example – may need to be adapted for this client group. Results are compared with the provider perspective. We conclude that the perspectives differ on two key dimensions. Such an empirical approach to examining psychiatric ethics may ensure that we incorporate the subjectivities of various interested parties in the clinical decision–making process. (shrink)

Evil in the Vedas and the Upanishads undergoes a theoretical transformation as this literature itself moves away from its consequentialist and naturalistic roots to a radical procedural approach to moral questions. The goods of life on the early account were largely natural: evil was a moral primitive that motivated a teleological approach to morality geared towards avoiding natural evil. The gods of nature (such as fire, and rain, intimately involved in metabolism) were propitiated to gain beneficent results, and to avoid (...) hunger and illness. To please the gods of nature involves eating, which is merely the imposition of natural evil on sacrificial victims so that one avoids the evils of disease and hunger oneself. The entire system is one of resentment: the goods of life are defined by way of the bads that they displace. Authors of the latter part of the Vedas, such as the Kaṭha Upaniṣad, show themselves to be concerned about the irreducibility of evil on the naturalistic account, but also more broadly with the irreducible phenomenon of moral luck that comes in tow with a teleological approach to ethics. Whether one is able to ward off evil and enjoy the goods of life is not under one’s control and is within the purview of the forces of nature. This motivates the transition to a procedural account of ethics---yoga---where evil is not a primitive but a side effect of the non-yogic life, characterized by a lack of self-governance. As Death teaches us, evil is not a moral primitive and can be reduced out of the moral equation by taking responsibility for a lack of autonomy, which transforms this external threat of a lack of autonomy into a self lack of autonomy, or self-governance. With this transformation we are delivered into the realm of preservation (Vishnu). (shrink)

There are many general economic policies I favour such that I would feel significantly ashamed were I to succumb to bribery, or to institutional pressure short of physical threat, to publicly support their opposites. Here are a few of these policies: (1) Rich countries should not impose trade barriers, including subsidies for their own producers, against imports from poor countries. (2) Leaders of poor countries should be regarded as irresponsible when they imply to their people that their economic difficulties arise (...) principally from wickedness and exploitative behavior on the part of rich countries – the moral urgency of (1) notwithstanding. (3) Much freer movement of people across national borders for purposes of labour should be allowed everywhere. (4) Destitution is an unduly severe penalty for laziness, lack of talent or intelligence, or bad luck. More productive people should provide the lazy, the unskilled and the unlucky with as large a basic income grant as is compatible with maximizing net social productivity (which no present society comes very close to doing, partly due to confused social morality and partly due to incentive-distorting tax systems). (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS I. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[i] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[ii] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. II. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[iii] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[iv] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[v] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[vi] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[vii] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[viii] In democratic societies, one must take into consideration community morals and values.[ix] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[x] III. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[xi] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[xii] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[xiii] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[xiv] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. IV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[xv] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[xvi] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[xvii] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[xviii] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[xix] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[xx] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[xxi] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. VI. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[xxii] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[xxiii] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[xxiv] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. VII. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [i] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [ii] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [iii] Moss, p. 1295-1298. [iv] Moss, p. 1296. [v] Moss, p. 1295-1298. [vi] Moss, p. 1295-1298. [vii] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [viii] Cohen, p. 1299-1301. [ix] Moss, p. 1297. [x] Cohen, p. 1300. [xi] Cappelen, p. 478-480. [xii] Cappalen, p. 478-480. [xiii] Cappelen, p.479. [xiv] Cappelen, p. 479. [xv] Cappelen, p. 479 [xvi] Cohen, p. 1301. [xvii] Cappelen, p. 478. [xviii] Cohen, p. 1299-1301. [xix] Cohen, p. 1301. [xx] Cappelen, p. 476-480. [xxi] Cappelen, p. 476-480. [xxii] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [xxiii] Kawachi, p. 18-33. [xxiv] Kawachi, p. 18-33. (shrink)

Every account of moral responsibility has conditions that distinguish between the consequences, actions, or traits that warrant praise or blame and those that do not. One intuitive condition is that praiseworthiness and blameworthiness cannot be affected by luck, that is, by factors beyond the agent’s control. Several philosophers build their accounts of moral responsibility on this luck-free condition, and we may call their views Luck-Free Moral Responsibility (LFMR). I offer moral and metaphysical arguments against LFMR. (...) First, I maintain that considerations of fairness that often motivate LFMR do not require its adoption. Second, I contend that LFMR has counterintuitive implications for the nature and scope of praiseworthiness and blameworthiness and that LFMR is vulnerable to a reductio ad absurdum. Third, I state some common reasons for thinking that LFMR’s commitment to true counterfactuals of libertarian freedom is problematic, and I argue that if there are no such true counterfactuals and if LFMR is true, a person is praiseworthy and blameworthy at most for a tiny fraction of her actions. Fourth, I argue that proponents of LFMR cannot escape this skeptical cost by appealing to a different kind of counterfactual of freedom. Fifth, I develop an anti-skeptical motivation to affirm the idea that luck can affect moral responsibility. (shrink)

Photo by Tingey Injury Law Firm on Unsplash ABSTRACT The coverage of healthcare costs allegedly brought about by people’s own earlier health-adverse behaviors is certainly a matter of justice. However, this raises the following questions: justice for whom? Is it right to take people’s past behaviors into account in determining their access to healthcare? If so, how do we go about taking those behaviors into account? These bioethical questions become even more complex when we consider them in the context of (...) a commitment to publicly funded, universal healthcare coverage. INTRODUCTION Healthcare coverage of lifestyle-related conditions is certainly a matter of justice. However, this raises the following justice-related question: Is it right to consider people’s past behaviors in determining their access to healthcare? If so, the methods of taking those behaviors into account must be fair and justifiable. This bioethical question becomes even more complex when we consider it in the context of a commitment to publicly funded, universal healthcare coverage. This paper takes an old, classic debate, evaluates newer approaches, and offers an argument favoring a combined approach which alters the liberal-egalitarian solution to account for social justice. ANALYSIS l. Causes of Disease If healthcare coverage were universal, irrespective of socioeconomic status and lifestyle, people would contribute to the cost of remedying the lifestyle-induced health problems of others. In the West, lifestyle-related diseases are burdensome.[1] This paper approaches this concern from a western lens that incorporates both a European tradition of “social safety nets” and an American tradition of personal freedoms. By taking such an approach, solutions to the consequences of one’s past behavior burdening others must consider an individual’s personal freedom to choose to act as he or she wishes, with the distributive social and economic equality of the many. The concept of disease caused by lifestyle and diet is proven. Many health conditions include behavioral risk factors. Multi-pack smoking increases the risk of chronic lung disease, while obesity increases the risk of type 2 diabetes. Inattention to high blood pressure, high cholesterol, and a lack of exercise leads to increased risks of coronary artery disease.[2] While poor lifestyle choices certainly influence these conditions, their causes are multifactorial, and it is difficult to say that any single string of poor choices led to their development. In a scenario where two men excessively eat fast food for 20 years, several discrete factors impact whether any of them might suffer an ischemic-embolic stroke or not. Genetics, circumstances, and activity will also contribute to outcomes. ll. Alcohol-Related End-Stage Liver Disease One paper suggests that alcohol-related end-stage liver disease (ARESLD) differs from other multifactorial disorders as alcohol alone causes the disease.[3] It justifies attributing personal responsibility to patients with ARESLD because the condition develops only after the cumulative effects of large quantities of alcohol consumed from years to decades.[4] However, the paper undermines its position by admitting that even the susceptibility to becoming an alcoholic has some degree of genetic predisposition.[5] Given the extreme scarcity of donor livers, some patients may be prioritized over others on the transplant waiting list. Since donor livers cannot be given to everyone, transplanting a liver into an alcoholic may result in death for competing candidates whose liver disease was not their fault. All else being equal, if bioethicists avoid claiming moral deficiency or judgment, those with apparently self-inflicted ARESLD will not be deprived of treatment but will have a lower priority for transplant.[6] In contrast, another position suggests that it is often difficult to define what behaviors are punishable as these are largely personal and value-laden.[7] Still, people do not support using their own resources to support the consequences of others’ poor choices, no matter how objective.[8] In democratic societies, one must take into consideration community morals and values.[9] Even if we were to punish people for their health-adverse behaviors, we could not logistically employ the vigorous and sustained efforts necessary to determine whose actions are morally weak.[10] lll. The Liberal-Egalitarian Proposal One past argument proposes a liberal-egalitarian solution to manage personal responsibility for so-called “lifestyle diseases.”[11] This Rawlsian system combines the European-style “social safety net” commitment to social and economic equality with the American liberal notion of pluralist toleration and personal freedoms. This idealized system aims to hold people responsible for their choices rather than the consequences to mitigate the downside of blaming those who might not be blameworthy. The approach avoids determining the questionable nature of luck and personal responsibility for health outcomes, fairness in the distribution of economic burden, and the intrusiveness required to practically determine who acts in a morally wrong and health-adverse way. The liberal-egalitarian model, a theory of distributive justice, has two facets: the liberal principle that people should be held accountable for their choices and the egalitarian principle that people who make the same choices should have the same outcomes.[12] This model attempts to fuse responsibility with equity by seeking to reward good behavior and tax bad behavior rather than punish the consequences of the action and navigate who deserves treatment. For instance, the hospital bedside is not the appropriate place to introduce responsibility for one’s health outcomes.[13] This appeals to the reality that, at that time, discerning the true causes of disease was not plausible and to humanity in avoiding a heartless and cruel approach. An argument in favor of the liberal-egalitarian model considers its method of implementation. This approach assumes that the healthcare system treats all individuals regardless of their choices or ability to cover costs. The liberal-egalitarian model also assumes that a certain adverse health condition is related, statistically speaking, to the consumption of a certain good and that good can be taxed. As such, it proposes to tax the consumption of that good to finance the collective burden which arises from that good’s consumption rather than require individuals to pay for their own treatment. In the example of ARESLD, the recommended solution would be taxing all alcohol. While a systematic infrastructure is not explicit, there is the implication that a per-unit tax can be imposed on alcohol so the total tax revenue would make up for the additional healthcare costs due to consumption.[14] Upholding the principle that all people who make the same choices should face the same costs, all consumers of alcohol would pay the same tax, regardless of factors such as genetic predisposition to alcoholism, lifestyle, or expected cost of treatment. Upholding the principle of individual responsibility, this model does not deny treatment to anyone, neutralizing factors outside that individual’s control by imposing the tax ex-ante. Other people are not burdened by those who consume the good. People who consume alcohol face a burden proportional to the amount consumed. This tax-based implementation is justified so long as the tax is not prohibitively high for the average consumer. Further, the model mitigates concerns over the intrusiveness of ascribing morality to health-adverse behaviors. lV. Moral and Social Arguments Against the Liberal-Egalitarian Position Arguments against the liberal-egalitarian model concerns its many assumptions. First, this model assumes that consumption of such goods is directly related to the health outcome and that these goods can be taxed.[15] Certain people genetically predisposed to alcoholism would be predisposed to consume more alcohol. The model falls short when applied to scenarios where health outcomes are not consumption-based, such as engaging in unsafe sex or abstaining from healthy lifestyle choices like exercise. Second, some might argue that the liberal-egalitarian model fails to remain neutral. Residual moral judgments tied to consumption choices introduce non-neutrality. Although taxation in free societies is determined by democratic procedures rather than by individuals in the healthcare system, moral and value-based judgments will be implicit in deciding what behaviors are taxable, such as the purchase of cigarettes. Third, the liberal-egalitarian model fails to determine whether one’s behavior is autonomous, as socio-cultural-economic factors may influence it and behavior is more a product of society, peer pressure, or income. Those also may reflect systemic inequalities. Therefore, this model, which rewards, or taxes based solely on decisions, regardless of their consequences and motivations, fails to consider that a person’s decisions may not be completely autonomous. V. Libertarian Arguments Against the Liberal-Egalitarian Model a. State Intrusiveness as Counter to the Liberal-Egalitarian Model Last, there is a libertarian worry that if the state guarantees universal healthcare coverage to all people, the state will have to become highly intrusive and investigate people’s morals.[16] At least one-third of all disease burden in North America, Europe, and the Asia-Pacific is attributable to lifestyle measures such as tobacco smoking, alcohol consumption, high cholesterol, and obesity.[17] With these various lifestyles, it is not likely to agree on what conduct to tax or condemn.[18] The fine-toothed comb required to determine whether each citizen has been engaging in these behaviors would intrude on daily life and personal freedom. Libertarians champion the argument that impractical intrusiveness would result from universal healthcare, and such a degree of intrusiveness would likely be universally unacceptable.[19] The liberal-egalitarian model mitigates the libertarian worry about state intrusiveness as it does not involve prying into one’s life and choices other than taxing goods. A liberal state should ideally be neutral to how people decide to live their lives. In all, libertarians can rest assured that the liberal-egalitarian tax-based model, through its ex-ante implementation, will require no prying state eyes. States that provide universal healthcare coverage and wish to condemn certain misconduct do not need to become overly intrusive to carry out measures to hold individuals accountable. b. Fairness Another libertarian worry regarding the guarantee of universal healthcare coverage in the context of lifestyle-driven diseases is that the public will be burdened unfairly with covering others’ ill-advised mistakes or bad luck. An ideal system to address this worry would link treatment or payment for treatment with whatever behavior caused that need.[20] The distribution of burdens should be linked to how different individuals contributed to the creation of those burdens. Applied to health policy, we should ask how the need for a certain treatment arose when determining how to distribute its cost.[21] The liberal-egalitarian model aspires to hold individuals responsible for their choices, not for the consequences of such choices. This model significantly mitigates the libertarian worry over unfair burdens for covering other people’s mistakes or social conditions, which lead to those bad outcomes, by ensuring to not burden others with any of the costs for the treatment of people who decide to engage in certain health-adverse behaviors. The aforementioned taxation-based system would only tax those who also engage in the health-adverse behavior through consumption, and that tax directly pays for the necessary collective treatment. As such, those who do not consume the good are not involved with the payment scheme, while those who do consume the good are responsible for payment in a matter proportional to the amount of the good they have consumed. Vl. Universal Coverage Taking a step back, one should consider whether these worries regarding the coverage of apparently self-inflicted health conditions in the context of universal healthcare are worthwhile issues. One perspective raises what is called the culturally imagined objection — an idea erroneously held by many that sick people, especially those who are poor and uneducated, bring these illnesses upon themselves due to poor decision-making and irresponsible risk-taking.[22] This perspective critiques the uniquely American view that, since individuals are free to choose their lifestyles, they should bear the costs of their lifestyle.[23] Taking this argument further, some (perhaps the strongly libertarian) would say that the poor health status among many individuals is the price individuals must pay for their American way of life and the liberty and freedom to live as they wish. However, people should not completely punish individuals for their health-adverse behaviors because these choices are largely pre-determined by a person’s socioeconomic influences.[24] The outcomes from these allegedly ill-advised behaviors, which largely affect poorer people, are not just poor behavior but rather a public health crisis. Perhaps the state and its people should take collective responsibility and cover the costs of treatment for those health outcomes without question, as a form of public service. Rather than worrying about accountability and taxing bad behavior or intrusiveness into personal decisions, some might argue that people need to collectively take responsibility for reducing the overarching systemic inequalities and covering the associated treatment costs as a measure of public health. Vll. Proposed Solution Given the strengths of the liberal-egalitarian model and taking into account libertarian and social justice-oriented objections, an ideal solution for the coverage of lifestyle-related health problems needs to consider the complex relationship between a person’s behaviors and their apparent health outcomes. It must consider how society as a whole passes judgment on behaviors and how to take into account that many health-adverse decisions are not truly autonomous decisions, as various genetic and socioeconomic factors influence them. An ideal solution combines the liberal-egalitarian tax-based model with the social justice concerns of universal coverage. Whatever the cost for the treatment of medical issues resulting in part or entirely from lifestyle and diet, taxes collected from spending associated with the behavior (like the purchase of alcohol, junk food, and cigarettes) ex-ante should fund 50 percent of the cost of treatment, while the universal healthcare taxation scheme should include the other 50 percent. Such a system would provide an incentive to avoid the purchases that can lead to unhealthy consumption and make healthier choices, slightly punish and discourage such purchases through taxation, yet not overly punish people whose outcomes may have more to do with socioeconomic factors and genetics. Adding public responsibility demonstrates acknowledgement that health care is in the public interest and can mitigate public health inequalities. This solution would fuse personal responsibility with the public responsibility of state-sponsored social improvement while ensuring that all people have fair access to necessary treatment, no matter their ability to pay. CONCLUSION The 50-50 system this paper proposes reflects both justice and personal responsibility in covering healthcare costs allegedly brought about by people’s own health-adverse behaviors. By allocating tax revenue from consumption that contributes or even alone causes poor health outcomes, such a system incorporates personal responsibility. By using general tax revenue for health care, such a system would meet the libertarian requirement of providing care without any moral investigation of past behaviors and the social justice consideration of providing health care to those who may have unwittingly ventured into ill-health due to systemic injustice, socioeconomics, or genetics. - [1] Cappelen, A. W. (2005). Responsibility in health care: A liberal egalitarian approach. Journal of Medical Ethics, 31(8), 476–480. https://doi.org/10.1136/jme.2004.010421 [2] Moss, A. H. (1991). Should alcoholics compete equally for liver transplantation? JAMA: The Journal of the American Medical Association, 265(10), 1295–1298. https://doi.org/10.1001/jama.1991.03460100097032 [3] Moss, p. 1295-1298. [4] Moss, p. 1296. [5] Moss, p. 1295-1298. [6] Moss, p. 1295-1298. [7] Cohen, C. IS THIS SUPPOSED TO BE COHEN AND BENJAMIN (1991). Alcoholics and liver transplantation. JAMA: The Journal of the American Medical Association, 265(10), 1299–1301. https://doi.org/10.1001/jama.1991.03460100101033 [8] Cohen, p. 1299-1301. [9] Moss, p. 1297. [10] Cohen, p. 1300. [11] Cappelen, p. 478-480. [12] Cappalen, p. 478-480. [13] Cappelen, p.479. [14] Cappelen, p. 479. [15] Cappelen, p. 479 [16] Cohen, p. 1301. [17] Cappelen, p. 478. [18] Cohen, p. 1299-1301. [19] Cohen, p. 1301. [20] Cappelen, p. 476-480. [21] Cappelen, p. 476-480. [22] Kawachi, I. (2005). Why the United States is not number one in Health. Healthy, Wealthy, and Fair, 18–33. https://doi.org/10.1093/acprof:oso/9780195170665.003.0013 [23] Kawachi, p. 18-33. [24] Kawachi, p. 18-33. (shrink)

Moral luck – which seems to appear when circumstances beyond a person’s control influence our moral attributions of praise and blame – is troubling in that modern moral theory has supposed morality to be immune to luck. In business, moral luck commonly influences our moral judgments, many of which have economic consequences that cannot be reversed. The possibility that the chance intervention of luck could influence the way in which we assign moral accountability in business (...) ethics is unsettling. This paper argues that if we cannot explain moral luck away, we should give consideration to moral risk in our moral judgments and the associated assignment of economic rewards regarding episodes in which moral luck plays a role. (shrink)

In 'What Luck Is Not', Lackey presents counterexamples to the two most prominent accounts of luck: the absence of control account and the modal account. I offer an account of luck that conjoins absence of control to a modal condition. I then show that Lackey's counterexamples mislocate the luck: the agents in her cases are lucky, but the luck precedes the event upon which Lackey focuses, and that event is itself only fortunate, (...) not lucky. Finally I offer an account of fortune. Fortune is luck-involving, and therefore easily confused with luck, but it is not itself lucky. (shrink)