: This article considers what contribution the work of John Rawls can make to questions about animal ethics. It argues that there are more normative resources in A Theory of Justice for a concern with animal welfare than some of Rawls's critics acknowledge. However, the move from A Theory of Justice to Political Liberalism sees a depletion of normative resources in Rawlsian thought for addressing animal ethics. The article concludes by endorsing the implication of A Theory of Justice that (...) we look for ways other than rights discourse to respect and protect the well-being of animals. (shrink)

Thomas Pogge answers the question if the capability approach can be justified with a firm ‘no’. Amongst others, he ridicules capability theorists for demanding compensation for each and every possible natural difference between people, including hair types. Not only does Pogge, so this paper argues, misconstrue the difference between the capability approach and Rawlsian resourcism. Even worse: he is actually implicitly relying on the idea of capabilities in his defence of the latter. According to him the resourcist holds (...) that the institutional order should not be biased towards the average person or the needs of some. Yet, as his own case of blind people and traffic lights can illustrate, whether or not this is the case is impossible to assess without resorting to some concept like people’s capabilities. Secondly, it is argued that the real issue at stake is not at all the best metric of justice—primary goods or capabilities—but rather the scope of theories of justice. On the surface the difference of opinion seems to be how to deal with so-called “personal heterogeneities”, yet the discussed case of interpersonal differences in metabolism and communal land-use choices hints at something else; Whereas Pogge insists that questions of justice only concern the institutional structure of society, many capability theorists support the inclusion of culture and social practices as possible sources of injustice. Unfortunately Pogge does not properly acknowledge this, as right from the start of his paper he frames the debate between both approaches in terms of institutions only. (shrink)

In this paper I show that Rawls’s contract apparatus in A Theory of Justice depends on a particular presumption that is in conflict with the goal of conserving environmental resources. He presumes that parties in the original position want as many resources as possible. I challenge Rawls’s approach by introducing a rational alternative to maximising. The strategy of satisficing merely goes for what is good enough. However, it seems that under conditions of scarcity Rawls’s maximising strategy is the only rational (...) alternative. I therefore scrutinise the common account of scarcity. I distinguish between absolute and relative scarcity in order to show that scarcity is influenced by our decisions. If we would not accept the claim to as much as possible without further legitimisation, like Rawls does, then scarcity might not be as severe a problem. Finally, I reject Rawls’s proposed solution for dealing with problems of sustainability, namely his idea of the just savings principle. I conclude that Rawlsian Justice as Fairness is bad for the environment. (shrink)

Cox and Fritz state the central problem as the absence of a framework for healthcare policy decisions; but, they overlook the theoretical underpinnings of public law. In response, they propose a two-step procedure to guide fair decision-making. The first step relies on Thomas Scanlon’s ‘contractualism’ for stakeholders to consider whether, or not, they could reasonably reject policy proposals made by others; then in the second step, John Rawls’s principles of justice are applied to these proposals; a fair policy requires to (...) pass both steps. I argue that Cox and Fritz misinterpret Rawls. His theory has two stages: first, public reason is used to generate principles of justice; second, public reason is used to interpret and apply these principles. The second stage requires that proposals are based on the principles of justice from the first stage, and these proposals have to be acceptable to reasonable persons. Thus, Rawls’s theory does not need Scanlonian supplementation. Moreover, the application of Rawls’s theory in Cox and Fritz’s model is confusing. In any case, the problems with applying Rawlsian justice to healthcare can be located elsewhere. First, Rawls’s theory would treat healthcare simply as a ‘primary good’ or resource. Social justice ought to, instead, consider healthcare as an opportunity, in the manner conceived by Amartya Sen. Second, Rawlsian justice rests, ultimately, on the conception of a reasonable person; until and unless the characteristics of reasonable stakeholders are clarified, any model of health justice will remain hostage to the unreasonable. (shrink)

This paper presents and defends a Rawlsian argument for perfectionist state policies. The argument draws on Rawls’s discussion of the “Aristotelian Principle,” highlighting the complex relationship between this principle and the social bases of self-respect. The paper explains how Rawls’s discussion and endorsement of this principle has significant and unappreciated implications for his account of the human good and the state’s role in promoting it in a well-ordered society. Although Rawls explicitly rejected state perfectionism, the paper shows how his (...) conception of justice has the resources to respond to the important criticism that it is insufficiently responsive to the claims of human excellence. Rawlsian perfectionism, in this way, strengthens Rawlsian justice by removing an important reason for rejecting it. (shrink)

This paper discusses the philosophical concept of John Rawls on distributive justice and how it can be applied as a possible guide in the Philippine ayuda distribution during the COVID-19 pandemic. First, it discusses how the pandemic affected the Philippine economy and the complaints on the ayuda program regarding the ayuda distribution in the country. Second, it explains Rawlsian distributive justice and Rawls’ ideas, such as the veil of ignorance, liberty, and difference principles. Lastly, it discusses Rawls’ notion of (...) distributive justice as a guide in the ayuda distribution to provide a perspective on the equitable and just distribution of benefits given the limited resources. The main point is that the distribution of financial assistance or ayuda can be guided by Rawls’s notion of distributive justice, which prioritizes the well-being of the least well-off or disadvantaged. (shrink)

The ideas of philosopher John Rawls should be appropriated for the information age. A literature review identifies previous contributions in fields such as communication and library and information science. The article postulates the following neo-Rawlsian propositions as co-ordinates for the development of a normative theory of the information society: that political philosophy should be incorporated into information society studies; that social and technological circumstances define the limits of progressive politics; that the right is prior to the good in social (...) morality; that the nation state should remain in sharp focus, despite globalization; that liberty, the first principle of social justice, requires updating to deal with the growth of surveillance and other challenges; that social wellbeing is a function of equal opportunities plus limited inequalities of outcome, in information as well as material resources; and that political stability depends upon an overlapping consensus accommodating both religion and secularism. Although incomplete, such co-ordinates can help to guide policy-makers in the twenty-first century. (shrink)

This chapter presents a critical assessment of Rawls's rejection of perfectionist politics. It advances both a negative and a constructive thesis. The negative thesis targets Rawls's account of political legitimacy. The constructive thesis contends that there are resources within Rawls's own theory of justice for vindicating state perfectionism. A key part of the constructive thesis appeals to what Rawls terms as the Aristotelian Principle (AP). A legitimate society is a society that satisfies a general test, one that is articulated by (...) Rawls's liberal principle of legitimacy. Rawls noted that the exclusion of perfectionist considerations from justice might prove on reflection to be unacceptable. Rawls's endorsement of the AP provides a footing for a form of state perfectionism that can strengthen the overall case for Rawlsian justice by enabling it to respond to the criticism that it is insufficiently responsive to the claims of human excellence. (shrink)

In this chapter, I argue that there is an important structural similarity between the Liberal Pluralism of John Rawls’ Theory of Justice and Political Islam. This structural similarity, so I argue, showcases an important problem concerning what I call higher-order disagreement – a problem that plagues Rawls’ early version of Liberal Pluralism, a Liberalist understanding of Political Islam, as well as Rawls’ “later” political conception of Liberal Pluralism. I end by suggesting how Medieval Islamic Philosophy may have given us the (...) intellectual resources to solve this issue and towards articulating a “perfectionist” conception of Liberalism that is true to what the later Rawls calls “the fact of reasonable pluralism.” In short, then, it is from Islamic Philosophy where we can find the resources for fixing some of the conceptual problems with pluralism in the Rawlsian tradition. (shrink)

Participation trophies in youth sports have become controversial in the so-called “culture wars” of recent years in Western countries. Conservative professional athletes and media pundits deride participation trophies, as they perceive them as akin to equality of outcome and Communist ideology. However, this is a mischaracterization of participation trophies, as liberalism can also provide a philosophical basis for a defense of these trophies. In this article, I rely on John Rawls’ contractual theory to build a defense of participation trophies. These (...) prizes can serve as educational resources to teach young athletes about the dignity of losers in sports, and the need for taxation in order to sustain a safety net in society at large. (shrink)

Technological and societal changes have made downward social and economic mobility a pressing issue in real-world politics. This article argues that a Rawlsian society would not provide any special protection against downward mobility, and would act rightly in declining to provide such protection. Special treatment for the downwardly mobile can be grounded neither in Rawls’s core principles—the basic liberties, fair equality of opportunity, and the difference principle—nor in other aspects of Rawls’s theory. Instead, a Rawlsian society is willing (...) to sacrifice particular individuals’ ambitions and plans for the achievement of justice, and offers those who lose out from justified change no special solicitude over and above the general solicitude extended to all. Rather than guaranteeing the maintenance of any particular individual or group’s economic position, it provides all of its members—the upwardly mobile, the downwardly mobile, and the immobile—a form of security that is at once more generous and more limited: that they will receive the liberties, opportunities, and resources promised by the principles of justice. (shrink)

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. (shrink)

To be a liberal is, among other things, to grant basic liberties some degree of priority over other aspects of justice. But why do basic liberties warrant this special treatment? For Rawls, the answer has to do with the allegedly special connection between these freedoms and the ‘two moral powers’ of reasonableness and rationality. Basic freedoms are said to be preconditions for the development and exercise of these powers and are held to warrant priority over other justice-relevant values for that (...) reason. In the first half of the article I mount an internal critique of this Rawlsian line, arguing that it is flawed in two main ways. First, it overestimates the contribution of basic freedom to moral personality. Second, it underestimates the contribution of non-liberty resources to moral personality. In the second half of the article I repair these flaws. The result is a new, intriguingly radical version of justice as fairness, one with surprising—yet plausible—implications for economic and gender justice. (shrink)

This article makes two arguments. First, that social justice constitutes an inherent part of the conception of sustainable development that the World Commission on Environment and Development outlined in Our Common Future. The primary goal of the Commission was to reconcile physical sustainability, need satisfaction and equal opportunities, within and between generations. Sustainable development is what defines this reconciliation. Second, it is argued that this conception of sustainable development is broadly compatible with liberal theories of justice. Sustainable development, however, goes (...) beyond liberal theories of justice in many respects. It is based on three assumptions, which are for the most part ignored in liberal theories: an accelerating ecological interdependence, historical inequality in past resource use, and the 'growth of limits'. These assumptions create a conflict between intra- and intergenerational justice, which is ignored in liberal theories, but which sustainable development tries to solve. It does so by imposing duties on developed countries that goes beyond liberal demands, and by abandoning the focus 'solely on protection' that dominates non-anthropocentric approaches to environmental sustainability. (shrink)

Justice entitles everyone in the world, including future generations, to an equitable share of the benefits of the world's natural resources. I argue that even though both Rawls and his libertarian critics seem hostile to it, this resource equity principle, suitably clarified, is a major part of an adequate strict compliance theory of global justice whether or not we take a libertarian or a Rawlsian approach. I offer a defence of the resource equity principle from both points of view.

We proposed adding a sustainability principle to the operational ethical principles guiding public healthcare resources allocation decisions. All our commentators acknowledge our core message: healthcare needs to pay attention to the future. They also strengthen our proposal by offering support by luck egalitarian and Rawlsian arguments, and helpfully point out ambiguities and gaps requiring attention in the further development of the proposal, and its practical implementation.

In this paper I outline an approach to the distribution of resources between psychotherapy modalities in the context of the UK’s health care system, using recent discussions of Cognitive Behavioural Psychotherapy as a way of highlighting resourcing issues. My main goal is to offer an approach that is just, and that accommodates the diversity of different schools of psychotherapy. In order to do this I draw extensively on the theories of Justice and of Political Liberalism developed by the late John (...) Rawls, and adapt these to the particular requirements of psychotherapy resourcing. I explore some of the implications of this particular analysis, and consider how the principles of Rawlsian justice might translate into ground rules for deliberation and decision-making. (shrink)

The international disparities in health and health-care provision comprise the gravest problem of medical ethics. The implications are explored of three theories of justice: an expanded version of Rawlsian contractarianism, Nozick's historical account, and a consequentialism which prioritizes the satisfaction of basic needs. The second too little satisfies medical needs to be cogent. The third is found to incorporate the strengths of the others, and to uphold fair rules and practices. Like the first, it also involves obligations transcending those (...) to an agent's relations and fellow-citizens. These conclusions are applied to international health-care provision, which they would transform. (shrink)

Papers presented at the Kierkegaard: Resources and Results Conference, held at McGill University, June 6-8, 1980.

Sen and Nussbaum's capability approach has in the past twenty years become an increasingly popular and influential approach to issues in global justice. Its main tenet is that when assessing quality of life or asking what kind of policies will be more conducive to human development, we should look not to resources or preference satisfaction, but to what people are able to be and to do. This should then be measured against a more or less narrow conception of what any (...) human being should be able to be and do, i.e. which functions are essentially human. To have a capability is to be able to function in that way. Thomas Pogge has recently argued that despite its many attractions, the capability approach did not present a sufficiently strong challenge to Rawlsian resourcism. In this paper, I address Pogge's criticisms of the capability approach, and I argue that from the point of view of Nussbaum's Aristotelian version of the approach, his objections are not successful. (shrink)

This article seeks to revisit the relationship between Rawls’s contractarianism and the moral status of animals, paying particular attention to the recent literature. Despite Rawls’s own reluctance to include animals as recipients of justice, and my own initial scepticism, a number of scholars have argued that his theory does provide resources that are useful for the animal advocate. The first type takes Rawls’s exclusion of animals from his theory of justice at face value but argues that animals can still be (...) protected within a moral realm independently of justice, or indirectly through the motivations of human contractors. The second type adapts his theory in a way that enables animals to be included within a contractarian theory of justice. It is argued, though, that none of the responses offered is successful in providing a sphere of protection for animals from within Rawls’s contractarian theory. It is doubtful if Rawls’s intention was for animals to receive a significant degree of protection within a moral realm independently of justice, and equally doubtful if the contractors in the original position would be motivated to act on behalf of animals. In the case of the second, whilst Rawlsian resources can be utilised to justify the attempt to amend the veil of ignorance so as to include animals, these are not dependent on a contractural agreement. Similarly, placing emphasis on social-co-operation as a means of incorporating animals into a theory of justice is flawed, not least because, paradoxically, it works for domesticated animals whilst they are being exploited. (shrink)

The present paper constitutes an introduction to a special issue of Diametros devoted to Setting Health-Care Priorities. What Ethical Theories Tell Us by Torbjörn Tännsjö. The book in question states that there are three moral theories which have valid implications in the field of the distribution of medical resources in a healthcare system: utilitarianism, the maximin/leximin view, and egalitarianism. A number of authors have contributed to this special issue with papers which challenge this thesis. Robert E. Goodin argues that, besides (...) general moral theories, some local principles of justice might be valid. Quinn Hiroshi Gibson states that Tännsjö should have considered the Rawlsian view on justice in its contractualist reading. Jay A. Zameska argues that his “revised lexical sufficientarianism” constitutes a more reliable moral view than prioritarianism. Finally, Lasse Nielsen points out that there is more to say about distributive justice than consequentialist theories can grasp. Moreover, he puts forward an argument in defense of prioritarianism. The final article in this issue constitutes Tännsjö’s replies to his critics. (shrink)

The first United Nations Millennium Development Goal calls for a distinct reduction of worldwide poverty. It is now widely accepted that the private sector is a crucial partner in achieving this ambitious target. Building on this insight, the ‹Bottom of the Pyramid’ concept provides a framework that highlights the untapped opportunities with the ‹poorest of the poor’, while at the same time acknowledging the abilities and resources of private enterprises for poverty alleviation. This article connects the idea of business with (...) the poor to sustainable development and especially to the notions of inter- and intragenerational justice. These principles of justice can be linked with the ‹Bottom of the Pyramid’ approach directly through the Rawlsian principles to foster holistic thinking. On this basis, the article offers a normative-ethical reasoning of corporations’ possible responsibilities for the poorest of the poor. Today’s state of worldwide inequalities is likely to generate future tensions between the privileged western world and the uncounted mass of poor (let alone the ethical dubiousness of this status). However, it is at the same time problematic if not even impossible to improve the situation of the poor by simply copying the resource intensive western way of living to the ‹Bottom of the Pyramid’ due to the limited carrying capacity of the earth. After highlighting possible moral dilemmas which may occur through such a potential trade off, this article concludes with an outlook on how the concepts ‹Bottom of the Pyramid’ and sustainable development could be combined. (shrink)

Proponents of environmentalist views often urge the teaching of such views and the inculcation of ‘green’ values within the educational curriculum of schools as a key component of achieving their ends. It might seem that modern versions of political morality that refuse to take a stance on controversial questions—religious, ethical, philosophical—or eschew appeal to perfectionist doctrines, such as Rawlsian political liberalism, are beset by a particularly acute difficulty in this regard. To the extent that environmentalist views embody claims about (...) ethical matters such as how individuals should live their lives, they fall foul of this version of political morality. This article evaluates the resources available to political liberalism to respond to the challenge of bringing the teaching of green values and virtues within the national curriculum. It argues that environmental concerns differ in morally important ways from other ethical, philosophical, and religious views that are typically off-limits to political liberalism. Much that passes as green ideals are not simply a conception of the good life in the manner that religious views, for example, are. Rather, many environmental goods are crucial to the realisation of socioeconomic justice and therefore escape the requirement of state neutrality on endorsing the truth or importance of their role. A minimal political liberal education includes teaching about justice-based concerns as part of a compulsory national curriculum. (shrink)

Rawlsian public reason requires public decisions to be justified through reasons that each citizen can accept as reasonable, free and equal. It has been objected that this model of public justification puts unfair burdens on marginalized groups. A possible version of the criticism is that the alleged unfairness is constituted by what Miranda Fricker and other authors call epistemic injustice. This form of injustice obtains when some agents are unjustly treated as not reliable, or when they are deprived of (...) epistemic resources to utter their claims or burdened when they need to express demands. I show that the Rawlsian model can stand the objection. Restricting justificatory reasons, at least when basic issues of human rights, liberties and opportunities are at stake, is needed in order to warrant a stable society as a fair system of cooperation among free and equal citizens. (shrink)

This timely and provocative book challenges the conventional wisdom that neoliberal capitalism is incompatible with social justice. Employing public choice and market process theory, Nick Cowen systematically compares and contrasts capitalism with socialist alternatives, illustrating how proponents of social justice have decisive reasons to opt for a capitalism guided by neoliberal ideas. Cowen shows how general rules of property and voluntary exchange facilitate widespread cooperation. Revisiting the works of John Rawls, he offers an interdisciplinary reconciliation of Rawlsian principles with (...) liberal democracy by introducing Robust Property-Owning Democracy, a new form of governance that aims to achieve social justice via practical, liberal means. Chapters address the knowledge problem and the incentive problem that emerge when aiming for a fair distribution of social resources and demonstrate how everyday political bargaining can help achieve just outcomes for all. Utilising insights from philosophy, politics and economics to show the role of market institutions and constitutional government in producing social justice, this book is crucial reading for academics, researchers and students of PPE and the political sciences. Its practical policy proposals will further benefit policymakers interested in mechanisms that spread the benefits of economic growth equitably. (shrink)

This book explores and elaborates three theories of public reason, drawn from Rawlsian political liberalism, natural law theory, and Confucianism. Drawing together academics from these separate approaches, the volume explores how the three theories critique each other, as well as how each one brings its theoretical arsenal to bear on the urgent contemporary debate of medical assistance in dying. The volume is structured in two parts: an exploration of the three traditions, followed by an in-depth overview of the conceptual (...) and historical background. In Part I, the three comprehensive opening chapters are supplemented by six dynamic chapters in dialogue with each other, each author responding to the other two traditions, and subsequently reflecting on the possible deficiencies of their own theories. The chapters in Part II cover a broad range of subjects, from an overview of the history of bioethics to the nature of autonomy and its status as a moral and political value. In its entirety, the volume provides a vibrant and exemplary collaborative resource to scholars interested in the role of public reason and its relevance in bioethical debate. (shrink)

An idea salient in the African and East Asian philosophical traditions is that the right sort of socio-political interaction would be similar to the intuitive ways that family members ought to relate to each other. Applying this perspective to economic and ecological inequalities, I articulate some principles implicit in healthy familial relationships, show what they entail for certain aspects of distributive justice at the national level, and contend that the implications are plausible relative to competing theories such as utilitarianism, Rawlsianism, (...) and the Capabilities Approach. Specifically, I maintain that reflection on familial norms suggests that an array of objective goods, particularly ones pertaining to relationality, the development of talents, and life, should be central to what the state distributes, an account that rivals subjective well-being, primary goods, or democratically chosen capabilities. When it comes to how much the state should ideally ensure each citizen has, reflection on familial norms supports a new, balancing approach, according to which all have a comparable share of resources needed for objective goodness, but more go to those with great ability or great disability, an approach that differs, and plausibly so, from maximizing, prioritizing the worst off, equalizing, or providing a sufficient minimum. (shrink)

Argues for political liberalism as a process-oriented view and process philosophy as a politically liberal view Daniel A. Dombrowski brings together the thought of the 20th-century philosophy's greatest political liberal, John Rawls, with the thought of the great process philosophers, Alfred North Whitehead and Charles Hartshorne. He shows that political liberalism is intimately linked with process philosophy, renaming it 'process liberalism'. He justifies this process liberalism in contrast to four potentially troublesome sources or influences: metaphysics, religion, right-wing politics and left-wing (...) politics. Dombrowski engages a series of interlocutors and alternative positions including Franklin I. Gamwell, Timothy D. Snyder, Martin Heidegger and Karl Marx. In conclusion, he offers a compelling, intricate and resourceful argument for nonhuman animal rights based on Rawlsian principles, which in turn forms the basis of a future environmental ethics. (shrink)

Rawls saw need for non-ideal theory also within society but never developed that project. In this chapter, Card suggests that the non-ideal part of Rawls’ Law of Peoples can be a resource for thinking about responding to evils when the subject is not state-centered. It is plausible that defense against great evils other than those of aggressive states should be governed by analogues of scruples that Rawlsian well-ordered societies observe in defending themselves against outlaw states. This essay explores those (...) hypotheses in relation to women’s self-defense and mutual defense against evils of misogyny, the term feminists apply to the most deeply hostile environments of and attitudes toward women and girls and to the cruelest wrongs to them/us, regardless whether perpetrators harbor feelings of hatred. It extrapolates and adapts to this case values, concepts, and methods from Rawls’s life’s work, especially his writing on war. (shrink)

During the past several decades, political philosophers have frequently clashed with one another over the question whether governments are morally required to remain neutral among reasonable conceptions of excellence and human flourishing. Whereas the numerous followers of John Rawls have maintained that a requirement of neutrality is indeed incumbent on every system of governance, other philosophers -- often designated as 'perfectionists' -- have argued against the existence of such a requirement. Liberalism with Excellence enters these debates not by plighting itself (...) unequivocally to one side or the other, but instead by reconceiving each of the sides and thus by redirecting the debates that have occurred between them. On the one hand, the book rejects the requirement of neutrality by contending that certain subsidies for the promotion of excellence in sundry areas of human endeavour can be proper and vital uses of resources by governments. Advocating such departures from the constraint of neutrality, the book presents a version of liberalism that can rightly be classified as 'perfectionist'. On the other hand, the species of perfectionism espoused in Liberalism with Excellence diverges markedly from the theories that have usually been so classified. Indeed, much of the book assails various aspects of those theories. What is more, the aspirational perfectionism elaborated in the closing chapters of the volume is reconcilable in most key respects with a suitably amplified version of Rawlsianism. Hence, by reconceiving both the perfectionist side and the neutralist side of the prevailing disputation, Liberalism with Excellence combines and transforms their respective insights. (shrink)

It appears to have been established that it is not possible for us to harm distant future generations by failing to adopt long-range welfare policies which would conserve resources or limit pollution. By exploring a number of possible worlds, the present article shows, first, that the argument appears to be at least as telling against Aristotelian, rights-based and Rawlsian approaches as it seems to be against utilitarianism, but second, and most importantly, that it only holds if we fail to (...) view moral agents as individuals. The article also concludes that the argument has profoundly counter-intuitive implications. (shrink)

Some people are worse off than others. Does this fact give rise to moral concern? Egalitarianism claims that it does, for a wide array of reasons. It is one of the most important and hotly debated problems in moral and political philosophy, occupying a central place in the work of John Rawls, Thomas Nagel, G. A. Cohen and Derek Parfit. It also plays an important role in practical contexts such as the allocation of health care resources, the design of education (...) and tax systems, and the pursuit of global justice. Egalitarianism is a superb introduction to the problem of contemporary egalitarian theories. It explains how rival theories of egalitarianism evaluate distributions of people’s well-being, and carefully assesses the theoretical structure of each theory. It also examines how egalitarian theories are applied to the distribution of health and health care, thus bringing a deceptively complex philosophical debate into clear focus. Beginning with a brief introduction to basic terminology, Iwao Hirose examines the following topics: Rawlsian egalitarianism luck egalitarianism telic egalitarianism prioritarianism sufficientarianism equality and time equality in health and health care. Including chapter summaries, annotated further reading and a glossary, this is an ideal starting point for anyone studying distributive justice for the first time, and will also be of interest to more advanced students and researchers in philosophy, economics, political theory, public policy, and public health. (shrink)

‘Rights and Territories: A Reply to Nine, Miller, and Stilz’ defends the Lockean theory of states’ territorial rights (as this theory was presented in Boundaries of Authority) against the critiques of Nine, Miller, and Stilz. In response to Nine’s concern that such a Lockean theory cannot justify the right of legitimate states to exclude aliens, it is argued that a consent-based theory like the Lockean one is flexible enough to justify a wide range of possible incidents of territorial rights – (...) importantly including, though not necessarily including, the sort of right to exclude aliens that is familiar from actual political practice. Miller’s criticisms are more wide-ranging. In response, the article argues that Lockean labor-based property rights are both stronger and more enduring than Miller suggests and that nationalism’s resources for dealing with concerns about rights-supersession and trapped minorities are importantly overstated by Miller. Against Stilz’s Kantian, ‘presentist’ account of states’ authority over persons and territories, it is argued that the rectification of past (historical) wrongs remains morally crucial even in the context of otherwise-just societies and that Stilz’s Kantian/rawlsian position unconvincingly privileges the rights to autonomy of territorially concentrated groups over those of dissenting individuals or wrongfully dispersed groups. (shrink)

This article discusses the adequacy of Rawls’ theory of justice as a tool for racial justice. It is argued that critics like Charles W Mills fail to appreciate both the insights and limits of the Rawlsian framework. The article has two main parts spread out over several different sections. The first is concerned with whether the Rawlsian framework suffices to prevent racial injustice. It is argued that there are reasons to doubt whether it does. The second part is (...) concerned with whether a Rawlsian framework has the resources to rectify past racial injustice. It is argued that it has more resources to do this than Mills allows. This second part of the article centers on two Rawlsian ideas: ideal theory and the fair equality of opportunity principle. It is argued that ideal theory is essential for the kind of rectificatory work that Mills wants nonideal theory to do, and that where there is a socioeconomic legacy of past injustice, it is hard to see how FEO could be implemented if it did no rectificatory work, a result which means that there is less need to turn to nonideal theory at all. (shrink)

This article explains how strong sustainability ethics has emerged and developed as a new field over the last two decades as a critical response to influential conceptions of weak sustainability. It investigates three competing, normative approaches to strong sustainability: the communitarian approach, the Rawlsian approach, and the capabilities approach. Although these approaches converge around the idea that there are critical, non-substitutable natural resources and services, they diverge on how to reconcile human development and environmental protection. The aim of the (...) paper is to provide a critical overview of these three perspectives, but also and mostly to show that when we put them into dialogue with each other, we can clarify the demands of sustainability. The paper concludes that the capabilities approach is the most suitable way to think about sustainability, but only if it goes beyond its dominantly anthropocentric view. (shrink)

The ‘reasonable person standard’ is often called on in difficult legal cases as the last resource to be appealed to when other solutions run out. Its complexity derives from the controversial tasks that people place on it. Two dialectics require some clarification: the objective/subjective interpretation of the standard and the ideal/ordinary person controversy. I shall move through these dialectics from the standpoint of an EV approach, assuming that on this interpretation the RPS can perform most persuasively its tasks. The all-round (...) model of phronetic agent that I present not only works better than competing models—such as the utilitarian–economic and the Rawlsian—in the law of tort but shows its best potentialities in other kinds of cases. In criminal law and matrimonial law cases the recourse to the EV approach offers through the virtues rich and substantial resources to evaluate conflictual cases. This approach makes the threshold of evaluation much closer to real life than competitors. (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)

This article considers and ultimately rejects three prominent liberal egalitarian strategies for safeguarding the occupational freedom of the economically talented. First, Dworkinian concerns regarding the envy of the talented for the less talented are shown to be insufficient to rule out occupationally coercive taxation. Second, Rawlsian arguments about the priority of basic liberties in general and freedom of occupation in particular are shown to be unsuccessful, primarily because Rawls lacks the theoretical resources to protect freedom of occupation as a (...) basic liberty. Finally, concerns about the practical difficulty and moral undesirability of gathering the information necessary to implement occupationally coercive taxation are shown to be insufficient to rule out such taxation. The aim of the article is not to lead liberal egalitarians to reject freedom of occupation. Rather, the aim is to highlight the difficulties in protecting freedom of occupation and to motivate work on alternative liberal egalitarian strategies for safeguarding this important economic liberty. At the end of the article, a hypothesis is put forward for why occupationally coercive taxation should be rejected that appeals to the prohibition on using people as means. (shrink)

It is common to interpret Rawls's maximin theory of justice as egalitarian. Compared to utilitarian theories, this may be true. However, in special cases practices that distribute resources so as to benefit the worst off actually increase the inequality between the worst off and some who are better off. In these cases the Rawlsian maximin parts company with what is here called true egalitarianism. A policy question requiring a distinction between maximin and "true egalitarian" allocations has arisen in the (...) arena of organ transplantation. This case is examined here as a venue for differentiating maximin and true egalitarian theories. Directed donation is the name given to donations of organs restricted to a particular social group. For example, the family of a member of the Ku Klux Klan donated his organs on the provision that they go only to members of the Caucasian race. While such donations appear to be discriminatory, if certain plausible assumptions are made, they satisfy the maximin criterion. They selectively advantage the recipient of the organs without harming anyone. Moreover, everyone who is lower on the waiting list is advantaged by moving up on the waiting list. This paper examines how maximin and more truly egalitarian theories handle this case arguing that, to the extent that directed donation is unethical, the best account of that conclusion is that an egalitarian principle of justice is to be preferred to the maximin. (shrink)

The neo-Lockean justification of the highly unequal distribution of income in capitalist societies is based upon two key premises: that people are the rightful owners of their labor and talents, and that the external world was, in the state of nature, unowned, and therefore up for grabs by people, who could rightfully appropriate parts of it subject to a ‘Lockean proviso.’ The argument is presented by Nozick. Counter-proposals to Nozick’s, for the most part, have either denied the premise that people (...) should morally be viewed as the owners of their talents, or have challenged Nozick’s Lockean proviso.Rawls, and to a more limited extent Ronald Dworkin, deny self-ownership. As Rawls writes: ‘…the difference principle represents, in effect, an agreement to regard the distribution of natural talents as a common asset … The naturally advantaged are not to gain merely because they are more gifted, but only to cover the costs of training and education and for using their endowments in ways that help the less fortunate as well. No one deserves his greater natural capacity nor merits a more favorable starting place in society.’ Behind the Rawlsian veil of ignorance, those who deliberate about justice are deprived of knowledge about characteristics whose distribution is morally arbitrary. In Dworkin’s proposal for resource egalitarianism, agents calculate the insurance policy they would hypothetically ask for, were they denied knowledge of what talents they will draw in the birth lottery. Compensation for unequal talents is, according to Dworkin, properly made by taxing and transferring income according to the way it would have been distributed as a consequence of such insurance. Dworkin’s veil of ignorance is thin, because agents in the appropriate posture for deliberating about income distribution know their preferences and attitudes toward risk, but not their talents. For both Rawls and Dworkin, the self-ownership premise is challenged by constructing a veil of ignorance in which people are deprived of knowledge of certain personal characteristics, knowledge of which would bias their opinions, from a moral viewpoint. (shrink)