This book advances a new interpretation of Hart's penal philosophy. Positioning itself in opposition to current interpretations, the book argues that Hart does not defend a mixed theory of punishment, nor a rule-utilitarian theory of punishment, nor a liberal form of utilitarianism, nor a goal and constraint approach. Rather, it is argued, his penal philosophy is based on his moral pluralism, which comprises two aspects: value pluralism and pluralism with respect to forms of moral reason. (...) It is held that this means, on the one hand, that criminal law has an irreducible complexity due to the compromises it makes to accommodate competing values, and on the other hand, that there need not be one single justification of punishment. This original interpretation is not based only on Hart's key volume on the subject Punishment and Responsibility, but on a careful reading of his complete works. The book will be a valuable resource for academics and researchers interested in Hart's philosophy, the philosophy of law and criminal law. (shrink)

Volume 10, Issue 1, March 2019, Page 85-90.

Punishment is a topic of increasing importance for citizens and policy makers. Why should we punish criminals? Which theory of punishment is most compelling? Is the death penalty ever justified? These questions and many others are addressed in this highly engaging guide. Punishment is a critical introduction to the philosophy of punishment offering a new and refreshing approach that will benefit readers of all backgrounds and interests. This is the first critical guide to examine all leading (...) contemporary theories of punishment, including the communicative theory of punishment, restorative justice, and the unified theory of punishment. There are also several case studies examined in detail including capital punishment, juvenile offending, and domestic abuse. -/- Punishment highlights the problems and prospects of different approaches in order to argue for a more pluralistic and compelling perspective that is novel and groundbreaking. -/- Introduction; Retributivism; Deterrence; Rehabilitation; Restorative Justice; Rawls, Hart, and "mixed" theories; Expressivism; The Unified Theory; Capital Punishment; Juvenile Offending; Domestic Abuse; Sexual Crimes; Conclusion; Index. (shrink)

An exploration of RA Duff's 'communicative theory of punishment' in contexts of deep legal and cultural pluralism.

The age-old debate about what constitutes just punishment has become deadlocked. Retributivists continue to privilege desert over all else, and consequentialists continue to privilege punishment's expected positive consequences, such as deterrence or rehabilitation, over all else. In this important intervention into the debate, Leo Zaibert argues that despite some obvious differences, these traditional positions are structurally very similar, and that the deadlock between them stems from the fact they both oversimplify the problem of punishment. Proponents of these (...) positions pay insufficient attention to the conflicts of values that punishment, even when justified, generates. Mobilizing recent developments in moral philosophy, Zaibert offers a properly pluralistic justification of punishment that is necessarily more complex than its traditional counterparts. An understanding of this complexity should promote a more cautious approach to inflicting punishment on individual wrongdoers and to developing punitive policies and institutions. (shrink)

Respect, Pluralism, and Justice is a series of essays which sketches a broadly Kantian framework for moral deliberation, and then uses it to address important social and political issues. Hill shows how Kantian theory can be developed to deal with questions about cultural diversity, punishment, political violence, responsibility for the consequences of wrongdoing, and state coercion in a pluralistic society.

This book brings together moral and legal philosophers,criminologists and political theorists in an attempt to address the interdependence of the study of punishment and of political theory as well as specific issues, such as freedom, autonomy, coercion and rights that arise in both. In addition to new essays on the compatibility of rights and utilitarianism and of autonomy and coercion in Kant's theory, the book contains an extended treatment of the idea of punishment as communication. This theme is (...) taken up in arguments over whether punishment is communicative, in the questions of what the content of any such communication could be in a pluralist society, and whether communicative accounts can make sense of the use of 'hard treatment'. By combining the techniques and expertise of different disciplines, the essays in this book shed new light on the problem of punishment. They also demonstrate the usefulness of that problem as a testing ground for legal and moral philosophy. (shrink)

Punishment is a topic of increasing importance for citizens and policymakers. Why should we punish criminals? Which theory of punishment is most compelling? Is the death penalty ever justified? These questions and many more are examined in this highly engaging and accessible guide. Punishment (2nd edition) is a critical introduction to the philosophy of punishment, offering a new and refreshing approach that will benefit readers of all backgrounds and interests. The first comprehensive critical guide to examine (...) all leading contemporary theories of punishments, this book explores – among others – retribution, the communicative theory of punishment, restorative justice and the unified theory of punishment. Thom Brooks applies these theories to several case studies in detail, including capital punishment, juvenile offending and domestic violence. Punishment highlights the problems and prospects of different approaches in order to argue for a more pluralistic and compelling perspective that is novel and ground-breaking. This second edition has extensive revisions and updates to all chapters, including an all-new chapter on the unified theory substantively redrafted and new chapters on cyber-crimes and social media as well as corporate crimes. Punishment is essential reading for undergraduate and graduate students in philosophy, criminal justice, criminology, justice studies, law, political science and sociology. "Lucid, fair-minded, and well-informed, Thom Brooks’ Punishment offers a superb introduction to a complex and contentious subject. Many a perplexed student will find illumination in his patient discussion of each of the leading theories. The way Brooks shows their interconnectedness and application in practice – to capital punishment, juvenile offenders, domestic violence, and the like – will interest not only students but scholars as well." ―Stuart P. Green, Distinguished Professor of Law and Nathan L. Jacobs Scholar, Rutgers School of Law "As a topic in moral and political philosophy, punishment has been jolted back to life. In the last quarter century, retribution has returned with a vengeance, both in the theoretical literature and (with a very different emphasis) in public policy. The rise of the victim as a player in the criminal justice system has also fuelled a counter-trend, placing an emphasis on redress. Human rights, privatization, globalization, the rise of the therapist, the lobbyist, the terrorist: all have affected our ways of punishing and of thinking about punishment. A new survey of the terrain is overdue. And who better to conduct it than Thom Brooks, whose grasp of the literature and feel for the issues is second to none? From the noble ideals of ‘communicative’ theory to the grim realities of children in prison: in Punishment Brooks covers it all with insight, rigour, and energy." ―John Gardner, Professor of Jurisprudence, University of Oxford "Thom Brooks has produced a valuable introduction to, and critical survey of, current theoretical approaches to punishment together with an analysis of their implications for practice. In addition, he has provided a spirited defence of a new, unified theory inspired by the British Idealists and encompassing retributive, consequentialist, and restorative elements. Written in a lucid and engaging style, the book will interest a wide range of readers – students, theorists of punishment, as well as those engaged in criminal justice policy." ―Alan Brudner, Albert Abel Professor Emeritus, Faculty of Law, University of Toronto. (shrink)

Social norms are commonly understood as rules that dictate which behaviors are appropriate, permissible, or obligatory in different situations for members of a given community. Many researchers have sought to explain the ubiquity of social norms in human life in terms of the psychological mechanisms underlying their acquisition, conformity, and enforcement. Existing theories of the psychology of social norms appeal to a variety of constructs, from prediction-error minimization, to reinforcement learning, to shared intentionality, to domain-specific adaptations for norm acquisition. In (...) this paper, we propose a novel methodological and conceptual framework for the cognitive science of social norms that we call normative pluralism. We begin with an analysis of the explanatory aims of the cognitive science of social norms. From this analysis, we derive a recommendation for a reformed conception of its explanandum: a minimally psychological construct that we call normative regularities. Our central empirical proposal is that the psychological underpinnings of social norms are most likely realized by a heterogeneous set of cognitive, motivational, and ecological mechanisms that vary between norms and between individuals, rather than by a single type of process or distinctive norm system. This pluralistic approach, we suggest, offers a methodologically sound point of departure for a fruitful and rigorous science of social norms. (shrink)

Punishment involves deliberating harming individuals. How, then, if at all, is it to be justified? This, the first of three papers on the philosophy of punishment (see also 'Punishment: Nonconsequentialism' and 'Punishment: The Future'), examines attempts to justify the practice or institution according to its consequences. One claim is that punishment reduces crime, and hence the resulting harms. Another is that punishment functions to rehabilitate offenders. A third claim is that punishment (or some (...) forms of punishment) can serve to make restitution to victims, and a fourth is that it can strengthen social values. The paper examines these claims, and finally considers pluralist theories which combine retributive and harm-reductive or utilitarian considerations. (Retributive theories are examined in their own right in 'Punishment: Nonconsequentialism'.). (shrink)

This paper is concerned with the tensions that arise when one juxtaposes one important liberal understanding of the nature and use of state power in circumstances of pluralism and (broadly) retributive accounts of punishment. The argument is that there are aspects of the liberal theory that seem to be in tension with aspects of retributive punishment, and that these tensions are difficult to avoid because of the attractiveness of precisely those features of each account. However, a proper (...) understanding of both liberalism and retributive punishment allows us to dissolve some of the tensions whilst also bringing each position into sharper relief. The paper begins by introducing the liberal position and outlining the apparent tensions that may arise with retributive punishment. In so doing, there is also a brief discussion of how this debate relates to the more familiar dispute between legal moralists and their opponents. The paper then proceeds by considering each of the areas of tension in turn. (shrink)

In Peculiar Institution David Garland offers a sociological explanation for America’s retention of the death penalty in an age of abolition. But the book does much more than that. Peculiar Institution appeared exactly two decades after the publication of Garland’s second major study Punishment and Modern Society. In that book he laid the foundations for a multidimensional sociology of punishment. However, Garland’s manifesto for a new pluralist sociology of punishment fell to a large extent on deaf ears. (...) It is against that background that I will argue that Peculiar Institution kills two birds with one stone: in addition to its declared intention to describe and explain America’s capital punishment complex, the book can also be read as a direct intervention in a much larger debate on how we should proceed when we aim to understand punishment in all its complexity. (shrink)

Husak makes a number of theoretical observations in favor of a general conception of sentencing that he calls sentencing pluralism. This framework is pluralistic in two different respects. In the first part of the chapter, he argues that the goals or objectives of a sentencing scheme are diverse and must draw from the insights supplied by various disciplines. Thus his framework embodies what he calls disciplinary pluralism. In the second part of the chapter, he argues that the sentence (...) offenders deserve cannot be identified without taking account of factors that are not contained within the proportionality calculus. Thus Husak’s framework also embodies what he calls desert pluralism. A sentencing theory that fails to include these two kinds of pluralism is deficient. (shrink)

Most philosophers reject what we might call "penal pluralism": the idea that punishment can and should encompass multiple penal goals or principles. This is rejected because it is often held that different penal goals or principles will conflict: the goal of punishing an offender to the degree deserved may differ and even undermine the goal of enabling deterrence or rehabilitation. For this reason, most philosophers argue that we must make a choice, such as choosing between retribution and its (...) alternatives. In "Some Remarks on Punishment," F. H. Bradley re-examines the justification of punishment in light of a critique of Darwinism's importance for ethics. My primary focus is on how Bradley's substantive discussion of punishment only because it is here that this article's arguments have most relevance for us today. (shrink)

The state that we inhabit plays a significant role in shaping our lives. For not only do its institutions constrain the kinds of lives we can lead, but it also claims the right to punish us if our choices take us beyond what it deems to be appropriate limits. Political philosophers have traditionally tried to justify the state's power by appealing to their preferred theories of justice, as articulated in complex and wide-ranging moral theories—utilitarianism, Kantianism, and the like. One of (...) John Rawls's greatest contributions to political philosophy has been his recognition that this is the wrong way for this field to approach its task. He points to what he calls “the fact of reasonable pluralism,” which is the incontestable fact that in a free society people striving to lead their lives ethically will subscribe to conflicting moral and religious doctrines, many of which will be “reasonable” in the special sense of leaving their adherents willing to cooperate with those with whom they have moral disagreements. And this means that political philosophers can no longer rely on any particular “comprehensive” doctrine in their attempts to justify the state. For doing so would be unfair to those who subscribe to a conflicting reasonable doctrine; it would mean that the coercive power of the state would not be justified to them in terms they can accept, even while they were forced to abide by its terms. (shrink)

This paper makes two essential claims about the nature of shame and shame punishment. I argue that, if we properly understand the nature of shame, that it is sometimes justifiable to shame others in the context of a pluralistic multicultural society. I begin by assessing the accounts of shame provided by Cheshire Calhoun (2004) and Julien Deonna, Raffaele Rodogno, & Fabrice Teroni (2012). I argue that both views have problems. I defend a theory of shame and embarrassment that connects (...) both emotions to “whole-self” properties. Shame and embarrassment, I claim, are products of the same underlying emotion. I distinguish between moralized and nonmoralized shame in order to show when, and how, moral and non-moral shame may be justly deployed. Shame is appropriate, I argue, if and only if it targets malleable moral or non-moral normative imperfections of a person’s ‘whole-self.’ Shame is unjustifiable when it targets durable aspects of a person’s “whole-self.” I conclude by distinguishing shame punishments from guilt punishments and show that my account can explain why it is wrong to shame individuals on account of their race, sex, gender, or body while permitting us to sometimes levy shame and shame punishment against others, even those otherwise immune to moral reasons. (shrink)

Through a series of texts and phone calls, Michelle Carter encouraged her boyfriend Conrad Roy to act on his suicidal thoughts, and after Roy killed himself, Carter was convicted of involuntary manslaughter. The case has received widespread attention, generating reactions ranging from rage at Ms. Carter to disbelief that she was convicted. An issue emphasized up to now is what it might mean for the First Amendment right of free speech if we hold that words can kill. In presenting the (...) case against punishing Ms. Carter, I show how the free speech issue intertwines with several others: Should the intimate exchanges between Carter and Roy have remained private? While privacy is valuable, it should not be a shield for harmful conduct, but did Ms. Carter, through her words, cause harm? If she believed that suicide would relieve Conrad of unbearable suffering, did she even act badly? And should the fact that society judges an individual’s actions to be immoral mean that the individual should be legally punished? The case serves as a touchstone for addressing fundamental issues of political, moral and legal theory with implications broader than whether Ms. Carter goes to prison. (shrink)

This article aims to review the concept of ‘Sokhyung(贖刑)’ as an example of a pluralistic interpretation of ‘Heumhul(欽恤)’ in The Book of Documents in the 18th and 19th centuries, and compared and reviewed the interpretation of The Book of Documents by Jeong Yak-yong(丁若鏞) and Shim Dae-yoon(沈大允). Sokhyung is to replace the original sentence by paying property after the sentence is confirmed. It is a specific application example of Heumhul, which means careful and lenient application of punishment. In The Book (...) of Documents, the discussion related to Sokhyung is presented in Chapter 11 of Soonjeon(舜典) and Yeohyung(呂刑). Seojipjeon(書集傳) written by Chae Chim(蔡沈) became the standard for interpreting Sokhyung, and he opposed Sokhyung because it was not fair. At this time, Sokhyung has the meaning of ‘commutation’, and in this respect, Sokhyung takes on the character of Heumhul in that it is a lenient application of the law. Scholars of the Joseon Dynasty generally tended to follow the views of Chae Chim, but a new interpretation trend emerged in the 18th and 19th centuries. Jeong Yak-yong was in favor of the system of Sokhyung on the grounds that the body was preserved by carrying out Sokhyung. At this time, Sokhyung has a meaning of Heumhul in that it is a method of carefully applying punishment and plays a role in realizing the Virtue that likes to save lives(好生之德). Shim Dae-yoon opposed the system of Sokhyung, but did not fully agree with Chae Chim's view. He argued that Sokhyung has the character of applying the law leniently and plays a role of promising that the punishment will disappear(刑期無刑), but criticized the system of Sokhyung in that it interferes with the discretionary application of the law(權衡). (shrink)

The state that we inhabit plays a significant role in shaping our lives. For not only do its institutions constrain the kinds of lives we can lead, but it also claims the right to punish us if our choices take us beyond what it deems to be appropriate limits. Political philosophers have traditionally tried to justify the state's power by appealing to their preferred theories of justice, as articulated in complex and wide-ranging moral theories—utilitarianism, Kantianism, and the like. One of (...) John Rawls's greatest contributions to political philosophy has been his recognition that this is the wrong way for this field to approach its task. He points to what he calls “the fact of reasonable pluralism,” which is the incontestable fact that in a free society people striving to lead their lives ethically will subscribe to conflicting moral and religious doctrines, many of which will be “reasonable” in the special sense of leaving their adherents willing to cooperate with those with whom they have moral disagreements. And this means that political philosophers can no longer rely on any particular “comprehensive” doctrine in their attempts to justify the state. For doing so would be unfair to those who subscribe to a conflicting reasonable doctrine; it would mean that the coercive power of the state would not be justified to them in terms they can accept, even while they were forced to abide by its terms. (shrink)

While discussing critical individuality as oneof the main goals of liberal education, theemphasis has usually been on direct educationalmeasures. Much less attention has been given tothe social preconditions for its development.This paper discusses the societal aspect of thequestion by employing the notion of spherepluralism. The attempt is to point out someways in which the diversified nature of societycan be employed in its full potential for thedevelopment of critical individuality. Thearticle aims to outline a form of spherepluralism, which is based on (...) structuraldifferentiation, cultural diversity, communalvitality, confessional pluralism andcross-communal criticism. The suggestion isthat the critical potential of sphere pluralismpresupposes a proper balance between sphereautonomy and inter-sphere criticism as well asthat between social construction of meaning andobjective-structural constraints. (shrink)

Political philosophy has seen vibrant debate over the connection, if any, between liberalism and pluralism. Some philosophers, following Isaiah Berlin, reckon a close connection between the two concepts. Others--most notably John Gray--believe that liberalism and pluralism are incompatible. In this essay, I argue that the puzzle can be solved by distinguishing the responsibilities of liberal states to their peoples from the responsibilities of liberal states to other states. There is an entailment from pluralism to liberalism, and it (...) in turn implies that while liberal states must tolerate "illiberal" lifestyles within their borders, liberal states must not tolerate illiberal states. The fact of liberal intolerance, however, does not justify unreasonably aggressive intervention by liberal states, nor does it mean that illiberal states deserve to be punished. (shrink)

Philosophers of criminal punishment widely agree that criminal punishment should be “proportional” to the “seriousness” of the offense. But this apparent consensus is only superficial, masking significant dissensus below the surface. Proposed proportionality principles differ on several distinct dimensions, including: regarding which offense or offender properties determine offense “seriousness” and thus constitute a proportionality relatum; regarding whether punishment is objectionably disproportionate only when excessively severe, or also when excessively lenient; and regarding whether the principle can deliver absolute (...) judgments, or only comparative ones. This essay proposes that these differences cannot be successfully adjudicated, and one candidate proportionality principle preferred over its rivals, in the abstract; a proportionality principle only makes sense as an integrated part of a more complete justificatory theory of criminal punishment. It then sketches a proportionality principle that best fits the responsibility-constrained pluralist theories of criminal punishment that currently predominate. The proportionality principle it favors provides that punishments should not be disproportionately severe, in noncomparative terms, relative to an agent’s culpability in relation to their wrongdoing. (shrink)

Michael Otsuka sets out to vindicate left-libertarianism, a political philosophy which combines stringent rights of control over one's own mind, body, and life with egalitarian rights of ownership of the world. Otsuka reclaims the ideas of John Locke from the libertarian Right, and shows how his Second Treatise of Government provides the theoretical foundations for a left-libertarianism which is both more libertarian and more egalitarian than the Kantian liberal theories of John Rawls and Thomas Nagel. Otsuka's libertarianism is founded on (...) a right of self-ownership. Here he is at one with 'right-wing' libertarians, such as Robert Nozick, in endorsing the highly anti-paternalistic and anti-moralistic implications of this right. But he parts company with these libertarians in so far as he argues that such a right is compatible with a fully egalitarian principle of equal opportunity for welfare. In embracing this principle, his own version of left-libertarianism is more strongly egalitarian than others which are currently well known. Otsuka argues that an account of legitimate political authority based upon the free consent of each is strengthened by the adoption of such an egalitarian principle. He defends a pluralistic, decentralized ideal of political society as a confederation of voluntary associations. Part I of Libertarianism without Inequality concerns the natural rights of property in oneself and the world. Part II considers the natural rights of punishment and self-defence that form the basis for the government's authority to legislate and punish. Part III explores the nature and limits of the powers of governments which are created by the consensual transfer of the natural rights of the governed. Libertarianism without Inequality is a book which everyone interested in political theory should read. (shrink)

The wrongness of rape -- Rationality and the rule of law in offences against the person -- Complicity and causality -- In defence of defences -- Justifications and reasons -- The gist of excuses -- Fletcher on offences and defences -- Provocation and pluralism -- The mark of responsibility -- The functions and justifications of criminal law and punishment -- Crime : in proportion and in perspective -- Reply to critics.

According to a rights forfeiture theory of punishment, liability to punishment hinges upon the notion that criminals forfeit their rights against hard treatment. In this paper, I assume the success of rights forfeiture theory in establishing the permissibility of punishment but aim to develop the view by considering how forfeited rights might be reclaimed. Built into the very notion of proportionate punishment is the idea that forfeited rights can be recovered. The interesting question is whether (...) class='Hi'>punishment is the sole means for reclaiming forfeited rights. I argue for a pluralistic theory of rights reclamation, according to which, there are multiple ways by which a wrongdoer can recapture her forfeited rights. In particular, I argue that offering remorseful compensation is a valid means by which a wrongdoer might partially, or fully, reclaim her right against punishment. (shrink)

Drawing from moral foundations theory, we show that differences in sensitivity to distinct moral norms help explain differences in the perceived fairness of punishing employees for off-duty deviance. We used an initial study to validate realistic examples of non-criminal behavior that were perceived as violating a specific moral foundation. Participants in the main study evaluated scenarios in which co-workers were fired for those behaviors, which took place outside of work but were revealed via social media. The extent to which participants (...) valued the norm violated by the co-worker positively predicted perceived fairness of the firing, and negatively predicted expressed intent to take retributive action against the responsible manager. This effect was moderated by the presence of a pre-existing organizational policy regarding off-duty conduct, which uniformly decreased negative reactions to the firing. Because social media now makes the revelation of an employee’s off-duty behavior to a broad audience increasingly likely, our results suggest the importance of developing an approach for responding to employee off-duty deviance while highlighting the relevance of moral pluralism to the study of third-party reactions. (shrink)

Doug Husak suggests that sometimes an actor should be deemed reckless, and not merely negligent, with respect to the risks that she knowingly created but has forgotten at the moment of action. The validity of this conclusion, he points out, depends crucially on what it means to be aware of a risk. Husak’s neutral prompt and counterfactual actual belief criteria are problematic, however. More persuasive is his suggestion that we understand belief, in this moral and criminal law context, as a (...) concept whose meaning is determined by its function as a culpability standard. Husak concludes that inadvertent actors are often less culpable than knowing-but-later-forgetful actors; this is plausible, but there are also numerous counterexamples. Holly Smith focuses on negligence cases in which an agent’s failure to notice a risk stems, not from a prior culpable choice, but from an objectionable attitude or set of attitudes. She is right to emphasize that genuine moral culpability does not depend on conscious choice. However, Smith also asserts that decisions that flow from an actor’s objectionable attitudes are only rarely culpable, because they often do not arise from a reasonably full configuration of the actor’s motives. This last requirement is, I fear, an unrealistic and unnecessarily demanding criterion of culpability. Even when many of the actor’s evaluative attitudes are inactive in Smith’s sense, the actor might deserve blame for not bringing them to bear on his decision. Michael Moore and Heidi Hurd thoroughly explore, and find deficient, H.L.A. Hart’s unexercised capacity theory of negligence. They are correct that that theory requires a further judgment: an actor’s inadvertence is culpable only if he had the capacity to have adverted if X where X is the source of the actor’s moral desert. They overstate, however, in suggesting that the capacity issue falls out of the picture once we identify that underlying desert basis. The authors also worry that if desert is grounded on an underlying vice, we lack a reliable way of ranking the different vices that might explain the actor’s inadvertence; this is not a fatal objection, however, because negligence determinations are quite feasible even in the absence of clear rankings. Moore and Hurd conclude by identifying eight distinct categories in which criminal liability for negligence is justifiable. Negligence is indeed a surprisingly complex and pluralist concept. The three articles in this symposium brightly illuminate some of the most fundamental conceptual and normative issues in the debate over whether it is just to blame and punish the negligently inadvertent. (shrink)

According to Leibniz, there is no death in the sense that the human being or animal is destroyed completely. This is due to his metaphysical pluralism which would suffer if the number of substances decreased. While animals transform into other animals after “death”, human beings are rewarded or punished of their behavior in this life. This paper presents a comprehensive account of how Leibniz thought the “death” to take place and discusses his often unclear views on the life after (...) death. I will also present a new, naturalistic reading of Leibniz’s views on afterlife. (shrink)

If a state with liberal political and justificatory commitments extends benefits of various kinds to persons forming families, what qualifications may such a state place on the right to access to those benefits? I will make two assumptions for the purposes of this paper. The first is the political and justificatory terrain of some form of political or otherwise non-perfectionist liberalism. The assumption is that we are considering the resources and limitations of a community of persons who accept moral (...) class='Hi'>pluralism (if not a specific doctrine like the "burdens of judgment"), some priority for individual freedom, and the obligation to justify public coercion and exclusion in terms accessible and fair to all members of morally and culturally diverse society. The second is that it is justified for a liberal state to recognize some forms of domestic partnerships or families in the first place and extend further benefits to them such as tax credits or laws extending (or facilitating the extension of) medical or social insurance. It is, of course, possible to imagine the argument that the liberal state gets out of the marriage business by getting out of it entirely - by extending no recognition or positive rights to families whatsoever beyond negative non-interference rights. I am interested in the dilemma of a society broadly like existing liberal ones which is committed both to subsidizing families and also to justificatory neutrality (expressed in American constitutional legal terms as the requirement of providing a "rational basis" for unequal treatment). Given these assumptions, I believe that the most justifiable policy on liberal grounds is not the institution of "marriage" increasingly open to new constituent relationships but rather a status of "registered domestic partnership" which fulfills the social and moral aims behind subsidizing the family but is entirely neutral not only to the gender or even to the numbers of the partners, but also to the affective and emotional content of domestic life and the purposes behind contracting domestic partnerships. So is there a right to polygamy and incestuous marriage? There is not a specific right to either and thus there is no a priori reason why some restrictions or even prohibitions on them might not be justified, but the same is true for every specific act where a general right to the freedom exists. I argue in this paper, however, that the arguments compatible with public reason for prohibiting them outright, or even for excluding them from the permissible types of legally registered partnerships, are quite weak. I argue that objections to polygamy from (1) female autonomy, (2) damage to children, (3) fairness in the marital market, and (4) the unfair burdening of society are serious and worth refuting, but do not establish a victorious case against multi-member relationships. As to incest, there are two separate questions. The first is whether the new institution of "registered domestic partnerships" should be open to them. The answer to that, given the state's lack of interest in citizens' reasons for forming partnerships and in what they do whilst being registered in one, is clearly "yes." The second is whether, entirely separate from the issue of legal recognition of domestic partnership, the state has a legitimate rational interest in deterring, preventing or punishing consanguineous sexual relations between close blood relations (first-degree incest). Here, the objections to allowing such relations are those from (1) child abuse; (2) unfair burdening of society; and (3) the creation of bad lives. I argue that while rape and other forms of child abuse would be no more legal or tolerated than they are now, the concern about any form of weakening a society's legal and political resources to combat such abuses does indeed register on the justificatory scale, but does not prove that such first-degree incestuous sexual relations are inherently bad enough to warrant intervention. I then argue that the concern about unfairly burdening society with unhealthy persons is not as dangerously totalitarian as we might initially fear, but nor is it strong enough to justify an outright prohibition. Finally, I argue that a concern to dissuade persons from creating certain kinds of lives (children with extreme birth defects) is also not as dangerously totalitarian as we might initially fear, and in fact goes further towards explaining why we might have a legitimate interest in intervening. Nonetheless, I argue that the criminalization of such acts only make sense when they are indicators of other offenses, namely negligence or abuse, and it thus seems that the act of consanguineous reproduction is itself insufficient. (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)

Religious traditions in the United States have been characterized by an ongoing tension between assimilation to the broader culture, typically reflected by mainline Protestant churches, and defiant rejection of cultural incursions, as witnessed by more sectarian movements such as Mormonism and Hassidism. But legal theorist and theologian Cathleen Kaveny contends that religious traditions do not need to swim in either the Current of Openness or the Current of Identity. There is a third possibility, which she calls the Current of Engagement, (...) which accommodates and respects tradition but which recognizes the need to interact with culture to remain relevant and to offer a prophetic critique of social and political and legal and economic practice. In fifty-six brief articles Kaveny illustrates the implications of the Current of Engagement in American public life. The articles are organized into five chapters or sections: Law as Teacher; Religious Liberty and its Limits; Conversations about Culture; Conversations about Belief; and Cases and Controversies. Kaveny provides astonishing insights into a range of hot-button issues: abortion, assisted suicide, government-sponsored torture, contraception, the Ashley Treatment, capital punishment, and the role of religious faith in a pluralistic society. (shrink)

The Shadow of God combines history and philosophy in a way that is, unlike Hegel, fundamentally pluralistic. It presents the period of German Idealism as a time when philosophers aimed to bring faith and reason together through the idea of autonomy. At the same time, the tensions endemic in that process led to a transfer of individual hope from an afterlife of reward or punishment to participation in a collective, historical process. This article responds to a series of critical (...) questions: Does the book assimilate consolation and reconciliation? Does it sufficiently distinguish knowledge and justification? Does it open the possibility for a reaffirmation of the individual? Does it underestimate the potential for a secularized Kantian philosophy to bring together equality, justification, and community? Does its interpretation of Kant give a place for his account of historical progress? Is awareness of the way in which theodicy came to be historicized helpful in understanding contemporary democracy and its discontents? (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)

In lieu of an abstract, here is a brief excerpt of the content:Commentary on “Sanity and Irresponsibility”Lloyd Fields (bio)AbstractI make two criticisms of Wilson’s proposal to dispense with a loaded axiological criterion of sanity. First, Edwards’s axiological criterion of sanity, which Wilson accepts, involves the requirement of impartiality, which at least excludes some standards of right and wrong. Second, value pluralism applies only to morally acceptable forms of life and thus presupposes a standard of right and wrong. I conclude (...) by noting that mental illnesses are not sufficiently characterised by extreme and persistent deviance from practical rationality, as conceived by Edwards and Wilson.KeywordsSanity, responsibility, mental illness, value pluralismWilson’s paper is set in an important tradition of which Susan Wolf is a notable exemplar. He tackles the crucially important issue of how practical rationality is related to mental health and of how certain forms of irrationality are connected with mental illness. This issue must be taken into account in order to avoid infecting the criteria of sanity with “idiosyncratic or culturally biased norms.” Like Wolf (1989, 137–151), Wilson holds that sanity is a necessary condition of responsibility. But Wilson rejects the second of Wolf’s two criteria of sanity on the grounds that it invokes a definite normative theory of right and wrong. He proposes instead that whether an agent is sane should be decided on the basis of whether s/he displays practical rationality, as defined by Edwards’s list of seven items. Following Edwards, Wilson implicitly equates “sanity” with “mental health” and “insanity” with “mental illness.” By rejecting an axiological criterion of sanity that depends on a normative theory of right and wrong, Wilson is able to ensure that individuals like JoJo are not judged to be insane and hence not morally responsible for their actions. Wilson is right to stress the importance of our not applying notions such as “mental illness” or “insanity” too widely, especially in such a way as to allow blameworthy persons to escape blame and punishment.But are Wilson’s own criteria of sanity free from dependence on a normative theory, or a normative standard, of right and wrong? First, let us note that Wilson states Edwards’s seventh condition of practical rationality as follows: “holding values that are or would be adopted under the conditions of (negative) freedom.” Edwards’s own formulation of this condition is the following: “having values which have been (or would be) adopted under conditions of freedom, enlightenment and impartiality” (1982, 315). Wilson explains “freedom” as the absence of coercion. It is uncertain what “enlightenment” means in this context. Impartiality would seem to include being impartial between oneself and others and between one’s own tribe, nation or race and that of others. Although this requirement is perhaps too general to be regarded as a sufficient standard [End Page 303] of right and wrong, it is at least part of such normative theories as utilitarianism and Kant’s moral theory, while it is inconsistent with ethical egoism, i.e., the view that an action is right or wrong depending on whether it serves or frustrates the agent’s overall best interests. One could dispute Wilson’s claim, therefore, that Edwards’s seventh item is not a “loaded” axiological criterion.Second, Wilson maintains that we can avoid assuming a loaded axiological criterion for sanity by adopting the position of value pluralism. Wolf’s axiological criterion for sanity is that the agent should be capable of knowing the difference between right and wrong. Wilson holds that this criterion, as presented, invokes a normative theory of right and wrong. The criterion would not do so if it were applied in accordance with value pluralism, which, Wilson says, “rejects the notion that there is one monolithic theory of right and wrong without denying that an actor may behave virtuously or viciously.” Wilson appears to assume that an “unloaded” version of Wolf’s axiological criterion would be more or less equivalent to Edwards’s seventh condition of practical rationality.Value pluralism maintains that there are incompatible forms of life that display distinct virtues. “Whichever form of life one is pursuing there are virtues which elude one because they are available only to people pursuing alternative and... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Moral Traditions: An Introduction to World Religious Ethics, and: Understanding Religious Ethics, and: Moral Struggle and Religious Ethics: On the Person as Classic in Comparative Theological ContextsBrian D. BerryMoral Traditions: An Introduction to World Religious Ethics Mari Rapela Heidt Winona, Minn.: Anselm Academic, 2010. 138 pp. $22.95.Understanding Religious Ethics Charles Mathewes Malden, Mass.: Wiley-Blackwell, 2010. 277 pp. $41.95.Moral Struggle and Religious Ethics: On the Person as Classic in (...) Comparative Theological Contexts David A. Clairmont Malden, Mass.: Wiley-Blackwell, 2011. 245 pp. $99.95These three texts each make significant contributions to comparative religious ethics, a relatively recent discipline that reflects the rise of religious pluralism and globalization. Taken together, these books raise questions about what comparative religious ethics is, how it should be done, and why it should be done. What makes comparative religious ethics “comparative” and to what extent can comparative religious ethics be made genuinely “theological”?Mari Rapela Heidt, who holds a PhD in theological ethics from Marquette University and currently lectures in the religious studies department at the University of Dayton, has written a well-organized and highly accessible introduction to the ethics of the world religions for beginning undergraduate students. Each of the main chapters in her book surveys a major world religion (Hinduism, Buddhism, Judaism, Christianity, Islam, and the Chinese moral tradition) through four lenses: a brief review of the tradition; the moral world of the religion; values, principles, or virtues in the tradition; and the religious tradition on a particular moral issue (e.g., Hinduism on abortion, Buddhism on wealth and poverty, Judaism on the environment, Christianity on war and peace, Islam on men and women, and China’s one-child [End Page 202] policy). The book also includes opening chapters that introduce students to the study of ethics and religious ethics; a final chapter on additional religious moral traditions (Sikhism, Jainism, Bahá’í, and Shinto); sidebars highlighting major religious figures, texts, or events (e.g., Gandhi, Thich Nhat Hanh, Elie Wiesel, the Charter of Medina, and the Cultural Revolution); and discussion questions, bibliography (including visual media), footnotes, a glossary, and an index.Although this book briefly discusses the discipline of comparative religious ethics and some of its descriptive and conceptual methods in its opening chapters, its broad scope and concise treatment mean that the actual task of comparing the similarities and differences in the ethics of the world religions is kept to a minimum. The few detailed comparisons that are made focus largely on Hindu, Buddhist, and Christian understandings of the concepts of reincarnation (29, 34, 64), dharma (18–19, 23–24, 34–35, 64), karma (18–19, 21–23, 35–36, 64), and ahimsa (25–27, 38, 70–71). While the main chapters are organized in a way that facilitates comparison, and discussion questions are included that invite students to observe similarities and differences, the book would be strengthened by giving greater attention to comparison throughout and adding a concluding chapter that summarizes its comparative content. It ends somewhat abruptly with a discussion of the Shinto moral tradition.Charles Mathewes, associate professor of religious studies at the University of Virginia, has written a book that, while limited to Judaism, Christianity, and Islam, achieves much greater comparative sophistication. The text is based on a course he has taught for more than ten years called “Religious Ethics and Moral Problems,” and it bears the marks of a seasoned teacher whose primary audience is advanced undergraduate students, both religious and secular. Mathewes writes from a Protestant Christian perspective “having a strong apocalyptic dimension which is focused on the next life,” acknowledging that Roman Catholics and Eastern Orthodox may find his views “odd or confused” (53). Part 1 discusses the relationship between God and morality and provides an overview of the ethics of each of the three Abrahamic religions. Parts 2 and 3 then examine not only the moral positions but “the arguments animating the traditions” (3) on a wide range of personal and social matters (e.g., friendship, sexuality, marriage and family, lying, forgiveness, capital punishment, war, and the environment). Part 4 turns to the even more ordinary topics of labor, leisure, and life and the more... (shrink)

What place, if any, ought cultural considerations have when we blame and punish in the criminal law? Bringing together political and legal theorists Criminal Law and Cultural Diversity offers original and diverse discussions that go to the heart of both legal and political debates about multiculturalism, human agency, and responsibility.

In lieu of an abstract, here is a brief excerpt of the content:Reviewed by:Redeeming a Prison Society: A Liturgical and Sacramental Response to Mass Incarceration by Amy LevadLloyd SteffenRedeeming a Prison Society: A Liturgical and Sacramental Response to Mass Incarceration Amy Levad minneapolis: fortress press, 2014. 233 pp. $39.00.Amy Levad (University of St. Thomas) has added a theological voice to the national conversation that Michelle Alexander opened with her devastating critique of the American criminal justice system in The New Jim (...) Crow: Mass Incarceration in the Age of Colorblindness. Alexander showed how policies grounded in the war on drugs have disproportionately distressed racial and ethnic minorities—African Americans and Latinos—and the poor, destroying lives and communities. Incarceration in the United States is today a system that perpetuates what Alexander called a “caste” system from which escape is, especially among black males, virtually impossible. In this informed and well-presented study, Levad takes up Alexander’s social justice analysis, extending it in new directions, offering a creative theological contribution to the mass incarceration crisis in the world’s first “genuine prison society.”Levad observes that a limitation in the Christian response to mass incarceration is the “lack of Catholic voices” (47), which her book makes an effort to correct. She draws on core insights of Catholic tradition to address conditions that foster crime while also responding “to the ways in which the criminal justice crisis both reflects and sustains social injustices” (48). Her book offers a wonderfully clear analysis of mass incarceration and related issues such as recidivism strategies and policing policies. She advocates “pulling levers,” policing policies that aim at avoiding prison, versus harsh “window-breaking” policies that for deterrence reasons criminalize even minor offences. Levad addresses theories of punishment, proposes ideas for prison reform, and, while acknowledging a limited need for prisons, sets forth constructive suggestions for how best to decarcerate society through restorative justice and rehabilitation practices that reintegrate offenders into society.The study is a provocative interdisciplinary conversation between criminology and theology. Levad’s focus is on liturgy and sacrament, the central resources of Roman Catholic theology, finding in the Eucharist the theological [End Page 204] model for inviting the marginalized and dispossessed into the common fellowship of human dignity. She then argues that penance and reconciliation yield attitudes and behaviors that parallel secular restorative justice efforts. Advocating alternatives to prison while denying the effectiveness of punitive retribution, Levad critiques the approaches of the US Conference of Catholic Bishops and other Catholics. She highlights Kathryn Soltis as a Catholic scholar who uses theological resources to affirm the dignity of prisoners, attend to the common good, and seek ways to repair relationships between victims and offenders.Some of Levad’s ideas could be developed further. Pluralism, for instance, is mentioned as a contextual issue for her theological work but never thoroughly developed. Utilitarianism is denied a constructive ethics role, but Levad’s discussion of recidivism appeals to it as a marker of the common good (122). And Levad’s attention to the internal failures of the Church in confronting social justice issues leads one to wonder whether the decarcerated vision of society she desires is practicable.Levad speaks to the heart of the incarceration crisis in America, challenging the willingness of Americans to “throw people away” (198) through imprisonment—especially the young, the poor, and minorities. With her underlying question of “what kind of people we want to be and what we want our communities to be like” (43), Levad presents readers with a distinctive “vision of justice in God’s reign conveyed by liturgy and sacraments” (197). With that, she has accomplished what she set out to do: confront the social injustice of mass incarceration with the best insights of modern criminology but also with a theological perspective that embodies the struggle to realize an engaged Catholic praxis of justice.Lloyd SteffenLehigh UniversityCopyright © 2016 Society of Christian Ethics... (shrink)