In this paper, I critically analyze Andrea Sangiovanni’s approach to international justice in the EU that he labels Reciprocity-based Internationalism (RBI). I aim to show that the type of reciprocity RBI operates with is not a morally attractive ground for distributive justice because it cannot cope with the case of member states’ inability to reciprocate the production of collective goods at the EU level. I illustrate this with the case of disability. I contrast RBI’s understanding of reciprocity with Christie Hartley’s (...) ‘relationship model’. I argue that the relationship model of reciprocity should characterize the EU, whose two core normative features are fraternity and equal status. The advantage of the relationship model is that it calls for a stronger type of solidarity than RBI does. That not only entails the willingness to support those worse-off members that cannot productively reciprocate other member states’ efforts at the EU level but also calls for a higher redistribution rate within the EU. In the paper, I make three comparisons between RBI’s ‘productive reciprocity’ and the relationship model. The first concerns non-EU-integration-related disadvantages; the second concerns membership cases, such as accession to federations and supranational unions, while the third comparison examines EU-integration-related disadvantages. I argue that the relationship model is a better alternative to RBI in both integration-related and non-integration-related disadvantages. Also, the relationship model can justify accession cases where previous historical ties are relevant, which are outside of the purview of RBI. (shrink)

Central to the social membership model of animal rights is the claim that relations with nonhuman animals should be reorganized such that domesticated animals are recognized as members of our shared societies. Though some elements of the membership model remain contested, the core of the membership model is that domesticated animals have a claim on, and a direct entitlement to, the benefits of cooperative relations. For many political theorists, however, distributive justice considerations apply only to a certain kind of cooperative (...) relationship. The community of justice recipients is thought to be limited by what Brian Berkey calls the Contribution/Capacity Basis of Entitlement. Accordingly, justice considerations apply to a scheme of cooperation and a conception of justice “entail[s] direct entitlements only for those who are contributors, or, alternatively, those who at least possess the capacities that are necessary to be capable of contributing to such a scheme”. This thesis – referred to as ‘contributionism’ – has typically been utilized to exclude nonhuman animals from justice considerations. The paper argues that contributionism is not fundamentally at odds with justice for domesticated animals, and conversely that contributionism remains a useful conceptual tool for explaining resource sharing with these nonhuman animals. (shrink)

Does rational bargaining yield a social contract that is efficient and so inclusive? A core allocation, that is, an allocation that gives each coalition at least as much as it can get on its own, is efficient. However, some coalitional games lack a core allocation, so rationality does not require one in those games. Does rationality therefore permit exclusion from the social contract? I replace realization of a core allocation with another type of equilibrium achievable in every coalitional game. Fully (...) rational agents coordinate the pursuit of incentives so that equilibria of this type are efficient. They adopt a social contract that is efficient and inclusive. (shrink)

In this paper, I argue that, contrary to what some critics suggest, political liberalism is not exclusionary with regards to the rights and interests of individuals with cognitive disabilities. I begin by defending four publicly justifiable reasons that are collectively sufficient for the inclusion of members of this group. Briefly, these are the epistemic uncertainty that inevitably exists about individuals’ actual capacities, the political liberal duty to treat parents fairly, the social framework that is required for the fulfilment of parental (...) duties, and the necessity of cultivating certain emotions that are strongly associated with reasonableness. These reasons show why a more inclusive reading of political liberalism is plausible, and how this can be achieved without abandoning or revising the theory’s commitment to public reason, the political conception of the person, and the role of social cooperation. I then turn to the question of what a more inclusive political liberalism would look like. More specifically, I argue that, although it would not require the participation of individuals with cognitive disabilities in the practice of legitimation, it would require their full inclusion in the realm of justice as equal rights-bearers. (shrink)

It is commonly thought that neo-Hobbesian contractarianism cannot yield direct moral standing for marginal humans and animals. However, it has been argued that marginal humans and animals can have a form of direct moral standing under neo-Hobbesian contractarianism: secondary moral standing. I will argue that, even if such standing is direct, this account is unsatisfactory because it is counterintuitive and fragile.

There is a gap between health economic evaluation methods and the value judgments of coverage decision makers, at least in Germany. Measuring preference satisfaction has been claimed to be inappropriate for allocating health care resources, e.g. because it disregards medical need. The existing methods oriented at medical need have been claimed to disregard non-consequentialist fairness concerns. The aim of this article is to propose a new, contractarian argument for justifying needs-based economic evaluation. It is based on consent rather than maximization (...) of some impersonal unit of value to accommodate the fairness concerns. This conceptual paper draws upon contractarian ethics and constitution economics to show how economic evaluation can be viewed as an institution to overcome societal conflicts in the allocation of scarce health care resources. For this, the problem of allocating scarce health care resources in a society is reconstructed as a social dilemma. Both disadvantaged patients and affluent healthy individuals can be argued to share interests in a societal contract to provide technologies which ameliorate medical need, based on progressive funding. The use of needs-based economic evaluation methods for coverage determination can be interpreted as institutions for conflict resolution as far as they use consented criteria to ensure the social contract’s sustainability and avoid implicit rationing or unaffordable contribution rates. This justifies the use of needs-based evaluation methods by Pareto-superiority and consent. The view of economic evaluation presented here may help account for fairness concerns in the further development of evaluation methods. This is because it directs the attention away from determining some unit of value to be maximized towards determining those persons who are most likely not to consent and meeting their concerns. Following this direction in methods development is likely to increase the acceptability of health economic evaluation by decision makers. (shrink)

This paper outlines the potential and necessity of the development of assistive technologies for people with intellectual disabilities. We analyse a policy recommendation designed to determine the contents of a basic health package supplied by the state, known as the Dunning Funnel. We contend that the Dunning Funnel is a useful methodology, but is weakened by a potentially relativistic understanding of “necessity” in relation to the requirements of people with IDs. We remedy this defect by using the capabilities approach as (...) outlined by Martha Nussbaum. We argue that this approach provides a strong normative case for ensuring that communities provide help to people with IDs, if those communities are to achieve a minimal standard of justice. However, the capabilities approach does not offer much specific guidance on how AT ought to be distributed, nor does it offer guidance on risks, like the bottomless pit problem. We propose that the Dunning Funnel used in combination with the capabilities approach will provide a suitable heuristic for determining the distribution of AT in a basic health package. (shrink)

John Rawls’s use of the “fully cooperating assumption” has been criticized for hindering attempts to address the needs of disabled individuals, or non-cooperators. In response, philosophers sympathetic to Rawls’s project have extended his theory. I assess one such extension by Cynthia Stark, that proposes dropping Rawls’s assumption in the constitutional stage (of his four-stage sequence), and address the needs of non-cooperators via the social minimum. I defend Stark’s proposal against criticisms by Sophia Wong, Christie Hartley, and Elizabeth Edenberg and Marilyn (...) Friedman. Nevertheless, I argue that Stark’s proposal is crucially incomplete. Her formulation of the social minimum lacks accompanying criteria with which the adequacy of the provisions for non-cooperators may be assessed. Despite initial appearances, Stark’s proposal does not fully address the needs of non-cooperators. I conclude by considering two payoffs of identifying this lack of criteria. (shrink)

This essay examines the citizen's apparent agelessness that is foundational to liberal democratic theories. By engaging the notion of citizenship rights, Lanoix challenges this assumed perpetual adulthood and argues for a new way of conceptualizing the citizen. The broader notion of citizen as cohabitant allows for the changing relationship a citizen will have with her citizenship rights and accommodates individuals who are not self-governing but who, nonetheless, share a democratic space.

This essay examines the citizen's apparent agelessness that is foundational to liberal democratic theories. By engaging the notion of citizenship rights, Lanoix challenges this assumed perpetual adulthood and argues for a new way of conceptualizing the citizen. The broader notion of citizen as cohabitant allows for the changing relationship a citizen will have with her citizenship rights and accommodates individuals who are not self-governing but who, nonetheless, share a democratic space.

: This essay examines the citizen's apparent agelessness that is foundational to liberal democratic theories. By engaging the notion of citizenship rights, Lanoix challenges this assumed perpetual adulthood and argues for a new way of conceptualizing the citizen. The broader notion of citizen as cohabitant allows for the changing relationship a citizen will have with her citizenship rights and accommodates individuals who are not self-governing but who, nonetheless, share a democratic space.

During the Covid‐19 pandemic, as resources dwindled, clinicians, health care institutions, and policymakers have expressed concern about potential legal liability for following crisis standards of care (CSC) plans. Although there is no robust empirical research to demonstrate that liability protections actually influence physician behavior, we argue that limited liability protections for health care professionals who follow established CSC plans may instead be justified by reliance on the principle of reciprocity. Expecting physicians to do something they know will harm their patients (...) causes moral distress and suffering that may leave lasting scars. Limited liability shields are both appropriate and proportionate to the risk physicians are being asked to take in such circumstances. Under certain narrow circumstances, it remains unclear that the standard of care is sufficiently flexible to protect physicians from liability. Given this uncertainty, the likelihood that physicians would be sued for such an act, and their desire for such immunity, this limited protection is morally legitimate. (shrink)

During the recent debates on whether to prioritize health care workers for COVID-19 vaccines, two main lines of arguments emerged: one centered on maximizing health and one centered on reciprocity. In this article, we scrutinize the argument from reciprocity. The notions of fittingness and proportionality are fundamental for the act of reciprocating. We consider the importance of these notions for various arguments from reciprocity, showing that the arguments are problematic. If there is a plausible argument for reciprocity during the pandemic, (...) this is most likely one that centers on the risk that health care workers take on while working. We argue that the scope of this argument is not plausibly extended only to health care workers. Other essential workers at risk are in the position to make the same arguments. We also argue that there is no compelling argument from reciprocity that makes reciprocating with vaccines, rather than by other means, necessary. Furthermore, allocating vaccines based on reciprocity will conflict with utility-maximizing. Given the weak state of the arguments, overriding concerns for utility seem unreasonable. (shrink)

Reciprocal libertarianism is a version of left-wing libertarianism that combines self-ownership with an egalitarian distribution of resources according to reciprocity. In this paper, I show that reciprocal libertarianism is a coherent and appealing view. I discuss how reciprocal libertarians can handle conflicts between self-ownership and reciprocity, and I show that reciprocal libertarianism can be realised in a framework of individual ownership of external resources or in a socialist scheme of common ownership (libertarian socialism). I also compare reciprocal libertarianism with left-libertarian (...) approaches: I argue that a reciprocity-sensitive version of left-libertarianism (reciprocal left-libertarianism) is coherent and morally superior to traditional left-libertarianism, on grounds of incorporating a distinctively solidaristic and recognition-oriented aspect of equality. The policy implications of reciprocal libertarianism will differ depending on which rights people can have over external resources, but all reciprocal libertarian views acknowledge the existence of social rights that people have as co-operators. (shrink)

This paper develops a general approach to how society should compensate for losses that individuals incur due to public health interventions aimed at controlling the spread of infectious diseases. The paper falls in three parts. The first part provides an initial introduction to the issues and briefly outlines five different kinds of public health interventions that will be used as test cases. They are all directed at individuals and aimed at controlling the spread of infectious diseases (1) isolation, (2) quarantine, (...) (3) recommended voluntary social distancing, (4) changes in health care provision for asymptomatic carriers of multi-resistant microorganisms, and (5) vaccination. The interventions will be briefly described including the various risks, burdens and harms individuals who are subject to these interventions may incur. The second part briefly surveys current compensation mechanisms as far as any exist and argue that even where they exist they are clearly insufficient and do not provide adequate compensation. The third part will then develop a general framework for compensation for losses incurred due to public health interventions in the infectious disease context. This is the major analytical and constructive part of the paper. It first analyses pragmatic and ethical arguments supporting the existence of an obligation on the part of the state to compensate for such losses, and then considers whether this obligation can be defeated by (1) resource considerations, or (2) issues relating to personal responsibility. (shrink)

Historically, philosophers have had little to say about justice and disability. However, in recent years and in response to disability rights movements, philosophers have started to consider the claims to justice of persons with mental and physical impairments. Importantly, some have charged that without extensive revision, social contract accounts of justice – which enjoy immense popularity among political philosophers – cannot address the needs and interests of persons with disabilities. In this article, I explain why social contract accounts are thought (...) to flounder when it comes to justice for persons with disabilities. Then I assess the merits of recent attempts to construct theories of justice inclusive of persons with disabilities. In particular, I consider Nussbaum’s capabilities approach, Kittay’s justice as caring, and various restatements of the social contract. (shrink)

It is widely accepted that states have a right to control immigration, but must accept refugees at risk in their home countries. If this is true, perhaps states have a right to deport refugees once their lives are no longer at risk in their home countries. I raise three types of arguments against this claim, and in support of refugees’ right to remain. Citizenship-based arguments hold that refugees have a right to obtain citizenship, and with citizenship comes the right to (...) remain. Plans-based arguments hold that refugees have a right to plan their lives, and they will struggle to plan without the right to remain. Reciprocity-based arguments hold that refugees have a right to reciprocal relationships with citizens, far easier if they know they can remain. I reject the first two arguments, and defend the third. (shrink)

It is widely accepted that states have a right to control immigration, but must accept refugees at risk in their home countries. If this is true, perhaps states have a right to deport refugees once their lives are no longer at risk in their home countries. I raise three types of arguments against this claim, and in support of refugees’ right to remain. Citizenship-based arguments hold that refugees have a right to obtain citizenship, and with citizenship comes the right to (...) remain. Plans-based arguments hold that refugees have a right to plan their lives, and they will struggle to plan without the right to remain. Reciprocity-based arguments hold that refugees have a right to reciprocal relationships with citizens, far easier if they know they can remain. I reject the first two arguments, and defend the third. (shrink)

Normative welfare economics commonly assumes that individuals’ preferences can be reliably inferred from their choices and relies on preference satisfaction as the normative standard for welfare. In recent years, several authors have criticized welfare economists’ reliance on preference satisfaction as the normative standard for welfare and have advocated grounding normative welfare economics on opportunities rather than preferences. In this paper, I argue that although preference-based approaches to normative welfare economics face significant conceptual and practical challenges, opportunity-based approaches fail to provide (...) a more reliable and informative foundation for normative welfare economics than preference-based approaches. I then identify and rebut various influential calls to ground normative welfare economics on opportunities rather than preferences to support my qualified defence of preference-based approaches. (shrink)

In this essay, we focus on the moral justification of a highly controversial measure to redress medical brain drain: the duty to stay. We argue that the moral justification for this duty lies primarily in the fact that medical students impose high risks on their fellow citizens while receiving their medical training, which in turn gives them a reciprocity-based reason to temporarily prioritize the medical needs of their fellow citizens.

The most recent major contribution to the literature on justice as mutual advantage is Peter Vanderschraaf’s book Strategic Justice. In this book, he develops a theory of justice as convention, where justice is those principles that rational, self-interested agents would choose to solve problems of partially conflicting interest. His theory is thus a kind of theory of justice as mutual advantage. A common criticism of theories of justice as mutual advantage is the Vulnerability Objection: if the principles of justice require (...) that resources are only shared with those that are net-contributors to a cooperative surplus, then those that are not net-contributors to that cooperative surplus (so-called vulnerable people) have no claim of justice to any share of the resources. But, the objection states, surely justice cannot exclude people simply because they are vulnerable. Vanderschraaf argues that his theory of justice as convention successfully answers the Vulnerability Objection. However, in this paper, I argue that although Vanderschraaf’s theory successfully demonstrates that it can be to the mutual advantage of rational, self-interested people to agree to share equally even when some people contribute more than others, the problem remains of why such people would share with those that can never contribute more to the cooperative surplus than what they would withdraw from it. Vanderschraaf’s solution is to weaken the requirement that people actually contribute. But that, I argue, undermines the claim that his theory is a theory of justice as mutual advantage. (shrink)

This paper defends an account of compassion and argues for the centrality of compassion to the proper practice of medicine. The argument proceeds by showing that failures of compassion can lead to poor medical treatment and disastrous outcomes. Several case studies are discussed, exemplifying the difference between compassionate and noncompassionate responses to patients seeking help. Arguments are offered in support of approaching reports of persistent pain with a trusting attitude, rather than distrust or skepticism. The article concludes by suggesting educational (...) improvements to encourage compassion. (shrink)

abstract Contractarianism roots moral standing in an agreement among rational agents in the circumstances of justice. Critics have argued that the theory must exclude nonhuman animals from the protection of justice. I argue that contractarianism can consistently accommodate the notion that nonhuman animals are owed direct moral consideration. They can acquire their moral status indirectly, but their claims to justice can be as stringent as those among able‐bodied rational adult humans. Any remaining criticisms of contractarianism likely rest on a disputable (...) moral realism; contractarianism can underwrite the direct moral considerability of nonhuman animals by appealing to a projectivist quasi‐realism. (shrink)

Contractarianism is more inclusive than critics (and, indeed, Gauthier) sometimes suggest. Contractarianism can justify equal moral standing for human persons (in some respects) and provide sufficient moral standing for many nonhuman animals to require what we commonly call decent treatment. Moreover, contractarianism may allow that some entities have more moral standing than others do. This does not necessarily license the oppression that liberal egalitarians rightly fear. Instead, it shows that contractarianism may support a nuanced account of moral status.

Standard accounts of reciprocal citizenship hold that citizens have a duty to participate in politics. Against this, several business ethicists and philosophers have recently argued that people can satisfy their obligations of civic reciprocity non-politically, by owning, managing, or working in for-profit businesses. In this article, I reject both the standard and the market accounts of reciprocal citizenship. Against the market view, I show that the ordinary work of profit maximization cannot take the place of traditional political activity. Yet contra (...) the standard political account, I show that a special class of the actions we perform in our work as employers and employees in for-profit companies can fulfill our obligations of reciprocity. Business ethicists must therefore develop a more nuanced account of the relationship between for-profit business endeavors and the debts we owe fellow citizens who undertake burdensome political work to our benefit. (shrink)

Unlike his theory of justice as fairness, John Rawls’s political liberalism has generally been spared from critiques regarding what is due to the disabled. This paper demonstrates that, due to the account of the basic ideas of society and persons provided by Rawls, political liberalism requires that the interests of numerous individuals with disabilities should be put aside when the most fundamental issues of justice are settled. The aim is to accommodate within public reason the due concern for the disabled (...) while upholding political liberalism. To achieve this aim, a revision of the basic ideas of persons and society is proposed. The idea of persons should be regarded as more fundamental than that of social cooperation, and persons should be defined in terms of minimal moral powers. (shrink)

Justice requires that public policy improve the lives of disadvantaged members of society. Dementia is a source of disadvantage, and a growing global public health challenge. This article examines the theoretical and ethical connections between theories of justice and public dementia policy. Disability in general, and dementia in particular, poses important challenges for theories of justice, especially social contract theories. First, the article argues that non-contractarian accounts of justice such as the Capabilities and Disadvantage approaches are better equipped than their (...) contractarian counterparts to analyse issues of justice and dementia. Secondly, using a capabilities framework, I analyse original empirical data from qualitative interviews and discussion groups with health and social care professionals. The article concludes that social connection is a ‘fertile functioning’—a multiplier of advantage that enables people to live well with dementia together—and should therefore be a priority for public dementia policy. (shrink)

This thesis focuses on what I call the question of exclusion. This question, I argue, is one that poses serious challenges to social contract approaches to justice and political legitimacy. In an intuitive way, the exclusion of some individuals seems to be a corollary of the social contractualist approach, which ascribes justice or legitimacy to a social arrangement insofar as it can be regarded as the product of the (actual – expressed or tacit – or hypothetical) consent of specified parties. (...) Consequently, this approach excludes those whose consent is not required in order to view an arrangement as legitimate or just. Given the enormous and continuing influence of John Rawls’s social contract theory, I take the Rawlsian view as my primary focus, concentrating on the way in which the question of exclusion raises challenges for Rawlsian contractualism. According to Rawls’s theory, those who participate in the hypothetical contract and to whom political power ought to be justifiable are reasonable and rational. They are reasonable in the sense that they understand and are willing to comply with the requirements of justice and they are rational in that they have the capacity to form, revise, and pursue a conception of the good. This gives rise to two categories of exclusion. In the first part of the thesis, I examine the exclusion of those who will develop the two moral powers sufficiently only if those who are represented in the social contract act (or refrain from acting) in certain ways. This category includes children, foetuses, and unreasonable citizens. Intuitively, justice issues in requirements in at least some of these cases, but it is hard to make sense of this on the Rawlsian approach. In the second part of the thesis, I address the question of exclusion regarding those who will never develop the two moral powers to the requisite degree, such as individuals with severe cognitive disabilities and non-human animals. Again, intuitively, justice issues in requirements here, but their justification is not clear on the contractualist approach. My conclusion is threefold. First, I argue that the problems the question of exclusion poses cannot be addressed by a single solution. Second, I safeguard Rawlsian contractualism by showing how each problem can be resolved. Third, I offer policy-prescriptions on a number of issues, such as education, abortion, and the criminal justice system. (shrink)