Harris argues that if QALYs are used only 50% of the population will be eligible for survival, whereas if random methods of allocation are used 100% will be eligible. We argue that this involves an equivocation in the use of "eligible", and provides no support for the random method. There is no advantage in having a 100% chance of being "eligible" for survival behind a veil of ignorance if you still only have a 50% chance of survival once the veil (...) is lifted. A 100% chance of a 50% chance is still only a 50% chance. We also argue that Harris provides no plausible way of dealing with the criticism that his random method of allocation may result in the squandering of resources. (shrink)

This paper continues the debate between myself and Peter Singer et al started in the Journal of Medical Ethics volume 21, no 3 about the ethical respectability of the use of QALYs in health care allocation. It discusses the question of what, in the way of health care provision, would be chosen by rational egoists behind a Rawlsian "veil of ignorance", and takes forward the vexed question of what is to count as "doing good" and hence as "doing the most (...) good" in health care. Most importantly, this paper argues that it would be unfair to discriminate against people because they have been disadvantaged by their genetic condition. It notes that McKie et al in their reply to my first contribution to this debate continue to fail to distinguish between chance and probability and it is argued that this failure causes them to miss the whole point of the argument. (shrink)

Since time immemorial, poverty reduction interventions in Sub‐Saharan Africa like everywhere in the South, have focused on the individual as the basic ingredient of a moral society (ethical individualism). According to this perspective, in order to lift human persons out of poverty, it is imperative to integrate poor persons into poverty eradication interventions irrespective of sex, social status and gender. Scholars and institutions that subscribed to this conception of poverty thought that individuals were poor because of personal weaknesses (case poverty).This (...) perspective has been greatly challenged due to the upsurge of gender and human rights scholarship in the 20th century. Gender scholars have painstakingly argued that in order to understand poverty, we need to look at society (ethical collectivism). They have rejected the Women in Development(WID) discourse that aims at integrating women into the development process in favour of the Gender and Development(GAD) approach to development and poverty reduction that aims at confronting power relations between men and women (empowerment).This GAD perspective looks at poverty in terms of the powerlessness speared head by prevailing structures in society (structural poverty) and hence the need to empower vulnerable persons such as women to challenge structures and strictures of oppression. The International Monetary fund (IMF) and World Bank as vehement promoters of economism in Sub‐Saharan Africa for decades have urged governments to include the perspectives of the poor in poverty polices through what they call participatory poverty assessments (PPAs). Despite its deceptive appearance, this PPAs stance of the IMF and World Bank tacitly looks at poverty as a case and not structural issue and that is why Uganda’s ambitious poverty reduction policy though greatly informed by Participatory Poverty Assessments greatly ignores structures and strictures that render women vulnerable to poverty. This paper critically assesses the obliviousness of Uganda’s Agricultural poverty policy to structures and how this has militated on the gender poverty production in Uganda. The paper contends that in order to realise engendered poverty eradication in Uganda, it is pertinent for the agricultural policy to ultimately make paradigm shift from focusing on the individual as the basic ingredient of a moral society (ethical individualism) to confronting structures and strictures that disempower and vulnerablelise individual moral agents (ethical collectivism). (shrink)