According to T. M. Scanlon’s anti-aggregation principle, it is wrong to save a larger number of people from minor harms rather than a smaller number from much more serious harms. This principle is a central part of many influential and anti-utilitarian ethical theories. According to the sequential-dominance principle, one does something wrong if one knowingly performs a sequence of acts whose outcome would be worse for everyone than the outcome of an alternative sequence of acts. The intuitive appeal of the (...) sequential-dominance principle should be obvious; everyone is knowingly made worse off if it is violated. In this paper, I present a number of cases where one is forced to violate either the anti-aggregation principle or the sequential-dominance principle. I show that these principles conflict regardless of whether one accepts a counterfactual or a temporal, worsening view of harm. Moreover, I show that this result holds regardless of how much worse a harm has to be in order to count as a much more serious harm. (shrink)

The vision of global health with justice which Larry Gostin articulates in his book Global Health Law envisages a switch to ‘upstream’ priority-setting for expenditure on health, with a focus upon social determinants and a goal of redressing health inequalities. This article explores what is meant by this proposal and offers a critical evaluation of it. It is argued that difficulties arise in respect of the ethical and evidential bases for such an approach to the setting of priorities, while significant (...) challenges may also arise in the necessary modification of structures of governance. (shrink)

Philosophy and Phenomenological Research, EarlyView.

The argument from background justice is that conformity to Lockean principles of justice in agreements and transactions does not preclude the development of inequalities that undermine the freedom and fairness of those very transactions, and that, therefore, special principles are needed to regulate society's “basic structure.” Rawls offers this argument as his “first kind of reason” for taking the basic structure to be the primary subject of justice. Here I explore the background justice argument and its implications for questions about (...) the scope of distributive justice. As it turns out, the background justice argument can offer no independent support for conclusions about the scope of distributive justice. For the special principles that it justifies inherit their scope from conclusions that must be established or assumed in advance. These prior conclusions are precisely what is at issue in debates about global justice. (shrink)

Many think that equality is an intrinsic value. However, this view, especially when based on a consequential foundation, faces familiar objections related to the claim that equality is sometimes good for none and bad for some: most notably the levelling down objection. This article explores a unique (consequential) conception of equality, as part of a more general conception of fairness concerning the resolution of interpersonal conflicts, which is not exposed to these objections.

A just social arrangement must guarantee a right to health care for all. This right should be understood as a positive right to basic human functional capabilities. The present article aims to delineate the right to health care as part of an account of distributive justice in health care in terms of the sufficiency of basic human functional capabilities. According to the proposed account, every individual currently living beneath the sufficiency threshold or in jeopardy of falling beneath the threshold has (...) a legitimate claim to justice. People's entitlements to health care should not be determined on the basis of brute luck and their efforts to maintain healthy lifestyles. The prioritization of competing claim-rights of individuals is guided by two allocation principles: number and benefit-size weighted sufficiency (among people beneath the threshold) and need-weighted utilitarianism (among people above the threshold). (shrink)

Deprivations normally give rise to undeserved inequality. It is commonly thought that one way of improving a situation with respect to equality is by reducing the incidence of deprivations. In this paper I argue that there is at least one respect in which reducing the incidence of deprivations can make things worse from the point of view of equality. While eliminating deprivations leads to the elimination of inequalities, reducing the incidence of deprivations leads to an uneven distribution of the pairwise (...) relations of inequality of a population, which leads to the concentration of pairwise relations of inequality in the worse off. If my argument is correct, egalitarians have reasons to broaden their dimensions of concern: egalitarians should not only be concerned about the unequal distribution of goods, but also about the unequal distribution of pairwise relations of inequality of a population. (shrink)

I here settle a recent dispute between two rival theories in distributive ethics: Restricted Prioritarianism and the Competing Claims View. Both views mandate that the distribution of benefits and burdens between individuals should be justifiable to each affected party in a way that depends on the strength of each individual’s separately assessed claim to receive a benefit. However, they disagree about what elements constitute the strength of those individuals’ claims. According to restricted prioritarianism, the strength of a claim is determined (...) in ‘prioritarian’ fashion by both what she stands to gain and her absolute level of well-being, while, according to the competing claims view, the strength of a claim is also partly determined by her level of well-being relative to others with conflicting interests. I argue that, suitably modified, the competing claims view is more plausible than restricted prioritarianism. (shrink)

Luck egalitarians claim that disadvantage is worse when it emerges from an unchosen risk than when it emerges from a chosen risk. I argue that disadvantage is also worse when it emerges from an unchosen risk that the disadvantaged agent would have declined to take, had he or she been able to do so, than when it emerges from an unchosen risk that the disadvantaged agent would not have declined to take. Such a view is significant because it allows both (...) luck egalitarians and prioritarians to respond to Voorhoeve and Fleurbaey's charge that they fail to accommodate intuitions about the moral relevance of interpersonal boundaries – the so-called separateness of persons objection. I argue that the view is plausible independently of its ability to answer the separateness of persons objection, and is a natural extension of the luck egalitarian concern with the impact of unchosen circumstance. (shrink)

The difference between the unity of the individual and the separateness of persons requires that there be a shift in the moral weight that we accord to changes in utility when we move from making intrapersonal tradeoffs to making interpersonal tradeoffs. We examine which forms of egalitarianism can, and which cannot, account for this shift. We argue that a form of egalitarianism which is concerned only with the extent of outcome inequality cannot account for this shift. We also argue that (...) a view which is concerned with both outcome inequality and with the unfairness of inequality in individuals‘ expected utilities can account for this shift. Finally, we limn an alternative view, on.. (shrink)

We analyse three moral dilemmas involving resource allocation in care for HIV-positive patients. Ole Norheim and Kjell Arne Johansson have argued that these cases reveal a tension between egalitarian concerns and concerns for better population health. We argue, by contrast, that these cases reveal a tension between, on the one hand, a concern for equal *chances*, and, on the other hand, both a concern for better health and an egalitarian concern for equal *outcomes*. We conclude that, in these cases, there (...) is much less tension than Norheim and Johansson claim between egalitarian concerns and concerns for better population health. (shrink)

The Levelling-Down Objection is a standard objection to monistic egalitarian theories where equality is the only thing that has intrinsic value. Most egalitarians, however, are value pluralists; they hold that, in addition to equality being intrinsically valuable, the egalitarian currency in which we are equal or unequal is also intrinsically valuable. In this paper, I shall argue that the Levelling-Down Objection still minimizes the weight that the intrinsic badness of inequality could have in the overall intrinsic evaluation of outcomes, given (...) a certain way of measuring the badness of inequality, namely, the Additive Individual-Complaints Measure. (shrink)

:The distinction between brute luck and option luck is fundamental for luck egalitarianism. Many luck egalitarians write as if it could be used to specify which outcomes people should be held responsible for. In this paper, I argue that the distinction can’t be used this way. In fact, luck egalitarians tend to rely instead on rough intuitive judgements about individual responsibility. This makes their view vulnerable to what’s known as the neutrality objection. I show that attempts to avoid this objection (...) are unsuccessful. I conclude that until it provides a better account of attributing responsibility, luck egalitarianism remains incomplete. (shrink)

The distinction between equality and sufficiency, much discussed in the distributive justice literature, is here applied to democratic theory. Overlooking this distinction can have significant normative implications, undermining some defences and criticisms of political equality, as I show by discussing the work of three prominent democratic theorists: Thomas Christiano, David Estlund, and Mark Warren. Most importantly, Christiano sometimes defends egalitarian conclusions using sufficientarian premises, or worries about inequality in situations where insufficiency is also part of the problem; inequality above the (...) level of sufficiency is not always as troubling. Estlund makes the reverse error. He attacks rather than defends political egalitarianism, but insufficiency seems to explain some of his concerns. Nonetheless, I show that political egalitarians may need to specify a sufficientarian threshold, to avoid levelling-down objections. Democratic theorists should thus take seriously the distinction between political equality and political sufficiency. More generally, political theorists and philosophers should be aware of omitted variable bias and interaction effects due to conceptual stretching arising from under-theorised distinctions in their thought experiments. (shrink)

The American Journal of Bioethics, Volume 11, Issue 12, Page 44-46, December 2011.

In this paper I criticize the standard argument for deontological egalitarianism, understood as the thesis that there is a moral claim to have an equal share of well-being or whatever other good counts. That argument is based on the idea that equals should be treated equally. I connect the debate over egalitarianism with that over comparative justice. A common theme is a general skepticism against comparative claims. I argue (i) that there can be no claim to equality based simply on (...) the fact of equal worth as that fact itself does not have any value for the supposed claim holder; and (ii) intuitions that suggest otherwise can be explained away without appealing to comparative claims. (shrink)

This thesis defends utilitarianism: the view that as far as morality goes, one ought to choose the option which will result in the most overall well-being. Utilitarianism is widely rejected by philosophers today, largely because of a number of influential objections. In this thesis I deal with three of them. Each is found in Bernard Williams’s ‘A Critique of Utilitarianism’ (1973). The first is the Integrity Objection, an intervention that has been influential whilst being subject to a wide variety of (...) interpretations. In Chapter Two I give my interpretation of Williams’s Integrity objection; in Chapter Three I discuss one common response to it, and in Chapters Four and Five I give my own defence of utilitarianism against it. In Chapter Six I discuss a second objection: the problem of pre-emption. This problem is also found in Williams, but has received greater attention through the work of other authors in recent years. It suggests that utilitarianism is unable to deal with some of the modern world’s most pressing moral problems, and raises an internal tension between the twin utilitarian aims of making a difference and achieving the best outcomes. In Chapter Seven I discuss a third objection: that utilitarianism is insufficiently egalitarian. I find this claim to be unwarranted, in light of recent social science and philosophy. My responses to Williams’s objections draw upon resources from the socialist tradition – in particular, that tradition’s emphasis on the importance of social connections between individuals. Socialists have often been hostile to utilitarianism, in part for socialist-inflected versions of Williams’s objections. Thus, in responding to these objections I aim to demonstrate that socialist thought contains the means to defuse not only mainstream philosophy’s rejection of utilitarianism but also its own, and thus to re-open the possibilities for a productive engagement between the two traditions. (shrink)