When one faces competing claims of varying strength on public resources for health, which claims count? This paper proposes the following answer. One should count, or aggregate, a person’s claim just in case one could sympathize with her desire to prioritize her own claim over the strongest competing claim. It argues that this principle yields appealing case judgments and has a plausible grounding in both sympathetic identification with each person, taken separately, and respect for the person for whom most is (...) at stake. It also defends this principle against several heretofore unanswered objections. (shrink)

Describes the author’s value of choice account of responsibility and examines a response by Stemplowska to an objection to this account, raised by Alex Voorhoeve. Argues that the problem raised by Voorhoeve’s example concerns the way in which risk is taken into account in contractualism rather than the value of choice account of responsibility. Departs from the author’s earlier work in arguing that the risk of harm should sometimes be taken into account on an ex ante rather than an ex (...) post basis. (shrink)

In "What We Owe to Each Other", T. M. Scanlon argues that one should save the greater number when faced with the choice between saving one life and two or more different lives. It is, Scanlon claims, a virtue of this argument that it does not appeal to the claims of groups of individuals but only to the claims of individuals. I demonstrate that this argument for saving the greater number, indeed, depends, contrary to what Scanlon says, upon an appeal (...) to the claim of a group of individuals to be saved. (shrink)

Philosophy & Public Affairs, 34 (2006): 109-35.

Several philosophers have defended versions of Minimax Complaint, or MC. According to MC, other things equal, we should act in the way that minimises the strongest individual complaint. In this paper, I argue that MC must be rejected because it has implausible implications in certain cases involving risk. In these cases, we can apply MC either ex ante, by focusing on the complaints that could be made based on the prospects that an act gives to people, or ex post, by (...) focusing on the complaints that could be made based on the actual results that an act has for people. I argue that MC has implausible implications either way. I then defend a view on which, other things equal, we should act in the way that minimizes the sum of complaints. (shrink)

Some moral theories tell you, in some situations in which you are interacting with a group of people, to avoid acting in the way that is expectedly best for everybody. This essay argues that such theories are mistaken. Go ahead and do what is expectedly best for everybody. The argument is based on the thought that when interacting with an individual it is fine for you to act in the expected interests of the individual and that many interactions with individuals (...) may compose an interaction with a group. (shrink)

This paper examines the efforts of contractualists to develop an alternative to aggregation to govern our duty not to harm (duty to rescue) others. I conclude that many of the moral principles articulated in the literature seem to reduce to aggregation by a different name. Those that do not are viable only as long as they are limited to a handful of oddball cases at the margins of social life. If extended to run-of-the-mill conduct that accounts for virtually all unintended (...) (in the sense of undesired) harm to others—noncriminal activities that impose some risk of harm on others—they would rule out all action. Moreover, because such conduct poses an irreducible conflict between freedom of action and freedom from expected harm, it can be regulated only by principles that accept the necessity of making precisely the sorts of interpersonal trade-offs that contractualism is foundationally committed to reject: trade-offs in which the numbers count, such that a risk of serious harm to one person can be justified by small benefits to the many. (shrink)

It is plausible to think that it is wrong to cure many people’s headaches rather than save someone else’s life. On the other hand, it is plausible to think that it is not wrong to expose someone to a tiny risk of death when curing this person’s headache. I will argue that these claims are inconsistent. For if we keep taking this tiny risk then it is likely that one person dies, while many others’ headaches are cured. In light of (...) this inconsistency, there is a conflict in our intuitions about beneficence and chance. This conflict is perplexing. And I have not been able to find a satisfactory way of resolving it. Perhaps you can do better? (shrink)

Policy-makers must sometimes choose between an alternative which has somewhat lower expected value for each person, but which will substantially improve the outcomes of the worst off, or an alternative which has somewhat higher expected value for each person, but which will leave those who end up worst off substantially less well off. The popular ex ante Pareto principle requires the choice of the alternative with higher expected utility for each. We argue that ex ante Pareto ought to be rejected (...) because it conflicts with the requirement that, when possible, one ought to decide as one would with full information. We apply our argument in an analysis of US policy on screening for breast cancer. -/- . (shrink)