This paper compares and contrasts three different substantive principles of justice for making health care priority-setting or “rationing” decisions: need principles, maximising principles and egalitarian principles. The principles are compared by tracing out their implications for a hypothetical rationing decision involving four identified patients. This decision has been the subject of an empirical study of public opinion based on small-group discussions, which found that the public seem to support a pluralistic combination of all three kinds of rationing principle. (...) In conclusion, it is suggested that there is room for further work by philosophers and others on the development of a coherent and pluralistic theory of health care rationing which accords with public opinions. (shrink)

In recent years, several political theorists have argued that reasonable principles of justice are practice-dependent. In this paper it is suggested that we can distinguish between at least two main models for doing practice-dependent theorizing about justice, interpretivism and constructivism, and that they can be understood as based in two different conceptions of practices. It is then argued that the reliance on the notion of participants that characterizes interpretivism disables this approach from adequately addressing certain matters of (...) class='Hi'>justice and that a better way of developing the idea of practice-dependence can be found in a constructivism that starts from the Rawlsian idea of overlapping consensus, but which shifts the focus of that approach from societies to a more open-ended category of domains, and which understands the parties to a possible overlapping consensus as stakeholders in a certain set of interconnected practices. (shrink)

John Rawls based his theory of justice, in the work of that name, on a ‘Kantian interpretation’ of the status of human beings as ‘free and equal’ persons. In his subsequent, ‘political rather than metaphysical’ expositions of his theory, the conception of citizens of democracies as ‘free and equal’ persons retained its foundational role. But Rawls appealed only to Kant’s moral philosophy, never to Kant’s own political philosophy as expounded in his 1797 Doctrine of Right in theMetaphysics of Morals. (...) I argue here that the structure of Kant’s political philosophy, with its categories of the innate right to freedom, private acquired right and public right, can clarify the relationship between Rawls’s two principles of justice and his scheme of basic liberties and primary goods. (shrink)

Background: Theoretically, the principle of justice is strong in healthcare priorities both nationally and internationally. Research, however, has indicated that questions can be raised as to how this principle is dealt with in clinical intensive care. Objective: The objective of this article is to examine how significant others may affect the principle of justice in the medical treatment and nursing care of intensive care patients. Method: Field observations and in-depth interviews with physicians and nurses in (...) intensive care units (ICU). Emphasis was placed on eliciting the underlying rationale for prioritisations in clinical intensive care with particular focus on clinicians’ considerations when limiting ICU treatment. Results: Significant others could induce an unintentional discrimination of ICU patients. Family members who were demanding received more time and attention for both the patient and themselves. Patients’ and families’ status and position and/or an interesting medical diagnosis seemed to govern the clinicians’ priorities of patients and families—consciously as well as unconsciously. The clinicians emphasised that patient information given through families was important. However, patients’ preferences and values conveyed to clinicians through their families were not always taken seriously. This even applied in cases with very serious prognoses and an explicit patient wish to forego life-prolonging treatment. Conclusion: The principle of justice was violated when qualified attention was given to significant others, and through this also to patients. Attention given to significant others was influenced by the healthcare workers’ professional and personal values, attitudes and interests. (shrink)

This article aims to expound the principle of justice, as a fundamental value and as an immanent category of law, as well as one of the fundamental human rights, prescribed and guaranteed by a myriad of international instruments and documents. After a brief historical account, by focusing on Article 40 of the Magna Carta Libertatum, which states that: “To No One Will we Sell, To No One Will we refuse or delay, right or justice”, this article claims (...) to show the importance of incorporation of this principle in the provisions of the Magna Carta and its impact on the development of theory and legislation in the past and present. Moreover, the article intends to explore the extent of influence that the priciple of justice has on the functioning of the law in general. Since justice implicates the permanent and constant will to render each person his due, and this achieved through equality, it results that justice means being equal. In this context, the article will explore the concept of equality as a precondition of justice, as well as the conditions and modalities for its implementation. Having in mind that the principle of justice is closely linked to the principle of equity, because equity precedes justice, or more precisely, equity is considered a source of justice, this article seeks to articulate the essential distinctions between these two concepts by focusing on their methods, i.e. in their approach for putting the idea of equality into action. (shrink)

As Alfandre and colleagues describe in “Between Usual and Crisis Phases of a Public Health Emergency: The Mediating Role of Contingency Measures”, efforts to maintain standards of care durin...

In the face of limited resources during the COVID-19 pandemic response, public health experts and ethicists have sought to apply guiding principles in determining how those resources, including vaccines, should be allocated.

There is a major divide between the work of normative theorists and concrete climate action (or inaction) politics and policies. In this volume, authors tackle the strained relationships between principles of justice and climate politics by responding to real-world climate politics and policies, offering proposals and analyses that take concerns of feasibility seriously, and identifying immediate justice and feasibility concerns with recent proposals for climate action. Contributors look at questions of feasibility as they relate to specific international institutions (...) like the IPCC and UNFCCC, and widely discussed principles of climate justice, including backward-looking principles like polluter pays and forward-looking principles like ability to pay. Others explore the feasibility hurdles and justice concerns that challenge popular mitigation proposals. (shrink)

THE PAPER DEFINES AND DEFENDS A PRINCIPLE OF COLLECTIVE SELF-DETERMINATION AS ONE OF THE PRINCIPLES OF THE ORDERING OF A JUST SOCIETY. THAT PRINCIPLE SPECIFIES THAT INDIVIDUALS PARTICIPATE EQUALLY IN THE MAKING OF DECISIONS WHICH WILL GOVERN THEIR ACTIONS WITHIN INSTITUTIONS OF SPECIAL COOPERATION. THE PAPER ADOPTS THE STRATEGY OF ARGUING TO PRINCIPLES OF JUSTICE BY ASKING WHAT PRINCIPLES WOULD BE CHOSEN IN RAWLS' ORIGINAL POSITION. IT ARGUES THAT, CONTRARY TO THE THRUST IMPLICIT IN RAWLS AND OTHER (...) LIBERAL THINKERS, PERSONS IN THE ORIGINAL POSITION WOULD HAVE NO BASIS FOR DISTINGUISHING BETWEEN POLITICAL AND NON-POLITICAL INSTITUTIONS OF SOCIAL COOPERATION, AND THUS WOULD CHOOSE THE PRINCIPLE OF SELF-DETERMINATION DIRECTLY AS APPLYING TO ALL INSTITUTIONS AND ACTIVITIES OF SOCIAL COOPERATION. (shrink)

Many theorists claim that justice is a question-begging concept that has no inherent substantive content. They point to disagreements among justice theorists themselves about basic aspects of the justice theory, such as the nature of corrective justice and the distinction between it and distributive justice, as even further reason to dismiss the concept of justice or to fill it with their preferred theoretical content. Yet most persons perceive that the concept of justice is (...) not an empty shell. Since ancient times it has been thought to encompass not merely a formal equality (treating like cases alike), but also a substantive equality grounded in the equal dignity of each human being which requires giving each person his or her "due" - what is his or hers as a matter of right - a requirement that is usually understood to be in direct conflict with the basic principles of aggregate social welfare theories such as utilitarianism or its modern variant, economic efficiency. The elaboration of this substantive equality and its implications for morality, justice, and law form the core of the natural-law or natural-right theories of law. In this article I build upon a summary and critique of John Finnis's natural law theory (1) to delineate the basic assumptions and principles of the natural law theory regarding the foundations of and relationships among morality, justice, and law; (2) to demonstrate the agreement of major natural law theorists, from Aristotle through Aquinas and Kant to Finnis, on these basic assumptions and principles; (3) to distinguish these basic assumptions and principles from those of the competing theories of utilitarianism and economic efficiency; and (4) to clarify the nature of and distinctions between the two basic divisions of substantive justice: distributive justice and interactive justice. I use the term "interactive justice" instead of the usual term, "corrective justice," since the former term is much more informative and precise in conveying the distinct nature and domain of this type of justice, whereas the latter term almost always misleads people into one or both of two related misconceptions: (1) that "corrective" justice is concerned solely with the correction of wrongful injuries and has nothing to say about the nature of the underlying wrongs or the prevention of their occurrence, and (2) that it is merely a remedial corollary of distributive justice which corrects deviations from the distributively just distribution. Distributive justice and interactive justice separately address the two fundamental problems of human existence, and they employ quite different criteria of equality to resolve those problems. Together, they seek to assure the attainment of the common good (the full realization, to the extent practicable, of each person's humanity) by providing each person with her fair share of the social stock of instrumental goods (positive freedom via distributive justice) and by securing her person and her existing stock of instrumental goods from interactions with others that are inconsistent with her status as a rational being with equal, absolute moral worth (negative freedom via interactive justice). (shrink)

The concept of benefit sharing pertains to the act of giving something in return to the participants, communities, and the country that have participated in global health research or bioprospecting activities. One of the key concerns of benefit sharing is the ethical justifications or reasons to support the practice of the concept in global health research and bioprospecting. This article evaluates one of such ethical justifications and its meaning to benefit sharing, namely justice. We conducted a systematic review to (...) map the various principles of justice that are linked to benefit sharing and analysed their meaning to the concept of benefit sharing. Five principles of justice have been shown to be relevant in the nuances of benefit sharing in both global health research and bioprospecting. The review findings indicate that each of these principles of justice provides a different perspective for a different benefit sharing rationale. For example, commutative justice provides a benefit sharing rationale that is focused on fair exchange of benefits between research sponsors and communities. Distributive justice produces a benefit sharing rationale that is focused on improving the health needs of the vulnerable research communities. We have suggested that a good benefit sharing framework particularly in global health research would be more beneficial if it combines all the principles of justice in its formulation. Nonetheless, there is a need for empirical studies to examine the various principles of justice and their nuances in benefit sharing among stakeholders in global health research. (shrink)

Príspevok je zameraný na problém spravodlivosti Johna Rawlsa v diele Teória spravodlivosti. Obsah práce je koncipovaný ako analýza dvoch princípov spravodlivosti, pričom sa zameriava na ich ťažiskové aspekty. Príspevok sa snaží vyjasniť význam dvoch zásad spravodlivosti prostredníctvom skúmania obsahového zloženia prvého i druhého princípu. V súvislosti s druhým princípom je cieľom nielen objasniť význam férovej rovnosti príležitostí, ale i vzťah druhého princípu s princípom efektívnosti a vzťah demokratického chápania spravodlivosti s princípom rozdielnosti. Zámerom príspevku je tiež poukázať na princíp distribúcie, (...) a to nielen z teoretickej perspektívy. V tejto súvislosti chce text upozorniť aj na prepojenosť distribúcie a zásluh. Pre Rawlsa je dôležité upozorňovať na lexikálnu nadradenosť prvého princípu, preto text neobchádza ani túto skutočnosť. Zároveň s tým verbalizuje rozdiel medzi oboma fundamentálnymi princípmi. (shrink)

In my recent article, I addressed the question of whether a potential categorical exclusion of decisionally impaired patients from non-therapeutic medical research would be inaccordance with the Principle of Justice as Fairness. I came to the conclusion that a categorical exclusion of decisionally impaired persons from relevant research projects may collide with Rawls’s understanding of Justice as Fairness. Derek Bell has criticized my paper by denying that it is legitimate to apply Rawls to this bioethical problem. In (...) my restatement I try to show that an extrapolation of John Rawls’s thought to such bioethical cases is possible, because Rawls himself has written that his orientation towards decisionally non-impaired persons is an idealized situation that allows extrapolations. In a second part I try to show that Bell hasroughly misunderstood my concept of “presumed consent” which I make a prerequisite for the legitimisation of research on decisionally impaired persons. In using advance consent as a proposal for resolving the problem, Bell has indirectly confirmed my approach because he is using a similar construct of consent, which operates with similar hypotheses and probabilities of error. I see here no categorical difference between Bell’s conclusion and my discussion. Thus, Bell’s reply does not represent a refutation of my thoughts, but rather it is a para phrased confirmation of my central theses. I conclude by showing the relevance of Rawls, pointing out that the discussion between Bell and me illustrates how Rawls’s concept of reflective equilibrium is an appropriate approach to finding a solution to this bioethical problem. (shrink)

In the past decade, scholars such as Samuel Freeman, Martin O’Neill, Alan Thomas and others have argued that no matter how widely Rawls’s theory of justice (TJ) was understood as a defence of the welfare state (WS), the socio-economic system Rawls defends and always defended is property-owing democracy (POD). In this article I present the argument that Rawls did not defend POD in TJ. However, while the claim that it was POD the socio-economic system implied by the principle (...) of difference generated heated reactions by defenders of the WS, the argument I raise differs from most of them. In the article I maintain that, for Rawls, principles of justice underdetermine the choice of social systems, and that although this is true of both principles, it is especially true of the difference principle, whose ability to arbitrate between different social and economic policies is limited. I show how the attempt to uniquely determine the set of social and economic policies authorized by the difference principle clashes with what Rawls explicitly states in TJ and contrasts with central aspects of his sociological and political conception of socio-economic decision-making. Although my aim is to show that the difference principle itself does not discriminate among socio-economic systems, this does not preclude that additional reasons can help in narrowing the range of socio-economic systems allowed. With reference to the ideal of social union that Rawls expounds in the third part of TJ, I argue that TJ does, in fact, offer additional reasons to appraise the WS as preferable to POD. I maintain that the centrality Rawls attributes to the social unity of a just society provides the basis for an understanding of Rawls’s position towards POD after TJ. (shrink)

An ethical conflict arises when we must perform research in the interest of future patients, but that this may occasionally injure the interests of today''s patients. In the case of cognitively impaired persons, the question arises whether it is compatible with humane healthcare not only to treat, but also to use these patients for research purposes. Some bioethicists and theologians have formulated a general duty of solidarity, also pertaining to cognitively impaired persons, as a justification for research on these persons. (...) If one examines this thesis from the theory of justice according to John Rawls, it is revealed that such a duty of solidarity cannot necessarily be extrapolated from Rawls' conception of justice. This is at least true of Rawls' difference principle, because accordingto the difference principle only those measures are justifiable which serve the interest of the respective least well off. Those measures which would engender additional injury for the least well off could not be balanced by any utility according to Rawls. However, John Rawls' difference principle is subordinate to the first principle, which is that each person has an equal right to the most extensive basic liberty compatible with the same liberty for others. These primary goods are determined by the freedom and integrity of the person. This integrity of decisionally impaired persons would be in danger if one would abstain from research and thus forego the increase in knowledge related to their disease. Thus one could conclude, at least from Rawls' first principle, that society must take on a duty to guarantee the degrees of freedom for cognitively impaired persons and thus also support the efforts for their healing. (shrink)

This chapter develops a ``nesting'' model of deontic normative principles (i.e., principles that specify moral constraints upon action) as a means to understanding the notion of a ``fundamental normative principle''. I show that an apparently promising attempt to make sense of this notion such that the ``real'' or ``fundamental'' demands of justice upon action are not constrained by social facts is either self-defeating or relatively unappealing. We should treat fundamental normative principles not as specifying fundamental constraints upon action, (...) but as specifying basic criteria for comparatively evaluating and ranking possibilities. (shrink)

This essay applies the principle of justice as fairness to the issue of same-sex marriage. I will outline Rawls’s theory of justice, including the original position and the veil of ignorance as the means by which choosers craft a just state. In considering whether same-sex marriage should be permissible, I argue that a just society, formulated in the Rawlsian context of justice as fairness, should allow them. I assert that gays and lesbians do count as equal (...) citizens because they possess the minimum requirements of the capacity for a sense of justice, a conception of the good, and the ability to be cooperating members of society. Furthermore, within the original position gays and lesbians will be represented because choosers do not know their sexual orientation because it is one of the individual characteristics that are withheld behind the veil. Since the choosers do not know their sexual orientation, they will be unable to use that information in their construction of what counts as a just state comprised of free and equal citizens. Because the family, and the institution of marriage as a primary manifestation of the family, is one of the major social institutions within the basic structure, limitations must be carefully scrutinized. (shrink)

In this paper I argue that in order to secure the commitment of believers in reasonable comprehensive doctrines to political liberalism a third principle of justice needs to be adopted in the Original Position. Rawls acknowledges that neutral legislation by the liberal state may negatively affect some reasonable comprehensive doctrines, and I offer a third principle of justice to help alleviate this problem. This principle, which I believe is in keeping with the United States constitutional (...) history especially where church-state relations are concerned, maintains that a constitutional regime should, insofar as possible, avoid adopting rules with harmful effects upon those comprehensive doctrines which satisfy the conditions of reasonable pluralism. (shrink)

In this article I examine the importance of self-respect in the justification of Rawls’s theory of justice. First, I present two elements that are part of the contemporary debate on self-respect as a form of self-worth—namely, moral status and merit. Second, I specify the bases that support self-respect within A Theory of Justice. Finally, I discuss at length the function of self-respect in justifying the principles of justice. This inquiry implies an analysis of the relationship between self-respect (...) and the component parts of the two principles of justice: basic liberties, fair equality of opportunity, and the difference principle. I also explore the connection between self-respect and the sense of justice in light of the stability argument, and how the relationship between the two is important for achieving social stability. (shrink)

This article examines the difficulties encountered in teaching professionalism to medical students in the current social and political climate where economic considerations take top priority in health care decision making. The conflict between the commitment to advocate at all times the interests of one’s patients over one’s own interests is discussed. With personal, institutional, tech industry, pharmaceutical industry, and third-party payer financial imperatives that stand between patients and the delivery of health care, this article investigates how medical ethics instructors are (...) to teach professionalism in a responsible way that does not avoid dealing with the principle of justice. (shrink)

G.A. Cohen argues that Rawlsian constructivism mistakenly conflates principles of justice with optimal rules of regulation, a confusion that arises out of how Rawls has us think about justice. I use the concepts/conceptions distinction to argue that while citizens may reasonably disagree about the substance and demands of justice, some principled convergence may be possible: we can agree upon regulative principles consistent with justice, as each of us understands it. Rawlian constructivism helps us find that principled (...) convergence, and this too is a conception of justice. (shrink)

John Rawls assumes that in the original position, under the veil of ignorance, after bargaining amongst each other, free, equal, moral and rational persons would make a rational decision to accept the principles of justice as fairness and thus the principles are established. Critics, however, question the authenticity and validity of this justification strategy. When rational individuals take the principles of justice as an original agreement, it is not a real contract. Rawls’s conception of justice as fairness (...) is just a personal notion, some individuals may accept it, but it is impossible to be accepted by all human beings in a real world. Therefore there is a justification/acceptance paradox of those principles which are the core of his political philosophy. So how should we justify those principles? Its answers may be provided not in the light of a philosophical justification but of a scientific one. (shrink)

John Rawls assumes that in the original position, under the veil of ignorance, after bargaining amongst each other, free, equal, moral and rational persons would make a rational decision to accept the principles of justice as fairness and thus the principles are established. Critics, however, question the authenticity and validity of this justification strategy. When rational individuals take the principles of justice as an original agreement, it is not a real contract. Rawls’s conception of justice as fairness (...) is just a personal notion, some individuals may accept it, but it is impossible to be accepted by all human beings in a real world. Therefore there is a justification/acceptance paradox of those principles which are the core of his political philosophy. So how should we justify those principles? Its answers may be provided not in the light of a philosophical justification but of a scientific one. (shrink)

The so-called debate between Jürgen Habermas and John Rawls concentrated mainly on the latter’s political liberalism. It dealt with the many aspects of Rawls’s philosophical project. In this article, I focus only on one of them, namely the epistemic or cognitivistic nature of principles of justice. The first part provides an overview of the debate, while the second part aims to show that Habermas has not misinterpreted Rawls’s position. I argue that Habermas rightly considers Rawls’s conception of justice (...) as a moral one. In the last part, I discuss two key questions raised by Habermas. The first concerns the relation between justification and acceptance of the principles of justice. The second concerns the relation between two validity terms: truth and reasonableness. (shrink)

Background Infertility is an increasingly prevalent disease in society and is considered by the World Health Organization to be a public health problem. An important ethical issue arises from the clarification of reproductive rights in a fair and equal way. The objective of this study was to deepen and update the knowledge and discussion about the difficulty of accessing infertility treatments in Brazil. Methods A cross-sectional observational study was carried out through the application of an online questionnaire that collected the (...) socioeconomic characteristics of couples and identify how barriers to infertility care affect the most vulnerable populations. We included couples who sought medical assistance to achieve pregnancy at two clinics in the states of São Paulo and Minas Gerais. Results A total of 201 questionnaires were analyzed. Most couples self-declared as white and the average age of wives was 36 years and husbands 38 years. 65% (65%) of couples would proceed with the treatment in a different city to which they lived, 37% evaluated as having easy access to a medical specialist only after indication, and more than half of the participating have thought about giving up the treatment due to some difficulty in accessing it. 39% of participants sought more than one medical service to find better reception, 42% of couples sought more than one medical service to define where it would be better financially, and 67.2% referred to the high cost of treatments, that is, financial issues, as a great difficulty in accessing medical services and/or treatment. Although 72.6% of couples considered having a good quality of life, 54.2% admitted that infertility and the search for treatment generated anxiety/stress in the couple’s life. Conclusion There is a need for public education on reproductive health and for policymakers to raise awareness of the importance of the difficulty that many couples face in seeking treatment to become pregnant, especially in countries with less financial resources. Indeed, it is commonly accepted that there is a universal human right to access healthcare of appropriate quality as a matter of justice. Discussion of access to reproductive technologies should be considered taking into account the longstanding ethical debate regarding fertility, fecundity, and infertility, as well as reproductive care. (shrink)

A common assumption in the selection of nonhuman animal subjects for research and the approval of research is that, if the risks of a procedure are too great for humans, and if there is a so-called scientific necessity, then it is permissible to use nonhuman animal subjects. I reject the common assumption as neglecting the central ethical issue of the permissibility of using nonhuman animal subjects and as being inconsistent with the principle of justice used in human subjects (...) research ethics. This principle requires that certain classes of individuals not be subjected to a disproportionate share of the burdens or risks of research. I argue for an extension of this principle to nonhuman animal research and show that a prima facie violation of the principle occurs because nonhuman animals bear an overwhelmingly disproportionate share of the risks of research without sufficient justification or reciprocal benefit. (shrink)

I suggest that the social justice issues raised by Internet regulation can be exposed and examined by using a methodology adapted from that described by John Rawls in 'A Theory of Justice'. Rawls' theory uses the hypothetical scenario of people deliberating about the justice of social institutions from the 'original position' as a method of removing bias in decision-making about justice. The original position imposes a 'veil of ignorance' that hides the particular circumstances of individuals from (...) them so that they will not be influenced by self-interest. I adapt Rawls' methodology by introducing an abstract description of information technology to those deliberating about justice from within the original position. This abstract description focuses on computing devices that users can use to access information and information networks that information devices use to communicate. The abstractness of this description prevents the particular characteristics of the Internet and the computing devices in use from influencing the decisions about the just use and regulation of information technology and networks. From this abstract position, the principles of justice that the participants accept for the rest of society will also apply to the computing devices people use to communicate, and to Internet regulation. (shrink)

The article begins by reconstructing the just distribution of the social bases of self-respect, a principle of justice that is covert in Rawls’s writing. I argue that, for Rawls, justice mandates that each social basis for self-respect be equalized. Curiously, for Rawls, that principle ranks higher than Rawls’s two more famous principles of justice - equal liberty and the difference principle. I then recall Rawls’s well-known confusion between self-respect and another form of self-appraisal, namely, (...) confidence in one’s determinate plans and capacities. Correcting that confusion forces Rawls to accept objectionable and illiberal politics. Surprisingly, a consistent Rawls must endorse absolute economic equality, deny liberty any priority whatsoever, or sponsor still other illiberal political views - evidence of a flaw in the ethical basis of Rawls’s politics. (shrink)

This paper addresses the fairness of microcredit interest rates. Since microfinance institutions provide credit for the poor at relatively high prices, the fairness of their interest rates has been repeatedly debated. We first apply Rawls' principles of justice to the case of microcredit interest rates and suggest some limitations related to the hypothesis of rationality of the borrowers and the level of inequality. We then suggest another framework based on the analysis of the distribution of the benefits generated by (...) the transaction to assess the fairness of interest rates. We conceptualize this as the distribution of the bargaining range between the borrowers' and the institutions' reservation price and discuss what these reservation prices could be in the context of microfinance. (shrink)

This paper addresses the fairness of microcredit interest rates. Since microfinance institutions provide credit for the poor at relatively high prices, the fairness of their interest rates has been repeatedly debated. We first apply Rawls' principles of justice to the case of microcredit interest rates and suggest some limitations related to the hypothesis of rationality of the borrowers and the level of inequality. We then suggest another framework based on the analysis of the distribution of the benefits generated by (...) the transaction to assess the fairness of interest rates. We conceptualize this as the distribution of the bargaining range between the borrowers' and the institutions' reservation price and discuss what these reservation prices could be in the context of microfinance. (shrink)

BackgroundThe expectation of pandemic-induced severe resource shortages has prompted authorities to draft and update frameworks to guide clinical decision-making and patient triage. While these documents differ in scope, they share a utilitarian focus on the maximization of benefit. This utilitarian view necessarily marginalizes certain groups, in particular individuals with increased medical needs.Main bodyHere, we posit that engagement with the disability critique demands that we broaden our understandings of justice and fairness in clinical decision-making and patient triage. We propose the (...) capabilities theory, which recognizes that justice requires a range of positive capabilities/freedoms conducive to the achievement of meaningful life goals, as a means to do so. Informed by a disability rights critique of the clinical response to the pandemic, we offer direction for the construction of future clinical triage protocols which will avoid ableist biases by incorporating a broader apprehension of what it means to be human.ConclusionThe clinical pandemic response, codified across triage protocols, should embrace a form of justice which incorporates a vision of pluralistic human capabilities and a valuing of positive freedoms. (shrink)

Discursive theories of justice have been questioned for putting forward high-level principles that should nevertheless play a role in practical discourses in which the justice of a claim is at stake. Here, I will critically examine and systematize the main tenets in Rawls’s and Habermas’s discursive theories, and will suggest that the principles of justice (Rawls) and universalization (Habermas) can and play the role of mandates of optimalization in real deliberations on justice.

This paper argues that intellectual property rights are incompatible with Rawls’s principles of justice. This conclusion is based upon an analysis of the social stratification that emerges as a result of the patent mechanism which defines a marginalized group and ensure that its members remain alienated from the rights, benefits, and freedoms afforded by the patent product. This stratification is further complicated, so I argue, by the copyright mechanism that restricts and redistributes those rights already distributed by means of (...) the patent mechanism. I argue that the positions of privilege established through both the patent and the copyright mechanisms are positions that do not “allow the most extensive liberty compatible with a like liberty for all.” They do not “benefit the least advantaged.” Nor are they “open to all under conditions of fair equality of opportunity.” In making this argument I critically assess the utilitarian defense of intellectual property rights and find it insufficient to respond to the injustices manifest in our current arrangement for the protection of intellectual property rights. (shrink)

The recognition of conflict puts an end to the idea that cosmopolitanism may be legitimized by a comprehensive doctrine. The article argues that within the limits of a post-secular society, toleration must be conceived as a principle of justice, based on regard for the law, within a society in which not only others’ rights but also other cultures must be respected.