Personal Responsibility in Health and Health Care: Luck Egalitarianism as a Plausible and Flexible Approach to Health

Allocating health care resources based on personal responsibility is a prominent and controversial idea. This article assesses the plausibility of such measures through the lens of luck egalitarianism, a prominent responsibility-sensitive theory of distributive justice. This article presents a framework of luck egalitarianism in health, which integrates other concerns of justice than health, is pluralist, and is compatible with a wide range of measures for giving lower priority to those deemed responsible. Applying this framework to oral health, the allocation of livers among potential transplant recipients and travel insurance demonstrates that this version of luck egalitarianism is a much more attractive and flexible theory than much of the contemporary discussion allows. This also pertains to its ability to provide plausible answers to two prominent critiques of harshness and intrusiveness. The discussion also shows that the luck egalitarian commitment to eliminating the influence of luck on people’s lives is likely to require substantial redistribution.

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The Luck Egalitarianism of G.A. Cohen - A Reply to David Miller

SATS ◽

10.1515/sats-2017-0008 ◽

2017 ◽

Vol 18 (1) ◽

Author(s):

Andreas Albertsen

Keyword(s):

Political Philosophy ◽

Distributive Justice ◽

Personal Responsibility ◽

Luck Egalitarianism ◽

Founding Father ◽

Textual Evidence ◽

The Relationship ◽

Luck Egalitarian

AbstractThe late G.A. Cohen is routinely considered a founding father of luck egalitarianism, a prominent responsibility-sensitive theory of distributive justice. David Miller argues that Cohen’s considered beliefs on distributive justice are not best understood as luck egalitarian. While the relationship between distributive justice and personal responsibility plays an important part in Cohen’s work, Miller maintains that it should be considered an isolated theme confined to Cohen’s exchange with Dworkin. We should not understand the view Cohen defends in this exchange as Cohen’s considered view. Accepting this thesis would change both our understanding of Cohen’s political philosophy and many recent luck egalitarian contributions. Miller’s argument offers an opportunity to reassess Cohen’s writings as a whole. Ultimately, however, the textual evidence against Miller’s argument is overwhelming. Cohen clearly considers the exchange with Dworkin to be about egalitarianism as such rather than about the best responsibility-sensitive version of egalitarianism. Furthermore, Cohen often offers luck egalitarian formulations of his own view outside of the exchange with Dworkin and uses luck egalitarianism as an independent yardstick for evaluating principles and distributions.

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LUCK-EGALITARIANISM: FAULTS AND COLLECTIVE CHOICE

Economics and Philosophy ◽

10.1017/s0266267111000046 ◽

2011 ◽

Vol 27 (2) ◽

pp. 151-173 ◽

Cited By ~ 2

Author(s):

Kasper Lippert-Rasmussen

Keyword(s):

Distributive Justice ◽

Collective Choice ◽

The Other ◽

Luck Egalitarianism ◽

Standard Formulation ◽

Luck Egalitarian

A standard formulation of luck-egalitarianism says that ‘it is [in itself] bad – unjust and unfair – for some to be worse off than others [through no fault or choice of their own]’, where ‘fault or choice’ means substantive responsibility-generating fault or choice. This formulation is ambiguous: one ambiguity concerns the possible existence of a gap between what is true of each worse-off individual and what is true of the group of worse-off individuals, fault or choice-wise, the other concerns the notion of fault. I show that certain ways of resolving these ambiguities lead to counterintuitive results; and that the most plausible way of resolving them leads to a theory of distributive justice in which responsibility plays a role significantly different from that in standard luck-egalitarian thinking. My main conclusion here is that luck-egalitarianism is best formulated as the view that it is [in itself] bad – unjust and unfair – for an individual to be worse off than others if, and only if, her being worse off does not fit the degree to which she is at fault in a not purely prudential sense.

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Concepts of Equity and Fairness in Health and Health Care

The Oxford Handbook of Health Economics ◽

10.1093/oxfordhb/9780199238828.013.0034 ◽

2011 ◽

pp. 813-836 ◽

Cited By ~ 1

Author(s):

Jan Abel Olsen

Keyword(s):

Health Care ◽

Health Economic ◽

Distributive Justice ◽

Personal Responsibility ◽

Economic Models ◽

Equality Of Opportunity ◽

Inequalities In Health ◽

Equity Issues ◽

Equity And Efficiency ◽

Equality Of Opportunities

This article describes the various concepts of equity and fairness that have been developed by economists in health and health care. It begins with a background framework on the principal causes of inequalities in health and health care. It is concerned with equity issues and theories of distributive justice being integrated into health economic models. The discussion of “paradigm of the health frontier” brings equity and efficiency together. It enquires what the key question of equality in terms of stream of health is and is concerned with the equality of opportunities or equality of outcomes. This issue is strongly related to the intricate issue of “personal responsibility.” The renewed interest in the literature on the distinction between equality of opportunity and equality of outcomes, as well as in the notion of responsibility, represents an attempt to clarify the reasons why one type of inequality can be labeled fair, while another be unfair. Finally, the article draws some implications.

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On the Usefulness of Luck Egalitarian Arguments for Global Justice

Global Justice : Theory Practice Rhetoric ◽

10.21248/gjn.1.0.3 ◽

1970 ◽

Vol 1 ◽

Author(s):

Christian Schemmel

Keyword(s):

Distributive Justice ◽

Global Justice ◽

Luck Egalitarianism ◽

Global Inequality ◽

Philosophical Literature ◽

Moral Claims ◽

Egalitarian Principle ◽

Luck Egalitarians ◽

Luck Egalitarian

Much of the recent philosophical literature about distributive justice and equality in the domestic context has been dominated by a family of theories now often called ‘luck egalitarianism’, according to which it is unfair if some people are worse off than others through no choice or fault of their own. This principle has also found its way into the literature about global justice. This paper explores some difficulties that this principle faces: it is largely insensitive to the causes of global inequality, and it is so demanding that it can only give rise to weak moral claims. I go on to argue that a) understanding justice claims as merely weak claims rests on an implausible and impractical concept of justice, and b) using the global luck egalitarian argument in practical discourse is likely to lead to misunderstanding, and to be counterproductive if the aim is to tackle global inequality. While these considerations do not suffice to make a conclusive case against the luck egalitarian principle, they should be acknowledged by global luck egalitarians – as some similar problems have indeed been by domestic luck egalitarians – and need to be addressed.

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Modes of Action and Clinical Efficacy of Particulate Hydroxyapatite in Preventive Oral Health Care − State of the Art

The Open Dentistry Journal ◽

10.2174/1874210601913010274 ◽

2019 ◽

Vol 13 (1) ◽

pp. 274-287 ◽

Cited By ~ 5

Author(s):

Joachim Enax ◽

Helge-Otto Fabritius ◽

Kathia Fabritius-Vilpoux ◽

Bennett T. Amaechi ◽

Frederic Meyer

Keyword(s):

Health Care ◽

Oral Health ◽

Oral Cavity ◽

Oral Care ◽

Oral Health Care ◽

Tooth Surface ◽

Cochrane Library ◽

Published Data ◽

Modes Of Action ◽

Wide Range

Background: Particulate Hydroxyapatite (HAP; Ca5(PO4)3(OH)) is being increasingly used as multifunctional active ingredient in oral care. Due to its high similarity to human enamel crystallites, it is considered as a biomimetic agent. Objective: The aim of this narrative review is to identify the modes of action of HAP in preventive oral health care based on published studies. The outcomes are expected to improve the understanding of the effects of HAP in the oral cavity and to provide a knowledge base for future research in the field of biomimetic oral care. Methods: The data analyzed and discussed are primarily based on selected published scientific studies and reviews from in vivo, in situ, and in vitro studies on HAP in the field of preventive oral health care. The databases Cochrane Library, EBSCO, PubMed and SciFinder were used for literature search. Results: We identified different modes of action of HAP in the oral cavity. They are mainly based on (I) Physical principles (e.g. attachment of HAP-particles to the tooth surface and cleaning properties), (II) Bio-chemical principles (e.g. source of calcium and phosphate ions under acidic conditions and formation of an interface between HAP-particles and the enamel), and (III) Biological principles (e.g. HAP-particles interacting with microorganisms). Conclusion: Although more mechanistic studies are needed, published data show that HAP has multiple modes of action in the oral cavity. Since the effects address a wide range of oral health problems, HAP is a biomimetic agent with a broad range of applications in preventive oral health care.

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Bringing together child health professionals and dental experts to tackle oral health in children

British Journal of General Practice ◽

10.3399/bjgp20x711017 ◽

2020 ◽

Vol 70 (suppl 1) ◽

pp. bjgp20X711017

Author(s):

Vinoshini Vasikaran ◽

Arpana Soni ◽

Mando Watson

Keyword(s):

Primary Care ◽

Health Care ◽

Oral Health ◽

Child Health ◽

Healthcare Professionals ◽

Health Concern ◽

Wide Range ◽

Health Advice ◽

The Impact ◽

Primary Care Professionals

BackgroundIn the UK, poor oral health among children continues to be a major public health concern. Primary care professionals are encouraged to take a proactive approach in engaging parents and carers to develop better oral health practices for their children. Unfortunately, research has shown that patients are often exposed to inconsistent and at worst conflicting advice.AimTo increase the confidence of primary care professionals in their knowledge surrounding preventative oral health and ensure the delivery of consistent and proactive oral health advice.MethodA local dentist and dental health educator were invited to a general practice multidisciplinary meeting to deliver an educational session on oral health advice for children. Qualitative and quantitative data in form of a questionnaire was collected to analyse the impact of the education session.ResultsThe meeting was attended by 15 healthcare professionals including GPs, paediatricians, a community mental health representative, and a school nurse. There were 78% of attendees who reported that they had never received any formal teaching on oral health care prior to this session. Qualitative data highlighted specific gaps in knowledge, while confidence ratings suggest significant improvement in confidence of attendees in their knowledge of oral health in children.ConclusionAchieving good oral health for all children requires the support of a wide range of healthcare professionals. Further education sessions such as this encourages joint learning and relationship building between professionals and influences behaviour to improve child health care as part of making every contact count. The emerging Primary Care Networks provide an excellent setting to deliver this education.

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Against Institutional Luck Egalitarianism

Journal of Ethics and Social Philosophy ◽

10.26556/jesp.v8i1.78 ◽

2017 ◽

Vol 8 (1) ◽

pp. 1-20

Author(s):

Rekha Nath

Keyword(s):

Distributive Justice ◽

Luck Egalitarianism ◽

Intuitive Appeal ◽

Institutional Influence ◽

Novel Theory ◽

Luck Egalitarian

Kok-Chor Tan has recently defended a novel theory of egalitarian distributive justice, institutional luck egalitarianism (ILE). On this theory, it is unjust for institutions to favor some individuals over others based on matters of luck. Tan takes his theory to preserve the intuitive appeal of luck egalitarianism while avoiding what he regards as absurd implications that face other versions of luck egalitarianism. Despite the centrality of the concept of institutional influence to his theory, Tan never spells out precisely what it means for an inequality to be produced by an institution. In this paper, I consider different conceptions of institutional influence that ILE might employ. It appears that however this concept is construed, ILE has serious problems. On some conceptions, the luck egalitarian character of the theory is undermined. On others, the theory gives rise to precisely the sorts of absurd implications facing other versions of luck egalitarianism that Tan takes his theory to avoid.

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Luck, Nature and Institutions

Moral Philosophy and Politics ◽

10.1515/mopp-2019-0018 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Cynthia A. Stark

Keyword(s):

Distributive Justice ◽

Luck Egalitarianism ◽

Natural Phenomena ◽

Naturally Occurring ◽

Luck Egalitarian

AbstractIn addition to having an institutional site or scope, a theory of distributive justice might also have an institutional ‘reach’ or currency. It has the first when it applies to only social (and not natural) phenomena. It has the second when it distributes only socially produced (and not naturally occurring) goods. One objection to luck egalitarianism is that it has absurd implications. In response, Tan has defended a luck egalitarian account that has a strictly institutional reach. I argue, first, that Tan’s view contains two fatal ambiguities and, second, that, to be sound, it requires an institutional currency. This second argument implies that virtually all extant luck egalitarian currencies are incompatible with his approach. I argue, third, that the alleged absurd implications often have little to do with the extent of luck egalitarianism’s reach.

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