The Significance of the Concept of Disease for Justice in Health Care

In this paper, I want to scrutinise the value of utilising the concept of disease for a theory of distributive justice in health care. Although many people believe that the presence of a disease-related condition is a prerequisite of a justified claim on health care resources, the impact of the philosophical debate on the concept of disease is still relatively minor. This is surprising, because how we conceive of disease determines the amount of justified claims on health care resources. Therefore, the severity of scarcity depends on our interpretation of the concept of disease. I want to defend a specific combination of a theory of disease with a theory of distributive justice. A naturalist account of disease, together with sufficientarianism, is able to perform a gate-keeping function regarding entitlements to medical treatment. Although this combination cannot solve all problems of justice in health care, it may inform rationing decisions as well.     

Gender‐role egalitarianism predicts desirable traits of potential marriage partners: A cross‐cultural comparison

We examined whether gender‐role egalitarianism predicted participants' rank‐order preferences for traits in potential marriage partners of the opposite sex, and whether gender‐role egalitarianism mediated cultural differences between participants from North America, Polynesia and East Asia. Participants completed the Sex‐Role Egalitarianism Scale and ranked the following traits in terms of their importance in choosing a potential marriage partner: kindness, physical attractiveness, social level, athleticism, creativity and liveliness. Parallel analyses for male and female participants reveal that traditional males value physical attractiveness more than egalitarian males, and that traditional females value social level more and kindness less than egalitarian females. Gender‐role egalitarianism fully mediated the effect of culture on kindness rankings, but no others. These results expand upon previous findings by accounting for individual differences regarding beliefs about traditional gender roles.     

Luck egalitarians versus relational egalitarians: on the prospects of a pluralist account of egalitarian justice

Pluralist egalitarians think that luck and relational egalitarianism each articulates a component in a pluralist account of egalitarian justice. However, this ecumenical view appears problematic in the light of Elizabeth Anderson's claim that the divide arises because two incompatible views of justification are in play, which in turn generates derivative disagreements – e.g. about the proper currency of egalitarian justice. In support of pluralist egalitarianism I argue that two of Anderson's derivative disagreements are not rooted in the disagreement over justification she identifies, and that the disagreement over justification cuts across standard disagreements between luck and relational egalitarian justice.     

Equality: Putting the Theory into Action

We outline our central reasons for pursuing the project of equality studies and some of the thinking we have done within an equality studies framework. We try to show that a multi-dimensional conceptual framework, applied to a set of key social contexts and articulating the concerns of subordinate social groups, can be a fruitful way of putting the idea of equality into practice. Finally, we address some central questions about how to bring about egalitarian social change. Editors’ note. John Baker et al’s article below condenses the key themes and arguments of their book, Equality: From Theory to Action. In the next issue of Res Publica, four writers will respond to these arguments, and there will be a reply from the book’s authors. We are grateful to Jurgen De Wispelaere for organising the original workshop on which the article and replies are based, and for his work in putting together this symposium.     

Intertemporal Distributive Judgement

This paper considers the simple two-person two-period case of distributive judgement, and argues (a) that sensible intertemporal distributive principle should consider both the distribution of people's life time well-being and the distribution of people's well-being at each period and (b) that, if (a) is correct, Egalitarianism is more acceptable than Prioritarianism since the latter must choose either one.     

Level and Inequality of Happiness in Nations: Does Greater Happiness of a Greater Number Imply Greater Inequality in Happiness?

Utilitarians and egalitarians have different priorities. Utilitarians prioritize the greatest level of happiness in society and are prepared to accept inequality, while egalitarians prioritize the smallest differences and are willing to accept a loss of happiness for this purpose. In theory these moral tenets conflict, but do they really clash in practice? This question is answered in two steps. First I consider the relation between level and inequality of happiness in nations; level of happiness is measured using average responses to a survey question on life satisfaction and inequality is measured with the standard deviation. There appears to be a strong negative correlation; in nations where average happiness is high, the standard deviation tends to be low. This indicates harmony instead of tension. Secondly I consider the institutional factors that are likely to affect happiness. It appears that level and equality of happiness depend largely on the same institutional context, which is another indication for harmony. We may conclude that the discussion between utilitarians and egalitarians is of little practical importance. This conclusion implies that increasing income inequality can go together with decreasing inequality in happiness and this conclusion provides moral support for Governments developing modern market economics     

Luck egalitarianism and non-overlapping generations

This paper argues that there are good reasons to limit the scope of luck egalitarianism to co-existing people. First, I outline reasons to be sceptical about how “luck” works intergenerationally and therefore the very grounding of luck egalitarianism between non-overlapping generations. Second, I argue that what Kasper Lippert-Rasmussen calls the “core luck egalitarian claim” allows significant intergenerational inequality which is a problem for those who object to such inequality. Third, luck egalitarianism cannot accommodate the intuition that it might be required to leave future generations better off than we are, even if it would come at no cost to ourselves. Finally, I argue that following another, broader, version of luck egalitarianism would require us to level down future generations and possibly even ourselves, which is a problem for those persuaded by the levelling-down objection.     

Book Reviews

Aronson, Ronald After Marxism
Chambliss, William J. and Zatz, Marjorie S. (Eds) Making Law: The State, the Law, and Structural Contradictions
Kirschner, Don S. Cold War Exile: The Unclosed Case of Maurice Halperin
Earle, Robert L. and Wirth, John D. (Eds) Identities in North America: The Search for Community
Dunn, Susan The Deaths of Louis XVI; Regicide and the French Political Imagination
Brothers, Barbara Jo Peace, War and Mental Health
Singer, Margaret Thaler with Lalich, Janja Cults in Out Midst
Smith, Craig Allen and Smith, Kathy B. The White House Speaks: Presidential Leadership as Persuasion
Renshon, Stanley A. High Hopes: The Clinton Presidency and the Politics of Ambition     

On the Concept of Fair Competition Prevalent in Today’s European Soccer Leagues

The notion of competition depicted in sport literature appears to be inconsistent with the goals of current European soccer competitions. This paper examines two misconceptions of fair competition which are prevalent in these competitions. First, it aims at refuting the view that professional soccer only requires some basic equality of chances beyond the differences in players’ skills and managers’ knowledge of game strategy. In other words, it refutes the view that professional soccer only demands a notion of fair competition understood as fair play. Second, the paper also aims at refuting the view that fair competition, in professional soccer, is simply a matter of financial viability. Hence, it calls for both genuine legal and ethical reforms, since professional soccer competition requires a notion of equality as both a goal and a right. Such a notion, we argue, must conceive of the differences in players’ skills and managers’ knowledge of game strategy as one of the primary factors in establishing a platform founded in fair competition. Therefore, this paper calls for a radical change of attitude toward or a radical approach to fair competition among European sport fans, policy-makers, and administrators.     

Raising Revenue for Persons with Disabilities

Whereas right-libertarians do not think that it is a requirement of justice that we raise revenues for persons with disabilities, both left-libertarians and liberal egalitarians think that there is such a requirement. An issue remains for the latter two theorists—how ought we to raise this revenue? Liberal egalitarians typically endorse either universal taxation or taxation of the wealthy. Left-libertarians, on the other hand, cannot so easily appeal to the methods of universal taxation and taxation of the wealthy, as they are illegitimately coercive. One such method left open to the left-libertarian is one proposed by Michael Otsuka. He argues that both left-libertarians and liberal egalitarians should find the method of taxation of the unjust to be a reasonably strong way of raising revenue. In this paper, I point out problems with Otsuka’s argument, as well as directly criticize the method of taxation of the unjust.