Health, Luck, and Justice

Princeton University Press

"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck.

Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state?

By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.

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About the author

Shlomi Segall is lecturer in the Department of Political Science and the Integrative Program of Philosophy, Economics, and Political Science (PEP) at the Hebrew University of Jerusalem.
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Additional Information

Publisher
Princeton University Press
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Published on
Dec 31, 2010
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Pages
239
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ISBN
9780691140537
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Features
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Language
English
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Genres
Medical / Ethics
Medical / Health Care Delivery
Medical / Public Health
Philosophy / Ethics & Moral Philosophy
Philosophy / Political
Political Science / History & Theory
Political Science / Public Policy / General
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Content Protection
This content is DRM protected.
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Shlomi Segall
Egalitarians have traditionally been suspicious of equality of opportunity. But the past twenty five years or so have seen a sea-change in egalitarian thinking about that concept. 'Luck egalitarians' such as G. A. Cohen, Richard Arneson, and John Roemer have paved a new way of thinking about equality of opportunity, and infused it with radical egalitarian content. In this book, Shlomi Segall brings together these developments in egalitarian theory and offers a comprehensive account of 'radical equality of opportunity'. Radical equality of opportunity (EOp) differs from more traditional conceptions on several dimensions. Most notably, while other accounts of equality of opportunity strive to neutralize legal and/or socio-economic obstacles to one's opportunity-set the radical account seeks to remove also natural ones. Radical EOp, then, aims at neutralizing all obstacles that lie outside individuals' control. This has far-reaching implications, and the book is devoted to exploring and defending them. The book touches on four main themes. First, it locates the ideal of radical EOp within egalitarian distributive justice. Segall advances there three claims in particular: that we ought to be concerned with equality in individual holdings (rather than merely social relations); that we ought to be bothered, as egalitarians, with unequal outcomes, and never equal ones; and that we ought to be concerned with disadvantages the absolute (rather than relative) badness of which, the agent could not have controlled. Second, the book applies the concept of radical equality of opportunity to office and hiring. It demonstrates that radical EOp yields an attractive account both with regard to justice in the allocation of jobs on the one hand, and discrimination, on the other. Third, the book offers an account of radical EOp in education and upbringing. Segall tries to defend there the rather radical implications of the account, namely that it may hold children responsible for their choices, and that it places quite demanding requirements on parents. Finally, the book develops an account of radical equality of opportunity for health, to rival Norman Daniels's Rawlsian account. The proposed account is distinguished in the parity that it creates between social and natural causes of ill health.
Shlomi Segall
Egalitarians have traditionally been suspicious of equality of opportunity. But the past twenty five years or so have seen a sea-change in egalitarian thinking about that concept. 'Luck egalitarians' such as G. A. Cohen, Richard Arneson, and John Roemer have paved a new way of thinking about equality of opportunity, and infused it with radical egalitarian content. In this book, Shlomi Segall brings together these developments in egalitarian theory and offers a comprehensive account of 'radical equality of opportunity'. Radical equality of opportunity (EOp) differs from more traditional conceptions on several dimensions. Most notably, while other accounts of equality of opportunity strive to neutralize legal and/or socio-economic obstacles to one's opportunity-set the radical account seeks to remove also natural ones. Radical EOp, then, aims at neutralizing all obstacles that lie outside individuals' control. This has far-reaching implications, and the book is devoted to exploring and defending them. The book touches on four main themes. First, it locates the ideal of radical EOp within egalitarian distributive justice. Segall advances there three claims in particular: that we ought to be concerned with equality in individual holdings (rather than merely social relations); that we ought to be bothered, as egalitarians, with unequal outcomes, and never equal ones; and that we ought to be concerned with disadvantages the absolute (rather than relative) badness of which, the agent could not have controlled. Second, the book applies the concept of radical equality of opportunity to office and hiring. It demonstrates that radical EOp yields an attractive account both with regard to justice in the allocation of jobs on the one hand, and discrimination, on the other. Third, the book offers an account of radical EOp in education and upbringing. Segall tries to defend there the rather radical implications of the account, namely that it may hold children responsible for their choices, and that it places quite demanding requirements on parents. Finally, the book develops an account of radical equality of opportunity for health, to rival Norman Daniels's Rawlsian account. The proposed account is distinguished in the parity that it creates between social and natural causes of ill health.
Shlomi Segall
"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck.

Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state?

By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.

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