Lifestyle, responsibility and justice
TL;DR: The following article asks whether responsibility-based reasoning should be accepted as relevant for fair and legitimate healthcare rationing and argues that while a backward-looking conception of individual responsibility should not be endorsed, a forward-looking notion of responsibility may be approved.
Abstract: Unhealthy lifestyle contributes significantly to the burden of disease. Scarce medical resources that could alternatively be spent on interventions to prevent or cure sufferings for which no one is to blame, are spent on prevention or treatment of (the risk of) disease that could be avoided through individual lifestyle changes. This may encourage policy makers and health care professionals to opt for a criterion of individual responsibility for medical suffering when setting priorities. The following article asks whether responsibility-based reasoning should be accepted as relevant for fair and legitimate healthcare rationing. The luck-egalitarian argument that inequalities in health expectancies that derive from unchosen features of people’s circumstances are unjust and should be compensated, while inequalities that reflect personal choices of lifestyle may not, is discussed. It seems that while a backward-looking interpretation of individual responsibility cannot be relevant as a criterion of priority setting, a forward-looking conception of responsibility may be approved.
Within all modern societies healthcare authorities are facing difficult priority setting problems. Various criteria for rationing medical intervention have been proposed due to scarcity of resources. Until now, individual responsibility for medical suffering has been given little attention in the public or in academic debate. This is about to change. As Alexander Cappelen and Ole Norheim have pointed out in a recent article in this journal, unhealthy lifestyle contributes increasingly to the burden of disease. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge.1 In this article the following question is addressed: should responsibility-based arguments be accepted as relevant to meeting healthcare rationing fairly and legitimately? I will argue that while a backward-looking conception of individual responsibility should not be endorsed, a forward-looking notion of responsibility may be approved.
There are both empirical and theoretical reasons for …
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TL;DR: Biomedical Research Involving Animals is a report of the proceedings of the 1983 conference which discussed a draft of the Guiding Principles for Research using Animals, which it was hoped would provide widely applicable criteria for establishing codes of practice or legislation concerning the use of laboratory animals for scientific purposes.
Abstract: considerations. Biomedical Research Involving Animals is a report of the proceedings of the 1983 conference which discussed a draft of the Guiding Principles for Research using Animals presented at the conference and which it was hoped would provide widely applicable criteria for establishing codes of practice or legislation concerning the use of laboratory animals for scientific purposes. Whilst no one could fault the intention, the list of participants emphasises the rather one-sided nature of the proceedings. Of some 200 participants, scientists outnumbered animal welfarists by more than 20 to 1. The sooner those involved in any of the scientific disciplines accept that responsible lay opinion in all areas where the welfare of man or animal is at stake must be given equal weight with scientific opinion, the better. The attitude expressed by one scientist at the round table conference that those who are not in favour of experiments with animals simply do not understand what basic scientific method is about, is no longer true or acceptable. Nevertheless, Biomedical Research InvolvingAnimals is a useful selection of papers and discussions on this controversial and contentious issue. The conference was divided into three sessions, each of which included three or four papers followed by discussion: Scientific Progress and Research Involving Animals; Determinants of Future Policy Regarding Research Involving Animals, and Care and Protection of Laboratory Animals. The book ends with reports and summaries by the session chairmen. I found the most interesting and useful paper was that of Dr Zimmermann, of the International Association for the Study of Pain, on Ethical Considerations in Relation to Pain in Animal Experimentation. In discussion, Dr Zimmermann makes the point which should give pause for thought to all those involved in experimental research:
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166 citations
01 Jan 2011
TL;DR: In the UK and beyond, during economic crises and in a political climate where many feel that mutual assistance has lost currency, calls for a new and forceful emphasis on the meaning of solidarity are increasingly heard.
Abstract: 1. References to solidarity are currently on the increase in public discourse. In the UK and beyond, during economic crises and in a political climate where many feel that mutual assistance has lost currency, calls for a new and forceful emphasis on the meaning of solidarity are increasingly heard. Such appeals to solidarity are inevitably linked to ideas about how societies function, and about how and where the boundary between individual, familial, communal and societal spheres of responsibilities should be drawn.
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TL;DR: It is proposed that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others.
Abstract: Combatting chronic, lifestyle-related disease has become a healthcare priority in the developed world. The role personal responsibility should play in healthcare provision has growing pertinence given the growing significance of individual lifestyle choices for health. Media reporting focussing on the ‘bad behaviour’ of individuals suffering lifestyle-related disease, and policies aimed at encouraging ‘responsibilisation’ in healthcare highlight the importance of understanding the scope of responsibility ascriptions in this context. Research into the social determinants of health and psychological mechanisms of health behaviour could undermine some commonly held and tacit assumptions about the moral responsibility of agents for the sorts of lifestyles they adopt. I use Philip Petit's conception of freedom as ‘fitness to be held responsible’ to consider the significance of some of this evidence for assessing the moral responsibility of agents. I propose that, in some cases, factors outside the agent's control may influence behaviour in such a way as to undermine her freedom along the three dimensions described by Pettit: freedom of action; a sense of identification with one's actions; and whether one's social position renders one vulnerable to pressure from more powerful others.
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Book•
01 Jan 1979
TL;DR: The principles of biomedical and Islamic medical ethics and an interfaith perspective on end-of-life issues and three cases to exemplify some of the conflicts in ethical decision-making are discussed.
Abstract: Morality and ethical theory types of ethical theory the principle of respect for autonomy the principle of nonmaleficence the principle of beneficence the principle of justice professional-patient relationships ideals, virtues and conscientiousness.
13,200 citations
Book•
01 Jan 1998TL;DR: The Structure of Contractualism and Responsibility Promises Relativism as discussed by the authors, and Williams on Internal and External Reasons and Values Reasons Values Well-Being Right and Wrong Wrongness and Reasons
Abstract: Introduction Reasons and Values Reasons Values Well-Being Right and Wrong Wrongness and Reasons The Structure of Contractualism Responsibility Promises Relativism Appendix: Williams on Internal and External Reasons Notes Bibliography Index
2,804 citations
TL;DR: The authors argues that the problems stem from a flawed understanding of the point of equality and argues that in focusing on correcting a supposed cosmic injustice, egalitarian writing has lost sight of the distinctively political aims of egalitarianism.
Abstract: This chapter argues that the problems stem from a flawed understanding of the point of equality. It also argues that in focusing on correcting a supposed cosmic injustice, egalitarian writing has lost sight of the distinctively political aims of egalitarianism. The chapter presents a series of cases in which luck egalitarianism generates injustice. It shows that the reasons luck egalitarians offer for refusing to come to the aid of the victims of bad option luck express a failure to treat these unfortunates with equal respect and concern. The chapter suggests that the reasons luck egalitarians offer for coming to the aid of the victims of bad brute luck express disrespect for them. Where luck egalitarians tend to be either harsh or paternalistic toward the victims of bad option luck, they seem compassionate toward the victims of bad brute luck.
2,022 citations