Social inequality in health, responsibility and egalitarian justice

Martin Marchman Andersen; Susanne Oksbjerg Dalton; Christoffer Johansen; John Lynch; Nils Holtug

doi:10.1093/pubmed/fdt012

Social inequality in health, responsibility and egalitarian justice

Martin Marchman Andersen, Susanne Oksbjerg Dalton, Christoffer Johansen, John Lynch, Nils Holtug

Department of Communication

18 Citations (Scopus)

Abstract

Are social inequalities in health unjust when brought about by differences in lifestyle? A widespread idea, luck egalitarianism, is that inequality stemming from individuals’ free choices is not to be considered unjust, since individuals, presumably, are themselves responsible for such choices. Thus, to the extent that lifestyles are in fact results of free choices, social inequality in health brought about by these choices is not in tension with egalitarian justice. If this is so, then it may put in question the justification of free and equal access to health care and existing medical research priorities. However, personal responsibility is a highly contested issue and in this article we first consider the case for, and second the case against, personal responsibility for health in light of recent developments in philosophical accounts of responsibility and equality. We suggest – but do not fully establish - that at the most fundamental level people are never responsible in such a way that appeals to individuals’ own responsibility can justify inequalities in health.

Original language	English
Journal	Journal of Public Health
Volume	35
Issue number	1
Pages (from-to)	4-8
Number of pages	5
ISSN	1741-3842
DOIs	https://doi.org/10.1093/pubmed/fdt012
Publication status	Published - Mar 2013

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10.1093/pubmed/fdt012

http://jpubhealth.oxfordjournals.org/cgi/content/full/fdt012? ijkey=frtEKkZDxcN99WX&keytype=ref

Cite this

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title = "Social inequality in health, responsibility and egalitarian justice",

abstract = "Are social inequalities in health unjust when brought about by differences in lifestyle? A widespread idea, luck egalitarianism, is that inequality stemming from individuals{\textquoteright} free choices is not to be considered unjust, since individuals, presumably, are themselves responsible for such choices. Thus, to the extent that lifestyles are in fact results of free choices, social inequality in health brought about by these choices is not in tension with egalitarian justice. If this is so, then it may put in question the justification of free and equal access to health care and existing medical research priorities. However, personal responsibility is a highly contested issue and in this article we first consider the case for, and second the case against, personal responsibility for health in light of recent developments in philosophical accounts of responsibility and equality. We suggest – but do not fully establish - that at the most fundamental level people are never responsible in such a way that appeals to individuals{\textquoteright} own responsibility can justify inequalities in health. ",

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AU - Andersen, Martin Marchman

AU - Dalton, Susanne Oksbjerg

AU - Johansen, Christoffer

AU - Lynch, John

AU - Holtug, Nils

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AB - Are social inequalities in health unjust when brought about by differences in lifestyle? A widespread idea, luck egalitarianism, is that inequality stemming from individuals’ free choices is not to be considered unjust, since individuals, presumably, are themselves responsible for such choices. Thus, to the extent that lifestyles are in fact results of free choices, social inequality in health brought about by these choices is not in tension with egalitarian justice. If this is so, then it may put in question the justification of free and equal access to health care and existing medical research priorities. However, personal responsibility is a highly contested issue and in this article we first consider the case for, and second the case against, personal responsibility for health in light of recent developments in philosophical accounts of responsibility and equality. We suggest – but do not fully establish - that at the most fundamental level people are never responsible in such a way that appeals to individuals’ own responsibility can justify inequalities in health.

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