Abstract

In the literature on responsibility and health care, many associate responsibility-sensitive health policies with a form of luck egalitarianism. On this view, if some health inequality is due to the choices, or responsible agency, of one of the patients involved, then it is not unjust, and we have no responsibility to compensate for it. If the inequality’s origins cannot be traced back to the patients’ choices, then it is not their responsibility, and thus it becomes society’s responsibility to compensate for it. This division of responsibilities between the individual and society applies not only to the past, but also to our responsibilities concerning the future. For instance, some luck egalitarians think that inequalities in life expectancy between men and women are unjust (Segall 2010) and should be compensated. Alex Voorhoeve has recently raised a new frontier in this debate concerning ‘prospective’ lives: the lives of those who will be born in the future. Against Voorhoeve, I argue that prospective inequalities are not a concern for egalitarians. This qualifies the claim that all inequalities not traceable to personal responsibility are unjust and suggests that there is no responsibility to structure society or our social institutions to avoid such prospective inequalities.