Lifestyle diseases constitute an increasing proportion of health problems and this trend is likely to continue. A better understanding of the responsibility argument is important for the assessment of policies aimed at meeting this challenge. Holding individuals accountable for their choices in the context of health care is, however, controversial. There are powerful arguments both for and against such policies. In this article the main arguments for and the traditional arguments against the use of individual responsibility as a criterion for (...) the distribution of scarce health resources will be briefly outlined. It is argued that one of the most prominent contemporary normative traditions, liberal egalitarianism, presents a way of holding individuals accountable for their choices that avoids most of the problems pointed out by the critics. The aim of the article is to propose a plausible interpretation of liberal egalitarianism with respect to responsibility and health care and assess it against reasonable counter-arguments. (shrink)

Norwegian School of Economics and Business Administration and Chr. Michelsen Institute, Norway, bertil.tungodden{at}nhh.no ' + u + '@' + d + ' '//--> Liberal egalitarian theories of justice argue that inequalities arising from non-responsibility factors should be eliminated, but that inequalities arising from responsibility factors should be accepted. This article discusses how the fairness argument for redistribution within a liberal egalitarian framework is affected by a relocation of the cut between responsibility and non-responsibility factors. The article also discusses the claim (...) that equalization of some non-responsibility factors will reduce the ideal level of redistribution. Key Words: responsibility • liberal egalitarianism • redistribution. (shrink)

It is a central political goal to secure disabled individuals the same opportunities as others to pursue their conception of a good life. This goal reflects an ambition to combine an egalitarian and a liberal moral intuition. In this article, we analyse how disabled individuals who take part in economic activity should be compensated in order to respect these two intuitions. The article asks how a system of disability compensation should be structured and what the level of such compensation should (...) be. It also analyses how the answers to these questions depend on whether the disabled individuals are held responsible for their choice of work effort. (shrink)

Genomics provides information on genetic susceptibility to diseases and new possibilities for interventions which can fundamentally alter the design of fair health policies. The aim of this paper is to explore implications of genomics from the perspective of equal opportunity ethics. The ideal of equal opportunity requires that individuals are held responsible for some, but not all, factors that affect their health. Informational problems, however, often make it difficult to implement the ideal of equal opportunity in the context of healthcare. (...) In this paper, examples are considered of how new genetic information may affect the way individual responsibility for choice is assigned. It is also argued that genomics may result in relocation of the responsibility cut by providing both new information and new technology. Finally, how genomics may affect healthcare policies and the market for health insurance is discussed. (shrink)

A liberal egalitarian theory of justice seeks to combine the values of equality, personal freedom, and personal responsibility. It is considered a much more promising position than strict egalitarianism, because it supposedly provides a fairness argument for inequalities reflecting differences in choice. However, we show that it is inherently difficult to fulfill this ambition. We present a liberal egalitarian paradox which shows that there does not exist any robust reward system that satisfies a minimal egalitarian and a minimal liberal requirement. (...) Moreover, we demonstrate how libertarianism may be justified in this framework if we drop the egalitarian condition. (shrink)

University of Oslo and Norwegian School of Economics and Business Administration, Norway We look at how one should reward effort without rewarding talent. One way to approach this issue is to ask how an increase in one individual's effort should be allowed to affect the post-tax income of others. The article provides characterizations of three main classes of redistribution mechanism on the basis of how these answer this question. Key Words: reward • effort • responsibility • equal opportunity • distributive (...) justice. (shrink)

This commentary argues that the observed heterogeneity in fairness views, documented in many economic experiments, poses a challenge to the partner choice theory developed by Baumard et al. It also discusses the extent to which their theory can explain how people consider inequalities due to pure luck.

Fairness preferences fundamentally affect individual behavior and play an important role in shaping social and political institutions. However, people differ both with respect to what they view as fair and with respect to how much weight they attach to fairness considerations. In this article, we study the role of family background in explaining these heterogeneities in fairness preferences. In particular, we examine how socioeconomic background relates to fairness views and to how people make trade-offs between fairness and self-interest. To study (...) this, we conducted an economic experiment with a representative sample of 14- to 15-year-old and matched the experimental data to administrative data on parental income and education. The participants made two distributive choices in the experiment. The first choice was to distribute money between themselves and another participant in a situation where there was no difference in merit. The second choice was to distribute money between two other participants with unequal merits. Our main finding is that there is a systematic difference in fairness view between children from low-socioceconomic status families and the rest of the participants; more than 50 percent of the participants from low-SES families are egalitarians, whereas only about 20 percent in the rest of the sample hold this fairness view. In contrast, we find no significant difference in the weight attached to fairness between children from different socioeconomic groups. (shrink)