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Responsibility and Distributive Justice$
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Carl Knight and Zofia Stemplowska

Print publication date: 2011

Print ISBN-13: 9780199565801

Published to Oxford Scholarship Online: May 2011

DOI: 10.1093/acprof:oso/9780199565801.001.0001

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Luck Prioritarian Justice in Health 1

Luck Prioritarian Justice in Health 1

(p.246) 12 Luck Prioritarian Justice in Health1
Responsibility and Distributive Justice

Shlomi Segall

Oxford University Press

This chapter inquires after the just distribution of health proper (as distinct from health care), arguing against a Rawlsian approach and in favour of a luck egalitarian one. It demonstrates that the Rawlsian approach of ‘fair equality of opportunity for health’ is subject to two objections: first, it does not mandate treatment for genetically caused medical conditions; and second, it is forced to mandate an equalization of health, even when unequal health would be of benefit to everyone's health. Since standard luck egalitarianism is just as vulnerable to this second ‘leveling down’ objection, the luck egalitarian can and ought to revert to a prioritarian pattern of distributing health. Luck prioritarian justice in health thus judges a distribution of health to be just if it promotes the health of those who are not responsible for their low level of health, and among those, gives higher priority to those whose health is (even) worse.

Keywords:   equality, health, justice, leveling down, luck egalitarianism, opportunity, prioritarianism, Rawls, responsibility

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