Iwao Hirose

Some people are worse off than others. Does this fact give rise to moral concern? Egalitarianism claims that it does, for a wide array of reasons. It is one of the most important and hotly debated problems in moral and political philosophy, occupying a central place in the work of John Rawls, Thomas Nagel, G. A. Cohen and Derek Parfit. It also plays an important role in practical contexts such as the allocation of health care resources, the design of education and tax systems, and the pursuit of global justice. Egalitarianism is a superb introduction to the problem of contemporary egalitarian theories. It explains how rival theories of egalitarianism evaluate distributions of people’s well-being, and carefully assesses the theoretical structure of each theory. It also examines how egalitarian theories are applied to the distribution of health and health care, thus bringing a deceptively complex philosophical debate into clear focus. Beginning with a brief introduction to basic terminology, Iwao Hirose examines the following topics: Rawlsian egalitarianism luck egalitarianism telic egalitarianism prioritarianism sufficientarianism equality and time equality in health and health care. Including chapter summaries, annotated further reading and a glossary, this is an ideal starting point for anyone studying distributive justice for the first time, and will also be of interest to more advanced students and researchers in philosophy, economics, political theory, public policy, and public health

Faced with a choice between saving one stranger and saving a group of strangers, some people endorse weighted lotteries, which give a strictly greater chance of being saved to the group of strangers than the single stranger. In this paper I attempt to criticize this view. I first consider a particular version of the weighted lotteries, Frances Kamm's procedure of proportional chances, and point out two implausible implications of her proposal. Then, I consider weighted lotteries in general, and claim (1) that the correct thing to distribute is not the chance of being saved but the good of being saved, (2) that assigning some chance to the single stranger is not the only way to give a positive (and equal) respect to the people concerned, and (3) that the weighted lottery appears to be deceptive since it would show the respect to the single stranger in a negligible way.

Should organ transplants be given to patients who have waited the longest, or need it most urgently, or those whose survival prospects are the best? The rationing of health care is universal and inevitable, taking place in poor and affluent countries, in publicly funded and private health care systems. Someone must budget for as well as dispense health care whilst aging populations severely stretch the availability of resources. The Ethics of Health Care Rationing is a clear and much-needed introduction to this increasingly important topic, considering and assessing the major ethical problems and dilemmas about the allocation, scarcity and rationing of health care. Beginning with a helpful overview of why rationing is an ethical problem, the authors examine the following key topics: What is the value of health? How can it be measured? What does it mean that a treatment is "good value for money"? What sort of distributive principles - utilitarian, egalitarian or prioritarian - should we rely on when thinking about health care rationing? Does rationing health care unfairly discriminate against the elderly and people with disabilities? Should patients be held responsible for their health? Why does the debate on responsibility for health lead to issues about socioeconomic status and social inequality? Throughout the book, examples from the US, UK and other countries are used to illustrate the ethical issues at stake. Additional features such as chapter summaries, annotated further reading and discussion questions make this an ideal starting point for students new to the subject, not only in philosophy but also in closely related fields such as politics, health economics, public health, medicine, nursing and social work.