Greg Bognar

In many societies, the aging of the population is becoming a major problem. This raises difficult issues for ethics and public policy. On what is known as the fair innings view, it is not impermissible to give lower priority to policies that primarily benefit the elderly. Philosophers have tried to justify this view on various grounds. In this article, I look at a consequentialist, a fairness-based, and a contractarian justification. I argue that all of them have implausible implications and fail to correspond to our moral intuitions. I end by outlining a different kind of consequentialist justification that avoids those implications and corresponds better to our considered moral judgments.

Some empirical findings seem to show that people value health benefits differently depending on the age of the beneficiary. Health economists and philosophers have offered justifications for these preferences on grounds of both efficiency and equity. In this paper, I examine the most prominent examples of both sorts of justification: the defence of age-weighting in the WHO's global burden of disease studies and the fair innings argument. I argue that neither sort of justification has been worked out in satisfactory form: age should not be taken into account in the framework of the burden of disease measure, and on the most promising formulations of the fair innings argument, it turns out to be merely an indicator of some other factor. I conclude by describing the role of age in theories of justice of healthcare resource allocation.

In the distribution of resources, persons must be respected, or so many philosophers contend. Unfortunately, they often leave it unclear why a certain allocation would respect persons, while another would not. In this paper, we explore what it means to respect persons in the distribution of scarce, life-saving resources. We begin by presenting two kinds of cases. In different age cases, we have a drug that we must use either to save a young person who would live for many more years or an old person who would only live for a few. In different numbers cases, we must save either one person or many persons from certain death. We argue that two familiar accounts of respect for persons―an equal worth account, suggested by Jeff McMahan, and a Kantian account, inspired by the Formula of Humanity―have implausible implications in such cases. We develop a new, “three-tiered” account: one that, we claim, generates results in such cases that accord better with many people’s considered judgments than those produced by its rivals.