Now available from Yale University Press:
Distributive Justice and Disability: Utilitarianism against Egalitarianism
by Mark S. Stein
“… an important, lucid, powerfully argued book that
sheds fresh light on the debate between utilitarians and egalitarians.” —Peter Singer,
Madison in Federalist No. 45: Happiness, not Federalism, is the Goal (posted 9/12/06)
Any Good in the Greatest Number? (revised 7/30/06)
Ronald Dworkin's Utilitarianism (posted 7/02/06)
Marx without Hegel is like... (posted 5/26/06)
Africa Needs a BIG Experiment (posted 5/21/06)
Organ Legators (posted 5/06/06)
Philosophers Fighting the Last War (posted 5/05/06)
Four Years After Death, Nozick to Publish Revised ASU (posted 4/30/06)
McCain Smarter than Krauthammer on Torture (posted 4/20/06)
The Meaningless "Separateness of Persons" Chestnut (posted 4/15/06)
The International Food Stamp (posted 3/28/06)
(posted July 2, 2006)
When would Ronald Dworkin provide less compensation to a person with a greater disability, while providing more compensation to a person with a lesser disability?
Short answer: When utilitarianism would do so, since Dworkin’s system of “hypothetical insurance” is essentially a form of utilitarianism. See Chapter 7 of my book.
Long and roundabout answer:
Last semester I taught Will Kymlicka’s excellent textbook, Contemporary Political Philosophy. Kymlicka is fair to utilitarianism, but utilitarianism is not his favorite theory of distributive justice; in fact, it is not even his second-favorite theory. Kymlicka believes that Rawls improves on utilitarianism, and that Dworkin improves on Rawls.
Kymlicka endorses Dworkin’s principle that (to simplify) unchosen disadvantages should be compensated. Kymlicka also endorses the means by which Dworkin proposes to effect compensation, the system of “hypothetical insurance.” There is a problem, however: Dworkin’s hypothetical insurance reaches results that are inconsistent with the principle of compensating for unchosen disadvantage. Kymlicka realizes that hypothetical insurance is not really the same as compensating for unchosen disadvantage, but he fails to realize how much daylight there is between the two; he fails to realize that hypothetical insurance is in fact a return to utilitarianism.
In setting compensation for disability, the system of hypothetical insurance asks the following question: To what extent would people insure against various kinds of disability, from a situation of equal material resources, assuming that they knew the frequency of disability but did not know whether they themselves were or would become disabled? The average level of insurance coverage that hypothetical insurance buyers would buy for a disability then becomes the actual level of compensation for that disability.
Suppose a painful disability, D1, that affects one out of every 1,000 people. A treatment is available that will completely and permanently alleviate the pain, but it is very expensive: the cost of the treatment is twice the initial equal share of resources. Presumably, hypothetical insurance buyers would buy enough insurance so that they would be able to afford the pain-relieving treatment if they happened to have the D1 disability when the veil of ignorance was lifted. (The cost of this insurance would be approximately .002 times the initial share of resources.)
Now suppose another disability, D2. This disability also affects one out of every 1,000 people, and it is even more painful than D1 (though it does not prevent people from working). Unfortunately, there is no current treatment for D2, and there is very little likelihood of ever finding a treatment. Presumably, then, hypothetical insurance buyers would insure against D2 at a far lower level of coverage than against D1: as there is no treatment for D2, compensation for that condition would be far less beneficial.
It is theoretically possible, of course, that hypothetical insurance buyers would insure against D2 at a higher level of coverage than against D1; maybe insurance buyers would take an attitude of maximum risk-aversion, and would seek to make their worst-off state (D2) as good as possible. But in considering Dworkin’s system of hypothetical insurance, we are likely to assume that hypothetical insurance buyers would not be maximally risk-averse (and by “we” I emphatically mean to include Dworkin himself).
So Dworkin’s system would provide far less compensation to people with a greater unchosen disadvantage (disability D2, which is more painful), and would provide far more compensation to people with a lesser unchosen disadvantage (disability D1, which is less painful but is treatable). Dworkin would provide far less compensation to people who are worse off, and far more compensation to people who could benefit more. This is not egalitarianism, but rather a kind of utilitarianism.
It is because Dworkin’s hypothetical insurance is a kind of utilitarianism that Dworkin can achieve an intermediate position on compensating the disabled, avoiding the extremes of zero redistribution and virtually unlimited redistribution.
There are many complications to Dworkin’s theory, and I have glossed over them in this post. So I repeat what I said in the Short Answer: See Chapter 7 of my book.
Permanent link to above post: www.pushpinpundit.com/v1n12070206.htm
(posted June 3, 2006; revised July 8, 2006)
Opponents of libertarianism typically see Robert Nozick as a clever magician. Through slight-of-hand tricks, Nozick makes libertarianism seem more appealing than it is. An alternative view is that libertarianism really is appealing, and that Nozick succeeds in conveying its appeal. But of course that can’t be right. Nozick is a clever magician, and in this post I try to illuminate one of his tricks. (I am referring here to the Nozick of Anarchy, State, and Utopia (ASU); as noted in a previous post, Nozick subsequently took a zig-zag path, repudiating libertarianism in The Examined Life, only to move back toward it in his last book, Invariances.)
In Part I of ASU, which takes up around 140 pages, Nozick considers whether a libertarian “minimal” state would arise from a state of nature, assuming general adherence to stringent libertarian property rights. Nozick argues that a minimal state would in fact arise (more precisely, he argues that an "ultraminimal state" would arise, and that those in charge of the ultraminimal state would have a moral obligation to transform it into a minimal state.) Nozick concludes that a minimal state is morally permissible, contrary to the view of anarchists who see all states as illegitimate.
Now in order to follow and evaluate Nozick’s argument in Part I of ASU, the reader must assume, with Nozick, the existence of stringent libertarian property rights; the reader must assume that redistribution of income from rich to poor is a violation of the moral rights of the rich. What’s more, when supporters of the welfare state read Part I of ASU, they likely find themselves resisting Nozick’s argument for the minimal state, simply because it is an argument that comes from Nozick. In order to reject the argument that Nozick makes in Part I, supporters of the welfare state likely find themselves not just accepting libertarian property rights, but straining to defend those sacred libertarian property rights from encroachment by the minimal state!
Then, when after 140 pages Nozick finally addresses the real issue – should there be a welfare state? – the supporters of the welfare state have already granted him almost the entire argument. Having assumed the truth of libertarianism for 140 pages, and having attempted to see the right to property as stronger even than Nozick would allow, the befuddled supporters of the welfare state are hard pressed to deny that the welfare state violates the moral rights of property owners. Neat trick, Nozick.
As may be evident to regular readers of this blog (hey guys, did we find a fourth for bridge?), I am thinking about writing a book with the subtitle Utilitarianism against Libertarianism, to provide some company for my book Utilitarianism against Egalitarianism. So I would like to ask: If anyone has seen the argument of this post elsewhere, please let me know.
Permanent link to above post: www.pushpinpundit.com/v1n11060306.htm
(posted June 2, 2006)
Rawls is sometimes considered the philosopher of the welfare state – as if the welfare state had no philosophy before he published A Theory of Justice in 1971. This view grants too much to Rawls, and too little to utilitarianism. After all, who do you think put the “welfare” in the welfare state? As FDR proclaimed in his 1936 campaign, “Always… your Government has had but one sign on its desk—‘Seek only the greater good of the greater number of Americans.’” An inexact statement of the principle of utility, to be sure, but the utilitarian sentiment is clear.
Rawls was not needed to provide a philosophical grounding for the welfare state because utilitarianism had long since accomplished that task. However, Rawls may have played a role in undermining the welfare state. During the period when utilitarianism was the dominant theory of distributive justice, the welfare state was created, expanded, and strengthened. Since Rawls dethroned utilitarianism in the early 1970’s, the record of the political Left has been mixed at best, especially in English-speaking countries. Coincidence? Perhaps…
I am not entirely serious about this, but I am not entirely joking either. Rawls appeals to a baseline – absolute economic equality – that is foreign to the experience of almost everyone in society. As a result, his theory is less able than utilitarianism to support an overlapping consensus (to coin a phrase) in favor of the welfare state.
The baseline that is most salient to people is the baseline of the status quo. From that baseline, Rawls’s difference principle, and his principle of fair equality of opportunity, treat people who are advantaged almost purely as a means to the betterment of those who are less advantaged. Any sacrifice by the better-off, no matter how great, is said to be justified if it provides any increase, no matter how small, in fair equality of opportunity or in the situation of the least advantaged class. How could anyone possibly think that such a lopsided theory could achieve the general assent of an entire society? If those who are better off are asked to support greater economic equality based on such a theory, their predominant reaction must be: forget greater economic equality.
The overlapping consensus necessary to sustain an extensive welfare state (not to mention Rawls’s own more ambitious plans) is not a consensus between theories of the good, as Rawls would have it. Catholic Rawlsians, Protestant Rawlsians and Jewish Rawlsians may all agree on Rawls’s principles of justice, but that does not get us very far. The requisite consensus in favor of the welfare state is a consensus between, or at least cutting across, economic classes. Only utilitarianism can achieve and maintain such a consensus, because only utilitarianism can say to the better off: “Your welfare counts as much as the welfare of those who are worse off. You need not sacrifice for their benefit unless they would gain more than you would lose.”
Of course, it’s not easy, even for utilitarianism, to maintain an overlapping consensus in favor of an extensive welfare state. People are never eager to give up things for the benefit of others. But people are sometimes willing to give up things if others will benefit more, especially if the difference in benefit is large, and if there is a focused social message in favor of utilitarian redistribution. By contrast, it is unrealistically utopian to think that people will be willing to give up things for the sake of others if those others will benefit less. Utopian egalitarian philosophies, such as the one offered by Rawls, undermine the welfare state by sapping the strength and focus of the utilitarian message.
Permanent link to above post: www.pushpinpundit.com/v1n10060206.htm
(posted May 26, 2006)
… lox without the bagel.
Permanent link to above post (why not?) – www.pushpinpundit.com/v1n9052606.htm
(posted May 21, 2006)
wide coalition of groups in
years ago, it seemed that the campaign for a BIG might succeed in
way to look at the BIG campaign is as an attempt to build a stronger welfare
state in the only country in Sub-Saharan Africa that can afford a welfare state
– a campaign irrelevant to the rest of Africa and, as it happens, too ambitious
programs in developing countries are often hailed by development experts.
Income-support programs in developing countries do more than provide for the immediate needs of the poor. These programs also promote economic growth. Stephen Devereux, probably the world’s leading expert on social protection in developing countries, writes that “the multiplier effects of injecting cash or food into poor communities has invariably been underestimated.” Devereux, Social Protection for the Poor (2002), p. 14. A 1997 World Bank report on the Brazil school subsidy program notes: "[T]he scholarship program has indirectly impacted the economy of those cities where it is implemented- the sudden flow of resources into poor neighborhoods has created an immediate growth in demand for basic goods, benefiting the local economy." Ayesha Vawda, Brazil: Stipends to Increase School Enrollment (1997).
Most current aid programs, whether by governments or international charities, are immensely wasteful. Aid-financed income support programs would be far more efficient in moving money from donors to the world’s poor.
A good current analogy to the aid-financed basic income grant can perhaps be found in the remittances sent by migrant workers back to poorer family members in their countries of origin. These remittances represent an infusion of cash, from outside a poor country, paid directly to people in that country. Everyone agrees that remittances are beneficial to the economies of poor countries.
there is reason to be very hopeful about the effects of a BIG in
In a previous post, I advocated an international food stamp program which, like the basic income grant, would be an income-support program. The advantage of a food stamp program is that it would attract funding by appealing to farm interests in rich countries; it would harness the political power of rich-country farmers for the benefit of the world’s poor. However, an aid-financed BIG would be easier to administer than a food stamp program. Either program, in my opinion, would be a far better use of aid money than most current projects.
Permanent link to above post: www.pushpinpundit.com/v1n8052106.htm
(posted May 6, 2006)
The “Karlovian” transplant case is a staple of anti-utilitarian theory. In this imaginary case, a doctor must decide whether to kill one of his patients in order to save five other patients with the victim’s transplanted organs. I refer to this charming example as the “Karlovian” transplant case because I can imagine Boris Karloff playing the role of doctor (“What I do is for the greatest benefit of humanity. Come, Igor!”).
Possibly as a result of over-exposure to the Karlovian transplant case, I have never liked the term “organ donor,” when used to describe people who elect to pass their organs on to others after they are dead. “Donor” to me suggests a gift given while the giver is alive. There really should be a term that makes it clear that the organs will not be taken until after death has occurred (and that death will occur for reasons unrelated to removal of the organs). Hence, my suggestion: “organ legator.” This term may be unfamiliar, but it does bring to mind the word “legacy”, which has a generally positive connotation.
The term “organ legator” would be especially useful in light of the increasing number of live-donor transplants (e.g., of one kidney). People tend to be possessive about their organs; they may be put off when the same term is used to describe those who give up an organ while alive and those who give up organs after they are dead.
Permanent link to above post: www.pushpinpundit.com/v1n7050606.htm
(posted May 5, 2006)
was against the 1999 Kosovo operation while it was being waged. The initial worsening of the humanitarian
situation seemed to confirm my fears, but then
Permanent link to above post: www.pushpinpundit.com/v1n6050506.htm
(posted April 30, 2006)
"It is disconcerting to be known primarily for an early work." So wrote the late Robert Nozick. He was referring, of course, to his most famous work, Anarchy, State, and Utopia (“ASU”), published in 1974. ASU is a powerful and controversial libertarian polemic. It is mistaken, in that it rejects the welfare-state policies recommended by utilitarianism. Nevertheless, ASU is often grouped with the late John Rawls's A Theory of Justice as one of the major works of contemporary political philosophy.
According to amazon.com, a revised edition of ASU will be published in December, 2006. It will be interesting to see what changes are made in the revised edition, especially as Nozick’s views followed a zig-zag course after publication of the original edition.
For a time, Nozick drew back from the libertarian position expressed in ASU. In his 1989 book The Examined Life (“EL”), Nozick went so far as to say that “[t]he libertarian position I once propounded now seems to me seriously inadequate....” EL contains an egalitarian estate-tax proposal and a communitarian endorsement of the welfare state.
Nozick's retreat from libertarianism made something of a splash when EL was first published. Subsequently, however, EL faded from the view of distributive theorists. Numerous critiques of ASU appeared after the publication of EL; most of these critiques (including one by me) made scant or no mention of Nozick's changed views. Incongruously, ASU continued to be the intellectual flagship of libertarianism even after its own author had disembarked from it.
The last book Nozick published before his death in 2002 was Invariances. In Invariances, published in 2001, Nozick appeared to return, at least partway, to the libertarian outlook of ASU. He wrote that the only kind of ethics government could legitimately enforce was the "ethics of respect", which he associated with the views he had set forth in ASU. Nozick also gave a very interesting interview, shortly before his death, to the libertarian writer Julian Sanchez. In this interview, Nozick stated: “What I was really saying in The Examined Life was that I was no longer as hardcore a libertarian as I had been before. But the rumors of my deviation (or apostasy!) from libertarianism were much exaggerated.”
With the revised edition of ASU, will Nozick place himself back in the libertarian fold? When were the revisions made, and by whom? It will be interesting to see. Hopefully, there will be a clear statement, in the revised edition, as to whether and to what extent the material in the book reflects Nozick’s actual views at the end of life.
Permanent link to above post: www.pushpinpundit.com/v1n5043006.htm
(posted April 20, 2006)
Should we torture a terrorist to discover where he has hidden a nuclear time bomb? In discussing this hoary hypothetical case, people often confuse two issues: (1) whether torture should ever be done; and (2) whether torture should ever be legal.
Charles Krauthammer exhibits such confusion in a December, 2005 article titled "The Truth about Torture". In this article, Krauthammer criticizes Senator John McCain’s refusal to agree to exceptions to his amendment (now passed into law) banning “cruel, inhuman, or degrading treatment or punishment.” Krauthammer writes:
According to Newsweek, in the ticking time bomb case McCain says that the president should disobey the very law that McCain seeks to pass--under the justification that ‘you do what you have to do. But you take responsibility for it.’ But if torturing the ticking time bomb suspect is ‘what you have to do,’ then why has McCain been going around arguing that such things must never be done?
Here Krauthammer is being obtuse. McCain doesn’t say torture must never be done; McCain says torture must never be legal. This is the correct position. Government officials facing a ticking bomb case should if necessary violate the law – at their peril. But torture should never be legal, because any crack in the prohibition of torture lets in a flood of torture.
It might be objected:
what if the government officials are sticklers for legality and refuse to
torture, even in the ticking bomb case, unless torture is legal? But since we already know that
Permanent link to above post: www.pushpinpundit.com/v1n4042006.htm
(posted April 15, 2006)
“Obviously utilitarians know perfectly well that persons are separate. What they deny is that it follows from this separateness that one ought not to trade benefits to one person against benefits to another.” Peter Singer, "Response to Martha Nussbaum", 2002.
I have written an entire article on the vague and ultimately meaningless criticism that utilitarianism fails to respect the distinctness of persons. I sort of wish I had saved myself the trouble, as the above quote by Peter Singer probably says all that needs to be said. Nevertheless, anyone who wants to check out my article can find it at Polity 35, no. 4 (July, 2003): 479-90. (and I would be happy to email an electronic copy to anyone with an email account ending in .edu)
Permanent link to above post: www.pushpinpundit.com/v1n3041506.htm
Any Good in the Greatest Number?
(revised July 30, 2006)
“Always… your Government has had but one sign on its desk—‘Seek only the greater good of the greater number of Americans.’” Franklin D. Roosevelt, 1936 (quoted in Dolbeare and Cummings, American Political Thought, Fifth ed., p. 415).
“[T]he purpose of government is to do the greatest good for the greatest number of people.” Christopher Reeve, 2000, as quoted by CBS News.
If the utilitarian philosophy survives for a thousand years (as of course it will), people will still be confused by that unfortunate phrase. The “greatest good for the greatest number” (or “greatest happiness of the greatest number”) is an inexact statement of the principle of utility. The greatest happiness is not always the same as the happiness of the greatest number. When these two goals diverge, utilitarianism seeks the greatest happiness – not the happiness of the greatest number. This point has been made by generations of utilitarian writers (including me, at pp. 220-21 of my book).
Suppose that we could give ice cream cones to 100 well-fed people, each of whom would like an ice cream cone. Alternatively, we could relieve 50 other people from horrible pain. Would utilitarianism tell us to give ice cream cones to the 100, in order to promote the happiness of the greatest number? No; utilitarianism would tell us to relieve the 50 from horrible pain, in order to promote the greatest happiness.
At one time, I thought all this was obvious. No one, I thought, could possibly be confused by the phrase “greatest happiness of the greatest number” into thinking that utilitarianism seeks not the greatest happiness, but the happiness of the greatest number. Now I know better: despite the best efforts of generations of utilitarian writers, that unfortunate phrase continues to sow confusion.
And yet, and yet… There may be some value in the phrase “greatest happiness of the greatest number”. “Greatest number” is not part of a rigorous definition of utilitarianism, but it can serve as a reminder that everyone’s interest must be counted.
Permanent link to above post: www.pushpinpundit.com/v1n2041306.htm
Theories of distributive justice are most severely tested in the area of disability. In this book, Mark Stein argues that utilitarianism performs better than egalitarian theories in dealing with the problems of disability. Egalitarian theories either give too little help to the disabled or too much, depending on what is sought to be equalized. Utilitarianism achieves the proper balance by placing resources where they will do the most good.
As pure egalitarian theories fail to address disability issues in a plausible way, egalitarian theorists are driven to incorporate elements of utilitarianism into their theories. Sometimes this incorporation of utilitarianism is done relatively openly, as by Amartya Sen; sometimes is it done in an obscure fashion, as by Ronald Dworkin.
Stein concedes that utilitarianism faces particular difficulties in the distribution of life-saving medical resources. Under one interpretation, utilitarianism would require us to discriminate against the disabled in the distribution of life. Stein opposes such discrimination and marshals utilitarian arguments against it. He also points out that whatever problems utilitarianism faces here, egalitarian theories face even greater problems. Often it seems right to distribute life-saving medical resources to those who will most benefit, in the sense of gaining the most life years, and egalitarian theories cannot do so.
Stein also discusses the proper use of examples in moral theory. Many examples used by the opponents of utilitarianism, such as Robert Nozick’s famous “utility monster”, evoke utilitarian intuitions and then turn those intuitions, deceptively, against utilitarianism.
This is the first book-length assessment of how competing theories of distributive justice deal with the problems of disability. It also offers what may be the broadest critique of egalitarian theory from a utilitarian perspective; Stein addresses the work of egalitarian theorists John Rawls, Ronald Dworkin, Amartya Sen, Bruce Ackerman, Martha Nussbaum, Norman Daniels, Philippe Van Parijs, and others.
“Distributive Justice and Disability is an
important, lucid, powerfully argued book that sheds fresh light on the debate
between utilitarians and egalitarians.”—Peter Singer,
“Distributive Justice and Disability offers a powerful brief for a utilitarian theory of distributive justice over its most prominent rival, egalitarianism. Mark Stein’s arguments are always pellucid and thoroughly engaging, and he handles the densest work of others with remarkable acuity. Bioethicists and political theorists will find this work invaluable.” – Ellen Frankel Paul, Professor of Political Science and Philosophy, and Deputy Director, Social Philosophy and Policy Center, Bowling Green State University
Justice and Disability is an engaging, smart, and insightful book on a
topic of social importance. Mark Stein’s arguments are controversial and
interesting, and his treatment is illuminating and helpful.” – Anne L. Alstott,
Jacquin D. Bierman Professor of Taxation,
“Mark Stein has written a thoughtful and impressive book that makes an
important contribution to utilitarian moral philosophy.” – Julia Driver,
Professor of Philosophy,
“Distributive Justice and Disability wrestles with many
difficult and contentious issues, but Mark Stein has a talent for taking very
complicated ideas and relating them in a clear and accessible manner. The
author engages an important topic, one that promises to become even more timely
over the coming years.” – Grant Reeher, Associate Professor of Political Science
and Senior Research Associate, Center for Policy Research,
(or download pdf from http://yalepress.yale.edu/yupbooks/excerpts/stein_distributive.pdf)
This book is about the contest between utilitarianism and egalitarianism. Utilitarianism, as a theory of distributive justice, tells us to help those who can most benefit, those who can gain the greatest increase in welfare. Egalitarian theories of distributive justice tell us to help those who are in some way worse off.[i] I advocate utilitarianism.
There is sometimes a convergence between utilitarianism and egalitarian theories; sometimes, those who can most benefit are those who are worse off in various ways. At other times, the theories diverge. One area in which utilitarianism often diverges from egalitarian theories is the area of disability.
I argue in this book that utilitarianism handles distributive issues involving disability better than do egalitarian theories. Egalitarianism would provide either too little help to the disabled or too much, depending on what is sought to be equalized.
An egalitarianism that seeks to equalize material resources would in general make no special provision for the disabled. Resource egalitarianism would not, in general, subsidize the medical expenses of poor people or pay for disability aids such as wheelchairs or guide dogs. Under resource egalitarianism, the disabled poor would be entitled only to the minimum income guaranteed to everyone in society; after spending that income on disability-related expenses, they would end up with a lot less than the nondisabled poor, and in some cases they would needlessly die.
On the other hand, an egalitarianism that seeks to equalize welfare would massively redistribute social resources to those severely disabled people who are considered to have the least welfare, such as, for example, young people with terminal cancer. Welfare egalitarianism would continue to lavish resources on the least-welfare disabled long after they ceased to derive much benefit from additional resources. In a welfare-egalitarian system, the nondisabled poor would be viewed purely as a means to increase the welfare of those with least welfare. The nondisabled poor would receive little, if any, help from the government, and they might even be subject to high taxes.
The common defect of egalitarian theories is that they are insensitive to relative benefit. Resource egalitarianism would distribute too little to disabled people who could benefit greatly from additional resources; welfare egalitarianism would distribute too much to disabled people who could benefit hardly at all from additional resources. By contrast, utilitarianism is completely sensitive to relative benefit. Utilitarianism seeks to place resources where they will do the most good. Only utilitarianism, or a theory with a large element of utilitarianism, can avoid both inadequate provision for the disabled and excessive redistribution to the disabled. Utilitarianism is the golden mean of distributive justice.
Because egalitarianism is insensitive to relative benefit, egalitarian theorists are driven to incorporate an element of utilitarianism into their theories: they are driven to distribute resources to those who are better off, by the lights of their own egalitarian theories, in cases where the better-off would benefit more. Sometimes this incorporation of utilitarian elements is done relatively openly, as by Amartya Sen; sometimes it is done in an obscure manner, as by Ronald Dworkin.
The foregoing assertions about egalitarianism and egalitarian theorists need to be backed up, of course. I hope to back them up, to the reader’s satisfaction, through the course of this book.
I begin, in Chapter 2, by discussing some preliminary but important matters of method. Like many normative theorists, I test theories against each other through the use of examples. Many of these examples involve interpersonal comparisons of welfare. I argue in Chapter 2 that moral intuition can be confounded if the examples used to test moral intuition contain interpersonal comparisons that are merely stipulated rather than interpersonal comparisons based convincingly on the facts of the example. Thus, Robert Nozick’s famous “utility monster” example evokes utilitarian intuitions and turns them, deceptively, against utilitarianism.
Though it is possible to employ such deceptive examples on behalf of utilitarianism rather than against it, I forbear to do so. When I adduce examples in which one person supposedly has more welfare than another person, or in which one person would supposedly benefit more from a scarce resource, I never stipulate that these interpersonal comparisons must be assumed by the reader as true; I always leave it to the reader to determine whether she agrees with my interpersonal comparisons, just as I leave it to the reader to determine whether she agrees with my intuitive judgment that certain distributive results are right or wrong.
In accordance with my belief that interpersonal comparisons should be convincing, I review, in Chapter 3, some empirical work on the relationship between disability and welfare. The common-sense view, reflected in the work of almost all distributive theorists, is that disability tends to reduce a person's welfare, and that the severely disabled have, on average, less welfare than the nondisabled. I generally endorse this view, with the reservation that because people have the capacity for hedonic adaptation, disability often may not reduce welfare by as much as the nondisabled observer might think.
I also briefly consider, in Chapter 3, the issue of what is a disability. There is no universally applied definition. Rather, the definition of disability varies according to the purpose of the inquiry. This book is a work of distributive theory; it is more about distributive justice than it is about disability. I use disability as a testing ground for utilitarian and egalitarian theories. In line with this approach, I take a broad view of what constitutes a disability. In my discussion, for example, cancer as well as blindness is a disability. Although my view of disability is broad, it is not idiosyncratic; I do not consider anything a disability that would not also be considered a disability by many other writers on distributive justice.
In Chapter 4, I discuss the utilitarian approach to disability and distribution. Utilitarianism seeks to maximize welfare. As disability tends to reduce welfare, measures to cure or ameliorate disability can substantially increase welfare. Therefore, utilitarianism will often endorse such measures. However, utilitarianism will not approve of aid to the disabled that would benefit them only slightly and would divert resources from alternative uses that could provide people with greater benefits.
I discuss at length, in Chapter 4, the argument, most identified with Sen, that utilitarianism would often allocate fewer resources to disabled people than to nondisabled people, so that the disabled would end up with fewer resources and also less welfare. This argument, I claim, is based on a fallacious exaggeration of the circumstances in which disabled people would benefit less from resources than would nondisabled people. In those unusual circumstances in which it is truly credible that disabled people would benefit less, I argue, it does not seem unfair to allocate fewer resources to them.
In Chapter 5, I discuss egalitarian approaches to disability and distribution. For the most part, my discussion of egalitarian theories in this chapter is thematic; I defer detailed consideration of specific egalitarian theorists until subsequent chapters.
Egalitarian theories vary along a number of dimensions. As already suggested, the key dividing line, as concerns disability and distribution, is the one between resource egalitarianism and welfare egalitarianism. I take this dichotomy from Dworkin. However, I give a somewhat different and, I believe, more natural meaning to the term "resources" than does Dworkin. Whereas Dworkin sometimes uses the term "resources" to mean material resources and sometimes uses that term to mean something else, in my discussion "resources" refers only to material resources.[ii]
Like Dworkin, I use the term "welfare" broadly. In my discussion, a welfare egalitarian is one who is concerned not with resources, but with the benefit that people derive from resources, in the broadest possible sense. Sen says that he wants to equalize not welfare, but "capabilities" to achieve "functionings";[iii] G.A. Cohen says that he wants to equalize not welfare, but "access to advantage.”[iv] I treat both Sen and Cohen as welfare egalitarians, as both are concerned with the benefits that people get from resources rather than merely with the equal distribution of resources.
As Ian Shapiro has observed, most contemporary theories of distributive justice can be described across two dimensions, according to the metric they use,[v] and the principle or function they apply to the chosen metric.[vi] For utilitarianism, the metric is welfare and the function is maximization: utilitarianism seeks to maximize welfare. Welfare egalitarianism uses the same metric as utilitarianism – welfare – but a different function: welfare egalitarianism seeks to equalize welfare. Resource egalitarianism uses the same function as welfare egalitarianism – equalization – but a different metric: resource egalitarianism seeks to equalize resources.
Resource egalitarians and welfare egalitarians often raise issues of disability in their arguments with each other. The resource egalitarian contends that welfare egalitarianism, if taken seriously, could require virtually unlimited redistribution from the nondisabled to the disabled, in order to bring the disabled as close as possible to equality of welfare with the nondisabled.[vii] The welfare egalitarian responds that a strict resource egalitarianism would allow disabled people no more resources than the nondisabled poor, even if the disabled would fare horribly without additional help.[viii]
I conclude, in Chapter 5, that welfare egalitarians and resource egalitarians are correct in the criticisms they level against each other. Welfare egalitarianism does indeed require too much redistribution to the disabled, and resource egalitarianism does indeed require too little.
I next proceed to a detailed consideration of particular egalitarian theorists. I devote more space to resource egalitarians than to welfare egalitarians, as resource egalitarians make a greater pretense of putting forth distributive principles that rely not at all on considerations of relative benefit. In Chapters 6, 7, and 8, respectively, I discuss three of the most prominent resource egalitarians: John Rawls, Ronald Dworkin, and Bruce Ackerman. I demonstrate that these theorists must contort their theories in order to provide redistribution to the disabled. They must then contort their theories once more in order to halt redistribution to the disabled. Thus, resource-egalitarian theorists oscillate between inadequate redistribution to the disabled and excessive redistribution to the disabled. Only when resource egalitarians surreptitiously incorporate an element of utilitarianism into their theories do they reach an intermediate and satisfying position.
I devote greatest attention to Dworkin's theory. Dworkin's system of hypothetical insurance is a challenge to my contention that a pure egalitarian theory cannot achieve a position intermediate between inadequate redistribution to the disabled and excessive redistribution to the disabled. I contend that Dworkin's hypothetical insurance is actually a form of utilitarianism, akin to hypothetical-choice variants of utilitarianism offered many years ago by utilitarian economists John Harsanyi and William Vickrey. Hypothetical insurance is a rough and not entirely satisfactory way of distributing resources to the people who would most benefit from them.
In Chapter 9, I turn to the contest between utilitarianism and welfare egalitarianism. I engage with a number of theorists who adhere at least partially to welfare egalitarianism, including Sen, Cohen, Norman Daniels, and Martha Nussbaum.
No theorist even pretends to be a pure welfare egalitarian; all of the welfare-egalitarian theorists acknowledge, some more explicitly than others, that one criterion in the distribution of resources to disabled people must be the extent to which the disabled would benefit from those resources. The real contest, therefore, is between utilitarianism and a hybrid theory, often called prioritarianism, that combines elements of utilitarianism and welfare egalitarianism. As considerations of relative benefit will often be determinative in prioritarianism, as they are in utilitarianism, it is difficult to pose the choice between the two theories in a manner perspicuous to moral intuition. I offer some considerations on behalf of utilitarianism and against prioritarianism, but I cannot completely rule out prioritarianism as an appealing theory; I can only conclude that a plausible version of prioritarianism must be very close to utilitarianism.
In Chapter 10, I consider the problem of aggregation. If many small benefits sum to more than a few large benefits, is it right to help the many rather than the few? I argue that utilitarianism rarely produces wrong-seeming results in cases involving aggregation; we are rarely convinced both that the many small benefits really do sum to more than the few large benefits and that it is wrong to help the many rather than the few. I also explain, in Chapter 10, why the utilitarian commitment to aggregation allows utilitarianism to be more respectful of liberty than a pure egalitarian theory can hope to be.
In Chapter 11, I discuss the distribution of life. Utilitarianism is able to advocate substantial aid to the disabled based on the assumption that disability substantially reduces welfare: in view of this substantial reduction, some measures to cure or aid the disabled hold the promise of substantially increasing welfare. However, the assumption that disability substantially reduces welfare also suggests the possibly counterintuitive conclusion that disabled lives are less worth saving, on utilitarian grounds, than are nondisabled lives. So although utilitarianism seems to give the right answers in most distributive contexts, it may apparently produce counterintuitive results in addressing the distribution of scarce life-saving medical resources.
Peter Singer and other utilitarian bioethicists have accepted the conclusion that disabled lives are in general less worth saving than nondisabled lives. Singer et al. have proposed that disabled people should receive less consideration, in the allocation of life-saving treatment, than people who are not disabled (other than in their need for such treatment).[ix] So, for example, a life-saving organ transplant should be given to an ambulatory person in preference to a paraplegic who would have the same post-transplant life expectancy, in order to maximize quality-adjusted life years.
I am troubled by the conclusion that disabled lives are less worth saving than nondisabled lives. I am not sure that utilitarianism requires us to discriminate against the disabled in the distribution of life; I offer an argument in Chapter 11 that utilitarianism does not so require. If utilitarianism does require discrimination against the disabled in the distribution of life, I am not sure that utilitarianism gives the right answer in all matters concerning the distribution of life. My advocacy of utilitarianism, then, is less confident in this area.
If the distribution of life poses problems for utilitarians, it poses even bigger problems for egalitarians. Any plausible theory in this area must take into account at least one form of relative benefit: life expectancy. In many cases, it seems right to give preference, in the distribution of life, to those who would gain the most life years. Egalitarian theories cannot do so. In addition, many versions of egalitarianism would appear to require that we discriminate in favor of disabled people in the allocation of life-saving medical treatment; to me, this policy would if anything be more counterintuitive than discriminating against the disabled.
While most of this book is an argument against egalitarianism, I should make it clear that I support the value of equality, in matters of distributive justice, in two ways. First, I believe that society should treat (at least) all its members with equal respect.[x] This does not distinguish me from other distributive theorists; as Sen has demonstrated, every contemporary theory of distributive justice can claim to be based on some notion of equal respect.[xi] Second, I am an economic egalitarian; I support measures to help the poor, both in my own country and in foreign countries where poverty causes enormous suffering. Economic egalitarianism is justified on utilitarian grounds because the poor can benefit so greatly from additional resources.
What I oppose is philosophical egalitarianism, or egalitarianism as a fundamental distributive principle– the principle that we should help those who are worse off, whether or not they can most benefit from our help. I claim that we should instead embrace the utilitarian principle of helping those who can most benefit, whether or not they are worse off.
[i]. These are rough descriptions of the utilitarian and egalitarian distributive injunctions. More detail, definition, and classification are given in Chapters 4 and 5.
[ii]. Except, of course, when I am describing Dworkin's own theory.
[iii]. Amartya Sen, Inequality Reexamined (Harvard University Press, 1992), pp. 39-56.
[iv]. G. A. Cohen, "On the Currency of Egalitarian Justice,” Ethics 99, no. 4 (1989): 906-945.
[v] Or, in the terminology of Sen and other economists, the space in which the theories operate. Sen, Inequality Reexamined, p. 2.
[vi] Ian Shapiro, Democracy’s Place (Cornell University Press, 1996), p. 112. “Principle” is Shapiro’s term, “function” is mine.
[vii]. See, for example, Ronald Dworkin, Sovereign Virtue: The Theory and Practice of Equality (Harvard University Press, 2000), pp. 79-80.
[viii]. See, for example, Sen, Inequality Reexamined, pp. 81-84.
[ix]. John McKie, Jeff Richardson, Peter Singer and Helga Kuhse, The Allocation of Health Care Resources: An Ethical Evaluation of the 'QALY' Approach (Ashgate/Dartmouth, 1998), pp. 99-116.
[x] On utilitarianism as equal respect, see Will Kymlicka, Liberalism, Community, and Culture (Oxford University Press, 1989), p. 26; R. M. Hare, "Rights, Utility, and Universalization: Reply to J.L. Mackie," in Utility and Rights, ed. R. G. Frey (University of Minnesota Press, 1984), p. 107.
I address some related issues, including the old “separateness of persons” chestnut, in Stein, “Utilitarianism and Conflation,” Polity 35, no. 4 (2003): 479-490.
[xi]. Sen, Inequality Reexamined.
The utilitarian philosopher Jeremy Bentham famously claimed that pushpin (a sort of game) was at least as valuable as poetry. The name Pushpin Pundit is ironic because, among other reasons, it has an alliterative (one might say poetic) sound.
http://www.utilitarianism.com/ (comprehensive set of links)
http://www.ucl.ac.uk/Bentham-Project/info/isus.htm (Intl Society for Utilitarian Studies)
Full-text articles and book excerpts by and about utilitarian philosophers:
http://lsolum.blogspot.com/ (Legal Theory Blog)
http://tj-forum.org/ (Transitional Justice Forum)
Mark S. Stein
pushpin –dot- pundit –at- gmail –dot- com
Please note: Sometimes I rudely fail to respond to emails.