A hybrid event for Uehiro Oxford Institute Members and Associates (booking not required).
Abstract
The idea of individual responsibility playing a part in healthcare allocation is controversial, and subject to a long list of objections (Sharkey and Gillam 2010). This talk focuses on one objection in particular: holding patients responsible for their health-affecting behaviours is unacceptably moralising. Call this The Moralisation Objection (MO).
The standard version of MO rests on an error about responsibility. MO presumes that to hold someone responsible is necessarily to regard them as blameworthy – examples of such reasoning can be found in several recent publications arguing against the relevance of responsibility in healthcare (Hurst 2024; Kennett 2024; Nath 2024; Shaw 2024). But this is not the conception of responsibility that is typically at play in arguments in favour of responsibility-sensitive health allocation. Rather, what is typically appealed to is a conception of what I call 'distributive responsibility'.
Distributive responsibility is familiar from political philosophy but neglected in medical ethics. It is a form of responsibility: it links one’s obligations to bear costs, and rights to enjoy benefits, to one’s intentional actions under certain circumstances. However, it is non-moral. Indeed, more broadly, it has no necessary relation to any ideas of praise or blame, including non-moral ones: one’s distributive responsibility is not essentially affected by the prudential or epistemic quality of one’s choices any more than by their moral quality. An example of this might be my decision to gamble, with my own money, in a casino. To say that it is I—and not you, say—who should shoulder the costs of losing a bet does not imply that I do something morally or prudentially blameworthy when I gamble. Thus, I suggest that an important strand of applied ethics has neglected a central insight from political philosophy, at significant cost to the coherence of the debate about responsibility-sensitive allocation.
Venue
Uehiro Oxford Institute, Suite 1 Seminar Area, Littlegate House, 16-17 St Ebbe’s Street, Oxford OX1 1PT (buzzer 1)
Zoom
Please attend in-person if you can. If you need to join online, the Zoom link is available from the Institute's Internal Google Calendar, or on request from axelle.duquesnoy@uehiro.ox.ac.uk
