This text explores the place to locate the cut between those inequalities for which it is fair to hold one responsible, and those for which it is not. The argument traces a thread of intellectual history, identifying a rejection of strong property rights which we inherit from Locke, and find in contemporary defenders of entitlements such as Nozick.

"Luck egalitarianism"--the idea that justice requires correcting disadvantages resulting from brute luck--has gained ground in recent years and is now the main rival to John Rawls's theory of distributive justice. Health, Luck, and Justice is the first attempt to systematically apply luck egalitarianism to the just distribution of health and health care. Challenging Rawlsian approaches to health policy, Shlomi Segall develops an account of just health that is sensitive to considerations of luck and personal responsibility, arguing that people's health and the health care they receive are just only when society works to neutralize the effects of bad luck. Combining philosophical analysis with a discussion of real-life public health issues, Health, Luck, and Justice addresses key questions: What is owed to patients who are in some way responsible for their own medical conditions? Could inequalities in health and life expectancy be just even when they are solely determined by the "natural lottery" of genes and other such factors? And is it just to allow political borders to affect the quality of health care and the distribution of health? Is it right, on the one hand, to break up national health care systems in multicultural societies? And, on the other hand, should our obligation to curb disparities in health extend beyond the nation-state? By focusing on the ways health is affected by the moral arbitrariness of luck, Health, Luck, and Justice provides an important new perspective on the ethics of national and international health policy.

This volume presents new essays investigating a difficult theoretical and practical problem: how do we find a place for individual responsibility in a theory of distributive justice? Does what we choose affect what we deserve? Would making justice sensitive to responsibility give people what they deserve? Would it advance or hinder equality?

How should we decide which inequalities between people are justified, and which are unjustified?One answer is that such inequalities are only justified where there is a corresponding variation in responsible action or choice on the part of the persons concerned. This view, which has become known as 'luck egalitarianism', has come to occupy a central place in recent debates about distributive justice. This book is the first full length treatment of this significant development in contemporary political philosophy.Each of its three parts addresses a key question concerning the theory. Which version of luck egalitarian comes closest to realizing luck egalitarian objectives? Does luck egalitarianism succeed as a view of egalitarian justice? And is it sound as an account of distributive justice in general?The book provides a distinctive answer to each of these questions, along the way engaging with the leading theorists identified in the literature as luck egalitarians, such as Richard Arneson, G. A. Cohen, and Ronald Dworkin, as well as the most influential critics, including Elizabeth Anderson, Marc Fleurbaey, Susan Hurley, Samuel Scheffler, and Jonathan Wolff.Key Features*Presents a critical survey of already classic debates about responsibility, equality and justice*Provides a sustained engagement with luck egalitarianism's critics*Stakes a distinctive position on the key questions regarding luck egalitarianism

Key contemporary discussions of distributive justice have formulated egalitarian approaches in terms of responsibility. But this approach, Hurley contends, has ignored the way our understanding of responsibility constrains the roles it can actually play within distributive justice.

Explores the nature of the ideal of relational equality and how it relates to distributive ideals of justice.

Can the need for incentives justify inequality? Starting from this question, Frank Vandenbroucke examines a conception of justice in which both equality and responsibility are involved. In the first part of the inquiry, which explores the implementation of that conception of justice, the justification of incentives assumes that agents make personal choices based only upon their own interests. The second part of the book challenges the idea that a normative conception of distributive justice can be based on that traditional assumption, i.e. that personal choices are not the subject matter of justice. Thus, Vandenbroucke questions the Rawlsian idea that the primary subject of a theory of justice is the basic structure of society, and not the individual conduct of its citizens. For a society to be really just, the ethos of individual conduct has to serve justice. Non-mathematical readers can skip the formal model proposed in Chapter 3 and understand the rest of the book.