A summary of Chapter 7: Justice.
Contains definitions as written in the book, often explicated/or debated in the summary or annotations.
(There also is a summary containing this chapter + chapters 1/4/5/6)
The Principles of Biomedical Ethics (8th edition)
annotations are not derived from the book
Chapter 7: Justice
Justice: fair, equitable and appropriate treatment in light of what is due or owed to affected
individuals and groups.
Distributive justice: fair, equitable and appropriate distribution of benefits and burdens determined
by norms that structure the terms of social cooperation – what can one do for the other in order to
gain justice (e.g. humans as research subject)
Principles of Justice:
The formal principle of justice (of formal equality)
‘equals must be treated equal, and unequals must be treated unequally’ – Aristotle
It does not specify when people should be treated equal, nor does it specify who/when
people are (un)equal. – What constitutes an equal and which differences are relevant in
comparing individuals/groups?
How do we determine the classes and who belongs to them? Material principles of justice
- The class decides on who are equals and who are not, thus decides whether you’re entitled
to ‘something’
Material Principles of Justice and Morally Relevant Properties of Persons
- ‘material principles identify the substantive properties for distribution’ – which properties
are (morally) relevant in order for a person to qualify for particular distributions. – Which
factors are supposedly relevant to decide on (un)equals and thus are of an influence on
particular distributions?
o Is something a relevant property? On which basis? In which ways? And with which
exceptions?
- Policies on distributive justice always derive from the rejection or acceptance of some set of
material principles (over another) and some procedures that specify/refine/balance them. –
which principles is valid and in which context, difficult (people value different things).
Material Principles in Theories of Justice
‘No obvious barrier prevents acceptance of more than one of these principles as valid – perhaps all
six – in a pluralistic theory of justice.’
- The principles are considered competitive, in order to combine them you have to identify
them as prima facie obligations. The weight of each obligation can’t be assessed
independently of particular goods/domains in which they are applicable. Thus you have to
combine them into a pluralistic theory of justice.
- Traditional theories of justice
- Theories closely connected to the value of health: inspired by Rawls, not fundamentally
Rawlsian – can be described as egalitarian. Also influenced by Aristotle’s moral theory – his
views about the roll and importance of states of human flourishing.
Utilitarian Theories – ‘to each person according to rules and actions that maximize social utility.’
, ‘justice as the name for the paramount and most stringent forms of obligation fixed by the principle
of utility’
It’s about achieving the maximum social utility, in order to serve the social utility we have
obligations. Justice here are the most important and strict obligations (because they serve the social
utility, thus obtaining them means acting the right way).
Following the obligations – utilitarian obligations of justice – individual rights are established. These
individual correlative rights should be enforced by law.
Human rights/principles of obligation are solely based on utility maximixation.
- The balance of social utility (wat does(n’t) lead to social utility) can easily change, therefore
the rights and obligations can as well. – The balance of social utility could change at any time,
and then the rights would also change.
Libertarian theories – ‘to each person a maximum of liberty and property resulting from the exercise
of liberty rights and participation in fair free-market exchanges’
‘justice as the unfettered operation of fair procedures and transactions under conditions of law and
order – in the operation of just procedures’
Libertarian theories ‘state the general duties that all members of society owe to one another… duties
to respect liberty and enforce individual liberty rights by coercive power when necessary.’ – Everyone
has their liberty and prosperity rights, the government is solely just when it protects these rights (of
their civilians). – a system of distribution thus is not just, unless everyone freely agrees on the
distribution.
Nozick’s principles of justice: justice in acquisition/transfer/rectification. ‘no pattern of just
distribution exists independent of free-market procedures of acquiring property, legitimately
transferring that property, and providing rectification for those whose property was illegitimately
taken or who otherwise were illegitimately obstructed in the free market’
Utilitarian vs. Libertarian – focuses on outcomes vs procedures (poor/wealthy as indicators for just in
utilitarian, but in libertarian not there we just focus on whether everyone had the same liberty rights.
Communitarian theories – ‘to each person according to principles of fair distribution derived from
conceptions of the good developed in moral communities’
‘communitarians see principles of justice as pluralistic, deriving from as many different conceptions
of the good as there are diverse moral communities.’
Communitarian theories focus on the relationship between individuals and society, how does society
shape individuals? – Individuals take part in a community, therefore they take form within that
community and their norms/standards.
- In these theories therefore, the community and its beliefs are more important than the
individual rights (because the individual is part of the community). – ‘the respect for and high
value placed on moral and political commitments found in communities and their traditions
and practices.’
The community and the common good are central, therefore public policy is focused on a shared
idea of what is good over the individual rights.
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