| Итог: | A considerable literature has emerged around the idea of using ‘personal
responsibility’ as an allocation criterion in healthcare distribution, where a person’s
being suitably responsible for their health needs may justify additional conditions
on receiving healthcare, and perhaps even limiting access entirely, sometimes
known as ‘responsibilisation’. This discussion focuses most prominently, but not
exclusively, on ‘luck egalitarianism’, the view that deviations from equality are
justified only by suitably free choices. A superficially separate issue in distributive
justice concerns the two–way relationship between health and other social goods:
deficits in health typically undermine one’s abilities to secure advantage in other
areas, which in turn often have further negative effects on health. This paper
outlines the degree to which this latter relationship between health and other social
goods exacerbates an existing problem for proponents of responsibilisation (the
‘harshness objection’) in ways that standard responses to this objection cannot
address. Placing significant conditions on healthcare access because of a person’s
prior responsibility risks trapping them in, or worsening, negative cycles where
poor health and associated lack of opportunity reinforce one another, making
further poor yet ultimately responsible choices more likely. It ends by considering
three possible solutions to this problem.
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