Department of Political Science

Fresh Starts for Poor Health Choices: Should We Provide Them and Who Should Pay?

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Should we grant a fresh start to those who come to regret their past lifestyle choices? A negative response to this question can be located in the luck egalitarian literature. As a responsibility-sensitive theory of justice, luck egalitarianism considers it just that people’s relative positions reflect their past choices, including those they regret. In a recent article, Vansteenkiste, Devooght and Schokkaert argue against the luck egalitarian view, maintaining instead that those who regret their past choices in health are disadvantaged in a relevant way and should receive compensation. Employing the ideal that people should be made equal as measured by equivalent resources, they purport to show the fairness of such an arrangement through a hypothetical scenario. Relaxing the implicit assumptions of this scenario brings forth several unattractive consequences of the fresh-start idea. The main problem is that in striving to ensure that people’s past choices do not affect their own opportunities, the authors must accept that these choices put heavy strains on the opportunities available to other people. Furthermore, the luck egalitarian position is more compelling than they admit.
Original languageEnglish
JournalPublic Health Ethics
Pages (from-to)55-64
Number of pages10
Publication statusPublished - 2016

    Research areas

  • lifestyle choices, lifestyle diseases, inequality in health, social inequality in health, luck egalitarianism, luck egalitarianism in health, health care, luck egalitarianism in healthcare, social determinants, equality of opportunity in health, marc fleurbaey, shlomi segall, g.a. Cohen

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