title: Communities, self-causation and the natural lottery.
abstract: This paper examines the various notions of community, and of the 'natural lottery' as well as investigating the role that 'self-causation' plays in communal obligations. In examining community, two opposing views are juxtaposed: (1) the view that community consists merely of persons united by duties of refraining from harm one to another, resulting in autonomy based justice which makes freedom an absolute condition of mortality; and (2) a broader view which sees the concept of community as entailing obligations of beneficence, resulting in beneficence based justice and which, therefore, sees freedom as a value to be cautiously traded with other values. In examining the 'natural lottery' in the light of community, the various consequences of viewing the lottery in various ways and the impact that our view of community has on these consequences, is explored. A third option, the option that the 'natural lottery' as the cause of illness and health is a shaky concept, is offered. Self-causation of illness and its linkage to concepts of community and of the 'natural lottery' is then briefly examined. It is concluded that (1) community implies a social contract which, in order to be conceived in the first place, necessitates more than a minimalist ethic: to come about, a degree of beneficence inspiring trust is presupposed; (2) conceiving community narrowly is neither what we ordinarily do when we think of the term nor, for that matter, workable in our world.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: University of Illinois College of Medicine, Peoria 61656.
authors.forename: E H
authors.initials: EH
authors.lastname: Loewy
mesh_terms: D001294:Attitude to Health; D004194:Disease / Q000209:etiology*; D006801:Humans; D008019:Life Style; D011056:Political Systems; D012924:Social Conditions; D012959:Socioeconomic Factors