If You're a Rawlsian, How Come You're So Close to Utilitarianism and Intuitionism? A Critique of Daniels's Accountability for Reasonableness.
Norman Daniels's theory of 'accountability for reasonableness' is an influential conception of fairness in healthcare resource allocation. Although it is widely thought that this theory provides a consistent extension of John Rawls's general conception of justice, this paper shows that accountability for reasonableness has important points of contact with both utilitarianism and intuitionism, the main targets of Rawls's argument. My aim is to demonstrate that its overlap with utilitarianism and intuitionism leaves accountability for reasonableness open to damaging critiques. The important role that utilitarian-like cost-effectiveness calculations are allowed to play in resource allocation processes disregards the separateness of persons and is seriously unfair towards individuals whose interests are sacrificed for the sake of groups. Furthermore, the function played by intuitions in settling frequent value conflicts opens the door for sheer custom and vested interests to steer decision-making.
Centre for Research in the Arts, Social Sciences and Humanities, and Girton College, University of Cambridge, Cambridge, UK. gb521@cam.ac.uk.
Gabriele
G
Badano
D003362:Cost-Benefit Analysis; D003657:Decision Making; D028663:Ethical Theory; D006292:Health Priorities; D006801:Humans; D040841:Resource Allocation / Q000941:ethics; D012935:Social Justice; D012941:Social Responsibility
Accountability for reasonableness; Healthcare resource allocation; John Rawls; Norman Daniels; Public justification