Affordability and Non-Perfectionism in Moral Action

Rumbold, Benedict; Charlton, Victoria; Rid, Annette; Mitchell, Polly; Wilson, James; Littlejohns, Peter; Max, Catherine; Weale, Albert

Abstract

One rationale policy-makers sometimes give for declining to fund a service or intervention is on the grounds that it would be ‘unaffordable’, which is to say, that the total cost of providing the service or intervention for all eligible recipients would exceed the budget limit. But does the mere fact that a service or intervention is unaffordable present a reason not to fund it? Thus far, the philosophical literature has remained largely silent on this issue. However, in this article, we consider this kind of thinking in depth. Albeit with certain important caveats, we argue that the use of affordability criteria in matters of public financing commits what Parfit might have called a ‘mistake in moral mathematics’. First, it fails to abide by what we term a principle of ‘non-perfectionism’ in moral action: the mere fact that it is practically impossible for you to do all the good that you have reason to do does not present a reason not to do whatever good you can do. And second, when used as a means of arbitrating between which services to fund, affordability criteria can lead to a kind of ‘numerical discrimination’. Various attendant issues around fairness and lotteries are also discussed.

Citation

Rumbold, B., Charlton, V., Rid, A., Mitchell, P., Wilson, J., Littlejohns, P., …Weale, A. (2019). Affordability and Non-Perfectionism in Moral Action. Ethical Theory and Moral Practice, 22(4), 973–991. https://doi.org/10.1007/s10677-019-10028-4

• Journal Article Type: Article
• Acceptance Date: Aug 23, 2019
• Online Publication Date: Sep 14, 2019
• Publication Date: Sep 14, 2019
• Deposit Date: Sep 3, 2019
• Publicly Available Date: Sep 15, 2020
• Journal: Ethical Theory and Moral Practice
• Print ISSN: 1386-2820
• Electronic ISSN: 1572-8447
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• Volume: 22
• Issue: 4
• Pages: 973–991
• DOI: https://doi.org/10.1007/s10677-019-10028-4
• Keywords: Affordability, Total cost, Non-perfectionism, Numerical discrimination, Fairness, Lotteries, Broome
• Public URL: https://nottingham-repository.worktribe.com/output/2553217
• Publisher URL: https://link.springer.com/article/10.1007%2Fs10677-019-10028-4
• Additional Information: Accepted: 23 August 2019; First Online: 14 September 2019; : ; : Annette Rid’s work was supported in part by the Clinical Center Department of Bioethics, which is in the Intramural Program of the National Institutes of Health. The views expressed here are those of the author and do not necessarily reflect the policies of the National Institutes of Health or the U.S. Department of Health and Human Services. Peter Littlejohns’s work was supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) South London at King’s College Hospital National Health Service Foundation Trust. The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health and Social Care.