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KMID : 1025620130160010011
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Korean Journal of Medical Ethics
2013 Volume.16 No. 1 p.11 ~ p.26
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Generational Justice in the Distribution of Health Care Resources: N. Daniels’ Prudential Life-Span Account
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Park Sang-Hyuk
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Abstract
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The problem of generational justice in modern welfare states is how to equitably distribute social burdens and benefits of the welfare system across generations in a society. Because of the aging of society, however, contributors to the welfare system got fewer whereas beneficiaries from the welfare system got more. In the 1980’s, ’liberal’ welfare institutions seemed to fail to maintain generational equity so that ’liberal’ welfare institutions, and ’liberalism’ itself were harshly criticized. Against these criticisms, Daniels proposed a liberal theory of generation justice, ’prudential life-span account’. In this paper, I try to provide its adequate understanding and defend it. To achieve my aim, I clarify its horizontal and vertical contexts and draw its theoretical and practical implications. Actually, the problem of ’generational justice’ is not one, but two problems which are ’justice between age groups’ and ’justice between birth cohorts’. Justice between age groups is typically understood as a problem of interpersonal distribution. Considering the fact that we all age, it should be understood as a problem of interpersonal distribution. So understood, the guiding principle of justice between age groups is the principle of prudence which is adequately framed. Regarding justice between birth cohorts, all birth cohorts have to solve the problem of justice between age groups and the only sustainable solution is to maintain a stable transfer system between young and old generations. To maintain this transfer system, co-existing birth cohorts should make benefit ratios approximate to equality. After clarifying ’prudential life-span account, I defend it from Mckerlie’s criticism.
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KEYWORD
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generational equity, justice between age-groups, justice between birth cohorts, prudence, rationing by age
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