Question

Explain in detail how contractarianism may lead to different results from both utilitarianism and egalitarianism in deciding the distribution of medical resourses.

Answer 1

Contractarians hold that distributions of social goods are fair when impartial people agree on the procedures used for distribution. The best-known defender of this position is John Rawls, who in A Theory of Justice (1971) and Political Liberalism (1993) contends that people form stable and just societies by building a consensus that merits endorsement by rational and informed people of goodwill.

Contractarianism has certain difficulties. Some regard it as a method for arriving at ethical principles, not as an alternative to views such as utilitarianism, egalitarianism, and libertarianism (Veatch). Accordingly, those who think it generates a unique theory need to clarify how it has a distinct content. In addition, it is hard to specify what is meant by "people's normal opportunity ranges" or to decide how to apply fair equality of opportunity. This position seems to suggest (arguably similar to egalitarianism) the unsatisfactory consequence that people should fund treatments, however exotic and costly, that offer a chance for the most disadvantaged to improve their normal opportunity range irrespective of the needs of the many; gifted children could be denied opportunities to excel so that others could enhance their normal opportunity range or be brought to the level of well-being and opportunities of average children. Another problem is that contractarianism presupposes, like utilitarianism, that there is a fair and objective system for ranking medical and social needs and deciding who benefits most from services (Brock). It is unclear whether such a comprehensive and objective ranking is possible. Such "objective" choices about appropriate or useful programs might be mixed with social and personal biases. These problems, however, do not undermine the contractarians' commitment to the justice of equal opportunity for children, including the fairness of providing basic health and social care for children.