Contractarianism Flashcards
Ovfview of contractarianism
Persons are primarily self interested
Rational assessment of best strategy for maximising self interest impels individuals to act morally
MORAL NORMS ARE DETERMINED BY MAXIMISATION OF JOINT INTEREST E.G. SOCIETY
And to consent to government authority
What is a contract - HOBBES 1588-1679
People should submit to government
Government watches over the people
System of government is just a dictatorship
The people cannot back out of contract
What is a contract - LOCKE 1632-1704
Social contract theory
Locked conception of the social contract differed from everlasting fundamental ways, retaining only the central notion that persons in a state of nature would willingly come together to form a state
Locke believed that individuals Ina. State of nature would be bound morally, by the law of nature, not to harm each other in their lives or possessions, but without government to defend them against those seeking to injure or enslave them, people would have no security in their rights and would live in fear. Locke argued that individuals would agree to form a state that would provide a ‘neutral judge’, acting to protect the lives, liberty and property of those within it.
Locke argued that a governments legitimacy comes from the citizens cdelegation to the government of their right of self defence (of self preservation), along with element soother rights as necessary to achieve e goal of security (e.g. Property will be liable to taxation). The government this acts as an impartial, objective agent of that self defence rather than each man acting as his own judge, jury and execute right - the condition in the state of nature.
What is a contract - ROUSSEAU
“Man is born free, and everywhere he is in chain”
Addresses the fundamental problems, how can we be free and live together? How can we live together without succumbing to the force and coercion of others?
We can do so by submitting our individual wills to the collective/general will, created through the agreement in issue with other free and equal persons
What is a contract - RAWLS 1921-2002
Liberty - every person to have an equal right to the most extensive total system of equal liberties compatible with a similar system of liberty for all
Fair opportunity - social goods open to all dear conditions of fair equality of opportunity, and if inequalities were to everyone’s benefit then they are justified
Difference - social and economic goods are to be arranged so that they are both to the greatest benefit of the least advantaged
Veatch’s theory (1981)
TRIPLE CONTRACT THEORY
social contract - basic contract for social interaction
Health professionals and society contract
Physicians and patients contract
VEATCH’S MODELS OF HCP
Engineering - HCP is a technical expert. Present the facts to the patient. Then the patient makes a decision.
Contractual - obligations and benefits for both parties. Contract can be broken if required. Both parties have control and individuality.
Collegiate - patient and healthcare professional are pursuing a common goal which is patient wellness.
What are the implications of social contract and healthcare?
Universal access
Robust minimum basic care
Financial equitable burdens
Allocation of resources must respect equal value and dignity of individuals
Democratic control of the system of healthcare
Mutuality and solidarity for all
What are counter arguments for contractarianism?
Nozick - compulsory redistributive taxation is forced labour
Englehardt - this compounded by tax spend on immoral acts e.g. Abortion
Epstein - private charity can cover the spend anyway
Personal responsibility for health - not societies role to care
The will of the people
Democratic influence Exclusion and prioritisation of certain treatments People are idiots Obtuse decisions Legal rights to change
Other issues with contractarianism
Cost and utility "Fair innings" - shouldn't treat the old Anti-ageism Needs vs wants Societies different values Private contracting in the NHS Contracting in education Care turning into a business
Critics - feminists say that men benefit but women are denigrated, often take career role and are under-recognised and undervalued
