Tuesday, 5 May 2015
Monday, 13 April 2015
How to criticise a gender norm
This post is about how to go about criticising gender norms (in a wide sense of the term, including explicit expectations but also things like gender schemas - implicit bias and stereotype threat.) Like many other feminists, I find gender norms bothering because of the undue pressure they put on people to behave in ways that limit their social freedom and which very often result in unequal opportunities for women and for men. Overall, women are at the losing end of this inequalities; I will not rehearse here all the counts on which women are worse off than men even in liberal egalitarian democracies that are formally committed to gender justice. (They include political representation, the holding of well-paid, prestigious and interesting jobs, income gaps and various daily, micro-inequalities.) Also – and maybe unlike some feminists – I think that men, too, can be the victims of gender norms – for instance they get conscripted into armies and killed in wars more than women, and probably suffer more injustice than women at the hands of police and the criminal system – especially when gender combines with race, as in the case of black men.
So there's a clear
prima facie case against gender norms: most of us would
benefit if they were to disappear, and we'd also have a fairer world
for that. Yet it's not clear which of these norms we really want to
change. Presumably not all, or at least not all gender norms are
equally bothering and in need of urgent rethinking; also, some may be
very difficult if at all possible to change. Also, it is not clear
what we want to put instead of the existing gender norms. Take an
example: one stereotype has it that women are nurturing and men are
competitive. In combination with a competition-based economy and the
fact that we as a society don't reward care generously, this
stereotype results in women ending up with less pay and social status
and men ending up with less family time and, possibly, fewer caring
relationships overall. Now, there are many ways in which we could aim
to change this situation into one that is more gender-symmetrical: We
could try to change the gender norm of women = care and men = market
success into a norm that requires women and men to be equally
focussed on market success (and let the care be done by whoever
happens to want it, or can't avoid it). Or we could try to change it
into a norm that requires men and women to take equal responsibility
for both care and market success. Or we could try to change it into a
norm that universally values care in both personal relationships and
relationships amongst citizens, and is therefore critical of the very
ideal of market success.
Now, some of this
discussion has been taking place, but, to my mind, not enough of it.
I assume one explanation is that the (academic and popular) debate
about gender norms often gets stuck at the question of their origins,
as if their origins was overwhelmingly important. Much debate is about the
social construction of gender: Some people stress that gender norms
are not given but created by social practices and institutions.
Others – often seen as unsympathetic to feminism – argue that
they are a result of evolution. I'm increasingly of the opinion that
whether gender roles are a result of evolution (as evolutionary
psychologists often claim) or of social construction (as many others
think) has in itself little normative relevance. More important than
the origin of a gender norm are, to my mind, the following questions:
(a) Is it desirable to
get rid of a particular gender norm?
(b) Does the gender
norm in question promote a behaviour that is morally valuable,
morally neutral or morally indifferent?
(c) Is it possible to
change the norm in question, and at what (moral) cost?
Defenders of
evolutionary psychology and of the social construction model can in
principle meet on the same answer to (a). If a gender norm puts some people at arbitrary disadvantage then we have a
plausible reason for opposing it, whatever it's origin. If boys come into the world with less ability to express themselves and women with less talent for maths, then maybe we should invest more in boys' linguistic competence and girl's mathematical skills.
On (b): Some of the
gender norms that regulate women's and men's behaviour seem to be, in
themselves, morally neutral: for instance, those related to dress,
appearance or courtship codes. (This is not to say that it cannot be
harmful to aim for some ideals of feminine beauty, or that it is fair
to expect women to invest more in their appearance than men in order
to be socially acceptable.) There's no harm in just abolishing them. But other gender norms have moral
content. Women are expected to be more nurturing and caring than men.
It's very contested that women do in fact tend to respond to
individual needs and relationships better than men. But the norm
itself promotes a morally valuable behaviour, which suggests we
should universalise, rather than abolish, it.
Yet, moving on to (c),
it may be feasible to get to a less gendered
society only by universalising the norms associated with male behaviours.
Take professional success: Some people claim that, in
order to 'get ahead' as a woman you need to emulate male behaviour
(and over-do it a bit.)
And the existence of implicit bias and tendency to discount women as
knowers may mean that as a woman it is particularly important to be
self-assertive in order to be taken seriously (an interesting
discussion here.)
If so, as a parent or mentor you may have only one effective
way to undermine gender norms: to nudge your female child or
mentoree to be more self-assertive and, more generally, emphasise
that women can and should be just as self-assertive as men. This, I
assume, it a genuinely difficult moral choice.
In any case, it seems
to me that it's not worth spending so much energy on discussing the
origin of gender norms, but focus instead on whether we want
them around and what we should replace them with. I'm curious to find
out what you think.
Monday, 16 March 2015
Equal Suffering: for a just distribution of airplane flight routes
There is a
long-standing debate in Belgium over the choice
of flight routes around the national airport located northeast of the capital,
Brussels. A plan last year that reorganized departure routes, routing the
majority over densely populate areas of the capital, was met with strong protest from Brussels residents who now had
to endure noise nuisance they didn’t have under the previous routes. Noise
nuisance from airplanes is, according to recent studies, linked to an important increased risk (10-20% higher
likelihood) of stroke, coronary heart disease, cardiovascular diseases, and
death. Assuming 1) that there is an unavoidable amount of flights above
populated areas and 2) that it is impossible to fully deaden the noises thereby
engendered, what would constitute a just
distribution of flight routes? In other words, what is a just distribution of suffering and risks
caused by plane nuisance? In this post we present three possible answers
and defend one of them.
1.
Fair distribution of costs and
benefits through the market
One answer to
the question is to say that the market already fairly allocates the benefits
and burdens associated with living under established flight routes. Rents and
property prices reflect the distribution of preferences that people have when
it comes to the trade-off between noise pollution and money. This approach would
favour policies that maintain the status quo and reject introducing any changes
in flight routes given that choices were made and expectations were built
around a stability of flight routes. We see two problems with this approach.
Firstly, we do not think that the choices made by some individuals to live
under the flight routes are genuine choices that reflect their preferences. On
the one hand, information about the health costs of airplane nuisance was not
available till recently (2013). On the other hand, there is the worry that many
individuals have no option but to take up residence under flight routes thereby
sacrificing or risking their health not because of a preference for money but
because properties in those areas are the only ones they can afford. Secondly,
even if we were to be certain that choices of all individuals were genuine or
to disregard
voluntariness, a
problem remains with regards to the consequences those choices have on third
parties, in this case the children of those who opt for health risks in
exchange for cheaper rent.
2.
Minimization of total suffering
A second
answer says a just distribution is one that minimizes total suffering. The
argument that flight routes should be organized such that airplane nuisance
affects the least number of people is popular and intuitive. It favours policies that concentrate flights over the least
populated areas. This approach relies on utilitarian reasoning, and although
electorally attractive, it suffers from the classical objection to
utilitarianism: it sacrifices the welfare of part of the population for the
aggregate welfare.
One could
argue, however, that offering compensation to the victims (those who live under
the flight routes) can address this objection. By compensating the victims we
show concern for their suffering and balance out the loss in wellbeing incurred
by the noise pollution. The compensation can take the form of an offer for
relocation or monetary compensation. Yet, we think this response suffers from
the same problems as the first answer which relies on compensation through the
market. The worry is that some might opt for monetary compensation and hence
nuisance and health risks because they are economically disadvantaged and that
their choice at any rate unfairly impacts their children. We recognize that forced
relocations could be one way to counter this worry. Nevertheless, we think it
is problematic as it imposes the burdens of relocation on only part of the
population making it open once more to the initial objection of sacrificing the
welfare of some for the aggregate welfare.
3.
Equalizing suffering and risk
The answer
we favour to the question of just distribution of nuisance and health risks is
one that advocates an equal sharing of the burden because it considers it
unjust to ask some to endure suffering or risk their health for the aggregate
welfare. The policy favoured by this approach would be maximal dispersion of
flights. Of course, maximal dispersion is only a proxy for equal distribution
of burdens for there will be inevitable inequalities. Equalizing risk is
impossible; those living close to the airport will be more affected than those
living farther. Maximal dispersion can be complemented by forced relocation
(for those areas where the risk is highest) and compensation (although the same
concerns about compensation above apply)
The principle of equalizing suffering and risk might strike many as counterintuitive. Don't we by maximal dispoersion simply subject a higher number of people to nuisance and risk than would have been the case under concentration policies? We stand by this principle, however, because we think it is the only one that treats everyone as equal and expresses equal concern/respect to each. Unlike the utilitarian argument, it can be justifiable to each individual. And, we think that justifiability to all trumps efficiency considerations.
That said, we note that a utilitarian appraoch might also support a policy of dispersion if we take into consideration the following two reasons. First, the negative impact of noise pollution is non-linear (the nuisance of two planes is higher than twice the nuisance of one). This means that concentration does not necessarily minimize aggregate suffering. Second, a policy of maximal dispersion might be highly effective in making a substantial number of citizens aware of the nuisance and dangers of airplane noise which could ultimately lead to more effective lobbying to reduce air traddic and find radical alternative solutions.
The principle of equalizing suffering and risk might strike many as counterintuitive. Don't we by maximal dispoersion simply subject a higher number of people to nuisance and risk than would have been the case under concentration policies? We stand by this principle, however, because we think it is the only one that treats everyone as equal and expresses equal concern/respect to each. Unlike the utilitarian argument, it can be justifiable to each individual. And, we think that justifiability to all trumps efficiency considerations.
That said, we note that a utilitarian appraoch might also support a policy of dispersion if we take into consideration the following two reasons. First, the negative impact of noise pollution is non-linear (the nuisance of two planes is higher than twice the nuisance of one). This means that concentration does not necessarily minimize aggregate suffering. Second, a policy of maximal dispersion might be highly effective in making a substantial number of citizens aware of the nuisance and dangers of airplane noise which could ultimately lead to more effective lobbying to reduce air traddic and find radical alternative solutions.
Siba Harb and Pierre Etienne Vandamme
Monday, 9 March 2015
Sunday, 22 February 2015
Beneficial competition or attack on legitimate interests: What to make of Uber’s disruption of the taxi industry?
Imagine you are standing on the street and waiting for a taxi to take you home. While you are having second thoughts as to whether the convenience of a taxi ride is really worth the cost, a private car stops in front of you and the person at the steering wheel offers to drive you home for a price significantly below the taxi rate. Once you have convinced yourself of the driver’s competence and reliability, what could possibly speak against accepting the offer? Not much, it may seem.
Granted, the scene just described may appear too unrealistic to merit serious ethical reflection. In cities around the world, however, smartphone technology has recently led to a surge of structurally similar situations. Ride-hailing platforms that act as brokers between private drivers and potential clients have been experiencing rapid growth and offer rates that are often below those of established taxi industries. Uber, the most prominent example, has extended its operation to 54 countries and has created headlines by attracting more than $2bn of investment during the last two years. In many places, however, this expansion has been accompanied by fervent political controversy, and in a number of jurisdictions regulatory opposition has brought Uber’s operation to a halt.
Some of the criticisms voiced in opposition to Uber reflect concerns that seem relatively uncontroversial. For example, the enforcement of adequate safety standards in cars (including mandatory liability insurance for drivers) and appropriate forms of taxation appear to represent valid objectives, both from the point of view of public interest and in terms of ensuring a level playing field in Uber’s competition with traditional taxi providers. At the same time, these objectives do not necessarily conflict with Uber’s business model. Assuming that drivers are subject to the same safety and tax requirements as traditional taxi providers, Uber may still be able to offer lower fares. In the following, I would like to consider two additional concerns that are more fundamentally connected to the way Uber operates and that also seem more difficult to evaluate.
The first concern relates to the interest of drivers that rely on their job as a primary source of income. One of the prominent complaints of taxi associations has been that Uber’s competition threatens the ability of professional drivers to make a living from their occupation. While Uber argues that its drivers are able to achieve incomes far above the average income of taxi drivers, protests by Uber drivers cast doubt on the generalisability of this claim. Moreover, recent data shows that the majority of drivers do not treat Uber as their main source of income, which in turn may contribute to the preparedness of Uber drivers to work for lower rates. If it is indeed the case that Uber’s business model poses a threat to the interest of drivers in being able to make a living from their occupation (be it in the traditional taxi sector or after a switch to Uber), does this interest provide a legitimate basis for banning Uber?
On the one hand, Uber would appear to exemplify the general potential of freelance working arrangements to erode income levels. Given that earnings in the established taxi industry are already at the low end of the income spectrum, we may think that, if anything, policy should aim at improving wages in the taxi industry, e.g. through appropriate minimum wage legislation, rather than allowing income levels to be threatened by Uber’s business model which, in virtue of treating drivers as individual contractors, is not bound by wage regulations. On the other hand, the interest to make a living from taxi driving would have to be defended against the interest of those who are willing to offer their service at a lower price, if only as a partial source of income, and would be prevented from doing so through an ban of platforms such as Uber. Such a defence, it seems to me, cannot necessarily be taken for granted. A judgment on the issue would have to take into account the level of material well-being and the occupational alternatives of both groups.
Setting aside the interest of drivers, the second concern may be cast in terms of public or general interest. While taxi rates are legally regulated, ride-hailing platforms are free to set their prices according to demand and supply. Uber, for example, relies on rate increases in times of high demand in order to incentivize additional drivers to offer their services. As a result, on holidays or in situations of emergency, fares can increase up to fourfold, to levels far above standard taxi rates. Regulated taxi fares, in contrast, may be thought to serve an important public interest in the availability, in general, of rides at rates that are affordable for a relatively wide section of the population. To the extent to which the success of Uber and other ride-hailing platforms leads to an erosion of the supply of fix-rate taxis, people with urgent transportation needs may find themselves in situations without affordable options.
Is the interest in affordable rides compelling enough to justify a ban on unregulated services such as Uber in order to protect the supply of fix-rate taxis? The answer to this question does not seem obvious either. Among the countervailing interests to consider are the interests of customers who would take advantage of Uber’s service during times at which fares are below the taxi rate. Among them are equally going to be people with urgent needs, some of whom may in fact not be able to afford the regulated taxi fare. And to the extent to which the taxi fare is affordable for them, can they be expected to effectively subsidise the rides of others? One consideration that seems clearly relevant here is the existence of alternative modes of transportation that may serve to protect the interest in generally available affordable transportation. An answer thus appears even more context-dependent than in the case of the first concern. What do you think?
Monday, 9 February 2015
On taxing meat – why (not)?
A recent study indicates that reducing the consumption of meat would help considerably to slow down climate change. It may even be one of the most efficient ways to do so, since livestock emissions are making up 14.5 percent of all human causedgreenhouse gas production - which is a little more than that of all cars, trains and planes combined. In addition animal suffering and the adverse effects of excessive meat consumption on human health present two strong reasons why industrial meat production should be severely regulated. Introducing a “sin tax” on meat therefore seems to make a lot of sense from an ethical point of view and also from the perspective of (health) economics. After all, we put so-called “sin taxes” on other behaviours that we consider bad for people or the environment like smoking or fuel. If taxing meat can be supported by even more compelling reasons (after all, neither oil nor tobacco suffer in the production of the desired goods), governments seem to be obliged to engage in it. Surprisingly, however, there has been little discussion so far in politics or the media about it.
One of the main concerns seems to be that taxing meat seems to hit those the hardest that fight with bringing food on the table on a daily basis, namely people with low income. Every excise tax is discriminating towards the poor, since it raises the prices on goods without regard to income. In the case of taxing food I think that most people will react extra sensitive: eating is one of the most basic human needs while smoking or driving a car is (often) not. It seems therefore quite harsh to tax something that most people consider as basic. Especially in countries with a meat based diet (e.g. Germany or the US) people might find that one of their basic sources of nutrition is being taken away. But apart from the strong sentiments, it may be unjust to tax food in general, since poor people will be left with even fewer choices than they have now. This is a serious concern, since many poor families are already in need of food stamps or other subsidies by the government.
Still, I think that analogous arguments from the discussion of taxing fuel or smoking hold. Just as you do not have to smoke and you do not have to drive everywhere (at least if there is public transport available), you do not have to eat meat in those large amounts in which we consume it in the first world. In Western countries, where there are still plenty of choices what groceries to buy and consume, there are many alternatives to the daily dose of ham or sausage. Taxing meat also does not need to make it totally unaffordable. After all, taxes do not need to be sky-high: a moderate rise in the prices of meat may lead to the desired result that people curb their consumption and keep it on a moderate level. In addition, gains from the taxes may be used to promote the production of meat alternatives (e.g. vegetarian spread or sausages, which are still remarkably expensive in most supermarkets) and in subsidizing farmers and companies that provide good conditions for their animals. Thus, animal suffering may also be relieved, which is no small reason. As long as we are talking about a moderate increase in pricing (maybe) together with an investment in supporting meat alternatives I think that taxing meat seems just enough given the benefits.
Another argument may be raised against “sin taxes” in general. A true libertarian might object that the main purpose of taxes is to finance government not to control or even punish people who pay them. However, we may ask what it is we are paying for exactly. If all we want is some sort of Nozickean minimal state the objection is quite valid indeed. But if we also want that the state takes care of our environment and the needs of our descendants, we may also want to finance this enterprise. In the case of climate change I think that the costs and the needs of those who are and will be affected are the decisive reasons, not considerations of paternalist control. States may have to save money in order to deal with the effects of climate change in the future, e.g. with the effects of floods or blizzards. They also need the money to invest in techniques to combat climate change, e.g. alternative energies. Hence, meat taxes would serve a classic purpose.
Of course, one may wonder whether taxing meat is feasible in practice. We may think of the effects of other sin taxes, e.g. people buying cheap cigarettes duty-free or on the black market, or people driving to other countries only to buy fuel). A black market for meat or cheap imports surely does not seem to be desirable considering the pain that may be inflicted on animals. Also, what should be avoided for the same reason is the meat industry trying to counter the effects of the tax by making their production more effective and cheap. Here, only better standards and harder regulation will probably be the best route (and will naturally make meat more expensive). Hence, much more effort is involved in dealing with the problem of our considerable meat consumption than a simple sin tax. Still, I think a moderate meat tax is a good place to start.
One of the main concerns seems to be that taxing meat seems to hit those the hardest that fight with bringing food on the table on a daily basis, namely people with low income. Every excise tax is discriminating towards the poor, since it raises the prices on goods without regard to income. In the case of taxing food I think that most people will react extra sensitive: eating is one of the most basic human needs while smoking or driving a car is (often) not. It seems therefore quite harsh to tax something that most people consider as basic. Especially in countries with a meat based diet (e.g. Germany or the US) people might find that one of their basic sources of nutrition is being taken away. But apart from the strong sentiments, it may be unjust to tax food in general, since poor people will be left with even fewer choices than they have now. This is a serious concern, since many poor families are already in need of food stamps or other subsidies by the government.
Still, I think that analogous arguments from the discussion of taxing fuel or smoking hold. Just as you do not have to smoke and you do not have to drive everywhere (at least if there is public transport available), you do not have to eat meat in those large amounts in which we consume it in the first world. In Western countries, where there are still plenty of choices what groceries to buy and consume, there are many alternatives to the daily dose of ham or sausage. Taxing meat also does not need to make it totally unaffordable. After all, taxes do not need to be sky-high: a moderate rise in the prices of meat may lead to the desired result that people curb their consumption and keep it on a moderate level. In addition, gains from the taxes may be used to promote the production of meat alternatives (e.g. vegetarian spread or sausages, which are still remarkably expensive in most supermarkets) and in subsidizing farmers and companies that provide good conditions for their animals. Thus, animal suffering may also be relieved, which is no small reason. As long as we are talking about a moderate increase in pricing (maybe) together with an investment in supporting meat alternatives I think that taxing meat seems just enough given the benefits.
Another argument may be raised against “sin taxes” in general. A true libertarian might object that the main purpose of taxes is to finance government not to control or even punish people who pay them. However, we may ask what it is we are paying for exactly. If all we want is some sort of Nozickean minimal state the objection is quite valid indeed. But if we also want that the state takes care of our environment and the needs of our descendants, we may also want to finance this enterprise. In the case of climate change I think that the costs and the needs of those who are and will be affected are the decisive reasons, not considerations of paternalist control. States may have to save money in order to deal with the effects of climate change in the future, e.g. with the effects of floods or blizzards. They also need the money to invest in techniques to combat climate change, e.g. alternative energies. Hence, meat taxes would serve a classic purpose.
Of course, one may wonder whether taxing meat is feasible in practice. We may think of the effects of other sin taxes, e.g. people buying cheap cigarettes duty-free or on the black market, or people driving to other countries only to buy fuel). A black market for meat or cheap imports surely does not seem to be desirable considering the pain that may be inflicted on animals. Also, what should be avoided for the same reason is the meat industry trying to counter the effects of the tax by making their production more effective and cheap. Here, only better standards and harder regulation will probably be the best route (and will naturally make meat more expensive). Hence, much more effort is involved in dealing with the problem of our considerable meat consumption than a simple sin tax. Still, I think a moderate meat tax is a good place to start.
Monday, 26 January 2015
'Truman Care' for Dementia
On the outskirts of Amsterdam, there is a small village
called Hogewey, notable because all of its 152 residents have severe or extreme
dementia. Hogewey is a gated model village, complete with town square, post
office, theatre, hair salon, café-restaurant and supermarket – as well as
cameras monitoring residents around the clock, and well-trained staff working
incognito, holding a myriad of occupations such as post-office clerks and
supermarket cashiers. Every detail of this ‘fake reality’ has been meticulously
designed to ensure that the residents can experience life as close to ‘normal’
as possible. Critics have drawn parallels with the deception depicted in the 1998 ‘social
science fiction’ film The Truman Show;
but many Alzheimer’s experts have praised the pioneering facility for being the
first to adjust ‘our’ reality to allow those with dementia to be in a safe and comforting
environment – one built around life rather than death.
I’d
like to briefly outline two sets of reasons for thinking we should move
towards this model of care (all-day reminiscence therapy, or 'Truman
Care' if you like), and to then briefly
discuss what I assume to be the main problem facing this kind of move.
The importance
of this discussion should not be underplayed. In the UK alone, (i) there
are more than 850,000 people with dementia (due to rise to more than 1 million
by 2025); (ii) £23 billion is spent per year on caring for those with the
condition - double the sum spent on cancer and three times that on heart
disease (plus, unpaid carers save the economy £11 billion a year); and (iii) a quarter of hospital beds are occupied by those with
dementia. In David Cameron’s words, dementia is “one of the greatest
challenges of our time”.
The Hogewey model provides an innovative response to the challenge of dementia care; but is it an ethical one? Isn’t it tantamount to deceiving people with dementia about their reality; and, if so, is this permissible? One way to assess this question is by reference to the core principles of biomedical ethics: (1) beneficence and/or non-maleficence, (2) respect for persons (i.e., autonomy), and (3) justice.
The Hogewey model provides an innovative response to the challenge of dementia care; but is it an ethical one? Isn’t it tantamount to deceiving people with dementia about their reality; and, if so, is this permissible? One way to assess this question is by reference to the core principles of biomedical ethics: (1) beneficence and/or non-maleficence, (2) respect for persons (i.e., autonomy), and (3) justice.
(1) Beneficence: All-day reminiscence therapy aims to relieve the anxiety, confusion and anger
that people with dementia can feel. Although the core concern is that many
of the residents are not aware that the place in which they live is a care
home, it is clear that this is in fact the essential point of Hogewey. Reminding a
person of the ‘truth’ of their situation can be confusing and/or harmful; and
within hospital-style environments, is it not uncommon for people to try to
escape and return to their real home. Hogewey's residents require less medication because they are (a) more active and (b) engaged in community. On the latter, studies have shown that isolation reduces the
production of myelin (a fibre that maintains our nerve cells); hence, the countless
studies reinforcing how many dementia patients feel lonely or isolated,
juxtaposed with Hogewey’s considerable success, calls into question how much of dementia is a result of disease, and how much is
a result of how we treat it. So, there are good beneficence-based reasons to favour the 'Truman Care' model.
(2) Respect for persons:
Much of the debate around autonomy and dementia has concerned the issue of the authority
of advance directives. Yet there are other respect-based issues to consider. Hogewey
shows respect for persons by respecting the continuity of life as far as possible: making each resident feel at home (connection
with pre-dementia self) has an impact on current ‘experiential interests’
(well-being of the person with dementia). One way in which they
achieve this is by having 7 different “lifestyle categories”: e.g., gooise is for those from the Dutch upper
class, and has chandeliers, lace tablecloths, and carers that behave like
maids; whereas ambachtelijke, for
those who were once in trades and crafts, has plain décor and serves simpler food.
Reminiscence therapy has been shown to trigger the recollection of past events
and experiences (boosting memories by an average of 12%) and allows residents
to feel comfortable in familiar surroundings, thereby reducing confusion and anxiety.
Another way of respecting persons (both as they are and as they were) is to focus
on everything they can still do, rather than things they can’t. Residents
are encouraged
to keep up day-to-day tasks they have always done: gardening, grocery
shopping,
going to the hairdresser, popping to the café, helping to prepare meals.
This respects both residents' personhood and their individual person
more than traditional care homes; and this offers a good respect-based
reason to favour the 'Truman Care' model.
In
all likelihood, the main problem facing this innovative and humane care
option would lie with affordability. Hogewey cost £15 million to build
and is only able to house just over 150 residents. This raises issues
concerning distributive justice.
(3) Justice:
Because we live in times of scarce resources, especially medical and
long-term care resources, there are some who contend that those who can
'benefit' the least - which might be thought to refer to those with
significant disabilities and/or those whose personhood is undermined by
their disease - may end up having the lowest moral claim on these
resources. This raises a difficult issue; but it does so for
conventional dementia care as much as for the Hogewey model. And since
we currently spend such a large amount of public money on caring for
those with dementia, and since the cost per resident of this radically
different approach is not much higher than most regular care homes in
the UK, it appears that there is an all-things-considered reason to
favour moving towards 'Truman Care'.
Monday, 5 January 2015
New Year Wishes
Justice Everywhere is taking a break during the winter holiday period. We shall return on 25th January.
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