67
However, diseases caused by the products or actions of others (versus those
resulting from personal choices) pose issues of justice. (1) Chronic diseases and
their morbidities actually cause harm to those who suffer from them. (2) They can
also be unwelcome surprises, disrupting and arbitrarily interfering with opportunities (compared with those available to typical healthy members of the community)
over a complete lifespan (Daniels 1981; Cranor 2017a). A powerful principle of
justice—the “fair equality of opportunity principle”—identifies what is wrong with
interfering with opportunities.
A rationale for this principle is that every country (developed or less developed)
has a range of opportunities for its citizens depending upon its wealth, technological
and industrial advances, education, natural resources, and so on. It is well settled
that it is unjust to legally exclude people from opportunities in a society, e.g., by
enacting laws forbidding women, disfavored minorities or those with particular religions from pursuing life goals compatible with their talents abilities and motivations (Rawls 1999). There are more subtle barriers to opportunity and reasons of
justice support the idea that no citizen should be arbitrarily disadvantaged from
pursuing his or her opportunities consistent with that person’s talents, abilities and
motivation, even though some will be more fortunate and some less fortunate in the
distribution of life’s talents, abilities and motivations (Daniels 1981; Rawls 1999).
This recognizes the equal status and standing of each person in the community.
Educational and medical institutions have a role in both minimizing more subtle
arbitrary disadvantages that can befall citizens as well as enhancing opportunities
for those who may experience subtle barriers to opportunity. These institutions
should provide for everyone in the community, regardless of talents, abilities, and
motivations, to have a fair opportunity to develop his or her endowments to the best
of his/her ability in order to achieve life goals conferred by his or her particular
bundle of endowments.
Both institutions are strategically important for counteracting obvious and less
visible barriers that arbitrarily and subtly can reduce one’s chances of a flourishing
life within the range of a country’s opportunities.
Because some chronic diseases result from personal choices Fries and others
recommend that physicians urge their patients to make personal choices that primordially prevent risks that lead to chronic diseases, which can bring associated
morbidities that substantially interfere with their life long opportunities (Fries et al.
2011). Similarly, legal institutions can be chosen and designed to primordially
reduce risk factors that lead to chronic diseases caused by the products or actions
of others.
Thus, the fair equality of opportunity principle requires that both medical care
and legal institutions should seek to (a) prevent diseases with good choices, timely
medical treatment, and environmental health protections; (b) treat diseases that
undermine persons’ health by ensuring access to medical care, and (c) maintain the
chronically ill as close to normal functioning as their ages and conditions allow by
providing medical treatment and accommodations (Daniels 1981; Cranor 2017a).
The remainder of this discussion focuses only on (a), just legal protections from
toxic substances.
Using Science and Law to Promote Humans’ Biological Integrity
However, diseases caused by the products or actions of others (versus those
resulting from personal choices) pose issues of justice. (1) Chronic diseases and
their morbidities actually cause harm to those who suffer from them. (2) They can
also be unwelcome surprises, disrupting and arbitrarily interfering with opportunities (compared with those available to typical healthy members of the community)
over a complete lifespan (Daniels 1981; Cranor 2017a). A powerful principle of
justice—the “fair equality of opportunity principle”—identifies what is wrong with
interfering with opportunities.
A rationale for this principle is that every country (developed or less developed)
has a range of opportunities for its citizens depending upon its wealth, technological
and industrial advances, education, natural resources, and so on. It is well settled
that it is unjust to legally exclude people from opportunities in a society, e.g., by
enacting laws forbidding women, disfavored minorities or those with particular religions from pursuing life goals compatible with their talents abilities and motivations (Rawls 1999). There are more subtle barriers to opportunity and reasons of
justice support the idea that no citizen should be arbitrarily disadvantaged from
pursuing his or her opportunities consistent with that person’s talents, abilities and
motivation, even though some will be more fortunate and some less fortunate in the
distribution of life’s talents, abilities and motivations (Daniels 1981; Rawls 1999).
This recognizes the equal status and standing of each person in the community.
Educational and medical institutions have a role in both minimizing more subtle
arbitrary disadvantages that can befall citizens as well as enhancing opportunities
for those who may experience subtle barriers to opportunity. These institutions
should provide for everyone in the community, regardless of talents, abilities, and
motivations, to have a fair opportunity to develop his or her endowments to the best
of his/her ability in order to achieve life goals conferred by his or her particular
bundle of endowments.
Both institutions are strategically important for counteracting obvious and less
visible barriers that arbitrarily and subtly can reduce one’s chances of a flourishing
life within the range of a country’s opportunities.
Because some chronic diseases result from personal choices Fries and others
recommend that physicians urge their patients to make personal choices that primordially prevent risks that lead to chronic diseases, which can bring associated
morbidities that substantially interfere with their life long opportunities (Fries et al.
2011). Similarly, legal institutions can be chosen and designed to primordially
reduce risk factors that lead to chronic diseases caused by the products or actions
of others.
Thus, the fair equality of opportunity principle requires that both medical care
and legal institutions should seek to (a) prevent diseases with good choices, timely
medical treatment, and environmental health protections; (b) treat diseases that
undermine persons’ health by ensuring access to medical care, and (c) maintain the
chronically ill as close to normal functioning as their ages and conditions allow by
providing medical treatment and accommodations (Daniels 1981; Cranor 2017a).
The remainder of this discussion focuses only on (a), just legal protections from
toxic substances.
Using Science and Law to Promote Humans’ Biological Integrity