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Mark S. Stein, Distributive Justice and Disability: Utilitarianism against Egalitarianism.

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Mark S. Stein, Distributive Justice and Disability: Utilitarianism against Egalitarianism (New Haven: Yale University Press, 2006), x + 304 pp.

1. Mark Stein believes that the best way of teasing out differences between utilitarian and egalitarian theories of distributive justice is to explore how these theories deal with disability. And in this superb, clearly written and entertaining book, Stein makes the case that, pitted head-to-head, utilitarianism is the clear winner. Egalitarian theories that seek to equalize resources, Stein argues, are unable to provide the extra medical resources that people with disabilities require, while egalitarian theories that equalize welfare make the opposite mistake and massively redistribute resources to a few especially disadvantaged individuals with disabilities, at the cost of resources for everyone else:

Resource egalitarianism would distribute too little to disabled people who could benefit greatly from additional resources; welfare egalitarianism would distribute too much to disabled people who could benefit hardly at all from additional resources. (2)

By contrast to resource and welfare egalitarianism, utilitarianism offers a "golden mean" that redistributes in a truly fair and sensible manner to persons with disabilities. It can do so because utilitarianism is the only distributive theory that always, and only, relies on the "greater benefit criterion," namely, that resources should be distributed to those who would most benefit from them in terms of increased welfare. Sensitivity to relative benefit is the key.

Using hypothetical cases to test our intuitions--a methodology I find apt and totally persuasive--Stein dispatches generic versions of resource and welfare egalitarianism before turning to the specific and nuanced accounts of John Rawls, Ronald Dworkin, and Bruce Ackerman (representing resource egalitarians), and then to those theorists who, whether they are prepared to admit this or not, merge welfare egalitarianism and utilitarianism--such as Amartya Sen, G.A. Cohen, Norman Daniels and Martha Nussbaum--before ending up with the so-called "prioritarians" (Derek Parfit and Richard Arneson), who, Stein argues, have more or less ceded the day to utilitarianism.

For such a compact and elegant book, Stein's coverage of the immense literature on distributive justice is astonishing. Besides demolishing the dominant accounts, he manages to find time to respond to standard, and on their face highly damaging, objections to utilitarianism as a form of distributive justice, including puzzles associated with aggregation (is relieving 1000 people of trivial aches and pains better than saving the life of one person, even if the overall welfare gain is the same?), and, most troubling of all, the fact that some utilitarians--notoriously Peter Singer--have argued that, as disabled lives are not as valuable (in welfare) as nondisabled lives, life-saving resources may well be wasted on them. Admirably, Stein...

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