Lydia Tsiakiri

When smokers are denied access to publicly funded fertility treatments, does this constitute discrimination? When obese patients are requested to lose weight before they are considered eligible for elective surgery, are they justified in claiming that they are subject to discrimination? The public and scholarly discussion of discrimination typically centres on immutable features, i.e., features that people cannot or should not be asked to change. Yet what happens when differential treatment targets features for which people are, or are perceived to be, responsible? Motivated by such questions, this dissertation examines what role personal responsibility should play and how it is perceived regarding assessments of (wrongful) discrimination. In this pursuit, it focuses on two fronts: the potentially discriminatory character of responsibility-sensitive healthcare resource allocation and the responsibility-sensitivity of lay perceptions of wrongful discrimination. First, by introducing a novel line of deontological arguments, it defends responsibility-sensitive healthcare resource allocation against concerns for disrespectful discrimination. Second, by examining how concrete variants of responsibility-sensitive healthcare policies fare against definitions of direct and harmful discrimination, it argues that when realized with moderate measures, responsibility-sensitive allocation can also escape concerns about harmful discrimination. Finally, by drawing on a cross-country survey vignette experiment, it shows that perceived wrongful discrimination is responsibility-sensitive, i.e., when someone is (perceived as) responsible for a feature, differential treatment on that basis is viewed as much more justified than when the feature is immutable. However, rather than a firm conclusion, this dissertation lays the foundation for further research to develop the insights advanced here.

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