Opportunity egalitarians argue that if there is an opportunity to work, there is no reason why the employed should transfer resources to the voluntary unemployed or the ‘undeserving poor’. According to Jonathan Wolff this suspicion results in authorities or institutions collecting various data from individuals as a condition for welfare or benefit payments. The purpose of such practices is to verify the extent to which the fortune of individuals is the result of their choices and how much can be attributed to their circumstances. Wolff argues that this argument results in disrespectful and humiliating practices, ‘subjecting the poor to a level of scrutiny and control not experienced by the better off’ [13, pp. 121–122]. Wolff calls this a process of ‘shameful revelation’ in which they are treated with rudeness and humiliation [13, p. 109].
Wolff discusses scrutiny and ‘coldness’ in the context of unemployment and welfare practices, but this critique can be extended to health and social care. Access to long-term care support services, for example, is becoming more difficult as a result of financial pressures on the system, and is increasingly based on strict assessments of the needs of individuals and the possible contributions by families. Home care services are being reduced to short-term visits of fifteen minutes per visit, while families are required to prove that they are not able to provide the support for their family members at home. In the Netherlands, for example, applications for home care support are scrutinized by city councils or central agencies in order to determine whether families (particularly spouses) have the capacity to take care of their loved ones themselves and whether they are not abusing the system. Care and home help are separated, with families made more responsible for household tasks. Access to long-term care facilities in institutions like nursing homes is likewise severely restricted, as admissions are also based on a scrutiny of the potential within families to deliver care at home.
In his book, The Decent Society, Avishai Margalit makes a distinction between a just society and a decent society [14]. According to Margalit, a decent society is one in which institutions are designed to prevent the humiliation of people by other people. Humiliation is defined by Margalit as ‘any behavior or condition that constitutes a sound reason for a person to consider his or her self-respect injured’ [14, p. 9]. Institutions have an inherent tendency to humiliate people, for example, by rejection, exclusion, paternalism, and denial of rights. Margalit notes that many institutions of the welfare state force their beneficiaries to go through humiliating procedures in order to obtain their rightful provisions. In contrast, a decent society is one that cares that the institutions themselves do not operate in a humiliating way. It is a society that fights conditions that constitute a justification for its dependents to consider themselves humiliated [14].
According to Margalit a just society is not necessarily a decent society. There is no doubt that the spirit of a just society, based on Rawls’s principles of liberty and justified difference, conflicts essentially with a non-decent society [14]. But, as Margalit argues, a Rawlsian just society and distribution of primary goods can still contain humiliating institutions, particularly in terms of the procedures by which goods are distributed to needy individuals. The distribution of services may be efficient and just, but can still reflect a lack of compassion and an expression of vindictiveness.
According to Rawls, part of the primary goods is the sense of value that people have of themselves—the sense that their life plans are worthy of realization—as well as the confidence to carry out their plans. Self-respect is the most basic primary good, as without it, there is no point in doing anything whatsoever. Rawls argues that the parties in the original position would wish to avoid at almost any cost the social conditions that undermine self-respect. Rational people wanting to establish a just society will do everything to avoid creating humiliating institutions or conditions, since these would diminish the most basic primary social good. One can accept differences in the distributions of some of the primary goods, but there is no room for any inequality in the distribution of self-respect [14]. If humiliating means damaging people’s self-respect, it should be clear that a society that does not humiliate its members is a necessary condition for a just society.