Material scarcity and scalar justice

A Correction to this article is available

This article has been updated


We defend a scalar theory of the relationship between material scarcity and justice. As scarcity increases beyond a specified threshold, we argue that deontological egalitarian constraints should be gradually relaxed and consequentialist considerations should increasingly determine distributions. We construct this theory by taking a bottom-up approach that is guided by principles of medical triage. Armed with this theory, we consider the range of conditions under which justice (of any form) applies. We argue that there are compelling reasons for thinking that justice applies under a far broader range of conditions than is standardly supposed, including those that could sensibly be labelled as conditions of extreme rather than moderate scarcity.

This is a preview of subscription content, log in to check access.

Change history

  • 19 November 2020

    In the original version of the article, the Acknowledgements section was not included.


  1. 1.

    To clarify, throughout this paper we use this concept of dependence in a logical sense: a condition that is necessary for concepts of justice to be meaningfully applicable. This use can be distinguished from other senses of dependence. For instance, ontological dependence: a condition that is necessary for institutions or practices of justice to develop and survive. (Following Hubin 1979, pp. 8–12.).

  2. 2.

    Rawls (1999, p. 110). For helpful recent discussion of the circumstances of justice, see Hope (2010); Tebble (2016); Vanderschraff (2006).

  3. 3.

    “Relaxed” refers to a range of theoretical options. For instance, as we show in Sects. 3 and 4, we may relax egalitarian principles by: reducing the range of goods to which they apply; restricting their application to a particular phase or phases in a distributive scheme; or by qualifying or limiting their application when doing so is necessary to achieve or avoid particular outcomes. “Suspending” refers to temporary but complete restrictions on the application of egalitarian principles.

  4. 4.

    The fact that consequentialism attempts to reduce the seemingly complex phenomenon of morality to a single, parsimonious principle that applies under all conditions is standardly viewed as one of its theoretical appeals. (See Kagan 1998, pp. 17–22.).

  5. 5.

    Following Richard Arneson (2013).

  6. 6.

    This insight is best articulated by Sen (1987).

  7. 7.

    Estlund (2016a, p. 23).

  8. 8.

    To clarify, we regard prioritarianism as a type of aggregated consequentialism, as it gives additional weight to the well-being of individuals that are worst off. (See Parfit 1991).

  9. 9.

    This deontological characterization is necessary for making the contrast between egalitarian constraints and the best aggregated consequences determinate. After all, as Amartya Sen (1992, p. ix) argues, even purely consequentialist theories like act utilitarianism are egalitarian insofar as they give each unit of pleasure equal weight.

  10. 10.

    See Caren (1981); Rawls (1999).

  11. 11.

    This is something that Rawls (2001a, p. 256) recognizes in passing.

  12. 12.

    See Hume (1738, bk. III, pt. II, sec. ii; 1751, sec. III, pt. I). Hume’s view has influenced a number of philosophers, including Hart (1961, pp. 189–195); Barry (1989); Rawls (1999, pp. 109–112).

  13. 13.

    See Hume (1751, sec. III, pt. I).

  14. 14.

    Ibid. See also Hume (1738, bk. III, pt. 2).

  15. 15.

    For further discussion, see Panichas (1983).

  16. 16.

    This reference to a “possible distribution” is a slight refinement of Hume’s actual position. As Robert Goodin notes, Hume refers to the holding of actual individuals rather than to possible distributions. This, however, is problematic: “Suppose, for example, that five percent of the population were in a situation of superabundance and the other ninety-five percent were starving [i.e., in a situation of super-scarcity]. That would mean that no one among them, taken individually would be in a condition of ‘moderate scarcity.’ But it would be absurd to say that in such circumstances the ‘circumstances of justice’ do not obtain” (Goodin 2001, p. 203). However, explicating super-scarcity in terms of a possible distribution rather than in terms of individual’s holdings rules out this absurd result. For it shows that super-scarcity obtains if and only if there is no possible distribution of goods that satisfies most people’s basic needs, regardless of people’s actual holdings.

  17. 17.

    We set aside the difficult interpretive issue of how Hume’s distinction between “strict” and “non-strict” considerations of justice relate to his parallel distinction between “artificial” and “natural” virtues; suffice it to say that, in Hume’s writings, the concept of a non-strict consideration of justice does not seem equivalent to the concept of a natural virtue. For a helpful overview of the debate over natural and artificial virtues in Hume, see O’Day (1994).

  18. 18.

    Rawls (1999, p. 109).

  19. 19.

    Ibid., p. 54.

  20. 20.

    Korsgaard (1996, p. 147). (For Rawls’s most complete formulation of the special conception of justice in the form of lexically ordered principles, see Rawls 1999, p. 266.).

  21. 21.

    See Rawls (1999, pp. 55, 152). (Here we follow the interpretation of Simmons (2010, pp. 13–14).

  22. 22.

    The etymology of the term “triage” is derived from the French word “trier”, originally used with respect to the sorting of agricultural products. The term is now standardly used in a medical context (Iserson and Moskop 2007). Medical triage “requires three elements: at least a modest scarcity of resources, a formal assessment of medical need, and implementation of an algorithm that delineates treatment priority” (Shafran et al. 2014, p. 1650).

  23. 23.

    Our approach is compatible with a reflective equilibrium methodology, in which one strives to refine one’s considered intuitions about concrete cases and abstract philosophical principles until they are in harmony. For further discussion, see Scanlon (2003, pp. 139–167).

  24. 24.

    For a helpful overview of different triage systems for distributing organs, and how some actual systems have evolved in the U.S., see Caplan and Coelho (1999, part IV). See also Mulgan (2014, lecture 14) and Arvan (2014a, b) for recent attempts to theorize what justice demands in conditions of extreme scarcity. In contrast to our “bottom-up” approach, Mulgan and Arvan employ a “top-down” methodology, based on a modified version of Rawls’s contractualist framework. Moreover, Mulgan’s and Arvan’s approaches, unlike the one we are defending here, do not aspire to uncover a general account of the relationship between material scarcity and justice.

  25. 25.

    We define an “essential need” as something that is necessary for a reasonable person to live at a moderate level of well-being. A “moderate level of well-being” is an unavoidably vague threshold. At one extreme, it clearly rules out purely cosmetic procedures, such as facelifts. At the other extreme, it clearly includes heart-transplant surgeries without which certain people would die. People disagree about how certain medical procedures and treatments such as IVF, Viagra, and even kidney transplants should be categorized. Given our present purposes, however, it suffices to assume that certain solid organ transplants, necessary for survival, qualify as essential. If, for example, kidney transplants do not fit into this category, it does not affect our central argument.

  26. 26.

    We use “most urgent” here to refer to cases that are in some way temporally exigent. This includes many life-threatening conditions, as well as cases of severe pain or injury.

  27. 27.

    Following Rhodes et al. (1992, p. 327).

  28. 28.

    Vlastos (1984, pp. 41–76, 49).

  29. 29.

    The same idea seems to hold with respect to other social goods, like education. If we assume that all children have a right to a public education, it will not be inegalitarian to spend more, say, transporting some to school than others, simply because they live farther away. Likewise, some students will have special learning needs that can only be met through additional per capita expenditures. In these cases, the right to education does not vary, only the resources needed to effectively ensure it under particular circumstances.

  30. 30.

    Institute of Medicine of the National Academies (2012).

  31. 31.

    Shafran, Kodish, and Tzakis (2014, p. 1651).

  32. 32.

    Rhodes (2007, p. 257). This is based on a 2003 figure. See United Network for Organ Sharing (UNOS) (2003).

  33. 33.

    Rhodes (2007, p. 329).

  34. 34.

    Unless, of course, their condition significantly deteriorates, in which case they will be reclassified as members of the group in relatively urgent need and treated accordingly.

  35. 35.

    In the actual world, different solid organs are distributed using slightly different principles. This is because the different organ subcommittees of the United Network of Organ Sharing formulated their respective allocation policies independently of one another. For example, even after the 2014 policy revisions, kidney allocation places great weight on how long patients have been on the waiting list (Ohler 2017, pp. 51–58). In contrast, lung allocations give greater weight to a calculation of pre- and post-transplant survival (Shafran, Kodish, and Tzakis, p. 1652).

  36. 36.

    See, e.g., Shafran, Kodish, and Tzakis (2014, p. 1650).

  37. 37.

    This hybrid principle can be situated in a broad research program in bioethics, which argues that the distribution of scarce medical resources should take place according to a combination of egalitarian and consequentialist principles. See, for instance, Becker (1979), Rhodes (2007), Tabery (forthcoming). We add the obvious caveat that this is just one philosophical theory of how principles of medical triage should operate in such material conditions. Nicholas Rescher, for instance, argues that such principles should also take into account considerations of desert such as past societal contribution. See Rescher (1969).

  38. 38.

    See Rhodes (2007, p. 329).

  39. 39.

    Alternatively, principle C could be more egalitarian, say, by affording the least likely to survive some chance of receiving an organ, though less chance overall than patients who are more likely to survive. Cf. Arvan (2014a, b), Mulgan (2014, pp. 173–184). We thank an anonymous reviewer for suggesting this possibility.

  40. 40.

    For this account of what justifies moral principles, see Scanlon (1998, pp. 5, 191–206).

  41. 41.

    See, e.g., Mulgan (2014), Arvan (2014a).

  42. 42.

    See Anderson (1999). Cf. Anderson (2010).

  43. 43.

    Rawls (2001c, p. 89), Simmons (2010). Cf. Adams (2020).

  44. 44.

    To clarify, we do not mean to imply that the only consideration that is relevant to a transitional nonideal theory is the consequentialist consideration of what will be effective in moving society towards the ideal of perfect justice. Rawls (2001c, p.89) is careful to note that such a transitional path must also be “morally permissible.” We simply emphasize that such consequentialist considerations take on greater weight in the context of a transitional nonideal theory.

  45. 45.

    Simmons (2010, p. 14). (Quoting Rawls 1999, p. 152.).

  46. 46.

    This leaves open the possibility that other considerations of justice (e.g., retributive justice) could apply in such conditions. It is even compatible with David Estlund’s thesis that certain considerations of justice would apply in conditions in which people are morally flawless. See Estlund (2016b).

  47. 47.

    If the reader thinks that distributives shares could also apply to human bodies (at least in sufficiently dire circumstances), then this example can be modified by also including the stipulation that the people in the boat are allergic to each other’s flesh and urine.

  48. 48.

    See Goodin (2001, p. 201, fn. 2).

  49. 49.

    See, for instance, Rawls (2001b, pp. 190–224).

  50. 50.

    Barry (1978).

  51. 51.

    Hope (2010, p. 130); emphasis in the original.

  52. 52.

    G. A. Cohen presents a similar argument in Cohen (2008, pp. 252–253). For additional discussion see Estlund (2014, p. 117).

  53. 53.

    Within the Kantian tradition there are some fragmented remarks about distributive norms that apply in conditions of extreme scarcity. Such remarks, however, primarily emphasize that such norms fall outside the scope of the demands of justice and, consequently, fail to illuminate the content of such norms. For example, in The Metaphysics of Morals Kant himself considers the old chestnut of whether someone can shove another person off a plank in order to save their own life after a shipwreck. Kant suggests that while a norm bears on who gets the plank, it falls outside the scope of what he terms “claims of civil right,” which impose demands of justice on people that should be enforced by a penal code (Kant 1791, Mds 6:234–235). For further discussion, see Finkelstein (2001). Still, even if this is correct and such norms are norms of “gustice” rather than “justice,” we have supplied a richer normative account of how the content of such norms depends on material scarcity.

  54. 54.

    This is implicit in Hume’s account. For instance, he writes: “Water and air, though the most necessary of all objects, are not challenged as the property of individuals; nor can any man commit injustice by the most lavish use and enjoyment of these blessings” (Hume 1751, sec. III, pt. I).

  55. 55.

    Rawls (1999, p. 110).


  1. Adams, M. (2020). The value of ideal theory. In J. Mandle & S. Roberts-Cady (Eds.), John Rawls: Debating the major questions. Oxford: Oxford University Press.

    Google Scholar 

  2. Anderson, E. (1999). What is the point of equality? Ethics, 109, 287–337.

    Google Scholar 

  3. Anderson, E. (2010). The fundamental disagreement between luck egalitarians and relational egalitarians. Canadian Journal of Philosophy, 36, 1–23.

    Google Scholar 

  4. Arneson, R. (2003). Egalitarianism. In N. Edward Zalta, (Ed.) The stanford encyclopedia of philosophy (Summer 2013 Edition).

  5. Arvan, M. (2014a). First steps toward a nonideal theory of justice. Ethics and Global Politics, 7(3), 95–117.

    Google Scholar 

  6. Arvan, M. (2014b). Justice as fairness in a broken world. Philosophy and Public Issues - Filosofia E Questioni Pubbliche, 4(2), 95–126.

    Google Scholar 

  7. Barry, B. (1978). Circumstances of justice and future generations. In R. I. Sikora & B. Barry (Eds.), Obligations to future generations (pp. 204–248). Philadelphia: Temple University Press.

    Google Scholar 

  8. Barry, B. (1989). Theories of justice. Berkeley: University of California Press.

    Google Scholar 

  9. Becker, E. L. (1979). Finite resources and medical triage. The American Journal of Medicine, 66, 549–550.

    Google Scholar 

  10. Caplan, A. L., & Coelho, D. H. (1999). The ethics of organ transplants. USA: Prometheus Books.

    Google Scholar 

  11. Caren, J. H. (1981). Equality, moral incentives, and the market: An essay in utopian politico-economic theory. Chicago: University of Chicago.

    Google Scholar 

  12. Cohen, G. A. (2008). Rescuing justice and equality (pp. 252–253). Cambridge, Mass.: Harvard University Press.

    Google Scholar 

  13. Estlund, D. (2014). Utopophobia. Philosophy & Public Affairs, 42, 113–134.

    Google Scholar 

  14. Estlund, D. (2016a). Just and juster. In D. Sobel, P. Vallentyne, & S. Wall (Eds.), Oxford studies in political philosophy (pp. 9–32). Oxford: Oxford University Press.

    Google Scholar 

  15. Estlund, D. (2016b). What is circumstantial about justice? Social Philosophy and Policy, 33, 292–311.

    Google Scholar 

  16. Finkelstein, C. O. (2001). Two men and a plank. Legal Theory, 7, 279–306.

    Google Scholar 

  17. Goodin, R. (2001). Managing scarcity: Towards a more political theory of justice. Philosophical Issues, 11, 202–228.

    Google Scholar 

  18. Hart, H. L. A. (1961). The concept of law (pp. 189–195). Oxford: The Clarendon Press.

    Google Scholar 

  19. Hope, S. (2010). The circumstances of justice. Hume Studies, 36, 125–148.

    Google Scholar 

  20. Hubin, D. C. (1979). The scope of justice. Philosophy & Public Affairs, 0, 3–24.

    Google Scholar 

  21. Hume, D. (1738). A treatise of human nature. Oxford: Clarendon Press.

    Google Scholar 

  22. Hume, D. (1751). An enquiry concerning the principles of morals. In J. B. Schneewind (Ed.). Indianapolis: Hackett Publishing Company.

  23. Institute of Medicine of the National Academies. (2012). Report Brief: Crisis Standards of Care—A Systems Framework for Catastrophic Disaster Response. Released online.

  24. Iserson, K. V., & Moskop, J. C. (2007). Triage in medicine, part I: Concept, history, and types. Annals of Emergency Medicine, 49, 275–281.

    Google Scholar 

  25. Kagan, S. (1998). Normative ethics. Boulder: Westfield.

    Google Scholar 

  26. Kant, I. (1791). The metaphysics of morals. New York: Macmillan.

    Google Scholar 

  27. Korsgaard, C. M. (1996). Creating the Kingdom of ends. Cambridge: Cambridge University Press.

    Google Scholar 

  28. Mulgan, T. (2014). Ethics for a broken world: Imagining philosophy after catastrophe. Routledge.

  29. O’Day, K. (1994). Hume’s distinction between the natural and artifical virtues. Hume Studies, 20, 121–142.

    Google Scholar 

  30. Ohler, L. (2017). Criteria for kidney allocation in the United States. In G. Orland, G. Remuzzi, & F. David Williams (Eds.), Kidney transplantation, bioengineering and regeneration. USA: Academic Press.

    Google Scholar 

  31. Panichas, G. E. (1983). Hume’s theory of property. Archives for Philosophy of Law and Social Philosophy, 69, 391–405.

    Google Scholar 

  32. Parfit, D. (1991). Equality or priority? (pp. 1–42). The Lindley Lecture, University of Kansas. (Reprinted from The Ideal of Equality, pp. 81–125, by M. Clayton and A. Williams, Eds., 2000, London: Macmillan and St Martin’s Press).

  33. Rawls, J. (1999). A theory of justice: Revised Edition. Cambridge Mass.: Belknap Press.

    Google Scholar 

  34. Rawls, J. (2001a). A kantian conception of equality. In S. Freeman (Ed.), John Rawls: Collected papers (pp. 254–266). Cambridge Mass.: Harvard University Press.

    Google Scholar 

  35. Rawls, J. (2001b). Justice as reciprocity. In S. Freeman (Ed.), John Rawls: Collected papers. Cambridge Mass.: Harvard University Press.

    Google Scholar 

  36. Rawls, J. (2001c). The law of peoples. Cambridge Mass.: Harvard University Press.

    Google Scholar 

  37. Rescher, N. (1969). The allocation of exotic medical lifesaving therapy. Ethics, 79, 173–186.

    Google Scholar 

  38. Rhodes, R. (2007). Justice in the distribution of transplant organs. In D. N. Weisstub & G. D. Pintos (Eds.), Autonomy and human rights in healthcare (pp. 257–269). USA: Springer.

    Google Scholar 

  39. Rhodes, R., Miller, C., & Myron, S. (1992). Transplant recipient selection: Peacetime vs. wartime triage. Cambridge Quarterly of Healthcare Ethics, 1(4), 327–331.

    Google Scholar 

  40. Scanlon, T. M. (1998). What we owe to each other (pp. 191–206). Cambridge Mass.: Belknap Press.

    Google Scholar 

  41. Scanlon, T. M. (2003). Rawls on justification. In S. Freeman (Ed.), The cambridge companion to rawls. Cambridge: Cambridge University Press.

    Google Scholar 

  42. Sen, A. (1987). Equality of what? In J. Rawls & S. M. McMurrin (Eds.), Liberty, equality, and the law: Selected tanner lectures on moral philosophy. Salt Lake City: University of Utah Press.

    Google Scholar 

  43. Sen, A. (1992). Inequality reexamined. Oxford: Oxford University Press.

    Google Scholar 

  44. Shafran, D., Kodish, E., & Tzakis, A. (2014). Organ shortage: The greatest challenge facing transplant medicine. World Journal of Surgery, 38, 1650–1657.

    Google Scholar 

  45. Simmons, A. J. (2010). Ideal and nonideal theory. Philosophy & Public Affairs, 38, 5–36.

    Google Scholar 

  46. Tabery, J., et al. The ethics of triage in the event of an influenza pandemic. Disaster Medicine and Public Health Preparedness (Forthcoming)

  47. Tebble, A. J. (2016). On the circumstances of justice. European Journal of Political Theory, 19(1), 1–23.

    Google Scholar 

  48. United Network for Organ Sharing. (UNOS) (2003) Annual report to the U.S. scientific registry of transplant recipients and the organ procurement and transplantation network.

  49. Vanderschraff, P. (2006). The circumstances of justice. Politics, Philosophy & Economics, 5, 321–351.

    Google Scholar 

  50. Vlastos, G. (1984). Justice and equality. In J. Waldron (Ed.), Theories of rights. Oxford: Oxford University Press.

    Google Scholar 

Download references

Author information



Corresponding author

Correspondence to Ross Mittiga.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Adams, M., Mittiga, R. Material scarcity and scalar justice. Philos Stud (2020).

Download citation


  • Circumstances of justice
  • Material resources
  • Triage
  • Scarcity
  • Consequentialism
  • Egalitarianism