Rational Arguments for Universal Basic Income Peer Reviewed Journals
J Med Ideals. 2021 Jan : medethics-2020-106477.
Examining the ethical underpinnings of universal bones income as a public health policy: prophylaxis, social engineering and 'good' lives
Matthew Thomas Johnson
Politics, Philosophy and Religion, Lancaster University, Kinesthesia of Arts and Social Sciences, Lancaster, United kingdom
Elliott Aidan Johnson
Politics, Philosophy and Religion, Lancaster Academy, Faculty of Arts and Social Sciences, Lancaster, UK
Received 2020 May 21; Revised 2020 Dec 7; Accepted 2020 December 19.
Abstruse
At a time of COVID-19 pandemic, universal basic income (UBI) has been presented equally a potential public wellness 'upstream intervention'. Enquiry indicates a possible bear upon on health by reducing poverty, fostering health-promoting behaviour and ameliorating biopsychosocial pathways to wellness. This novel instance for UBI as a public health measure is starting to receive attention from a range of political positions and organisations. Nevertheless, discussion of the ethical underpinnings of UBI as a public wellness policy is sparse. This is depriving policymakers of articulate perspectives about the reasons for, restrictions to and potential for the policy's design and implementation. In this commodity, we annotation prospective pathways to impact on health in order to appraise fit with Rawlsian, capabilities and perfectionist approaches to public health policy. We suggest that Raz' pluralist perfectionist approach may fit most comfortably with the prospective pathways to impact, which has implications for allocation of resources.
Keywords: ideals, health promotion, political philosophy, public wellness ideals
COVID-19 has brought the United kingdom of great britain and northern ireland's health policy to the forefront of public consciousness. Although recent conservative governments have sought to pursue a 'prevention calendar'1 in order to shift public understanding of the National Health Service as consisting solely of a 'National Hospital Service',2 the land'due south response to the pandemic has seemed reactive and ad hoc. Given that no vaccine is available at the time of writing and that treatment is, at this stage, experimental, there is skillful reason to consider alternative means of promoting health. In that context, Laura Webber and colleagues3 accept called for a 'health in all policies' approach grounded in 'upstream interventions' that address the social determinants of wellness, such as inequality, rather than the behavioural consequences farther 'downstream', such as nutrition.4 The importance of such interventions has become apparent during the pandemic, which has disproportionately afflicted those in lower socioeconomic groups and been exacerbated globally by inequality.
Universal basic income (UBI) has been presented as ane such intervention,5 6 with enquiry indicating a possible impact on health by reducing poverty, fostering health-promoting behaviour and ameliorating biopsychosocial pathways to wellness.7 UBI ensures a minimum income, but, dissimilar the UK'south Universal Credit,viii it is not allocated on the ground of demand or means. This is considering, every bit the contempo Earth Depository financial institution Report suggests,9 UBI is defined by its being 'paid to all, unconditionally and in cash', although with numerous caveats with regards to 'amount and frequency, and whether children or noncitizens would benefit' (p57). This account, to which we subscribe, excludes minimum income guarantee schemes that remain conditional on income level. The novel wellness case for UBI as a public health measure has a complicated relationship to other justifications grounded in promoting citizens' rights10 increasing efficiency in welfare systems11 and promoting growth.12 With the Spanish Authorities announcing that it will introduce UBI every bit a straight response to the social and economic insecurity acquired by COVID-xix,13 information technology is essential that the upstanding underpinnings of a health focus are examined, since the philosophical justification for the policy has articulate implications for design and implementation. This is true irrespective of the health system of a detail country, since the mechanism of bear upon is via social determinants of wellness.
In this article, we outline our theoretical pathways to health impact in order to examine three possible political philosophical approaches to advancing the policy. Bidadanure's review of political philosophical positions on UBI indicates a spread of approaches ranging from clear Rawlsian deontic positions on ane side and perfectionist, consequentialist positions at the other.14 At that place are ways in which the health case for UBI maps onto and accentuates this schema. We accept identified 3 allegorical positions that fit onto a deontological and perfectionist spectrum to demonstrate the different implications that upstanding underpinnings nowadays to a novel health case for UBI. Nosotros suggest that the commitment of Rawlsian deontic accounts to neutrality may lead them to reject UBI as a public health measure on account of its potential to transform conceptions of the good. Nosotros so advise that this may be less problematic for the capabilities arroyo, but that UBI may be rejected in favour of targeted interventions. Finally, nosotros propose that Raz' pluralist perfectionist approach may fit most comfortably with the prospective pathways to affect, which has implications for allocation of resources. We set aside questions regarding UBI'south impact on other aspects of people'due south interests but acknowledge that a transformative intervention such equally this may have myriad incidental or indirect consequences. We begin by outlining the pathways to health.
Pathways to health
The Blackness Report15 and Whitehall II Report of Ceremonious Servants16 have served to institute the understanding of key social determinants of health, asserting that poverty and inequality strongly influence wellness outcomes. Johnson et al17 utilize existing knowledge of social determinants to UBI to present a theoretical model that includes 3 prospective interacting pathways to health bear on via transformation of socioeconomic circumstances (effigy 1). Outset, UBI may reduce poverty, which increases the ability of individuals to satisfy their basic needs.18 Second, UBI may provide social security to mitigate 'wellness inequalities and the structural weather condition that put people 'at risk of risks'', such as 'discrimination, poverty, residential segregation, inadequate schools, unemployment' (pS47).19 This reduces exposure to long-term social sources of stress, such as workplace and domestic bullying and corruption,7 20 which foster a wide range of stress-related conditions, as indicated by Whitehall II.sixteen Third, by reducing unpredictability, UBI can reduce health-diminishing behaviour seen in those unable to perceive longevity.21 Where UBI fosters predictability, it can promote longer term thinking that contributes to health and well-existence, which may explain improved health among recipients of Tribal Cash Transfers.22
UBI model of wellness affect from Johnson et al.17 UBI, universal basic income.
Johnson et alv take argued, though, both that no schemes meet the World Bank's definition of UBI, insofar equally they are neither universal nor unconditional, and no trials have been designed or evaluated comprehensively for wellness bear upon. However, in their scoping study on evaluating the instance for UBI, Gibson, Hearty and Craig accept produced a systematic review of cash transfer schemes that include collation of evidence on health touch on. They nowadays a series of tables of existing bear witness that outlines fundamental features of the transfers, such as grouping targeted and conditionality and comprehensive detail on methods of evaluation.23 24 These programmes include minimum income guarantees, such equally those in Gary, Indiana, USA, Manitoba (MINCOME) and Finland (which replaced conditional welfare payments with unconditional payments to existing recipients simply rejected universality); periodic dispersions of public appurtenances, such equally the Alaska Permanent Dividend Fund (APDF) and the Tribal Casino Greenbacks Transfer and small-scale-scale experiments involving small cash transfers, such as the Madhya Pradesh Unconditional Cash Transfer Pilot (MPUCT). It is important to note that, where a normative justification is provided, it seldom refers to health and is more oft grounded in poverty reduction without upstanding analysis of the reasons for poverty being bad for health or unemployment reduction with an assumption that employment is a good.
The programmes in Gary, Indiana, USA (randomised controlled trial (RCT)) and the APDF (quasi experiment (QE), difference in deviation (DiD)) have shown evidence of a positive impact on birth weight.25 26 The MPUCT pilot (cluster RCT) was associated with a 46% reduction in illness and injury not requiring inpatient hospital treatment,27 the Finnish trial (RCT) with reduced stress,xx MINCOME (RCT) with improved adult mental health28 and Tribal payments (QE; DiD, triple difference, controlled before and later on) with reduced rates of psychiatric and substance abuse disorders among children.22 The ethical bases for these studies are almost impossible to decide, since the policymakers behind the policy rarely provide comprehensive justifications other than to suggest that the policy is intended to achieve isolated ends: poverty reduction (eg, Gary, Indiana); distribution of common wealth (APDF) or labour marketplace participation comeback (eg, Finland).
These data signal impact on wellness just do not establish the possible breadth and strength of effect of a UBI that meets the Globe Bank'south definition. Our model provides scope for evaluating designs of UBI co-ordinate to prospective wellness impact. It suggests that schemes that are unconditional, universal and sufficient to satisfy basic needs promote outcomes unattainable in conditional schemes by virtue of improved satisfaction of fabric needs, behavioural modify and stress reduction.7 This provides prima facie example to ensure that individuals attain the Minimum Income Standard (MIS),29 which, in the Britain, was £313.68 in 2019 for a single person with no children (cyberspace of straight taxes, such every bit income revenue enhancement and national insurance, but gross of council tax).29 This is an extremely costly commitment, equating to £854.7bn per year for a full MIS level payment to all citizens. Whether that is deemed permissible as a means of promoting wellness and, if information technology is, what proportion of an MIS is derived from UBI is determined, ultimately, by the ethical underpinnings of those designing the policy.
Ethical muddles
The notion that public policy should advance population wellness is a core working assumption for a number of central organisations to have assessed UBI, including Compass—a non-party political system focused on social reform30—what works Scotland23 and, understandably, the WHO.31 At that place is a working instrumentalist assumption that policies that promote health are good and, where UBI promotes health, it is adept. In this regards, health is treated both as an unalloyed proficient and as a facilitative adept for whatever other ends individuals may wish to pursue. Nevertheless, there is seldom business organisation for the possibility that such goods tin can exist realised through very different and much more clearly coercive means. At that place is not necessarily awareness that the line of reasoning may be shared with puritans within the Temperance Movement (and the Taliban) who sought to promote health via prohibition of intoxicating substances and criminalisation of those engaged in 'individual' vices.32 The enormous expansion of the prison population and the side effects of prohibition on users' health speak to the difficulty of promoting health coercively.33 Such issues as well speak to the means in which conceptualisation of health may be discipline to culturally contingent conception,34 even if wellness in terms of homeostasis may not.35 (It is for these reasons that liberals, such as Hayek,36 take viewed country planning as the first stage on a slippery slope towards tyranny. At that place is not, yet, adequate consideration of that possibility in this instance.
This lack of business organization for ethics is merely exaggerated by proponents of UBI associating its prospective health impact with the 'good life'.37 This, conspicuously, has perfectionist, Aristotelian connotations in its association of health with human potential and its use of UBI as a means to that end. That UBI's wellness proponents do non necessarily interrogate the normative ethics of their broader positions on promoting health may seem anodyne. However, understanding precisely their intention is fundamentally important to understanding what place instruments of wellness promotion play within broader, and oft competing, public policy agendas. Improving understanding is one key footstep to developing more effective justifications for, and means of addressing opposition to, the policy.
Wellness equally facilitative
Whether social democratic left38 39 or libertarian right (eg, Friedman and Friedman'south negative income tax),40 the majority of UBI'due south proponents take presented UBI deontologically as a means of upholding justice.14 As Kantian approaches, they follow Rawls'41 formulation of the right being prior to the adept, viewing policy every bit a means of upholding respect for persons by acknowledging the nobility of homo reason. In terms of Berlin's42 categorisation of liberty, such proponents of UBI uphold negative liberty, beingness concerned with preserving a private sphere in which individuals are gratis from interference. In this regard, UBI resembles a Rawlsian social primary good43—one of several edifice blocks that secures freedom for individuals. Indeed, Rawls44 follows Friedman, Hayek and others in upholding a minimum income guarantee. This business relationship of UBI is concerned with the opportunity aspect of liberty.45 Providing security from the coercion of others grants individuals opportunity to pursue their ain conceptions of the good, whatever they may be. It enables the country to remain neutral with regards to detail conceptions of the good.46 Whether individuals achieve their conceptions of the good or non is only relevant in instances of individuals being prevented through coercion by others. Business organisation is for ways, not ends.47
Maybe the clearest indication of where UBI might sit every bit an instrument is provided by work by and on Rawls. Rawls views health as a natural master good that is a prerequisite of the pursuit of conceptions of the skillful,48 49 which is subjected to arbitrary distribution and not directly under the command of the basic construction of lodge.43 Although mention of means of promoting health are sparse, Rawls does note that inoculation against illness may exist benign to communities in sum44 and that there is scope for government to promote public health, which may have distributive effects.44 However, he also suggests that questions of healthcare relate only to special cases beyond the normal range of the citizen body44 and that the primary good of income and wealth provides means of securing adequate treatment. Green48 suggested that wellness'southward importance means that it ought to be introduced alongside the basic principles of justice, with citizens entitled to equal admission to care irrespective of income. In contrast to this invasive revision of Rawls' principles of justice, Daniels (p.165)50 regards healthcare institutions as a fundamental means of providing 'for fair equality of opportunity'. Daniels is clear that socioeconomic inequality fosters inequality in health and that without health, in that location cannot be equality of opportunity.51 52 As such, he favours a range of interventions to accost socioeconomic inequality, including investment in childhood development, nutrition programmes and transformation of work to improve worker autonomy and skills development too as to reduce stress.53 This is attuned to the underpinning concerns in the prospective pathways to wellness outlined above. Rawls revised may provide support for a bones UBI. Later on all, UBI is 'bones' because it is grounded in concern for people's 'basic' needs, on which the attainment of health rests.54
This account is compatible with Mia Birdsong's37 invocation of the 'good life':
Coin (or the absenteeism of it) tin can limit what yous remember is possible for your life, how you're able to spend time with your loved ones, where you're able to go, how you experience about yourself, and who you can be. Coin, practically and psychologically, impacts how much agency we accept. Nosotros all want 'the adept life' however we ascertain that, and these conversations made me think about what we believe about who deserves it (and who doesn't).
In Rawlsian terms, as an 'upstream intervention', UBI may serve as a basic public good on which all 'reasonable' comprehensive doctrines can concord, even if individuals themselves elect to pursue ways of life that are fundamentally detrimental to their wellness. In this regard, UBI may resemble what Rawls envisaged in terms of inoculation every bit a social good. Prioritising the right over the good means that there tin can exist no guarantee that individuals accomplish the ends that they themselves regard as valuable, let alone a value that others may regard as valuable, such as health among the organisations noted above. Fifty-fifty if individuals invoke a 'skillful life', the state is not then obliged.
However, as Moskop (p.335)55 argues, the provision of support via UBI is uneven and may found a 'bottomless pit able to consume all available resources and more'. Providing equal opportunity via health may reduce opportunities for the pursuit of other ends. Individuals may regard wellness every bit a subjective good56 that ought not to be the footing for redistribution. Moreover, if UBI has a causal bear on on health or promotes a particular conception of wellness, there may be grounds for because the possibility that it is coercive and partial. The behaviour change theoretical pathway to health may signal just that. This coercion is both distinct from, and attendant to, any compulsion involved in procuring taxation to fund the plan. For that reason and others, Rawls may provide justification for a basic UBI well beneath the MIS, such as that proposed by Reed and Lansley30 to complement forms of income from the other opportunities facilitated by master appurtenances.
Rawlsian accounts view conceptions of the practiced as relatively fully formed and unmoving. Yet, in that location is evidence to suggest that economic condition can influence personality type57 58 and that economic interventions, such as UBI, can touch on personality traits59 60 too every bit behaviour.61 People'south personality traits being altered by an intervention challenges the supposition that conceptions of the skilful are fixed. The proffer that economic instruments can be used equally a means of promoting means of life undermines the neutrality of the state. While both inoculations and UBI may take a prophylactic event, the latter may also have an effect on people's very being in general and their conceptions of the skillful, in particular. Although not physically invasive, it may more than closely resemble circumcision or other identity constitutive interventions that are justified on the grounds of public health.35 Whatever justification for such transformative impact on the grounds of people's personalities being forged pathologically by harmful socioeconomic circumstances slides very speedily away from respect for people'due south empirical selves, to concern for the 'true' or 'rational' selves associated with positive accounts of freedom.42
In this context, Hayek's36 business organization that a state's bureaucratic partiality leads to a general diminution in liberty may seem hysterical given that the end pursued is health. However, given that funding such an intervention necessarily requires an increase in taxation and given that the likes of Hayek's36 view taxation as beingness fundamentally coercive, there are reasons for such thinkers either to minimise or pass up.10 In this regard, the likes of Daniels may need to reconsider the extent to which investments in creating opportunity end up shaping citizens' thinking. This may be ane philosophical reason for the UK Conservative Government's opposition to UBI.
Health every bit capabilities
If Rawlsian approaches may find fault with UBI on the footing of health'south relationship to conceptions of the expert, there are some paradigms, such as Nussbaum's62 capabilities approach, that speak forcefully of health as a primal facet of human flourishing.63 In this regard, it is not simply that health is the ground for opportunity, just that its absence precludes the realisation of human potential.64 A life without health is non a fully human existence. Despite this Aristotelian heritage, Nussbaum upholds the priority of the right over the good64 and the opportunity aspect of liberty. She holds both that practical reason, as the cardinal distinguishing human adequacy, can only exist realised in the absence of interference64 65 and that human dignity can but exist upheld through respect for personhood.63 Notwithstanding, she is less likely to exist constrained by business organisation for social technology than Rawls. This is because she invokes adaptive preference to explain people's preferences for conceptions of the skillful that undermine their broader interests. She cites the case of women in patriarchal societies who support Female Genital Mutilation (FGM) past mode of illustration.62 As such, although she shares Rawlsian commitment to the priority of the right over the expert, she believes that injustice has the chapters to shape people's perspectives, including with regards to health. If achieving justice removes adaptive preferences, so exist information technology.
Put merely, Nussbaum is articulate that it is rational to realise health,63 that policy ought to promote the resources that individuals require in order to realise health and that the quantity and type of resource required necessarily differ from the person to person due to the uniqueness and separateness of persons.66 The specificity of needs is peculiarly important insofar as information technology indicates that justice depends on differential handling of citizens. Disabled people necessarily require boosted goods in order to alive skilful lives.66–68 Concern for the detail needs of individuals is one of the central reasons that Nussbaum rejects every bit inadequate the primary goods arroyo of Rawls.68 This calls into question the value of 'upstream' interventions grounded in equal provision of appurtenances. As such, Nussbaum is more probable than Rawlsians to view UBI only as part of a more comprehensive set of interventions to support realisation of wellness. Indeed, there are proficient reasons to suggest that whatever support for UBI from the capabilities approach would pb to a depression-level cash transfer. Nussbaum is not necessarily attuned to concern for the effect of material inequality on people'due south health69 that lies at the centre of the inequality and behavioural pathways to sick-health. Rather, she is sufficientarian, arguing that 'Having decent, aplenty housing may be enough: information technology is not clear that human being nobility requires that everyone accept exactly the same type of housing. To agree that conventionalities might exist to fetishize possessions too much' (p.41).65 Having enough may be comparatively little and there may be reason to suggest that the capabilities arroyo may be much more conspicuously wedded to targeted wellness interventions in keeping with other need-based and means-based systems.
Although capabilities is a universalist arroyo with business concern for human need that asserts the objective importance of health, it sits uneasily with deployment of UBI equally an upstream wellness intervention. This may be one reason for centrist politicians informed past capabilities70 to reject the policy. How, though, might UBI sit with perfectionist approaches?
Health every bit perfection
Although the majority of UBI's proponents are deontic, there are some perfectionist accounts that might more naturally be attuned to promotion of health. Maskivker,71 for example, argues that liberty from paid employment is central to pursuit of a particular platonic of a 'practiced life'. Similarly, in Skidelski and Skidelski's72 How much is enough?, the authors examine the possibility that a fetishisation of wealth has deprived individuals of the capacity to realise eudaimonic ends. This is implied by Srnicek and Williams (p.121),73 who draw on Marx'due south alienation thesis to claim that UBI would enable workers to 'deadening downwards and reflect, safely protected from the abiding pressures of neoliberalism'. In referencing the 'expert life', Psychologists for Social Alter (p3)74 have stated that
UBI is probable to lead to a general increase in social trust and a lessening of the shame, humiliation and devaluation that comes with relying on means-tested welfare benefits or beingness occupied in unpaid caring.
The sense hither is that individuals cannot live good lives burdened past those negative emotions. The notion of health'due south being integral to a good life is credible in Psychologists for Social Change's (p2)74 claim that in that location is 'potential for UBI to increase all five psychological indicators of a good for you society: bureau, security, connection, meaning and trust'. These are goods that proponents regard every bit objectively valuable independently of individuals' conceptions of the expert. Informed by such a perspective, the state could legitimately seek to impose that formulation via UBI.
In contrast to Nussbaum, because perfectionist approaches are concerned with practise, rather than opportunity,45 at that place is good reason to be concerned with health as operation, not just as capability. Unconstrained by deontic concern for neutrality, the likes of Joseph Raz assume no 'principled limits to the pursuit of moral goals on the part of the state' but do believe that there are 'limits to the ways that can legitimately be adopted in promoting the well-beingness of people and in the pursuit of moral ethics' (p420).75 These limits mean that perfectionist policies must 'be confined to the cosmos of the conditions of autonomy' (p422).75 Like Nussbaum, Raz upholds an account of human well-being grounded in capacity for tillage of reason, but, unlike Nussbaum, he believes both that people's ability to attain well-beingness depends on the state'due south ability 'to create morally valuable opportunities, and to eliminate repugnant ones' (p417).75 This does not mean coercive imposition, however, since that deprives individuals of the capacity for autonomy. Rather, Raz believes in a duty of the land to 'assistance in creating the inner capacities required for the acquit of an autonomous life', including 'health' (p407).75 This perfectionism is consistent with paternalist business organization 'for laws improving safety controls and quality controls of manufactured appurtenances, and employ similar reasoning to demand strict qualifications as a condition for advertizement one's services in medicine, police, or the other professions' (p422).75
In this context, UBI may serve effectively as a paternalist measure to promote health via the pathways to health noted above. Indeed, it may office more effectively than direct health promotion via targeted measures. This is not only considering it affects all citizens, rather than just target cohorts, merely also considering targeting may actually serve to entrench health inequalities by imposing extrinsic mortality cues that compound impulsive, health-diminishing behaviour.21 This is apparent in smoking cessation campaigns that actually increase perceived mortality and foreshorten people'southward interests.76 It may also remove disincentives to health imposed by needs-based welfare systems.18 77 Simply transforming people'due south perceptions of their lives has the capacity to transform their conceptions of the good, opening upwards longer term thinking and planning as a ways of achieving greater health. As such, there are good perfectionist reasons to support UBI as a non-coercive instrument precisely because of the pathways to health impact noted higher up. In this regard, although Hayek36 and others are right to land partiality has the potential to make unequal the state'due south treatment of conceptions of the skilful, the deployment of UBI as an upstream, institutionally constrained public health measure may non propel guild headlong downward the glace slope to puritanical imposition.
Still, the objection raised by Moskop regarding the cost of investment remains salient here. If there are many different skilful lives and different elements to those adept lives, what toll tin can be allocated to promotion of one specific element? If in that location are finite resources, how best can perfectionists make use of resources to promote the good? While utilize of resource is a full general effect to be addressed past any approach to policymaking, the business concern is particularly pressing for perfectionists by virtue of their demand to understand the effect of instruments on very specific ends. If the model of impact (effigy 1) is correct, perfectionists have prima facie reason to support those schemes that meet the MIS in total.
Conclusion: the applied importance of agreement ethics
Much of the word above may seem anodyne and, for organisations like Compass, the categorisation of their ethical commitments may seem solely of academic importance. Indeed, nosotros agree that people's perception of the policy is influenced more conspicuously by testify of impact5 and past the salience of that impact to their circumstances.78 Moreover, upstanding concerns may seem moot. Given that UBI is intended to exist 'basic' rather than comprehensive, information technology is unclear that it tin can promote any one particular 'good' life. The fact that it may be the basis for 'good' lives to be pursued means that, prima facie, it fits more closely with an opportunity concept, than an exercise concept. However, when examined in terms of our pathways to bear upon, it may more comfortably be pursued as an arm of perfectionist policy. Exploring the ethical foundations to people'southward invocation of UBI as a public wellness measure out is a precondition of understanding the limits and limitations of the policy every bit a whole and to ascertain whether wellness is a key or incidental element of the approach. Information technology is also an essential means of considering the relative importance of UBI to health in relation to other goods, values, interests and concerns, which nosotros map in table 1 below. Getting to grips with people's ethical underpinnings enables cess of other problems, such every bit the dissimilar circumstances, if whatsoever, under which the payment can be removed, such as an private's existence imprisoned39 or declining to fulfil civic duties.79 It enables consideration of the size, budget and regularity of payment, maintaining other welfare payments likewise equally not-monetary ways of satisfying need, as in the case of disabled people.lxxx 81 It enables consideration of possible negative health impacts associated with lump-sum payments that might support other important social activity.82
Table 1
Summary of ethical approaches and positions on UBI for health impact
| Rawlsian | Capabilities | Perfectionism | |
| Ethics | Deontic | Deontic | Consequentialism |
| Value of health | Instrumental | Instrumental/intrinsic | Intrinsic |
| Human relationship of health to liberty | Opportunity | Opportunity/capability | Part |
| Prospective position on UBI for health impact | Basic | Rejected | Comprehensive |
Without clear ethical underpinnings, this could be a botched and unhelpful public health intervention. Raising the level of awareness among organisations and policymakers not only makes the policy more than coherent only also gives a much clearer sense of purpose to public wellness measures in the context of a deeply controversial and expensive intervention.83 Given the pressure placed past the COVID-xix pandemic on health systems—however they are configured—public budgets and people's well-being, it is vital that these problems be examined in greater depth through collaboration between political philosophers, wellness researchers and policymakers. Given that the well-established evidence on social determinants and the emerging evidence on the impact of greenbacks transfers on health supports our theoretical model of affect, the case for using such work to design rigorous trials for health promotion and to evaluate these robustly is compelling.
Footnotes
Contributors: MTJ drafted the content. EAJ provided comments and revisions and referenced the article.
Funding: Enquiry was conducted equally office of the authors' employment at Lancaster University.
Competing interests: None declared.
Patient consent for publication: Non required.
Provenance and peer review: Non commissioned; externally peer reviewed.
Data availability argument: There are no data in this work.
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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7817385/
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