In his seminal work “A Theory of Justice,” John Rawls uses a hypothetical device known as the “original position” to frame specific interpretations of the idea that citizens are free and equal individuals and that society should be equitable. In this paper, I will describe Rawls’s defense of egalitarianism, explain the difference between “extreme” and “moderate” egalitarianism, discuss the main strengths and weaknesses of his argument, and explore how his position relates to the issue of medical ethics.

Rawls begins by making an indirect reference to the utilitarian argument, which holds that society should strive to achieve the greatest good for the greatest number of people. However, he is opposed to this traditional philosophical perspective and proposes his own theory of justice for a liberal society: justice as fairness. For Rawls, the central task of government is to preserve and promote the liberty and welfare of individuals. As such, principles of justice are need to serve as standards for the design and ongoing evaluation of social institutions and practices. Yet Rawls wonders how we could formulate these principles of justice, and in answer he devises the thought experiment of the original position. 

We are to imagine ourselves as free and equal individuals who have collectively agreed upon and committed ourselves to the principles of both political and social justice. In doing so we stand behind “the veil of ignorance.” Because rational judgment must be impartial on pain of inconsistency, each person must imagine themselves without knowledge of their personal, social, and historical circumstances. In this way, people can still cooperate with one another and adhere to standards of rational decision-making, but they are to be impartial. To deal with the uncertainty of the original position, Rawls proposes a strategy known as “maximin,” which requires us to choose from all alternatives the one whose worst outcome would be the least bad. For instance, consider slavery. Not knowing whether one would be a slave, the risk of permitting slavery is simply too great.

As such, Rawls believes that the most rational choice for individuals in the original position would be his two principles of justice. The first ensures that each person has an equal right to the most extensive total system of equal basic liberties compatible with a similar system of liberty for all. The second states that social and economic inequalities are to be arranged so that they are both (a) to the greatest benefit of the least advantaged and (b) attached to offices and positions open to all under conditions of fair equality of opportunity. 

According to Rawls, these two principles can govern the distribution of all social goods. However, because the first principle guarantees a system of equal liberty for all, it has priority. The second principle governs the distribution of social goods other than liberty. Although society can take measures to organize itself in a way that would eliminate differences in wealth, Rawls argues that individuals in the original position would not choose this form of egalitarianism. Instead, they would follow the maximin strategy. As a result, in a just society, differences in wealth and social position can be tolerated only when they benefit those who are least advantaged. In addition, there must be an equality of opportunity for access to the best social benefits. For example, admission to medical school should not be limited by irrelevant factors, such as race or gender, and those who face financial challenges in pursuing their education could claim a right to compensatory assistance. 

Rawls’s theory of egalitarianism is significantly different from some extreme versions. Namely, for Rawls, any inequality can be justified if it causes no harm, or if it is to the benefit of those worst off. By contrast, extreme versions of egalitarianism sometimes reject all forms of inequality. Some forms of socialism entail the political pursuit of a classless, moneyless society. Under these conditions, in contrast to Rawls, no inequality could be justified.

Rawls’ argument has various strengths and weaknesses. One strength is the wide-ranging relevance of the original position. This brilliant thought experiment is easy to understand and apply in a variety of contexts. On the other hand, a potential drawback of Rawls’s theory is his reliance on subjectivity. To justify the principles that will govern society, a person is invited to imagine herself behind a veil of ignorance, engaging in a rational but selfish calculus for her own benefit. Yet not all reasons are subjective. In other words, there may be reasons to choose principles that are not grounded in self-interest. It is conceivable that even from behind a veil of ignorance, people would make decisions against their own best interests. They may well prefer a society with enormous inequality, either because they believe it is more fair, or on the off-chance that they happen to be wealthy.

One way to extend Rawls’s theory of justice is to see how it could apply to a field like bioethics. Rawls endorses the legitimacy of paternalism, and although he does not attempt to justify individual cases, he does tell us that we should consider the preferences of others when we are in a situation whereby we must act on their behalf. For instance, suppose we know that a person believes in the efficacy of electroconvulsive therapy (ECT) for the treatment of severe depression. If that person should become so depressed as to be unable to reach a decision about his own treatment, then we might be justified, according to Rawls’s paternalism, in seeing that this person receives ECT. 

The scope of Rawls’s contribution to political and ethical thought is difficult to overstate. The original position with its veil of ignorance is one of the most ingenious thought experiments ever devised, and it would certainly be worth considering at the crossroads of a difficult decision.