Is our account of just health, with its emphasis on equitably distributing the risks through preventive health measures, incompatible with individual liberties? In Just Health Care I addressed this question by examining what rationale might justify stringent occupational safety and health standards and still respect individual liberty to consent to risk. In this chapter, I consider a more recent challenge to such stringent regulation that derives from the disability rights movement. Since people with disabilities have historically been denied the opportunity to work by employers who invoke stereotyped claims about risks, they have insisted on their individual right to consent to workplace risks as a way of avoiding such undue paternalism. Recent legislation and some case law support this approach. This new challenge to stringent health protection thus appeals not only to individual liberties but also to a potential conflict with the same notion of opportunity that grounded the need for such health protection. Can just health address this challenge? I argue that it can. In addition, the ability of our integrated theory to address issues of moral disagreement about priority setting allows us to respond to moral disagreements about what we owe people with special sensitivities to risk.

To protect opportunity, we saw in Chapter 5, justice requires preventive health measures that go beyond individual interventions such as medical screening and vaccination to include broader safety and health regulation outside the health sector itself.