Research project The Moral Demands of Equality in Aging Societies

Purpose and Aims
The aim of this research project is to explore the philosophical implications of population aging—in particular, the ethical and policy challenges faced by aging societies. These societies are characterized by a combination of low mortality rates and low birth rates, resulting in rapidly aging populations. All developed countries, including Sweden and its Nordic neighbors, belong to this group. It is widely recognized that the changing age composition of their populations will present them with unprecedented challenges in the coming decades: maintaining economic growth, adjusting their social policies, preserving their social welfare system. One of the most important challenges, however, concerns equality. How will aging societies be able to maintain equality throughout the lifetime between different age groups and successive generations in the face of enormous demographic change? More generally, how should we understand the demands of equality in the context of aging societies?

As demographers put it, developed countries are at the late stages of the demographic transition. This transition started in Western and Northern Europe in the late 18th–early 19th century. First, infant and child mortality fell, followed by the gradual decrease in late-life mortality, leading to rapid population growth and increasing life
expectancies. At the same time, however, fertility rates also began to decrease and they eventually fell below replacement rates, resulting in smaller and even shrinking populations and a relative increase in the number of older people. The transition was completed by the end of the 20th century. Today, as late-life mortality continues to decrease, these trends are creating societies with a relatively large and growing elderly population and smaller and contracting younger populations. It is expected that developed countries will experience continuing and even accelerating aging in the coming decades. Thus, an ever larger share of the population will consist of elderly people.

The changes and adaptations that aging societies will be forced to make are profound. Due to their unprecedented demographic make-up, they will have to adjust their labor market policies, social welfare systems, health care priorities, and old-age support systems; they will have to make difficult trade-offs within and between health care, social welfare and other social objectives. It is fundamentally important that societies are able to make these adjustments without giving up the moral ideal of equality between citizens and maintain adequate well-being for all their members, regardless of their age and the generation to which they belong.

My aim is to examine and formulate the demands of equality in the context of aging societies. This research project is normative—its goal is to formulate broad principles and guidelines applicable to social policies and institutions that can foster adapting and mitigating the effects of demographic change. Although the project is in philosophy, it will be informed by discussions in demography, economics, and social policy. Thus, it will take an interdisciplinary perspective.

More specifically, I will be interested in the moral demands of equality both between age groups and generations. (A person belongs to only one generation, but to many age groups as she moves through life.) And I will understand equality in a broad sense, to include theories that make equality the aim of policies (what philosophers call egalitarianism), or give relatively more weight to benefiting the worse off (prioritarianism), or give absolute weight to benefiting the worst off (maximin), or insist that everyone should have an adequate level of resources or welfare (sufficientarianism). These theories have different, and to date largely unexplored, implications for distribution between age groups at particular times and between generations over time.

The research project will focus on three related areas in particular:

(1) Intergenerational cooperation. Philosophers and social scientists describe the workings of major redistributive social institutions—primarily health care and old-age support (pension) systems—as ongoing schemes of intergenerational cooperation. As birth cohorts—that is, groups of people born at a particular place (e.g., in a specific country) during a particular time period (e.g., in a given year or decade)—leave behind childhood dependency, they become the producers of social welfare. (For simplicity, here I use “birth cohort” and “generation” interchangeably.) On top of their own consumption and saving, they support earlier and later birth cohorts in the expectation that subsequent birth cohorts will do the same, maintaining the cooperative scheme and supporting the consumption of earlier cohorts in old age.

There are three important philosophical questions about such schemes.

First, how should intergenerational cooperative schemes be conceptualized? It is generally accepted that at least between the young and old they present a problem for the idea of cooperation based on reciprocity. This is because birth cohorts that support earlier birth cohorts will not benefit from the cooperation of those cohorts—their benefits will be based on cooperation from later birth cohorts. Thus, reciprocity between the young and old does not obtain. Consequently, what is the basis of intergenerational cooperation if it cannot be based on mutual reciprocity?

Second, what are the conditions of the stability of intergenerational cooperation? How can intergenerational cooperation be maintained in the face of changing demographics, including low fertility rates and falling late-life mortality? Formal models of intergenerational cooperation are used to formulate hypotheses to explain and forecast social trends.Building on the results of demography, economics, and political science, I will examine this question from the perspective of social and political philosophy. What are the terms of intergenerational cooperation that can maintain and strengthen redistributive institutions in the face of demographic change?

The third question concerns the fairness of intergenerational cooperation. It is widely agreed that schemes of intergenerational cooperation must be arranged such that they are able to maintain well-being and social equality for members of all birth cohorts. What are the demands of social justice in this area? Theories of distributive equality cannot be straightforwardly applied to intergenerational cooperation. Egalitarian, prioritarian, sufficientarian and other views have different implications for rates of saving, the form and extent of intergenerational transfers, and the design of social welfare institutions. Since they were originally developed with synchronous inequalities in mind, they must be modified in order to take demographic change into account. My interest is in extending and developing theories of equality in order to give an account of fairness in intergenerational cooperation. During this phase of the research project, I plan to produce 2–3 papers addressing the problems of reciprocity, stability, fairness and equality in intergenerational cooperation. Since this part of the research project is interdisciplinary, I will seek out the collaboration of researchers in the relevant disciplines (see below).

(2) The value of longevity. Population aging raises fundamental philosophical questions about the value of life. Everyone agrees that increasing life spans are a good thing: unless life becomes an unbearable burden, it is good to live as long as possible. But how much value should societies place on increasing life spans? Is prolonging lives always a desirable social objective, or is there a point at which life extension begins to have decreasing value or even ceases to be a benefit? What sort of trade-offs should we make between increasing longevity and greater equality? The answers to these questions have obvious relevance to social policies. For instance, they make a difference to the way we should carry out cost-benefit analyses of regulations and cost-effectiveness analyses of health care interventions.

Longevity also raises more general philosophical questions. What are the implications of increasing longevity for philosophical theories of well-being? Is living longer always better? What is the relation between increased quantity of life and the quality of life? If longer lives bring about longer periods of disability, frailty, or dependency, how should we think about the contribution of extra years of life to the overall quality of life? After all, people care not only about the amount of well-being within a life, but also about its distribution. Thus, different theories of well-being in philosophy—including hedonism, preference satisfaction views, and objective theories—may provide different answers to these questions. Examining these answers can help advance the debate between them.

During this phase of the research project, I plan to write 3–4 papers on longevity and equality, social policies and equality, and longevity and well-being. These will in part be developed from previous work I have done on well-being and ethical issues in cost-effectiveness and cost-benefit analyses, which I have not, however, had the chance to relate to longevity.

(3) Priority setting between age groups. A basic requirement of equality is that no one should be discriminated against on irrelevant grounds—for example, on the basis of race or sex. In many contexts, age is also an irrelevant ground, thus age discrimination is unfair. But in the context of setting priorities between alternative resource uses—in health care, for example—the role of age is much more controversial. Many people believe that equality requires that resources are distribute equally between age groups. Others, however, contend that what matters is equality over whole lives, which implies that it is not impermissible to distribute resources unequally between different age groups as long as overall lifetime equality is maintained.

This part of the research project will examine the problem of equality between age groups. One novelty of my approach will be to relate the problem to the previous two topics—intergenerational cooperation and the value of longevity. My hypothesis is that findings in these topics have important implications for the theory of equality between age groups as well as applied issues like the ethics of priority setting in health care. I plan to map out these implications.

In addition, I aim to take explicitly into account the social and demographic context. Research in demography suggests that it is different to grow old in a young population and to grow old in an aging population; it is different to be old in a society that is, demographically speaking, relatively stable and unchanging, and in a society whose population and age composition are undergoing rapid change. That is, demographic context matters, and social equality may well have different demands in different demographic settings. These points, however, have mostly been neglected in the philosophical literature, where almost no attention has been paid to changes in the age composition of societies and the dynamic nature of demographic trends. I plan to develop a more comprehensive view on the demands of equality between age groups by considering these factors.

During this phase of the research project, I plan to complete 4–5 papers on equality between age groups, the demands of equality in different demographic contexts, and on equality in priority setting in health.

In summary, my research project centers on three questions:

(1) What are the normative conditions of the stability and fairness of intergenerational cooperation in aging societies? What are the implications of these conditions for the demands of equality between generations?
(2) What is the value of longevity? What are the implications of the theory of the value of longevity for equality between age groups and between generations?
(3) What are the demands of equality in setting priorities between age groups, taking into account the demographic and social context of aging societies?

The overarching goal of this project is to contribute to the establishment of a field at the intersection of practical philosophy and demography. Currently, there is little work in this area. Demographers are acutely aware that demographic change will have a profound effect on social equality, but they tend to set the normative and philosophical questions aside in their work. My research project is intended to bring these questions out into the limelight.

Project managers

Greg Bognar

Professor

Department of Philosophy

greg.bognar@philosophy.su.se

See profile page for Greg Bognar