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  • Global Greed and Prudence:A Reply to Alvarez1
  • Michael Campbell (bio)


In a recent article in this journal, Alvarez claims that developed countries ought to donate (at least) 1% of their GDP to support healthcare in developing countries.2 He provides an argument in favour of this, which purports to show that it is rational for wealthy countries to act even though there is no prospect of their receiving immediate benefits in return.3 This argument consists of three main claims:

(1) assisting the poor is not burdensome to [wealthy countries], (2) such action is in accordance with the emerging global norms that regulate international relations despite the absence of mechanisms that are expected to enforce such norms, and (3) assisting the poor is the prudent thing to do because it sets the stage for enabling and motivating mutual assistance.4

In what follows, I will focus on claims (1) and (3) and the relationship between them. I will contend that insofar as helping the poor is not burdensome, it is sufficient neither to enable, nor to motivate, mutual assistance. This is because we cannot be confident that, on the basis of this help, developing nations will feel any compunction in the future to reciprocate in kind. On the other hand, a redistribution of resources to the extent required both to enable and to motivate reciprocity would involve such a widespread recalibration of the current balance of global power that its prudence cannot be demonstrated by appeal to unspecified future benefits. Despite this, it is a fact that we have the duty to help those in developing nations. Since our confidence in the reality of those duties does not track our confidence in the prudence of obedience to them, it follows that (unless our belief in this duty [End Page 83] is merely an irrational proclivity) the basis of this part of morality does not lie in self-interest.

Patients as Prisoners

Alvarez’s central contention is that wealthy and poor nations stand in a relation of mutual dependency and therefore it is in the overall interests of wealthy nations to act altruistically (and hence not to pursue the course which leads to the greatest expected satisfaction of their interests).

His argument for this is drawn from Gauthier’s attempt to derive moral norms from rational choice theory. Alvarez takes the position of wealthy countries vis-à-vis their poor neighbours to be analogous to the relation between individuals in a “prisoner’s dilemma” (PD) situation, both of whom act prudently if and only if they refuse to try to maximise their self-interest.

We can represent this in the classic PD matrix:

  Donate Do not donate
Donate 10,10 10,0
Do not donate 0,10 5,5

Here, the columns represent the strategy of wealthy nations, the rows show the strategy of poor nations and the ordered pair (a, b) represents the payoff for wealthy and poor nations, respectively. If each country pursues the strategy that will guarantee them the greatest expected utility, then neither country will donate. In that case, both countries miss out on the best possible outcome. Therefore, in order to maximise overall and individual benefit, each country has to act based on the expectation that each other country will act cooperatively and not simply in terms of immediate self-interest. As Gauthier argues, the upshot of the PD is therefore that it is rational for both parties to be “constrained maximisers” (CM):

[a] constrained maximiser is [someone who is] conditionally disposed to cooperate in ways that, followed by all, would yield nearly optimal and fair outcomes, and does co-operate in such ways when she may actually expect to benefit.5

This principle will secure the ex-ante agreement of all self-interested rational agents. Adopting it is the best strategy for all parties and is (in ideal circumstances, at least) the rational thing to do.6 [End Page 84]

This is the conclusion that Alvarez endorses in the case of the distribution of global healthcare resources.

However, for this claim to be plausible, we must account for the obvious disanalogy between individuals in a PD and the interactions between nations, namely, that...


Additional Information

Print ISSN
pp. 83-95
Launched on MUSE
Open Access
Archive Status
Archived 2017
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