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Without focusing on the details of specific health systems, this chapter considers what we owe each other with regard to promoting and restoring health and what this means for the balance between prevention and treatment. I argue that we have robust obligations both with regard to prevention and treatment, though the specifics of what is owed depend on decisions about how to fit a reasonable array of such services within resource limits. Among our preventive obligations are interventions that provide incentives for adopting health regarding behaviors, though these are harder to justify on some accounts of justice than others. For example, luck egalitarianism provides no justification for such incentives, though a Rawlsian account does. The chapter concludes by considering whether the fact that risk is more concentrated in some people than others, say in identified victims rather than statistical ones, is morally relevant to giving them some priority. I claim that concentration of risk is morally relevant under some conditions and that this may favor identified over statistical victims to the extent that risk concentration is the relevant contrast between them.

This chapter reviews the literature from psychology on aid allocation decisions—focusing specifically on the “identifiable victim effect.” The goal is to build a bridge between what the research from psychology and other disciplines tells us about the effect and the normative discussions that follow. The research goes beyond anecdotal contrasts between a certain legendary identifiable victim and overlooked statistical victims. Instead, controlled experiments test isolated psychological factors, including specificity, vividness, and proportion of a reference group. Thus, it paints a more complete picture of how human sympathy drives decision-making in ways that diverge from normative frameworks discussed elsewhere.

Probabilities are pervasive in our lives, and thus our ability to learn and use probabilistic information effectively has a central place in humankind’s adaptive capacities. Curiously, research on the “statistical victim effect” and related phenomena suggests that we are not good at according probabilistic information appropriate weight in judgment and decision-making. Recently, explanations of these anomalous judgments and decisions have been given in terms of “dual-process” models of the mind, according to which the mind has two distinctive ways of processing information, one intuitive and affective (thus knowing little of probability and logic) and the other more reflective and cognitive (thus better at probability and logic, but less readily brought to bear). Using evidence from recent work in cognitive and affective neuroscience, this chapter raises some questions about dual-process models of this kind and suggests an alternative explanation of the “statistical” or “identifiable” victim effect, based upon implicit probabilistic learning.