Ideal and Nonideal Theory

Abstract

Time has come to apply the theories in the real world. We have seen that in the metaphysical laboratory, where we put them to crucial tests in our thought experiments, the theories conflict. Now time has come to investigate their implications in real life and to tease out their implications for priority-setting in health care. This task has to be accomplished in steps, however. It is important to distinguish between their implications for priority setting under the assumption of strict compliance (with one or another of the theories), and a realistic situation where it is expected that even people who accept one of the theories will, once their turn to carry the costs has come, try and bend the rules in their favour. Here a simplified notion of ideal and nonideal theory will be developed and put to use. And I will start by looking into the implications of the theories under the assumption of strict compliance (ideal theory), only later to turn to the problems associated with noncompliance (nonideal theory). All this prepares room for a discussion about the normative significance of noncompliance to be undertaken later in this book. The question then is whether the fact that noncompliance with the theories is to be expected spells problems for the theories as such. Does it count against their plausibility that people are not prepared to act in accordance with them?