Cambridge Quarterly of Healthcare Ethics (2013), 22, 408–419. © Cambridge University Press 2013. doi:10.1017/S0963180113000315 408 Responses and Dialogue Normative Theorizing about Genetics COLIN FARRELLY A response to “On the Very Idea of Genetic Justice: Why Farrelly’s Pluralistic Prioritarianism Cannot Tackle Genetic Complexity” by Michele Loi ( CQ 21(1)) In a recent article in this journal 1 Michele Loi reaches the conclusion that we ought to abandon “the very idea that regulating access to genomics involves an account of genetic justice, that is, an account of what would constitute a fair distribu- tion of genetic endowments, describable as a distinct ideal, independent from the social bases of inequality.” 2 This is a conclusion to which I am actually, at least partially, sympathetic. And this may seem surprising given that it is my work on genetic justice that is the main target of criticism in Loi’s article. 3 Indeed, Loi takes his conclusion to be a position contrary to my own conclu- sions on these issues. I am certainly in agreement with the suggestion that genetic justice ought not to be treated as a distinct ideal, independent of considerations of the broader demands of social justice. In fact, something like that conclusion is the very conclusion I have argued for in my own work. The lax genetic difference principle (lax GDP), 4 for example, maintains that genetic inequalities (important to the natural primary goods [NPGs]) are to be arranged so that they are to the greatest reasonable benefit of the least advan- taged. The insertion of the reasonable- ness clause was an explicit attempt to ensure that the aspiration to mitigate genetic disadvantage was cognizant of other kinds of disadvantage (e.g., social disadvantage) and values (e.g., freedom) that fall under the purview of social justice. Rather than serially ordering a principle of justice (genetic or otherwise), like John Rawls 5 does with his equal basic liberties principle and Norman Daniels 6 does with a principle of access to healthcare (by adding healthcare to Rawls’s principle of fair equality of opportunity), the lax GDP is a principle designed to bring the complexities of trade-offs to the fore of our delibera- tions rather than simply bracketing them. And the central aspiration behind the development of the lax GDP was the desire to expand the frontiers of justice to include the distribution of our genetic potentials for valued phenotypes, like health and intelligence. Loi takes issue with what he calls the “particularistic” aspect of my pluralistic prioritarianism, the view that I adopt for developing an account of genetic justice. My view is particularistic, claims Loi, in that it involves the weighing of different claims of justice (e.g., the duty to mitigate disease caused by genetics vs. the duty to mitigate disease caused by environment). Loi contrasts this particu- laristic pluralistic prioritarian approach with “monism,” a view he ascribes to Richard Arneson, which maintains that well-being is the currency of justice “in the sense that the moral weight of remov- ing genetic or environmental forms of deprivation is established by convert- ing all the relevant factors into a unified