There was no shortage of praise this week for Angelina’s Jolie’s very public decision to undergo a preventative mastectomy. Many referred to her decision as brave; one Fox News commentator went so far as to call it “heroic.” Her decision certainly was brave. Surgery is always risky and, for an actor who lives by her looks, the choice cannot have been an easy one. We hear a lot about choice and the freedom to choose in contemporary political discourse, but rarely do we ask a critically important question: When is a choice really a choice?
The first point to consider is that not all choices are of the same weight. In Leviathan, Thomas Hobbes famously argued that when an armed robber announces, “Your money or your life!” or when we throw valuable goods off a ship to keep it from sinking in a storm, these are real choices. We may feel “forced” to turn over our wallets or toss overboard our precious cargo, but for Hobbes, we could still choose otherwise and are thus still making a valid choice. What feels intuitively wrong about Hobbes’ argument is that there is all the difference in the world between “Mushrooms or pepperoni?” and “Your money or your life!” Choosing which pair of shoes I want to wear today is nothing at all like choosing whether or not to have major surgery.
But even the weightiest of choices can only be made if we possess the resources and opportunities that allow us to choose between real alternatives. As Sadhbh Walshe pointed out in The Guardian, the 21 million U.S. women who can’t afford heath insurance don’t have the option of choosing a preventative mastectomy, difficult as that choice might be. This is why economic inequality matters. Access to resources determines the range of real choices we are able to make. If I am unable to afford college tuition, I am unable to choose whether or not to earn a degree. If I cannot afford health insurance or medical care, I cannot choose whether or not to see a doctor. There are also multiplier effects at work here. A healthy, well-educated person is able to perceive and take advantage of a wider range of real choices than is a sickly, poorly educated person.
The distribution of resources, in other words, affects the distribution of free choice – something to remember when freedom is touted as the reason why health care or education or housing should be available only to those who can afford to pay the market rates.