Background:To describe how pediatric cancer-induced financial distress and perceptions of their social role affected fathers' psychological responses to this distress, and quality of life (QOL) for them and their families. Procedure:We analyzed father-only responses from a larger cross-sectional survey study about the impact of pediatric cancer-induced financial distress on parents. Our analytic sample was n = 87 fathers who participated in the larger study. We analyzed their data using descriptive statistics and directed content analysis. Results:Conflicting role responsibilities (be there for child; work to maintain income and insurance coverage) seemed to generate responses resembling characteristic posttraumatic stress symptoms in reaction to acute declines in family finances and/or the chronic stress of insufficient finances to meet financial demands, that is, financial trauma. Fathers' personal sense of not being able to adequately provide for their child with cancer and also meet their family's basic needs produced embarrassment and humiliation, which led to discomfort talking about finances; fear, persistent thoughts and anxiety about money; reduced joy; beliefs that they did not deserve to express their needs; and feeling vulnerable to repeated financial stressors. Conclusions:Pediatric cancer-induced financial burden contributed to fathers' symptom severity and burden, and QOL declines. Clinicians should develop sensitivity to the multiple ways that pediatric cancer affects individuals and families. Future research should examine the effects of pediatric cancer-induced financial burden on mothers, and develop ways to sensitively and systematically assess financial burden, associated psychological responses and declines in QOL, and intervene as indicated.

The term 'predistribution' draws attention to the need for policies and institutions that are designed to improve the position of the least advantaged members of society by generating a fairer distribution of opportunities and benefits from the operation of the free market system, with less reliance on redistributive tax-and-transfer mechanisms. Although the idea of progressive predistribution has only recently begun to attract the attention of politicians and commentators in the mainstream media, there is an older and more philosophically grounded predistributive approach that goes back to the idea of the property-owning democracy (POD) proposed by Economist James Meade and further developed by liberal political philosopher John Rawls. In this article, I argue that neither the Meadeian/Rawlsian POD model, nor the more recent analysis of the idea of progressive predistribution, provide a clear and convincing account of the distinction between predistributive and redistributive mechanisms. I then argue that a more promising account of this distinction is provided by the idea of the socialization of economic rent through taxation of the rental value of land, and that there are good reasons to think that a shift in the burden of taxation away from production and employment and on to the rental value of land might turn out to be both more genuinely predistributive and more effectively progressive than other possible predistributive mechanisms that have recently been proposed, most notably the aggressive taxation of private inheritances as a means to broaden the distribution of privately owned capital and productive property.

The distinction drawn by Rawls between the ideas of property-owning democracy and welfare state capitalism parallels his distinction between justice-based ‘liberalisms of freedom’ (including his own conception of justice as fairness) and utilitarian- based ‘liberalisms of happiness’. In this paper I argue that Rawls’s failure to attach the same level of significance to essential socio-economic rights and liberties as he attached to the traditional liberal civil and political rights and liberties gives justice as fairness a quasi-utilitarian character, which is incompatible with the fundamental objective of protecting the highest.-order interests of citizens conceived as free and equal. I argue that in order fully to protect these interests, rights to access to non-human capital and productive resources should be assigned the same level of significance as that assigned to the civil and political rights and liberties, and prioritized over the lower-order rights and benefits regulated by Rawls’s second principle of justice.

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