Responsibility and Distributive Justice

Under what conditions are people responsible for their choices and the outcomes of those choices? How could such conditions be fostered by liberal societies? Should what people are due as a matter of justice depend on what they are responsible for? For example, how far should healthcare provision depend on patients´ past choices? What values would be realized and which hampered by making justice sensitive to responsibility? Would it give people what they deserve? Would it advance or hinder equality?