Everyday Ethics

Health care is a popular area in applied ethics.  There are all sorts of “sexy” ethical questions, such as whether physician-assisted suicide is acceptable, whether people with minimal brain functioning have rights, whether a fetus is a person, and many more.  The real question, one that few people have the nerve to write about, is the issue of pay for service medical care.  In a nation like ours that has phenomenal wealth, many individuals are denied life-saving medical treatment do to an inability to pay.  If ever there was an ethical question in need of a solution, this is it.

There are two points that I wish to make regarding this matter, the first of which concerns why this topic is so rarely addressed as a philosophical question.  It is often characterized as a political, social, or economic question.  But like most of the social issues that we face, providing access to medical care has a decidedly moral flavor.  I am tempted to suggest that this issue is not addressed as a moral one, first and foremost, because the answer is so obvious:  all humans, regardless of ability to pay, should be able to go to the doctor and get whatever treatment they need.

Acknowledging this right is potentially dangerous, because the clearest justification for why we do not have a system that reflects this right is that it is not economically attractive for either doctors or taxpayers.  This is a chilling indictment of our value system, in that it seems we value our own money more than the physical well-being of all our citizens.  Because we are somewhat ashamed of this reality, we avoid the question that reveals it.

The second point that I wish to consider is how our right to medical care might be justified.  After all, the above claim that we all have a basic right to health care is more of an intuition than a rationally argued moral claim.  It seems, however, that we can easily derive this right from other rights that are either universally accepted or entrenched in our legal system.

The legal right not to be discriminated against supports a policy of equal access to medical care.  After all, being able to get medical care when necessary is crucially connected to fulfillment of basic human interests, namely avoidance of suffering and survival.  To claim that denying medical care to the poor is morally wrong does not lead to the absurd conclusion that denying a poor person a new Lexus, for example, is also wrong.  In one case, acknowledging the relevant right is crucial to basic human survival, while the other is strictly a superficial want.  If we believe that an individual’s basic human interests should be fulfilled regardless of economic status, this can easily be extended to a basic right to receive medical care without the need to extend this right to all material wants.

The universal human right to not be subjected to unnecessary suffering is perhaps a stronger foundation for a right to basic medical care.  Prevention of suffering is one of our strongest moral intuitions, and denying basic medical care to the poor is a clear cause of preventable suffering.  Thus, if we believe it is morally wrong to allow suffering when we are able to prevent it, denying medical care to those who cannot pay is also morally wrong.

We have only scratched the surface of this complex moral question.  Clearly, there is much work to be done in this area, and we can only hope that the politicians and social advocates, as well as the philosophers, will not shy away from it in favor of “sexier”, though far less important ethical questions.  In the meantime, we can educate others about the logical results of basic moral rules that we all support, namely our duty to prevent suffering when we are able to.

About the Author

Elijah Weber is a graduate student in Environmental Ethics at Colorado State University. He holds bachelor’s degrees in sociology and philosophy from Chapman University and currently lives in Fort Collins, Colorado, with his wife Laura.