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Is There a Natural Right to Health Care?

by Margaret Datiles 

The Declaration of Independence states that all men “are endowed by their Creator with certain unalienable rights, that among these are life, liberty and the pursuit of happiness. That to secure these rights, Governments are instituted among men, deriving their just powers from the consent of the governed.”

These two key sentences of the Declaration emphasize that there are “natural” rights, which all people have by virtue of being human, and there are “positive” rights, which are created by governments for the sake of protecting and allowing the proper exercise of the natural rights. 

Is a right to health care among these unalienable rights?

Various schools of thought provide different answers to this question. For example, some conservative political theorists argue that there is no natural right to health care. According to this theory, a right to health care cannot be considered “natural” because it is not an independent right. Unlike the right to life, which exists on its own and at all times, a right to health care is dependent on the existence and actions of others. It is not a right which can be enjoyed independent of society, but rather an entitlement to a service to be performed by another.

On the other hand, Pope John XXIII wrote in his 1963 encyclical, Pacem in Terris, that a right to basic medical care is implicit in the right to life:

But first we must speak of man’s rights. Man has the right to live. He has the right to bodily integrity and to the means necessary for the proper development of life, particularly food, clothing, shelter, medical care, rest, and, finally, the necessary social services. In consequence, he has the right to be looked after in the event of illhealth; disability stemming from his work; widowhood; old age; enforced unemployment; or whenever through no fault of his own he is deprived of the means of livelihood.”

Although the Church has not provided greater detail on its argument for the existence of a natural right to health care, it is my opinion that the right which John XXIII describes here and which the Catechism also refers to is a limited right to basic medical care (sometimes referred to as “critical care”), which can fall into the category of “natural rights” only insofar as it emanates from the natural right to life.

Regardless of our opinions of whether or not there is a natural right to health care, all Christians are called to care for the sick in what ways we can out of love for God. As Christians, we have a moral obligation to God to act compassionately and charitably toward others. This corresponds with Christ’s example in the Gospels as a healer, and with the Catholic moral tradition of following Christ’s example of serving the poor, sick, suffering and abandoned.

Since we have a moral obligation to God to care for the sick, to what extent must we provide health care?

I can think of two general principles which guide decisions regarding the moral duty to provide health care. The provision of health care must: (1) not offend any person’s natural rights; and (2) reflect good stewardship of resources.

There is no moral duty to provide drugs or procedures which are offensive to natural rights. For example, there is no duty to provide death-inducing drugs or abortion services.  The provision of such drugs and procedures are destructive to the natural right to life.

According to the principle of good stewardship, there is no duty to provide medical services that are beyond one’s means, or which would be otherwise harmful to the common good. As God created man to be stewards of the earth’s resources, we are obliged to use all resources responsibly, with an eye towards attaining and protecting the common good.

The availability and cost of certain medical treatments greatly determines the boundaries of the duty to provide health care. It may not be a responsible use of resources to provide certain medications or services without compensation. For example, flu shots, vitamins, IVs, oxygen tubes, food, water, shelter and warmth are much less expensive and readily available in our society than are neurosurgeries and CAT scans. Although our obligation to provide basic healthcare may include the former, it might not necessarily include the latter.

God does not impose an obligation on someone that is impossible to fulfill. For example, if a patient is in a sparsely-equipped hospital in a very poor country, and the hospital does not have oxygen tubes or IV fluid, then there is no duty to provide them. The extent of our moral obligation to provide basic medical care is proportional to the means available. As you can see, the scope of the duty varies according to material and other relevant conditions.

If a community decides to provide free health care to those entrusted under its care, it must do so in a manner that is fair and just to the health care providers, and which responsibly takes into consideration the effect on the community’s economy.

Specifically, it should not infringe on the rights of health care providers (such as the right to freedom of conscience), and must not misuse the financial resources of the society (e.g., it must not result in debt or bankruptcy). It also should not cause health care providers to remain unjustly under-compensated for their work. 

These maxims are necessary in order to act according to the principle of good stewardship and to avoid detriment to the common good.

In conclusion, regardless of whether or not a natural right to health care exists, we have a duty to God to care for the sick. As the health care debate continues to remain at the political and cultural forefront, it is important not to get confused by expansive, all-encompassing definitions of the right to health care. Instead, we must remember that the extent of our moral duty to provide basic medical care should be determined by considerations of good stewardship, attainment of the common good, and protection of natural rights.

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(The views expressed in this column are those of the author and do not necessarily reflect the positions of Headline Bistro or the Knights of Columbus.)