The Patient as Obligation - The Binary Failure of "Privilege" vs. "Right" Part 1 - My Right - Sez Who?

S D Med 2019 Dec;72(12):562-571

Sanford Clinic - Infectious Disease, Sioux Falls, South Dakota.

Privilege vs. Right in healthcare is a failed binary because it has divided the nation. The "my right" end of the false choice has been confusing, because it portrays obligations as rights. Further, it rhetorically attempts to grant a right where none exists. Of central concern is the question of authority and from where it arises. With the proffered death of God comes the death of any transcendent set of propositions about right and wrong. Every person then becomes a "godlet" being tempted to exert authority over other godlets, prompting the response, "Sez who?" The claim that "healthcare is a right" strives to redefine the terms of authority in healthcare but must answer the same question, "Sez who?" Efforts to anchor a right to healthcare in posited law fail because there is no such right either explicitly or implicitly enumerated in the Constitution. Further, the stretch to ground a right to healthcare as "inalienable" also fails because inalienable rights (life, liberty, and the pursuit of happiness) are not forced but rather protected. The Affordable Care Act of 2010 attempted to force such a right through mandatory purchase of insurance - and so unraveled. Appeals to this right based on "moral obligation" are laudable but fall back to the same question, "Sez who?" The Natural Law, as a transcendent ought pulls from within every civilization and system of thought - and answers such a question not as human right but as human obligation. The Natural Law, as the common moral ground therefore has the gravitas to command our allegiance and be the authoritative foundation for healthcare reform.

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December 2019

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