Sunday, November 29, 2009

Rights and Obligations: A Philosophical Foundation

I had an eye-opening conversation recently with one of my favorite political sparring partners, who observed that basic human “rights” can be viewed as either negative or positive.

In a free society, people should have rights not to have others interfere with certain freedoms: freedom of thought, of speech, of religion, of self-protection, etc. So far, so good. Most of us can agree that people have rights that shouldn’t be infringed by others who may want to limit or “negate” those freedoms.

But to my surprise, I learned that not everyone agrees that we also have rights to (as well as from) certain things. There are those who, like my respected dialectical opponent, believe that liberty involves freedom from being obligated to others. According to this logic, saying that one person is obligated to help another is antithetical to personal liberty, because it implies that the person in the helping position is not free to choose.

That’s true. If we have obligations to others, then we are not perfectly free to exercise unlimited personal choice where others are involved—and in my view, others are almost always involved. We can’t diminish ourselves or fail to use our talents and skills in a positive way without having a negative impact on others. I say that from a moral perspective, we are not free to choose not to consider others when we make decisions. As social creatures, we are inextricably bound to others in society.

This example came up in the course of the conversation: A person is seriously hurt, lying down and bleeding on the sidewalk. Does a passer-by have an obligation to help? Is he or she morally free to say no?

I say the passer-by has an obligation to help, to the best of his or her ability—to call for help, render first aid if trained to do so, even to offer solace and comfort until professional help arrives. To ignore the injured person would be morally wrong unless there is nothing at all the person can do without risking his or her own well being. (For example, if a stranger were bleeding, would I stanch the flow of blood with my bare hands? Probably not. Would I and should I put pressure on an artery if I had appropriate training and gloves to protect myself? Yes.)

Philosophical differences like these have a direct bearing on how people view matters of public policy, such as the current health care debate. I believe that as a society capable of offering its citizens optimum care, we have a moral obligation—long ignored—to provide universal health care opportunities. Those who have the attitude that we are not obligated to others may have a very different view.

In the USA, at least 45,000 people die every year for lack of access to health care. Fearful of running up bills they couldn’t hope to pay, many ignore symptoms until they are beyond help for a life-threatening condition. Others can’t afford routine screening tests, such as mammograms, or routine care for high blood-pressure, diabetes, or pregnancy. Millions are less healthy, happy, and productive than they ought to be because they can’t afford medical care that would reduce pain, increase energy, or otherwise improve quality of life.

Having people in our family, community, or country who are sick, dying, or chronically unwell affects everyone. This situation diminishes health and well-being for others (including care-givers) and deprives us all of the talents and contributions the unwell would otherwise provide. Because critical, emergency care is so much more expensive than preventive care, the 46 million uninsured in this country drive up health costs for everyone and put a significant dent in the national budget.

No one has seriously challenged analyses by the Congressional Budget Office and others that say that the current situation regarding health care in this country is unsustainable and that the bill now before Congress would reduce the Federal deficit. Those against it are, for the most part, those who are against any kind of change, positive or otherwise, period. (Is that what “conservative” means these days?) But many Americans—especially those fortunate enough to have affordable, comprehensive health insurance now—are essentially indifferent, their opinions informed only by ads or sound bites on their favorite TV or radio station.

As Americans, I say that we have a moral obligation to concern ourselves with the well-being of others, as citizens as well as individuals. For one thing, it’s really a matter of enlightened self-interest: it’s better to live in a country where people are healthy and happy and the economy works well for everyone than it is to live in a country with sickness, misery, and looming fiscal disaster. That’s a matter of practicality and should be, in itself, reason enough to support the kind of health reform now being debated in the nation’s capital.

But from a philosophical standpoint, as well, we all make a fundamentally moral decision, whether we are aware of it or not: We decide if we believe or do not believe that we are and ought to be “our brother’s keeper.”


Idna said...

Jane, only the most heartless among us would walk by and not try to help a person who is seriously hurt, lying down and bleeding on the sidewalk. But your jump to the necessity to pass the "bill before Congress" (whatever that may end up being) to fulfill a moral requirement is illogical.

There are lots of questions about the numbers being thrown around as "facts" ... including the 45,000 dying for lack of insurance and the supposed cost of the bill.

The "Harvard" study that you quote was "funded by a federal research grant. It was released by Physicians for a National Health Program, which favors government-backed or "single-payer" health insurance."

Two things immediately jump out at me ... the study is paid for by a federal grant and the authors belong to a group who are pushing a single-payer program. Not exactly an openminded, no-dog-in- the-fight type of study. (Sort of like the fraudulent global warming "studies.")

The CBO statement HAS been challenged and looking at historical data concerning other programs like Medicare and Social Security, shows how WAY OFF the CBO can be.

So your moral stand on helping your fellow man is commendable and held by pretty much all decent people. Your leap to the need to legislate this with an economically suicidal federal bill based on information from questionable "studies" is fallacious logic in the least.

There have been several SANE ideas put forward to fix what's wrong with waste in Health Care. None of which are in the current Congressional Bills.

Citizen Jane said...

There you go again, Idna, with your favorite argument--the straw man fallacy. The source could be suspected of having a bias, so therefore all information from that source is suspect. I suppose you feel the same way about the recent findings of MIT--after all, all colleges get some federal funds, right?

I've actually been waiting and looking for any evidence to contradict the Harvard study and have found none. Nor have I seen any reputable analyst dispute those figures. (Of course, I don't watch FOX or consider it a reputable source.)

My point is that many good, compassionate people do believe that it's not our business as citizens to worry about the needs of other citizens, human rights, or similar values or to address them through government action.

Idna said...

Dear Jane,
You accuse me of the straw man fallacy ... of looking at the source and questioning it's findings if it's biased. I stand by my suspicion of Drs. Steffie Woolhandler and David Himmelstein, co-authors of the 45,000 death report. Describing the organization they belong to in their own words: "Physicians for a National Health Program is a single issue organization advocating a universal, comprehensive single-payer national health program."

I'm SURE they would be fair and balanced in their findings. HA!

By the way ... as you accuse me of skepticism regarding sources, ("There you go again ....") Here's a portion of a response you gave me in an earlier blog after I gave you some links that you had requested:

Jane said: "Thanks for the links, Idna. I notice that two of them are from representatives of conservative "think tanks"--The Pacific Research Institute and the American Research Institute. All too often, the "research" these organizations do is to spruce up and repackage talking points the conservative minority wants to push. That's not to say that the issue of vaccine supplies isn't complex and that the system may not be as good as it should be. I'm just saying that I consider those sources suspect."

Looks like you're accusing me of the same thing you do!

Citizen Jane said...

Hi, Idna,

I think we both agree that it is important to "consider the source." I'm just saying that data should not always be discounted ONLY because its source may have an agenda or a point of view.

Some months ago, I saw a presentation by "Mad As Hell Doctors," practicing physicians who were and are furious about the real-life patients they see every day to come to emergency rooms too sick to be saved--because they couldn't afford to have checkups and routine health care. Some people think that number--45,000 deaths a year--is just the tip of the iceberg. Not seeing any evidence whatever to the contrary, I'm inclined to take the Harvard study at face value.

Sue said...

Hi, Jane,

An interesting post. I have a couple of comments. First, unless we want to live in a cave somewhere without any interaction with or reliance on anyone else, then we are connected to others around us, which means both helping and being helped by them. There's an old saying that one person's rights end where another's begin. Freedom is the same. One person's freedom is dependent on the freedom of others.

Second, morality means that we do have a choice whether to help people or not -- and how we choose to help them. Thus, I might make a perfectly moral choice to not help one person or group because I choose to give my help elsewhere, for example, to donate to the local food bank but not to give to panhandlers. Or, for that matter, not to give to any charitable organizations or causes because my family needs all my resources to keep going or even because I think people should take care of themselves. That is, I can choose to not honor an obligation to others and still be a moral person.

Third, the definition of "Conservative" means (nowadays and in the past) keeping things as they are rather than changing them, particularly if that change will result in a significant upheaval of the status quo. Conservatives offer a necessary and desirable balance to those who would change things either just for the sake of change or because they feel that the new way is better than the old. True democracy and legitimate governance come when both sides work together to compromise. Some things should be changed because of the overall benefit, others should be left alone for the same reason -- or because the needs can be adequately if not better met through some other means.

I've been thinking recently about some of the implications of the "freedom of religion" issue that's been discussed previously on this site. It occurred to me that in societies where there is an established church, that organization takes on some of the social welfare needs of society. The lack of an established religion means that this country has two options: to have the government take over that role, or to create a private network offering necessary services. In reality, we have a combination. If the government were completely responsible for the support of the needy, for example, we wouldn't need food banks, homeless shelters, and the like. If the government did nothing, we should have significantly lower taxes, but would have a greater need to contribute to the aid of the less fortunate -- which might not be as efficiently organized as what the government provides (debatable, of course!). I'm not sure which I prefer; both have advantages and drawbacks. What is clear is that there will always be people who need assistance on a temporary or permanent basis -- unless we want to throw away all those who can't make it on their own, which is antithetical to this nation's belief in and commitment to the right to "life, liberty, and the pursuit of happiness" (note that life itself is the first of those rights).

So it really comes down to: what is best for our society to meet the needs of its citizens. There's still a lot of room for legitimate disagreement and discussion -- whether it's health care or government regulation of enterprises such as banking, or the funding of projects for the common good such as highways and schools. Let's keep the discussion going, listening to what others have to say, taking into consideration their biases, but also using those biases as a touchstone for testing our own. That's what true liberty, freedom of speech, democracy, and ultimately moral behavior are based on.

Six said...

Hi Jane,

Your question about what people are morally obligated to do is an interesting one - and I would argue that given the example you used of someone lying bleeding in the street that any sane person is morally obligated to try to do something to help. HOWEVER, there is a BIG difference between being moraly obligated to do something, and being LEGALLY, under the violent threat of forced imprisonment if you do not do what someone else deems is a moral obligation. Just because something is the proper thing to do according to our morals, does not mean that it is okay to pass a law forcing everyone to comply.

Laws should exist primarily and nearly (not quite exclusively, but close) to protect the rights of the people from being infringed on through coercion, violent force of others and forms of rights-violations. Leaving someone dying in the street is wrong. However, I do not want some politician passing a law to say that if I do so, I will be thrown in jail (which in effect is what laws do say).

The difference between us is that I want to actually protect people's rights, you are more conservative-like than you want to admit in trying to use the violent force of government to get people to live by the moral code you support - even if it means violating someones constitutional rights to do so. You are much more anti-liberty and pro-statist than you realize.

Citizen Jane said...

Hi, Six,

Guilty. I am a statist. As a family counselor, I often have to help families--even families of two or three--make rules, set boundaries, and agree on appropriate consequences for transgressing the agreed-upon rules and boundaries. I believe that the "state" arises naturally from the fact that we are social creatures and absolutely must have structures to govern our interpersonal relationships. The more people there are in a community, the more complex the "state" has to be.

That said, I'm against legislating morality unless absolutely necessary--so, for example, I'm pro-choice (which is not at all the same thing as being "pro-abortion"). Sometimes there's an overlap between what's legal and what's moral, but often there isn't. (We can all think of things that are perfectly legal but morally wrong.)

I've been accused of being an "idealist"--although I think it's perfectly possible to be both idealistic and practical at the same time. I admire you libertarians for your idealism, but I am sometimes frustrated that it keeps you from really engaging in the problem-solving and messy decision-making that we must do as a nation.

I think libertarian principles would work just fine if everyone were, in fact, like libertarians often are and like to see themselves: well educated and informed, rational, intellectually honest, respectful of the rights of others. In fact, though, that ideal world exists only in the imagination.

The Tarquin said...

So on the "bleeding-person-on-the-ground" thought experiment, I just wanted to clarify something. The discussion at hand is about Rights. Defining Rights is something which is of uniquely supreme importance to those of us who think that the primary role of government is to protect Rights. Does the person on the ground have a RIGHT to help from any arbitrary passerby? No. Could one still say that it's morally laudable for that passerby to help? Of course!

If a passerby refused to help, would I personally deride, decry, shun, and scorn that individual? Damn straight I would. They've shown themselves to be a heartless asshole. But that's a personal assessment, based on a personal philosophy, and a personal moral compass. To me, so say that the casualty on the ground has a right to help from a passerby is not only to say that that passerby has a strict obligation to help BUT ALSO to say that the government can and should use all of its coercive force to make the passerby help. And, if the passerby doesn't, to punish him with the full weight of the state.

So does the victim have a right to help from the passerby? No. Does the passerby have a personal obligation to help? No. Should the state be able to punish the passerby for not helping? No.

Should the passerby help that person anyway? Yes.

In closing, here's a quote from George Washington that, if I were in charge, would be inscribed on every government building and permanently tattooed on every elected official:

"Government is not reason. It is not eloquence. Government is force; like fire it is a dangerous servant -- and a fearful master."