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.”