Sunday, October 09, 2011

Does society have a responsibility to care?

A reader was taken aback while watching the Republican presidential debate in Tampa, Fla., recently. During the debate among contenders for the Republican nomination for the U.S. presidency that was sponsored by CNN, U.S. Rep. Ron Paul made clear he didn't believe it was right to let sick people die, but he argued that those who are sick should take responsibility for themselves.

As the exchange between Paul and moderator Wolf Blitzer continued, Paul was asked if a young man who might fall into a coma should be left to die. A handful of audience members at the debate shouted "Yeah."

My reader was motivated to write because of "the disgraceful cheering that took place" at that debate. Still, the reader believes the question was a fair one: "Does society have the obligation to care for someone who shows up at a hospital room without medical insurance? Does society have an obligation to care for him?"

But my reader would like to reframe the question a bit. "If a person possibly expects society to give him medical care sometime in the future, is he obligated to prepay in some way?"

He explains that one way this might manifest itself is whether someone is obligated to donate blood if he expects society to be able to provide it for him at some point in the future. He argues that since the current system of voluntary blood donation seems to supply enough blood, a person who doesn't donate could say he shouldn't have to because there is no shortage.

"But," my reader continues, "that's not the situation with organ donation." He notes that there is a shortage of organs available for transplantation and people die waiting for them. "Therefore," he asks, "shouldn't a person who expects or hopes that society will find an organ suitable for him if he needs it sometime in the future be obligated to be an organ donor if he should die suddenly?"

Absent the vitriol, my reader circles back to the question similar to the one raised at the Republican debate: "Is a person who expects society to give him medical treatment obligated to make arrangements to pay for it?"

Yes, of course, we'd like to think that people would be able to take responsibility for their health care and pay for the services they use. We'd also like to think that those who might draw on particular services in the future choose to give back if the opportunity arises so that others can draw on similar services.

But if the underlying question my reader poses is whether those who don't have the resources to pay or those who haven't taken the time to donate blood or fill out organ-donor cards should be denied services, the answer is no.

We've decided that, as a society, it's inappropriate to turn away those who are in need of medical or emergency services that could save their lives, even if they can't afford such services. That decision reflects an ethical choice we've made about how we're going to live together. Those who shouted "Yeah!" to a suggestion that we let folks die rather than provide health care fall distinctly outside of the agreed-upon norms.

A goal of having everyone take responsibility for their health and contribute to those efforts of which they might afford themselves in the future is a good one. But having such a goal doesn't remove the responsibility of caring for those who might not have been as prescient, responsible, or capable to make the same decisions before they find themselves in need.

Jeffrey L. Seglin, author of The Right Thing:Conscience, Profit and Personal Responsibility in Today's Business," is a lecturer in public policy and director of the communications program at Harvard's Kennedy School.

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(c) 2011 JEFFREY L. SEGLIN. Distributed by Tribune MediaServices, Inc.


William Jacobson said...


Society has decided that it benefits society to provide basic medical services that preserve life. To this end, society has opted to provide basic services to all comers regardless of ability to pay.

I don't believe that your poster's suggestions would be either viable (someone who can not pay now probably could not have prepaid either) or further society's goals so as a matter of public policy have already been considered and rejected.

William Jacobson
Anaheim, CA

Anonymous said...

The CNN Presidential Debate that was the subject of the writer's comoplaint was a typical "gotcha" moment brought about by "Commentator" Wolf Blitzer. The question asked of Ron Paul was a set up by Blitzer, a known liberal broadcaster and Paul should have fought Blitzer on it. It is clear that in the United States, if someone presents themself at a hospital without medical insurance coverage, they will not be turned away. The discussion abou pre-paying for such things as blood and organs is simply beyond the capability of such a forum as this one.

Charlie Seng
Lancaster, SC