A Plumbline in the Wind

A wandering websurfer by the name of BJ “stumbled into” my last post and left a comment. This person thinks I am “off base,” which no doubt many people do, if they bother to think about me at all, which I’m relieved they don’t. BJ, at any rate, thinks I’m off base because I don’t follow the liberal line, although he (or she) ascribes even more conservative views to me than I actually hold. I have answered some of BJ’s comment in a subsequent comment, but there is one piece of it that merits a post of its own:

Also, isn’t healthcare a human right? Did Christ walk by the leper and say, “well, you should get a job and pay for treatment” or did he say recognize the suffering and and seek to heal? Are we not called upon as Christians to help the weak (pro-life anyone?)

The phrasing implies that BJ believes three things: 1) That healthcare is a human right; 2) That the actions of Christ somehow support this contention; and 3) That this is somehow tied up in the call for Christians to help the weak.

Taking the second point first: Even if the premise were granted that healthcare is a human right, Christ did not come to give people their rights. He came to give them not what they deserved, but something to which they had no right and could never earn: eternal salvation. He did not administer healthcare: He healed by His power as God the Son. Of course He did not tell people to get a job and seek treatment; He did tell people to go and sin no more. The only person whom He encountered who had experienced healthcare was the woman with the issue of blood, who had “spent all her living on physicians.”

To the first point: Is healthcare a human right? BJ considers it obvious that it is. But is it, and what would it mean if it were?

To begin with, what are “human rights”? It’s a phrase we throw around a lot nowadays, but the meaning of the concept is not at all obvious, nor is its validity. What do we mean by a right?

Let us start with a limited example. I have a right to take $100 out of my bank account. Whence does this right come? It comes because I have an agreement with the bank whereby I put the money under the bank’s care with the condition that I could take it out whenever I wanted to do so. My right to take the money out implies a reciprocal duty on the part of the bank to have the money ready for me when I want it. My right in this case is derived from my being party to an agreement.

When I make a right turn from the street that leads into my subdivision to the street I live on, I have a right to drive around the turn without stopping. This is called “right of way.” This right is given to me by some governmental entity (I suppose the township); it implies a reciprocal duty of drivers coming down my street to stop and to allow me to pass, indicated by a red octagonal stop sign. This right is not absolute. If a pedestrian is in the intersection when I want to turn, I do not have the right to run the pedestrian over. The township could take away this right of way at any time by erecting a stop sign in the appropriate place. Unlike my right to take money out of the bank, this right is derived not from an agreement to which I am a party, but from a higher authority, namely the township government.

Under the constitutions of the United States and the state of Michigan, I have the right to vote in elections for various officials. This right is not absolute: not only can it be taken away under certain limited circumstances, I also do not have the right to vote in elections for every official. I cannot go to Detroit or Lansing and vote for the mayors of those cities, because I do not reside in Detroit or Lansing. Much less can I vote for the governor of California or the attorney-general of Nebraska, since I don’t live in those states. My right to vote derives from the constitution and laws of the place where I live; thus it is not abstract but concrete, like the rights mentioned earlier. Like them, it implies a reciprocal duty: the officials of my precinct have a duty to hold an election at the time prescribed by law, to allow me to enter the polling place and cast a vote, and to count my vote after I have cast it. I have these rights because I am a citizen of the United States, at least eighteen years of age, a citizen of the state of Michigan and of a particular municipality resident in a particular precinct, and not a convicted felon.

When people talk about rights, however, they often are thinking of something on an even higher level. For example, we Americans like to say that we have the right to practice religion freely. We further assert that this right is guaranteed by the Constitution of the United States. The most fundamental provision of the Constitution cited in support of this right, the First Amendment, does not create a right to the practice of religion. Rather it states that this right shall not be abridged, as if the right is prior to the Constitution. The Constitution implies that the right is somehow inherent in the citizen, from some unspecified source. (This differs, by the way, from the French Declaration of the Rights of Man and Citizen, which purports to create this and similar rights and subjects them to the provisions of the law.) This right, too, implies a reciprocal duty. This duty is wholly negative: it is the duty of all government officials to refrain from stopping me from exercising my religion. No one has a duty (as a result of this right) to build a church, or to join the clergy, or to furnish me with liturgical books, or to do anything positive on my behalf.

It is this last sort of right that people generally mean when they talk about human rights. One human right often cited as most basic is the “right to life.” By this we mean not that anyone has, in the ultimate sense, the right to have been born and to be alive, but that people, once they have begun to live, should not have their enjoyment of the state of being alive terminated by the action of other human beings. My right to life is not a right with respect to God–He created me by an act of free, unmerited grace, for reasons entirely His own and neither known nor controlled by me; and He can, in perfect righteousness, withdraw that gift from me at any time. I have no rights with respect to God because God has no duties to me. My right to life is a right with respect to other human beings, who have a duty not to kill me. There may be circumstances, which are a matter of disagreement among rational persons of good will, under which I might forfeit that right, or under which that duty might not be operative, but the general principle is that I can’t simply be killed because someone feels like it.

Every right implies a reciprocal duty, positive or negative, whether the right exists under a private contract, under law, or from some source higher than positive human law. Rights such as life, or the free exercise of religion, are the kind of rights usually described as human rights. In the case of both these rights, and of similar ones like the freedom of speech, the reciprocal duties to these rights are negative and incumbent equally upon everyone. Rights arising under contract can have reciprocal duties that are either negative or positive, but are incumbent only upon the parties to the contract. Rights arising under laws likewise have duties that are either negative or positive, and which can be incumbent on everyone (as in the right of way) or on specific persons (as in the right to vote).

This understood, is healthcare a human right? Let us presume that by “healthcare” we mean receiving the administration of medical services, such as medicine, surgery, and similar services; that is, things that are done by human beings to other human beings. If it is a human right, then its origin must not be in a contract or in the law, but in some higher authority, whether divine commandment or natural law, both of which Christians believe have their origin in God. If it is right, then it must imply a reciprocal duty. One may presume, therefore, that this duty is the duty of some (or all) human beings to administer medical services to all other human beings. If this balance of right and duty is a human right, then it does not arise under contract, so that it cannot be dependent on any such element as the payment of money.

Now while some people (perhaps BJ) expect manufacturers of medicines to do so without receiving any compensation, I would not imagine that even BJ would expect physicians to forgo food, clothing, and shelter, so presumably someone, or everyone, will be expected to pay for this, as a matter of divinely ordained duty. Since there is only a limited number of physicians and hours in the day, and even–believe it or not–a limited amount of money, what is the limit on this right? How is it to be limited, or, if it is a human right, can it be limited?

I once saw a bad television movie about a woman who was dying of a progressively debilitating and incurable disease. The woman’s sister, wishing to see her cured, was depicted as meeting with various doctors and scientists who where conducting research into the causes of the disease and ways of relieving it. Being told, in the course of one of these meetings, that the research a particular group of scientists were doing had not yet led to any results, the sister became angry and exclaimed, “That’s not acceptable! My sister doesn’t deserve to die! There has to be a pill that will cure her! I want that pill now!” This is, I suppose, the ultimate expression of the notion of a right to healthcare. I have a right to a pill that will cure whatever disease I have, so that I, and anyone I love, will never die. Sorry, lady; take your case to a higher court. Better yet, read the book of Job and see what answer you’re going to get.

Here’s the problem of putting healthcare into the realm of human rights rather than the realm of prudential action. Because the need for healthcare is potentially infinite, as a human right, it implies a potentially infinite positive duty incumbent upon everyone’s resources to provide it. What I was pointing out in the last post–which I suspect that BJ misunderstood–was the way in which the growth of the expense of healthcare is a function not of the evil intentions of any person or group (not even, BJ, the Republican Party!) but a function of the success of scientists and physicians at discovering more and more treatments for disease. If healthcare is a human right, then this expense must be borne by someone, even at the cost of consuming all resources that might be applied to any other purpose. If on the other hand, it is a matter for prudential action, then rational persons can discuss what the best way is to make use of the resources and knowledge that do exist.

I conclude with the third point: that we have a duty as Christians to help the weak. Note that this is a duty we have as Christians, not as citizens. We cannot presume that our non-Christian fellow-citizens feel the same duty, although no doubt many of them do. BJ mentions the term “pro-life” in this context, a term which is used as an equivalent for the opposition to legalized abortion. Our duty to work against legalized abortion, however, does not arise from our duty to be compassionate to unborn children or to any other weak persons. It arises rather from our responsibility as citizens in a democratic state to support laws (generally in the form of voting for those who support such laws and against those who do not) that are consistent with the negative duty incumbent upon all persons not to kill innocent human beings. If we lived in a state in which citizens had nothing to say about the laws of the state, then we would not have that duty, because the laws would be entirely out of our responsibility. We would have the duty to assist in preserving unborn children in any way we could (which in some places, like China, could be personally dangerous), and that duty would fall under our duty to help the weak. But the duty we have as citizens in the United States to vote, as much as possible, for candidates for public office who will support measures to suppress abortion comes from a higher kind of personal responsibility.

Some Christians, no doubt of good will (and I suspect that BJ may be of this inclination), contend that our duty to help the weak should be expressed by supporting public policies that are to some degree socialistic. That is, I, through the coercive power of the state, force my neighbor to contribute to some activity that I believe is helping someone. Maybe there is a good reason to do this; but is it a manifestation of my duty to help the weak? If I give $200 to Cross International to feed, clothe, and house the poor in Africa, I am exercising (in a poor way) my duty to help the weak. If I put a gun to my neighbor’s head to force him to give $200 to Cross International, could I be said to be doing the same thing? Some might say so, but I doubt it. If, instead of wielding the gun myself, I combine with others to use the state’s monopoly of force to extract the money from my neighbor, I may be doing something legal and even morally licit; but I wouldn’t confuse it with the exercise of my own compassion.

Another way of viewing such a question is to look at what promotes the common good. Questions in this sphere are prudential, not moral, questions. That an unborn child should not be deliberately killed is a moral question, but not all questions are. If we approach every question as if it was a moral one, then rational discourse will soon disappear and all issues will have to be decided by force. It appears to me that it is a particular temptation of the Left to consider prudential questions as moral ones, within an entirely secular moral framework that eliminates any room for the consideration of an eternal perspective. But that’s another story.