Health care as a right: some practical implications

This article examines some of the important legal and moral issues raised by the recognition of a right to health care. The acceptance of such a right entails an ethical position critical of those societies which fail to provide for comprehensive access to basic health care facilities, and of those legal systems which do not impose a duty upon medical professionals to render aid in emergency situations. It will be found that, in the common-law world, judicial and legislative strategies to ensure a minimum level of medical care have proved inadequate due to the absence of such a duty. Correlative to a threshold right of access to health care is a moral obligation upon those providing medical services to respect the dignity and autonomy of their patients. A consistent moral or rights based approach has as a practical consequence the need to subordinate any purely scientific conception of the doctor's role to a set of legal and ethical standards which are appropriately sensitive to the value commitments and informed choices of the individual patient. The pre-eminent ethical claims upon health care professionals must not be obscured by the putative demands of scientific development. In view of this it is necessary to re-examine both the general allocation of resources within the health service and legal control of current medical practice in relation to decision making at the 'edges of life' and the requirement of informed consent to treatment. In sum it is argued that any assessment of the health care system and of the relevant law which focuses on the rights of the patient must be both consistent and wide-ranging.