12.13.2010

Edward Feser Explains the Church's Teaching on Health Care as a Right

Entirely lucid, as Professor Feser's writing usually is:
It is in any event important to remind ourselves of what the Church actually teaches, and what she teaches is not at all what such liberal Catholics think it is. To be sure, in line with statements made by popes John XXIII and John Paul II, the Catechism of the Catholic Church does indeed speak of a “right to medical care” as among those the “political community” has a duty to uphold (2211). But does this entail that universal health care must be funded by and/or administered by the federal government, or indeed by any government? No, it doesn’t. Consider first that the same documents that affirm a “right” to medical care also affirm “rights” to “food, clothing, [and] shelter” (John XXIII, Pacem in Terris 8) and “to private property, to free enterprise, [and] to obtain work and housing” (the Catechism again). But no one claims that the Church teaches that governments have a duty to provide everyone with a government job, or free food, clothing, shelter, or other kinds of property at taxpayer expense, or a guarantee of entrepreneurial opportunities.

Why not? Because the term “right” is simply not used in Catholic moral theology in the crude manner in which modern American liberal politicians like to use it, viz. as expressing a legally enforceable demand on the part of an individual that he be provided with some benefit by government (either in the form of a service funded by the taxpayer or in the form of coercion of those who might otherwise “discriminate” against him). Rather, the theory of rights enshrined in traditional natural law thinking and the traditional Catholic moral theology informed by it is very complex and nuanced, and includes a number of crucial distinctions that must be borne in mind in any analysis of what the magisterial documents of the Church entail. There is, for example, the distinction between objective right – some thing or act one might in some sense have a claim to – and subjective right – the moral power he might have to claim that thing or act he has an objective right to. There is the distinction between natural rights – rights we have simply by virtue of being human – and positive rights – those that exist only given a certain man-made legal framework. There is the distinction between a connatural right – a right one has independently of any conditions – and an acquired right – a right one has given the fulfillment of certain conditions. There is the distinction between an affirmative right – a right to have some good provided to one – and a negative right – a right merely not to be impeded in the pursuit of some good. There is the distinction between a perfect right – a right which is a precondition of the possibility of everyday moral life – and an imperfect right – a right which is not strictly necessary to make everyday moral life possible but which nevertheless considerably facilitates it. Among perfect rights, there are those which must be enforced via the power of the state (e.g. the right not to be killed unjustly) and those which are not appropriately enforced in this way (e.g. the right to be treated with respect by one’s children). Among imperfect rights, there are rights to things strictly due to us (e.g. gratitude from those we have benefited) and rights to things that are not strictly due to us (e.g. to be treated pleasantly by those we come into contact with in day to day life). There are further distinctions to be made, and elaborations and qualifications to be made to the distinctions already made; and a good book on ethics or moral theology of the sort I recommended in an earlier post will spell them out for the interested reader. (Volume I of Cronin’s Science of Ethics is particularly good on this subject, as on so much else.)

The point for present purposes is to emphasize that noting that a magisterial document speaks of a “right” to something by itself does nothing to show that government must provide it. All it shows is that people have a claim of some sort against others – how strong a claim, how that claim is to be respected, whether and to what extent government has a role in ensuring that it is respected, etc. are all further issues requiring careful analysis. This is especially so of something like a “right to medical care,” which, unlike such negative rights as the right of an innocent person not to be killed, involves a positive claim against others that a certain service be provided. Does the right to medical care entail that government itself must provide medical services? Or only that it provide citizens with the means to purchase such services? Must it provide them to all citizens, or only to those otherwise unable to afford them? What level of government is supposed to do this – municipal, state, or federal? Does it require government to force some individuals to become medical doctors, nurses, and the like so that the services can be provided? (They don’t grow on trees, after all.) Or is government involvement really necessary here at all? Is the right in question instead only a right that others provide those who need medical assistance with the means to do so in some way or other – through government if necessary, but through private means if possible? And if so, which persons in particular are supposed to provide this aid – family members and friends, churches and charities, or total strangers too? Merely noting that the Church teaches that people have a “right” to medical care (or to food, shelter, a job, etc.) answers none of these questions.

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