Public Health and Globalisation by Iain Brassington

Author:Iain Brassington
Language: eng
Format: epub
Tags: Public health, national health service, self-interest, rights, duty, morality, ethics, politics, society, globalisation, globalization, NHS
ISBN: 9781845406561
Publisher: Andrews UK Limited 2016
Published: 2016-09-13T00:00:00+00:00

3. Public Health and Duty

It would appear, as things stand, that we can give a reasonably good argument in defence of the claim that, if there is a right to healthcare, and if that right really is a human right rather than simply a civic right, we have a moral reason to provide a public health service whose reach is transnational; put another way, we have no particular reason to provide a national health service. Providing a national health service represents a way for us to begin to accommodate people’s putative human right to healthcare, but if we are concerned to accommodate those rights as fully as possible - which seems to be demanded by the supposition that they are human rights at all - we will quickly find we have exhausted what can be provided by a national health service.

On some accounts of rights, though, there is still room for dispute about the provision of a public health service. Those who want to defend healthcare’s status as something to which we have a human right or an entitlement - it does not matter for the moment whether that right or entitlement comes from membership of a community, or whether it’s something more basic like a human right - might face an attack from one of two fronts.

One line of attack is constituted by the simple denial that there is a right to healthcare, at least inasmuch as that right is supposed to be fundamental and irreducible to other considerations. Such an attack might be mounted as a part of a wider sceptical claim about human rights tout court. Whatever else we might say about the provision of healthcare, we might have no right to have it provided for the simple reason that we have no relevant rights.

Another line of attack that might be used against a rights-based argument for a public health service is to turn it against itself. Some people might want to argue against the provision of a public health service not because we have no right to healthcare - or, at least, not primarily because we have no such right - but rather because, whatever rights we do have to healthcare, they are simply less important than other rights, and these other rights cancel out the healthcare right. In other words, the claim would be that there is no significant or overriding right to healthcare; and we could - if we were feeling concessive - make this claim while still allowing that there is a weak right to healthcare.

But how might such an argument work? One approach would be to exploit a line suggested by Robert Nozick’s account of justice. We have already seen how the account of justice offered by John Rawls might be put to work in favour of the public provision of welfare services. Nozick’s account of justice differs significantly; for while (at risk of oversimplifying affairs) Rawls is concerned with justice as the “end point” of social policy, Nozick is concerned to provide a procedural account of justice.

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