Topics Justice

Question Is medical care or education a basic human right? If so, why? what is a basic human right? Thanks!

Accepted:
November 26, 2005

Comments

It makes sense to start with your more general question: What is a (basic) human right? Official documents and public pronouncements typically leave this nebulous by not making explicit who bears what correlative duties to the human rights postulated or invoked. They are typically clearer with regard to the object of any human right -- that which this human right is a right to.

Toward making the correlative duties explicit: I think that any human right imposes at least two kinds of duties on other human agents (persons, corporations, organizations, governments, etc.). These are interactional duties: duties not to deprive human persons of the objects of this human right, and institutional duties: duties not to collaborate in imposing on human persons social rules under which some will foreseeably and avoidably lack secure access to the objects of their human rights (unless one also makes compensating efforts to reform the rules or to protect their victims).

A specific human right might then be accepted just in case it can be supported by the following three considerations. First, the object of the candidate human right must be genuinely important to all or nearly all human beings during some parts of their lives. Second, avoiding the duties correlative to the candidate human right must be considerably less important or not important at all. Third, the two preceding judgments must be broadly sharable across cultures.

Supported by these three considerations, accepted human rights then furnish widely sharable minimal standards for how agents should treat human beings and for the justice of social rules. Human rights to basic levels of education and medical care would, I think, meet this test:

First, the objects of these candidate human rights are genuinely important for meaningful participation in a society's social and political life and, in the case of medical care, even for biological functioning and survival.

Second, the correlative burdens are relatively light: We must not act in ways that deprive others of basic education or medical care, and we must help organize our society so that all its members have secure access to these goods insofar as this is reasonably possible.

Third, the preceding two judgments are widely sharable across cultures, so long as the right is confined to basic levels of education and medical care and such basic levels are fixed in light of the resources available in the social systems whose rules are under assessment.

Imagine a society in which access to even basic education and medical care must be paid for and where therefore, quite foreseeably and quite avoidably, many born into poor families will not be able to learn reading and writing in school or to receive treatment for a ruptured appendix. My acceptance of human rights to basic levels of education and medical care commits me to judging such a society to be seriously unjust and to the view that this judgment is widely shareable across cultures.

Think of the IMF imposing strucutural adjustment programs on African countries, requiring the latter to introduce school fees, with the result of a substantial drop in school enrollments, and higher fees for medical care, with the result that many serious and readily treatable diseases remained untreated. My acceptance of human rights to basic levels of education and medical care commits me to judging such IMF conduct to be seriously wrong and to the view that this judgment is widely shareable across cultures.

The commitments derived in the last two paragraphs reinforce my belief that, on my rough and incomplete account of what human rights are, your two candidate rights should be accepted as human rights.

These two candidates, and many others as well, become much harder -- I believe: impossible -- to defend if one defines human rights as (also) imposing correlative duties to protect and promote. I therefore reject this definition. To be sure, I do not deny that we have moral duties to protect and to promote human rights. I am denying merely that these duties are correlative to human rights -- that is, that any violations of these duties are violations of the corresponding human rights.

This is one of the most important questions of political philosophy today. It's important, however, to distinguish between the way it may be asked as a legal or empirical question and the way it may be asked as a philosophical question.

By rights, here, we are talking about what I call "claim rights"--that is, the right to make claims upon others for some good. For example, children have the right to make claims upon their parents for nourishment and support. Citizens have the right to make claims upon their government for protection. Here we're talking about the right of people to make claims upon one another for medical care and education.

Claim rights may be opposed to "rights of non-interference"--that is, rights to be free from restrictions or harms imposed by others, either states or other individuals. So, for example, the right to free speech is a right to speak without interference from the state (and in some cases non-state agents).

"Basic" rights may be thought of as necessary rights, rights that cannot be ignored, that are not contingent or elective, rights that cannot be denied without fundamentally changing the political order itself. It's a good philosophical question whether there really are such rights. (I have my doubts.) But for the sake of argument here, let's simply call "basic" rights that simply must be observed.

"Human" rights differ from typical legal rights in that they are rights that are thought to be held by all people everywhere, no matter what state rules them. Many historically have rooted these rights in something beyond the social-political order, for example nature or the divine. Hence, human rights are often thought to be co-extensive with natural rights.

Empirically and legally, the question boils down to these: (1) do the legal and political institutions of the day establish rights to education and medical care, and (2) do they establish them as "basic" "human" rights? (Most wealthy countries answer 1 in the affirmative but 2 in the negative, though socialist policies around the world tend toward an affirmative answer to both.)

Philosophically, the question amounts to whether or not these rights ought to be established. Briefly, I'd answer this way:

There seem to be no natural rights; there seems to be no natural moral law. But natural dimensions of human being are proper to consider in formulating rights and laws. So, if basic human rights are to be determined, they won't be found. They must be created through a process of moral reflection. Medical care and education are among those that ought to be established as basic human rights.

But still, we must answer your question: "Why?"

Claim rights ought to be established when it's better to do so than not to do so, that is when the consequences of doing so are better than the consequences of not doing so. Claim rights should not be established when the consequences of doing so are worse than the consequences of not doing so.

Things get sticky here, and it would really take many volumes to suss it all out; but I would say briefly that providing basic medical services and education to everyone is possible at a sufficiently low cost as to make it morally compulsory to do so. A world where everyone has the opportunity for education and basic medical care is on the face of it better than a world where everyone doesn't. A world where education and medical care are available only to the wealthy is on the face of it worse than a world where they're available to all.

This view does require certain moral commitments to human equality, that I think defensible and correct. But they are debatable views.

One way I look at is like this: We can group rights (both claim rights and rights of non-interference) into three categories: (1) security rights; (2) liberty rights; and (3) flourishiing rights. Rights discourses historically (and very roughly) began with a focus on security (Hobbes), then expanded to included additional considerations of liberty (Locke, Jefferson, Madison), and then began to consider more aspects of human flourishing (Mill, Marx). Curiously, advances in biology and psychology have led us today to a deeper understanding of what conditions are necessary for the human animal to flourish, and this understanding has returned us to considerations about human excellence and human flourishing characteristic of many ancient and medieval forms of ethical philosophy.

So, my own view is that establishing medical care and education as basic human rights not only reflects the progress of rights thinking as it has considered more and more the idea of flourishing rights. It also reflects a rediscovery of the value and accuracy of ancient ethical discourses focusing on excellence, virtue, and flourishing. That is to say, the ancient focus on excellence and the modern focus on rights come together in the recognition of medical care and education as basic human rights.

Question Is medical care or education a basic human right? If so, why? what is a basic human right? Thanks! Accepted:November 26, 2005

Question Is medical care or education a basic human right? If so, why? what is a basic human right? Thanks!

Accepted:
November 26, 2005