Altruism in Health Care

Abstract

Can a commitment to social justice and to altruism in medicine coexist? Can medicine remain a locus of human generosity and compassion as health care provision becomes more and more a social responsibility? Over the past decade a number of writers, myself among them, have sought to assert that there is a fundamental human right to health care. In different ways we have argued that access to health care cannot be allowed to depend upon one’s financial resources or on the free generosity of some health care providers. Each person, we have said, has a legitimate moral claim to a fair share of the health resources a society provides ([11, 12, 24, 33]). But even as we have argued this way, it has been incumbent upon us to consider the costs of the right we would affirm. On the economic side, this matter has received attention as thinkers have explored the problem of how quality of care can be conjoined with equality of its distribution ([4, 9]). But far less attention has been given to the possible moral costs of this right. In what follows I want to examine one of these possible costs by asking whether some of the altruistic moral attitudes and practices traditionally associated with medical care can survive in an environment of social or legally established rights and claims.