Among the political and legal concepts of the 20th century, a special place is occupied by the doctrine of natural law and rights. It continues the tradition of a philosophical interpretation of the law and relies on various concepts that have developed in modern Western European and American philosophy. Contemporary natural-legal theories recognize the existence along with a positive law of the ideal order of relations among people.
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This highest normative order is called natural law. According to such views, the legislation of the state is valid and legitimate only if it corresponds to the ideal law. In such a public sphere as universal healthcare, the described theory plays a significant role since some provisions of modern medicine largely relate to this concept. Therefore, it is required to review the theory of natural law and rights to consider its application in the field of healthcare and draw a specific conclusion as to whether the norms of this theory in this public area are observed.
Christianity, like many other religions, contributes to the development of ideas about the existence of the law given by God. The doctrine of free will in this context is the consequence of the human responsibility to God, as well as a religious and moral regulator of relations among people. An attempt to establish truly fair canons for all the people is the common feature of the whole world’s religions. According to Boyd and Thorsten, natural-legal views in modern jurisprudence are combined with the historical and sociological study of legal ideas (77). The basic essence of such a concept is to show that the formation of the society does not affect its ability to adapt to modern conditions and does not violate the established order of freedoms and values.
Among natural rights, the right to life occupies a special place. This fundamental concept is at the top of the natural-legal pyramid, which is understandable – when depriving someone of life, all other freedoms lose their meaning. The human right to life is fixed in most official government documents. Human laws took a significant place in the first bourgeois-democratic constitutions of the late 18th century. For example, the world-famous Declaration of 1776 refers to the possibility of the need to allow each person to have his or her destiny and implies respect for personal dignity (Boyd and Thorsten 103). Over time, this concept has significantly developed since the society was interested in finding ways to preserve the right to personal happiness and self-development.
Other views were held by another English thinker Locke who puts forward a different theory of the original and natural state of the human (Boyd and Thorsten 92). The philosopher considers the initial absolute freedom of people not to be the source of struggle but the expression of their natural equality and readiness to follow reasonable natural laws (Boyd and Thorsten 92). This people’s readiness leads them to realize that in the interests of the common good, it is necessary, while retaining freedom, to give part of the function to the government, which is called upon to ensure the further development of the society.
It is how a social contract is reached among people. The more rights the person has, the wider the range of his or her duties to the society is. The state does not have absolute arbitrary power. In Locke’s opinion, a social contract presupposes the responsibility of the country to its residents (qt. in Boyd and Thorsten 93). If the state does not fulfill its duty and violates natural freedoms, people have the right to fight against such a social order.
Similar approaches to the structure of the country and relations among people belonging to the outstanding American figure of Thomas Jefferson whose views regarding interpreting the theory of natural law and rights differed from Christian ones (Boyd and Thorsten 91). Jefferson focuses on human rights and singles out a range of freedoms – the freedom of conscience, speech, procedural rights, security rights, etc.
He insisted on the separation of church and state, which was a bold proposal in conditions of that society. According to Boyd and Thorsten, Jefferson claimed that, despite the divine origin of the human, higher powers could not control what happened to people on the earth, and the society had the right to decide how it was better to develop (91). Jefferson’s ideas are reflected in many of his followers’ works, and his contribution to the development of the natural rights theory is significant.
Another approach related to the theory of natural law and rights is the position of the American writer Ayn Rand who first popularized the idea of freedom determined by property rights and based on the Aristotelian interpretation of the natural law (Boyd and Thorsten 99). Instead of an altruistic approach to understanding human relations, the writer proposes to focus on personal happiness, thereby denying the idea of any action for the benefit of others (qt. in Boyd and Thorsten 100). Certainly, Rand’s worldview was influenced by the classical philosophy of liberalism, which was reflected in her fundamental ideas. Ethical egoism is one of the key points of her theory, and this approach is also famous, despite being criticized by many people.
The Issue of Universal Healthcare
The issues of world medicine are relevant for all countries without exception since the well-being of citizens directly depends on the quality of healthcare. The development of technologies and innovations in this field made it possible to use the most modern methods of treatment, and what previously seemed impossible, for example, cancer therapies, is practiced now. From morality, some controversial issues may arise, for instance, ethical selfishness or the lack of professional performance of immediate duties (Hall and Bobinski 129). A human factor still plays an essential role, even despite the automation of many processes, and some mistakes and contradictions in the work are inevitable.
Patients’ claims for medical and nursing care are primarily related to the insufficient qualification of personnel. The absence of narrow specialists, problems with diagnostics, difficulties in obtaining preferential medicines in pharmacies, high prices for paid medical services, etc. also cause dissatisfaction (Hall and Bobinski 114). Certainly, all these issues complicate the process of work and thereby cause tension, which leads to misunderstandings and conflicts.
Many patients require special treatment, claiming that they are entitled to rely on highly professional care. In some cases, their claims are justified because, according to Almgren, some physicians may not observe the ethical principles of their work and undermine not only their dignity but also the reputation of the healthcare system as a whole (8). Therefore, it is difficult to achieve full harmony if a human factor plays a significant role in the work process.
Level of Medical Personnel’s Training
The quality of medical care largely depends on the level of doctors’ training, the qualifications of other healthcare professionals, and their responsible attitude to their duties and patients. The quality of doctor-patient relationships is the key to successful treatment and the indicator of professionalism in the provision of medical care. Understanding the nature of these relationships influences physicians’ ability to correctly diagnose, prescribe treatment, and also provide psychological support.
People working in the healthcare sector often experience stress at work because their environment makes high demands that exceed the abilities of doctors and nurses. The consequences of stress include high employee turnover, reduced productivity, accidents, rudeness, and medical errors (Hall and Bobinski 274).
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Because of doctors’ excessive workload, there is little time to communicate with patients, which leads to complaints about a rough and incorrect attitude. To avoid it, it is essential to strive to improve the working schedule using competent time planning, the possibility of providing psychological assistance to medical specialists themselves, as well as strengthening the motivation of the staff (Almgren 93). Otherwise, changes for the better will not be possible, and constant controversial nuances will arise.
Too low salaries and high-performance requirements sometimes cause the lack of completeness of clinics by medical or nursing staff. This issue is unlikely to be relevant to the problem of professionalism and rather refers to a social and ethical problem. The lack of specialists hurts the overall level of medical care since many employees are forced to work overtime, which leads to increased fatigue and the loss of motivation (Almgren 183). All these issues are relevant to universal healthcare and are significant problems that need to be addressed.
Application of the Theory of Natural Rights and Law to Universal Healthcare
The theory of natural rights and law can be applied to the healthcare sector since some ethical issues in this area can be related to the provisions of the concept. Medical issues imply compliance with certain ethical issues that are directly relevant to human rights. The implementation of specific provisions is an indicator of the success and quality of medical services, and their non-compliance, on the contrary, negatively affects the state of medicine.
The Right to Health Services as the Right to Life
All people have the right to their religion and the right to receive appropriate medical care (Muñoz 369). The main purpose of medicine is to protect the health of citizens and provide timely assistance at the request of patients. These provisions are prescribed in all state laws of countries with a developed healthcare system. Modern society promotes people’s interests and provides for human life as the highest value (Marske et al. 61).
Accordingly, the provision of medical services is an inalienable and unconditional right of people to use health services and have access to professional medical consultations. Various insurance documents are designed to legitimize this right and to systematize the possibility of protecting public health. Nevertheless, if the person does not have the opportunity to purchase an insurance policy or another document that confirms his or her access to receiving appropriate care, it does not mean that the state has the right to refuse. Free treatment is the feature of a civilized society, and compliance with this law is natural.
Freedom of Choice
The freedom of choice is a component of natural rights that was considered by Thomas Jefferson (Boyd and Thorsten 91). This concept can be fully applied to the sphere of universal healthcare since every person has the right to independently choose whether medical services are necessary to him or her and what type of assistance is needed. Modern services provide for a free choice of assistance, and although Jefferson’s theory denied God’s participation in human rights, the relationship between religion and medicine can be traced (Muñoz 371). Also, no one can force the human to use the services of doctors, which is also quite natural. Personal motivation and desire play a major role, and the violation of this norm is the violation of human rights, which is inadmissible in a modern civilized society.
Observance of Medical Secrecy
One of the aspects of healthcare that should be strictly observed is compliance with medical secrecy, that is, the prohibition on disclosure of patients’ data. If the theory of natural law is applied in this case, it can be noted that everyone has the right to protect his or her interests and preserve information about the state of health. Some controversial points, however, may arise in this case. For example, if the patient can harm other people, refusing hospitalization or appropriate treatment, medical workers are entitled to bring this person to justice.
This behavior contradicts the concept of protecting human health, and measures should be taken against such violators, for example, by bringing them to administrative responsibility. However, if there is no threat of an epidemic or another problem, and a person insists that his or her data should not be disclosed, doctors cannot pass on information about the state of the patient’s health, which also is a natural right given to people by the state.
When resorting to the concepts of philosophers, Locke’s claim of mutual responsibility can also be considered as one of the approaches to universal healthcare (Boyd and Thorsten 91). The point is that medical specialists are obliged to help all those in need, which corresponds to the conditions of their professional ethics. However, patients also have some responsibilities that need to be followed to maintain a balance. For instance, such a violation of moral and ethical standards as rudeness towards medical personnel is unacceptable since everyone has a natural right to personal dignity. Also, both doctors and patients should be tolerant of one another.
Any forms of intolerant behavior contradict the moral foundations of modern society. Therefore, to create the most favorable working conditions, it is significant to adhere to ethical norms of behavior and to not only demand observance of natural rights but also to personally observe them. Otherwise, disagreements will not allow achieving mutual understanding, and insufficiently quality assistance will be provided because it will be impossible to find a compromise on a specific issue.
Thus, the theory of natural rights and law can be observed in the field of universal healthcare, and some of the provisions of this concept are reflected in medicine. Various philosophers’ approaches confirm the relevance of this topic and some possible contradictions that may arise. The field of modern healthcare has several controversial issues, and following specific theoretical provisions can help to solve these problems.
Almgren, Gunnar. Health Care Politics, Policy, and Services: A Social Justice Analysis. 3rd ed., Springer, 2017.
Boyd, Craig A., and Don Thorsten. Christian Ethics and Moral Philosophy : An Introduction to Issues and Approaches. Baker Academic, 2018.
Hall, Mark A., and Mary Anne Bobinski. Health Care Law and Ethics. 8th ed., Wolters Kluwer Law & Business, 2014.
Marske, Charles E., et al. “The Significance of Natural Law in Contemporary Legal Thought.” The Catholic Lawyer, vol. 24, no. 1, 2017, pp. 60-76.
Muñoz, Vincent P. “Two Concepts of Religious Liberty: The Natural Rights and Moral Autonomy Approaches to the Free Exercise of Religion.” American Political Science Review, vol. 110, no. 2, 2016, pp. 369-381.