By Mark D. White

There is a symposium in the latest issue of Bioethics (35/8, October 2021), edited by Michael Da Silva and Daniel Weinstock, on the topic of health rights that explores their ethical, political, and economics dimensions of "health rights"—the opening paragraph of the editors' introduction provides context and citations to supporting and critical literature:

‘Socio‐economic’ rights are a species of so‐called ‘positive’ right that call for performance of certain actions—most often the provision of particular goods and services—on the part of the rights claims’ purported corresponding duty‐bearers.¹ Advocates of ‘socio‐economic’ rights to health, healthcare, or public health (‘health rights’) have produced several plausible theories that address some of the most pressing challenges for socio‐economic rights claims. Many critics still deny that moral health rights exist or that rights‐based approaches will best achieve health justice,² but health rights theorists at least provide sophisticated answers to basic questions like ‘Who possesses the rights and their corresponding duties?’and ‘What are the nature, scope, and content of the duties?’Answers to these questions differ and will not convince all critics, but rights‐based approaches to the corner of bioethics devoted to health justice now at least constitute part of the scholarly mainstream.³ Regardless of their theoretical bona fides, in turn, health rights exist in many legal systems. The international right to health is well established and most domestic constitutions recognize rights to healthcare, if not broader rights to health or public health.⁴ Theorists should and do attempt to ‘make sense’ of this phenomenon.⁵

(The footnotes appear at the end of this post.)

As the rest of the introductory essay recognizes, and the papers in the symposium explore, a right to health, as with positive rights in general, is fraught with conflicts with negative rights (against interference and compulsion) as well as other positive rights that may compete with health rights in principle or along more practical concerns of resource scarcity.

• Understanding the right to health in the context of collective rights to self-determination, by Éliot Litalien
• Individual and ‘national’ healthcare rights: Analysing the potential conflicts, by Michael Da Silva
• A justification of health policy federalism, by Daniel Weinstock
• Rethinking the right to health: Ableism and the binary between individual and collective rights, by Amie Leigh Zimmer
• Judicial interventions in health policy: Epistemic competence and the courts, by Leticia Morales
• Decolonizing health care: Challenges of cultural and epistemic pluralism in medical decision-making with Indigenous communities, by Sara Marie Cohen-Fournier, Gregory Brass, and Laurence J. Kirmayer

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Footnotes to opening paragraph of introduction:

¹ For good summaries, see Rumbold, B. E. (2017). The moral right to health: A survey of available conceptions. Critical Review of International Social and Political Philosophy, 20(4), 508–528; Hassoun, N. (2015). The human right to health. Philosophy Compass, 10(4), 275–283; Hassoun, N. (2020). The human right to health: A defense. Journal of Social Philosophy, 51(2), 158–179. On the less commonly discussed purported ‘right to public health’, see Wilson, J. (2016). The right to public health. Journal of Medical Ethics, 42(6), 367–375.
² Gopal Sreenivasan provides one of the strongest arguments against moral health rights in Sreenivasan, G. (2012). A human right to health? Some inconclusive scepticism. Proceedings of the Aristotelian Society Supplementary Volume, 86, 239–265 and Sreenivasan, G. (2016). Health care and human rights: Against the split duty gambit. Theoretical Medicine and Bioethics, 37(4), 343–364, though he recognizes that legal rights exist and may be justified. Cohen, J. (2020). Paradigm under threat: Health and human rights today. Health and Human Rights Journal, 22(2), 309–312 has a nice, succinct overview of criticisms of rights‐based approaches to health justice and attempts to respond to such critiques.
³ The last two comments build on sources cited in note 1. For a succinct discussion focused on theorizing the international rights, see Wolff, J. (2012). The human right to health. W. W. Norton.
⁴ United Nations. (1966, December 16). International Covenant on Economic, Social and Cultural Rights, 993 UNTS 3, art. 12; Rosevear, E., Hirschl, R., & Jung, C. (2019). Justiciable and aspirational economic and social rights in national constitutions. In K. G. Young (Ed.), The future of economic and social rights (pp. 37–65). Cambridge University Press.
⁵ The language here is inspired by Nickel, J. W. (1987). Making sense of human rights: Philosophical reflections on the Universal Declaration of Human Rights. University of California Press. Wolff, op. cit. note 3 is an example of an attempt to ‘make sense’ of existing laws from a philosophical perspective.