Reviewing recent health correspondence on the Internet, and in listening to some rugged individualists, new age spiritualists and libertarians, I am struck by the conviction that many of these people were blindly accepting the belief that each of us is totally responsible for where we are in life, physically, financially, mentally and in health, that the government, our society's bonding agent, owes us nothing, that we came in to this life choosing the health and conditions that we live with and that we continually make or reaffirm these choices and, presumably, the purpose of this life is for us to experience the lessons of these individual choices. That view does not agree with the history of the United States and now of the world.
I write this as we come upon the fourth of July, a significant date in the history of the world, when a people in 1776 stated in a grand document carefully crafted by many of the best political and legal minds of their age on that continent, in clear language that:
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these rights are Life, Liberty and the pursuit of Happiness, — That to secure these rights, Governments are instituted among Men, deriving their just powers from the Consent of the governed, --That whenever any Form of Government becomes destructive of these ends, it is the Right of the People to alter and abolish it, and to institute new Government, laying its foundation on such principles and organizing its powers in such form, as to them shall seem most likely to effect their Safety and Happiness."
Those bold words were, of course, stated in the opening of the Declaration of Independence of the United States of America published on July 4, 1776.
These were not idle words. At that time the rights set forth in that document already had well defined legal meaning in the traditional English law from which each of the drafters of this document drew his knowledge. William Blackstone, author of Commentaries on the Laws of England, whose first edition of 1769-1769 (4 volumes) was readily available in America at the time, and who was later studied by such as Abraham Lincoln, had written in volume I, that the "the rights of all mankind .... may be reduced to three principal or primary articles; the right of personal security; the right of personal liberty; and the right of private property." He described the first right as: "The right of personal security consists in a person's legal and uninterrupted enjoyment of his life, his limbs, his body, his health, and his reputation." It would be well for modern jurist to review those well known basic rights.
It was recognized, even before the government of the United States was formed, that in the use of these words the government had a positive duty. Blackstone went on to say:
"The law not only regards life and member, and protects every man in the enjoyment of them, but also furnishes him with every thing necessary for their support. For there is no man to indigent or wretched, but he may demand a supply sufficient for all the necessities of life, from the more opulent part of the community,..."
The United States Constitution states in the bill of rights, its first ten amendments (9thAmendment) that: "The enumeration in the Constitution, of certain rights, shall not be construed to deny or disparage others retained by the people." And when it says in its preamble that:
"We the people of the United States, in order to form a more perfect Union, establish Justice, insure domestic Tranquility, provide for the common defense, promote the general Welfare, and secure the Blessings of Liberty to ourselves and our Posterity, do ordain and establish this Constitution of the United States of America."
That constitution created a joint and mutual promise for the common benefit of all, and not just a few lucky ones. Skill, luck, foresight and good fortune were promoted, but not at the expense of the common and mutual welfare of all members and the rights of each member. Indeed, the fortunes of any and every member were promoted and defended as integral parts of and responsible to this joint and mutual covenant.
Whether we approach a social problem through legal analysis or political platform, in the United States this covenant requires that we must constantly keep before us our common bond. We are indeed not islands of individuality, but members of a greater community, a greater family, that believes in fundamental rights of all people. We may differ from time to time in our opinions on how to protect and achieve these rights and perform these mutual obligations, but we are bound together to support them.
In 1948 as one of the then 58 member General Assembly of the United Nations, the United States helped draft the Universal Declaration of Human Rights in the Spirit of Franklin D. Roosevelt's Four Freedoms which included Freedom for Want, and Harry S. Truman's full employment legislation. Mrs. Eleanor Roosevelt was the chairperson of the Human Rights Commission that drafted this document adopted by the General Assembly of the United Nations in accordance with its charter. This declaration stated "without distinction as to race, color, six, language, religion, political or other opinion, national or social origin, property, birth or other status," that:
"Article 3. Everyone has the right to life, liberty and security."
"Article 22. Everyone, as a member of society, has the right to social security and is entitled to realization, through national effort and international co-operation and in accordance with the organization and resources of each State, or the economic, social and cultural rights indispensable for his dignity and the free development of his personality."
"Article 24. Everyone has the right to rest and leisure, including reasonable limitations of working hours and periodic holidays with pay."
"Article 25. (1) Everyone has the right to a standard of living adequate for the health and well- being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control."
(2) Motherhood and childhood are entitled to special care and assistance. All children, whether born in or out of wedlock, shall enjoy the same social protection."
"Article 28. Everyone is entitled to a social and international order in which the rights and freedoms set forth in the Declaration can be fully realized."
"Article 29. (1) Everyone has duties to the community in which alone the free and full development of his personality is possible."
(2) In the exercise of his rights and freedoms, everyone shall be subject only to such limitations as are determined by law solely for the purpose of securing due recognition and respect for the rights and freedoms of others and of meeting the just requirements of morality, public order and the general welfare of a democratic society."
The basic rights to life were revisited by the world community in the International Covenant on Economic, social and Cultural Rights entered into force on January 3, 1976, that declared among other principles:
Article 6 1. Every human being has the inherent right to life. This right shall be protected by law. No one shall be arbitrarily deprived of his life.
Article 9 1. Everyone has the right to liberty and security of person.
The World Health Constitution affirms that it is one of the fundamental rights of every human being to enjoy "the highest attainable standard of health" and that "governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures."
In 1970 the General Assembly of the World Health Organization in resolution WHA 23.41 states without qualification that "the right to health is a fundamental human right."
On August 1, 1975, this human rights provision was incorporated into the final act of the Helsinki Accord:
"The participating States will respect human rights and fundamental freedoms ... for all without distinction as to race, sex, language or religion. They will promote and encourage the effective exercise of civil, political, economic, social, cultural and other rights and freedoms all of which derive from the inherent dignity of the human person and are essential to his free and full development."
It seems clear that in today's world the common social responsibility for providing basic assistance towards achievement of the optimum health of each of its members member cannot seriously be challenged. Only the failure of individual states to achieve this fundamental right is subject to criticism. While we, in the United States chide other countries for their failure to recognize or protect human rights, we may at times be dismal failures in assuring the provision of these rights when it comes to health. The question is not ‘does anyone have the right to such a human condition,' but ‘how can we best achieve it!' Every heath professional should address his or her duty to respect, support and promote these rights. Every person who undertakes to affect these rights, whether or not through profit, should look to the fullest implementation of these rights within the framework of his, her or its basic subsistence needs, before looking to making any profit through the provision of these rights. This can be quite uncomfortable in the lands where the only law or god is the bottom line and what can be put into one's own pocket.