Changes in Australian Health Care system have attracted debates from politicians with the most important one being embarkment on a plan to realize ideal health care for all, rather than just for those who can afford it. The universal publicly-funded health care is however not supported everyone. Some people support it while others argue against it. The main issue of concern in these arguments is the concept of human dignity as the basis of human rights. This essay analyzes two perspectives on how the public views the concept of human dignity in relation to provision of universal public health. It describes how the concept of human dignity is understood in each perspective. In addition, the paper identifies the social cultures, norms or circumstances that may have influenced each of the two perspectives, and the extent to which they impact the understanding of human dignity. Also described in the essay is the manner in which each of the two perspectives justifies particular actions and choices with reference to human dignity. Another issue that is not left out in the paper is identification of the aspect of human dignity that could be jeopardized by any action arising from each perspective, when human dignity and human person are considered in isolation.

The first perspective understands human dignity in relation to social structures where human dignity is diminished when social structures do not meet the basic health care needs for all, and vice versa. Marmot (2004) argues that unfairness in the society can be seen as an act that negatively affects people’s dignity and respect, which may have serious consequences for identity and autonomy (Horton, 2004). In this context, fairness refers to the quality of treating people equally and it is a very important aspect of social relations, human behavior and organization of society. Therefore, a well organized society that is committed to raising human dignity must demonstrate farness for all by providing universal access to high quality medical care. Marmot (2004) gives an example of the whole principle of the UK National Health Service with universal provisions to health care, a principle that is worth exporting by Australia and other nations.

A person who is able to express autonomous control over his or her life is said to have dignity. Expression of this autonomy is only possible if a person is in good health, which also allows for expression of dignity. Since social inequality deprives people of health, it is therefore detrimental to dignity (Marmot, 2004). Every nation must therefore strive to achieve a more even share of good health, rather than just improving the average health status of the general population, in order to raise human dignity (Woodward and Kawachi, 2000). According to Woodward and Kawachi (2000), social inequalities become unfair to humans when poor health prevents them from making informed autonomous choices about the meaning and purpose of their lives. Conditions that lead to marked health disparities in the society affect every member of the society because they render all members of the society unable to express their dignity (Marmot, 2004).

Social inequalities that deprive individuals  of good health and hence dignity are avoidable to an extent that they stem  from implementation of policy options that can be exercised by the government, such as provision of welfare benefits and public health care funding (Woodward and Kawachi, 2000). In other words, disparities in health care can be corrected through policy interventions that eventually serve to raise human dignity. A government that cares about improving the health of its population must incorporate considerations of the health impact of alternative options in its policy setting process (Woodward and Kawachi, 2000). This is one area where the Australian government has made a forward step. The current changes in Australian Health Care system that seek to provide ideal health care for all will ensure improvement in health of the entire Australian population. The whole population will be able to flourish as human beings making informed, autonomous choices about the meaning and purpose of their lives.  Eventually, these people will have their human dignity raised (Horton, 2004). Australian Health Care System recognizes that public health programmes that reduce health inequalities can help in improving the lives of its population, and hence raising their dignity in a more cost effective way.

Bostrom (2010) considers meeting the health needs of the population through provision of free access to public health as a form of enhancement. According to the author, enhancement refers to any intervention that improves the functioning of an organism or that creates a new subsystem that an organism previously lacked. Therefore, in one way or another, human dignity is raised through enhancement. Human dignity can be promoted by certain enhancements that promote human autonomy and ability to make informed choices about life. For example, enhancement of mental energy would make a person more capable of an independent initiative thereby raising human dignity (Bostrom, 2010). Like any form of enhancement, meeting the basic health care needs for all will improve human dignity, making it relevant for Australia to continue providing universal health care to its population.

Considering the aspects of human dignity and human person in isolation, the quality aspects of human dignity can be jeopardized by improving the social structure of the population with reference to the first perspective. According to Bostrom (2010), dignity as a quality means worthiness in some absolute sense that makes a person autonomized and objectivized. For instance, a greatly increased access to free health care might diminish a person’s capability to be independent, leading to reduction in human dignity. Some enhancements that boost emotional responsiveness and inner self motivation, such as creation of even social structures, have the effect of destabilizing a dignified inner equilibrium. Ultimately, a large proportion of the population might become more susceptible to subversive or destructive interference, and undermine their ability to stand firm and quietly defy the world (Condit, 2010), a factor that  jeopardizes the quality  aspect of human dignity.

The second perspective understands the concept of human dignity as a form of equality of all human beings. Access to health care therefore affirms the fundamental dignity and equality of all human beings. In order to uphold this dignity, universal health care must be provided for all (Ryan, 2008).  In this perspective, human dignity provides equal foundation for equality of all human beings. Donnelley (2009) emphasizes that human rights that fight for equality for all human beings go beyond the inherent dignity of human person to provide mechanisms for realizing a life of dignity. Human rights therefore specify the forms of life that are worthy of beings with moral worth and provides guidance to practices to realize dignity that justifies the intrinsic value of the human person (Klug and Wildbore, 2011). This basically means that the inherent human dignity must be expressed in everyday life through practices that encourage equality such as provision of public access to health care (Donnelley, 2009).

Sulmasy (2008) emphasizes that access to health care should be stipulated as an affirmative right that upholds human dignity, and universal access must be supported. According to Ryan (2008), both human rights and public health are motivated by the fundamental concern of human dignity. This calls for programs of social change that takes care of the socio-economic conditions and poor health with the aim of improving access to health care (Barilan and Brusa, 2008). Human rights and human dignity is one of the most vibrant aspects in the society today. By allowing equal access to good health for all, human dignity is affirmed and raised (Gabr, 2012). The promotion and protection of human rights and of access to health care are fundamentally linked. Public access to health care leads to the promotion of human dignity because it minimizes the burden of health care to the population in a universal manner.  Human dignity is considered along with human rights to be inherent and universal.

Human dignity is possessed by all human beings and it gives them the right of freedom and choice (Barilan and Brusa, 2008). Health care promotes human dignity and should be given priority over other social rights to help encourage autonomy of human beings (Ryan, 2008). The international human right agreement implicitly recognizes a right to health for all. It is also stated in article 25 of the Universal Declaration of Human Rights that everyone has the right to a standard of living…. adequate for health and well-being of himself and family including medical care, food and clothing……. Article 1 also states that all human beings are born free and equal in dignity and rights (Klug and Wildbore, 2011). Every nation is charged with the responsibility of ensuring that its population gets access to equal health care by implementing health-related practices such as access to public health that mainly help those who are already marginalized. With such a program, access to health care is not only left for those who could afford it (Ryan, 2008).

The concept of human dignity and free access to public health also gains recognition in the field of bioethics with respect to its affirmation of fundamental human dignity (Barilan and Brusa, 2008). Presently, most bioethicists seek to develop a universal language and global strategies that can help improve the health care of citizens and to help raise their dignity (Arneson, 2009). The best reason for upholding the idea of provision of free access to health care is the significant overlap between the concerns of public health, universal human rights and human dignity. This encourages the society to improve the overall well-being of its population such as adequate basic health care (Fenton, 2010).

One of the major purposes of human rights law internationally is to achieve greater quality (Gabr, 2012). More specifically, human rights help to turn the fact of equality into the basis of ethical theory and define how it should act. Every person has the right to equality of respect and access to health care and deserves a chance to raise his or her dignity. In human right thinking, freedom of making informed choices is necessary and can be encouraged by ensuring equity in access to health care. Equity is what all human beings are born with, and all humans need to live the lives they choose to live to embrace their dignity. Therefore, there is a substantive right to equality and policies must be made to ensure that every citizen has equal access to health care for affirmation of human dignity (Klug and Wildbore, 2011). Universal access to health care must therefore be safeguarded.

Considering the aspects of human dignity and human person in isolation, the extrinsic aspects of human dignity can be jeopardized by ensuring equality for all human beings with reference to the second perspective. Somerville (2009) defines dignity as what makes us human and whether one has dignity depends on the circumstances in which one finds himself or herself. In other words, dignity depends on what one cannot or can do. This is known as the extrinsic aspect of human dignity. By ensuring equality among all members of in order to affirm human dignity, it will be difficult rate these people according to what they can or cannot do. This means that everyone will find himself or herself in similar circumstances with respect to access to health care (Arneson, 2009). Again, everyone being treated equally badly is not a concept of human rights, thus does not uphold human dignity. It is insufficient to ensure that everyone is getting equal treatment and that all groups are treated with equal lack of access to free health care. If equality is the main goal of human rights, then human dignity is its foundational value (Klug and Wildbore, 2011). In view of these arguments, universal publicly-funded health care should be implemented.

 

References

Arneson, R. (2009). What If Anything, Renders All Humans Morally Equal? Oxford: Blackwell

Barilan, Y. & Brusa, M. (2008). Human Rights and Bioethics. Journal of Medical Ethics, 34(5):379-383.

Bostrom, N. (2010). Dignity and Enhancement. Retrieved, May 21 2014, from http://ieet.org/archive/bostrom-dignity.pdf

Buijsen, M. (2010). Autonomy, Human Dignity, and the Right to Healthcare: A Dutch Perspective. Cambridge Quarterly of Healthcare Ethics, 19: 321-328.

Condit, D. (2010). Health-Care Counter-Reform. The Linacre Quarterly, 77:426-444.

Donnelley, J. (2009). Human Dignity and Human Rights. United States of America: University of Denver Press.

Fenton, E. (2010). Bioethics and Human Rights: Curb Your Enthusiasm. New Oxford: Oxford University Press.

Gabr, M. (2012). Health Ethics, Equity and Human Dignity. Retrieved, May 21 2014, from http://www.humiliationstudies.org/documents/GabrHealthEthics.pdf

Horton, R. (2004). Rediscovering Human Dignity. Lancet, 364: 1081–85.

Klug, F. & Wildbore, H. (2011). Equality, Dignity and Discrimination Under Human Rights Law; Selected Cases. United States of America: Center for the Study of Human Rights.

Marmot, M. (2004). Dignity and Inequality. Lancet, 364: 1019-21.

Ryan, M. (2008). Health and Human Rights. Theological Studies, 69 (1): 144-163.

Somerville, M. (2009). Defining Human Dignity. Retrieved, May 21 2014, from http://noeuthanasia.org.au/documents/Somerville-defining-human-dignity.pdf

Sulmasy, D.  (2008). Dignity, Rights, Health Care, and Human Flourishing. In Autonomy and Human Rights in Health Care: An International Perspective, edited by D.N. Weisstaub. International Library Of Ethics, Law, and the New Medicine, 36: 25-36. Dordrecht: Springer.

Woodward, A. & Kawachi, I. (2000). Why Reduce Health Inequalities? Journal of Epidemiology and Community Health, 54(12): 923-929.