Social & Moral Worth

Should a person's social and moral worth play a role when it comes to allocation of medical resources? This tends to be one of the most contentious issues in the debate over the provision of expensive medical care to prisoners. Those who object rely heavily upon the visceral argument that these prisoners have committed heinous acts and therefore no longer deserve to get the sort of medical care which is unavailable to poor, law-abiding citizens.

From a purely medical perspective, however, this is not a valid argument. Doctors are committed to providing the best possible medical care to all human beings, regardless of any personal opinions about their patients' moral and social worth. Doctors in the military, for example, are obligated to provide the same treatment to captured prisoners who may have been responsible for the wounds on less seriously injured soldiers who are comrades of the doctors and who are still waiting their turn for medical attention.

Any other standard of care would be dangerous. We certainly wouldn't want doctors to start using their personal prejudices as the criteria by which they decide what sort of medical treatment will be received by whom. Who wants their doctor to start deciding that this or that patient has less moral or social "worth" and hence deserves less than her best efforts at care?

But can society at large make decisions about who can receive what sort of medical treatments based upon judgments of their moral or social worth?

Society certainly needs to be able to decide how to allocate scarce resources and differences in "worth" are perhaps as valid as any other criteria. On the other hand, decisions about the "worth" of other human beings is still a difficult ground to tread safely. Most societies have, at best, a mediocre track record when it comes to evaluating the worth of minorities, for example.

 

Prisoners as Citizens

Closely related to the question of prisoners' social and moral worth is their status as citizens of the community and of the nation. Whereas the previous question focused upon prisoners' moral status and whether they deserve the same moral and ethical considerations, this one changes matters slightly to focus instead upon their legal status and whether they deserve the same legal rights and considerations.

This represents an important shift because it eliminates many of the potential problems and dangers inherent in assessing the social and moral worth of other human beings. There is a long-recognized legal principle that while people who are not members of a community may deserve certain basic rights and privileges, they do not necessarily deserve all of the rights and privileges accorded to members. Thus, non-members have rights to life, liberty, free speech, etc., but they do not have the right to vote.

There is very little debate over whether this principle is valid in general, but there is quite a bit of debate over just what qualifies as basic, minimum rights and privileges which everyone should have, regardless of their membership or citizenship status. This is especially true when it comes to health care because there is such a wide ranger of possible treatments available to people.

Should prisoners receive only the very minimum necessary to keep them comfortable? Should expensive diagnostic and treatment options be made available to them? Where exactly should the line be drawn? If a prisoner does receive a lower standard of medical treatment and is later found to be innocent, what sort of responsibility do the state and society bear if he now leaves prison sicker than when he entered? Most people would balk at providing no more than the absolute bare minimum, but they would also balk at providing access to the absolute latest and best which remain unavailable to the nation's poor.

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