Rights With No Responsibilities

Is there such a thing as a right without a responsibility? Our most fundamental rights to “life, liberty and the pursuit of happiness” come – of necessity – with the responsibility not to abridge someone else’s rights to life, liberty, and the pursuit of happiness.

Consider the Bill of Rights. Each is accompanied by responsibility.
• Right to free speech (First Amendment) means you cannot stop someone else from speaking things out loud that you bitterly oppose.
• Right to bear arms (Second Amendment) comes with an obligation to bear them responsibly and not use them against each other.
• The Fourth Amendment puts the responsibility squarely on the government not to unreasonably search or seize us or our property.
• The right to a fair and speedy trial (Sixth Amendment) again places responsibility squarely with the legal system not to hold us indefinitely without due process.

Apply this concept to health care and see where it leads. [Healthcare – one word – is the system. Health care – two words – is the service.]

We all have a right to life, that is, no one has the right to make us dead. Many people reason that a right to life includes a right to be healthy. Certainly no one has the right to make us unhealthy. But do we have the right to make ourselves unhealthy? I would answer Yes! That is part of being free.

Does the right to make ourselves unhealthy come with no consequence? Silly question. Being unhealthy carries the consequence of needing health care. Who should pay, whose responsibility is it to pay for the services we choose to consume? Does that responsibility fall on others? Here I would answer a resounding No!

Wait. Wait. Before people start attacking me again over “Should fat people pay more?” we should only be held responsible for those things over which we have control. The majority of obese individuals; the majority of people with cirrhosis of the liver; all people who smoke cigarettes made a choice. They have control.

Andre the Giant (from the movie Princess Bride) and others who are genetically large did not choose their parents (and their genes). For them, weighing 400 pounds could be normal even healthy, but most important, they had no control.

Same thing is true for people who develop breast or prostate cancer. Not so for lung cancer where over 80% were smokers. Yes, Dana Reeve, deceased wife of also deceased actor Christopher Reeve (Superman), and my good friend Sh. were both non-smokers who died from lung cancer. There are exceptions. We must design a system that covers the vast majority and then build in enough flexibility to handle outliers.

When our bodies are unhealthy because of what we do (overeat) or what we do not do (exercise), we should be held responsible and accountable. When our bodies are unhealthy and we could not prevent it, we should not be held responsible.

We can, should, indeed must have a lively extended discussion about all the important elements such as how much to pay, incentives, productivity effects, and healthcare as infrastructure.

What should NOT require any discussion is the acceptance of personal responsibility, which comes of necessity with the freedoms enshrined in our founding principles

Freedom to fly includes freedom to fall.

If you have rights, certainly if you have freedom, your actions have consequences for which someone will be held responsible. If not you, then who?

System MD

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5 comments ↓

#1 Why is personal responsibility so prominent in education and not even mentioned in healthcare? — Medical Malprocess on 09.28.09 at 3:13 am

[...] the Bill of Rights carries with it responsibilities.  Our founding fathers never envisioned one without the [...]

#2 Nynelly on 10.04.09 at 8:09 am

best new blog

#3 A politically incorrect inconvenient truth you will never hear from a politician. — Medical Malprocess on 10.05.09 at 3:48 am

[...] Our Founding Fathers did not elucidate the responsibilities in the Bill of Rights because it never occurred to them that people could believe rights come without responsibility. [...]

#4 Nerdse on 11.01.09 at 11:46 pm

I’m going to repeat this until you get as sick of seeing it as I get of the way you treat fat people in your blogs.

FIND OUT WHAT CAUSES SOME PEOPLE TO GAIN WEIGHT ON 1000 CALORIES WHILE OTHERS STAY SLIM ON 4000 CALORIES.

And please explain why you think it’s only OK to eat 4000 calories or more a day if you’re thin. If it’s OK for thin people, it’s OK for everyone. GLUTTONY IS GLUTTONY REGARDLESS OF THE PHYSICAL SIZE OF THE GLUTTON.

Answer this, if you can: Why is the fat person called a liar & a cheat for sticking to 1200 or less calories a day, exercising, but not losing weight while the thin person who eats like a pig is held up as an example of the picture of health?

There are people, like Sandra Bullock, who stay slim without dieting. She openly admits to keeping that fantastic body while eating whatever she pleases, This phenomenon is there for us to utilize, with their permission, to find out what’s going on with the difference in size & the same food intake.

My son suggested perhaps the thin person only absorbs a fraction of the calories they take in. That’s a pretty decent consideration – & if that’s going on, what happens to them if there is a food shortage? Won’t that precious thin person, whom you all love so much, perish even if the fat person gives away most or all of their share of the food? Don’t say it won’t happen. I’ve done it while traveling, & I’ve seen plenty of fat people do so. I haven’t seen many thin people share food with someone in need.

Aren’t you supposed to consider the peril to the life of a thin glutton who has to have that many calories to survive? Aren’t you supposed to do something to help? They’re THIN, for heaven’s sake – your favorite kind of person – & yet you don’t care enough to find out why, because it might benefit a fat person. And you can’t abide that thought, can you?

Makes me wonder if that one poster on a different anti-fat blog was right. Maybe your oaths really DON’T mean anything to you.

Now, consider the possibilities, unless your God complex is so big you can’t listen to the people who post here. If fat people store every single calorie as fat, & thin gluttons burn all of them or else don’t absorb them all, & if you can find out why, you have the potential to keep the wonderful thin person alive if there’s ever a shortage of food. The down side is you’ll also be able to help the fat person lose weight on their diet, & you’ll have to admit that maybe all of them aren’t lying about their food intake & activity level.

I know. It’s a bitter pill to swallow, that idea that your self-righteous hatred of fat people might have to give way to save a thin person. I sincerely believe that you’d like to see all fat people euthanized unless they lose weight. In fact, I’d bet you hate thin people if they have ever been fat. I’d bet every note you write on their care mentions how fat they used to be & how that’s the reason they’re sick now, that if they’d never been fat they’d never have gotten sick. I also believe you’d rather let a thin glutton die, even from something they can’t help, than figure out the problem for both & benefit a fat person.

You have some good ideas, but most of your ideas have to do with punishing people, on the basis that some of them are doing something wrong, something you don’t like. Compassion isn’t in your dictionary or your life. You are not perfect, regardless of what you think. You’ve likely made plenty of mistakes in your life, ones that haven’t yet made you ill. Yet.

News flash: Nobody died & made you God. God didn’t make you His Prime MInister, either. And don’t tell me you’re an atheist – because then you couldn’t believe you’re God, as you so obviously fo.

#5 deanewaldman on 11.02.09 at 9:00 pm

I will respond to the substance of your angry personal diatribe and avoid defending myself against someone who neither knows nor understands me nor thinks about what I write and what I ask.

I am not prejudiced against obese people. I write nothing about gluttony. I know that I am not God.

I believe amongst other things in personal responsibility: we should be responsible for the consequences of our choices. Obviously, this applies only when we have a choice. If you drive drunk and injure someone, you are responsible. If while you are driving, the brakes fail (even though you maintained the car) and you injure someone, you are not at fault because you were not responsible.

Obese people have more health problems and therefore need more health services. That is not my opinion nor is it a value judgment. I am simply stating a fact.

Some people are obese despite eating responsibly. They do not choose to be obese and therefore should not be held responsible. For every one of such people, there are 100 who eat-to-excess and therefore choose to be obese. When they (of necessity) demand extra health services, they should be responsible.

I do not sit in judgment of anyone. I do not count the calories you ingest whether you are thin or fat. My issue is equity and responsibility. If one person CHOOSES to demand more resources than another, he or she should pay more than the person who demands less. The obese over-eater and the two pack-a-day smoker are the same in that sense. They made a choice to use more (health care services) than others and they should be held accountable and responsible for that choice.

Two people go to a restaurant. Person A orders hamburger, fries and a coke. Person B orders soup, salad, hamburger, fries, a coke, desert and coffee. Should they pay the same?

System MD

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