Julian Sanchez header image 2

photos by Lara Shipley

Health Care, Vegetarians, and Contextual Rights

August 4th, 2009 · 24 Comments

Via Doug Bandow, Theodore Dalrymple makes an argument against a right to health care—though it applies to positive or welfare rights more generally—that I used to find persuasive, and now find less so:

Where does the right to health care come from? Did it exist in, say, 250 B.C., or in A.D. 1750? If it did, how was it that our ancestors, who were no less intelligent than we, failed completely to notice it?

If, on the other hand, the right to health care did not exist in those benighted days, how did it come into existence, and how did we come to recognize it once it did?

Now, I assume—or at least hope—Dalrymple is perfectly capable of thinking of any number of genuine rights that ancient societies failed to recognize. Indeed, our ancestors “failed to notice” a great many of the rights we now consider fundamental at very many times in the past, so he can’t just mean that historically neglected rights are necessarily invalid. What I think he means is that rights are usually thought of as being universal, what people are in principle entitled to in any time or place just by dint of their humanity. We can say of Medieval serfs that they should have been treated very differently than they were by their societies, but since “ought” implies “can,” it seems absurd or incoherent to suggest that they should have had access to antibiotics or chemotherapy or any of the myriad other relatively recent innovations that constitute modern health care, let alone that they had a right to these things. What sort of right is it, after all, that cannot even in principle be satisfied? But supposing rights are universal, the thinking goes, they must have enjoyed (in principle) the same rights that we do, so a right that would have been impossible for them to claim must not be a genuine right today, even if such a purported right is now technologically satisfiable. Which I think is what Bandow is getting at when, in his own post, he asks precisely what level and kind of health care we’re all entitled to—the idea being that any concrete answer will either seem to wish away scarcity or appear contingent or arbitrary in a way we don’t expect abstract rights to be.

If the “right to health care” were really a claim on specific set of goods or services, the argument would go through well enough.  But we can conceive of this right—and of positive rights generally—in another, more plausible way. What we can instead say, speaking very roughly,  is that people have a right to the aid of others in avoiding severe harms when the cost of providing that aid is relatively low—a right that others help me when the burden of helping on them is relatively slight compared with the benefit to me. Alternatively, we might frame this as a sort of share right, either to some minimal proportion of social resources, or to a quality of life not too radically short of the prevailing level when this is possible. I’m not arguing that there is such a right, I’m just arguing that there isn’t a formal problem with asserting such a right timelessly and universally.

If this sounds doubtful, consider some less controversial negative rights that just about everyone thinks we have—rights against the imposition of certain kinds of harms. In a small and technologically primitive community, we can probably think of all sorts of harms that individuals simply cannot realistically help but impose upon each other: the spread of various lethal contagious diseases, air and water pollution from human waste or cooking fires. It is not literally impossible to avoid imposing these externalities—everyone could go off into the mountains and commit suicide or, less dramatically, refrain from cooking their meat—but insofar as that would leave everyone very much worse off, the burden of avoiding these harms is too high to generate a binding duty or a corollary right. At a different level of development, the interest in avoiding these harms might be much greater relative to the cost of refraining from the behaviors that impose them, and we might say that there is such a duty and right. Now, in one sense, my neighbor and I both have some “new” rights not enjoyed by our ancestors: to wit, the right that the other not leave bonfires or big mounds of human feces in the front yard. But jumping up a level of abstraction, we’ve got the same conditional right not to be involuntarily subjected to relative diminutions of quality of life above a certain level, when the relative cost to each of us of not subjecting the other is below a certain level. Whether I’ve picked especially good examples here is less important than whether we think it’s plausible to conceive of our particular rights and duties varying across technological contexts, while the rights functions that determine our concrete obligations and entitlements  remain fixed and universal.

We can say something similar about this argument from Wesley J. Smith:

I think the biology of the matter is important because it raises the question of how can meat-eating be immoral when an omnivorous diet is not only natural but offers us the best balance of nutrients. Vegans, for example, must take a supplement to obtain Vitamin D. Hence, I don’t see how eating a naturally human diet can ever be considered immoral.

Now, I’m not entirely sure how Smith thinks this argument is supposed to work, why he imagines “naturalness” is relevant, why he imagines modern factory farming is plausibly described as “natural,” or how the balance of nutrients fits into it. (I presume he would consider it beside the point if we discovered tomorrow that toddler is the most nutritious sort of meal.) But one way it might work is along these lines: Our ancestors would probably not have survived had they not killed and eaten animals; it cannot have been wrong for them to do what was required to survive; therefore killing and eating animals must be morally permissible. I don’t think I’d actually accept the second premise without qualification, but I think it’s probably fine in this context. Now, this is a little different from the previous case, because we might think that what we owe our fellow humans depends on the reciprocal obligations we’d impose on each other in a social contract formed under certain idealized bargaining conditions, and not so much when it comes to cows. Partly for that reason, I’m extraordinarily reluctant to use the language of “rights” when talking about how we ought to treat animals. But I don’t find it inconceivable, as Smith seems to, that it could have been perfectly moral for our ancestors to kill and eat animals to avoid death or serious illness, while it is not so moral for us to do the same—or, more accurately, to do rather worse in terms of how livestock are typically treated—in order to avoid the need to take Vitamin D supplements.

Update: I should probably be clear that I do still agree with the original sentiment this far: A “right to health care” isn’t going to make sense as a fundamentally distinct category of entitlement, but only as the upshot under certain conditions of a general duty to aid. So it’s not that there’s something metaphysically special about health care, but rather that if you think there’s such a duty to aid, provision of health care might turn out to be the most efficient way to satisfy it, to the extent that it’s both important to people’s welfare and hard for them to obtain on their own. An obvious upshot of this is that a practical “right to health care” as an entitlement in a particular context can’t be an unbounded one—it can’t mean that you have a right to whatever treatment might help ameliorate your condition or extend your life,  regardless of cost.

Tags: Libertarian Theory · Moral Philosophy



24 responses so far ↓

  • 1 Hugh // Aug 4, 2009 at 7:11 pm

    I’m vegan and not so far as I know in need of supplements for my vitamin D. Sunlight for D3 and the D2 produced by plants and fungi (and invertebrates for those without dietary constraints) seems to work fine. Eating parsley helps with the body’s production of D vitamins in the winter when there’s less sunlight. Not the main point, I realize, but if one wants to argue that a vegan diet cannot be ‘naturally’ complete, Vitamin D wouldn’t be the soundest factual approach.

  • 2 Steven Maloney // Aug 5, 2009 at 8:03 am


    My first impulse would be to say that what we owe one another with regards to health care is at this point a discussion that flows from our right to contract. I’m sort of making this up as I type it, but my initial impression would be that the complexity of our political and economic arrangements require that we distribute care in certain ways in order to call those prior arrangements legitimate as well as facilitating the enduring quality of those arrangements by keeping future contractees healthy.

    As what we can do when we make contracts becomes more complex, it would not be surprising that new obligations might develop from old rights. The substantive effects of our right to contract have changed over time.

    With the case of animals, it seems that much of the objection comes not from eating animals, but killing them. It may seem like a stupid distinction, but what you have described is how the substantial meaning of what it means to kill and eat animals has changed over time. In that case, the question (regardless of how one answers it) is not “has the principle changed over time?” but “does what we do now conform with our principles of moral permissibility?”

    I’m not sure if these distinctions are useful or not, but I’d be interested to hear your thoughts.

    PS – thanks for the link the other week, I got a noticeable bump in traffic!

  • 3 Allen // Aug 5, 2009 at 9:42 am

    I understand rights as something the strong grant to the weak. I prefer to think in terms of moral responsibility. We have a moral responsibility to help others when doing so does not pose significant harm to ourselves. It is immoral to stand by and allow others to suffer needlessly when it is in our power to help them.

    Regarding Smith’s assertion, morality is a function of necessity. It is not immoral to kill and eat animals (including human animals) if doing so is necessary for survival. Ignoring Smith’s ignorance about the nutritional completeness of a vegan diet, in modern times it is simply not necessary to kill and eat animals. Therefore any harm that we cause animals by raising, hunting and killing animals for food is unecessary harm. It is immoral to cause unnecessary harm.

  • 4 The Policy Constitution | Steven Douglas Maloney // Aug 5, 2009 at 10:28 am

    [...] Julian Sanchez (via Doug Bandow), Congressman John Conyers has pledged to make “the right to health [...]

  • 5 Emile // Aug 5, 2009 at 12:12 pm


    You say “It is not immoral to kill and eat animals (including human animals) if doing so is necessary for survival.”

    Really? That doesn’t jibe with my moral intuitions. I assume you’re imagining a life raft, kill the guy with the short straw kind of situation? I would say that it hinges on consent even there; collectively agreeing to kill and eat the short straw drawer is different than deciding on your own to kill and eat the first person to fall asleep.

  • 6 Mike // Aug 5, 2009 at 1:02 pm

    Does anyone else who isn’t a vegetarian read this blog? I’m used to hearing at least something of a dissenting voice.

    Most arguments about vegetarianism are doomed to failure, though, because the sides don’t agree on first principles. There is an inherent belief in every creature that its food is not entitled to rights, or that if it is, that its rights are less important than its ability to be tasty. To assert that eating chicken is wrong one much accept first that chickens have some rights to begin with.

  • 7 Julian Sanchez // Aug 5, 2009 at 2:14 pm

    I don’t think chickens have any rights. And, in general, I think it’s pretty much self-evidently false that only rights-violating acts can be wrongful.

  • 8 William Carlton // Aug 5, 2009 at 3:19 pm

    Humans are clearly adapted to eating cooked foods. Vegetarianism is one thing, in a developed society where such a diet can be strictly supported, industrially or non-.

    But veganism is clearly bullshit. I would venture to guess that it’s an impulse toward dietary Puritanism. It’s moralism about food. The evidence is that human beings are uniquely resistant to compounds resulting from cooked foods than other animals. Much of the raw foods movement is couched in deeply discredited pseudo-science about “life forces” and such, or supposed plant enzymes that are supposed to do good work in our bodies that don’t make it past the first contact with our own digestive system anyway.

    Just look at the fact that so many women following vegan diets experience irregular periods or stop menstruating altogether, and this is in a typically modern, middle-to-upper class and bountiful corner of history. Never mind the scarcities of the past.

    Looking at the way that decreased fertility as a consequence of eating a fully raw foods diet hardly qualifies as adaptive pretty much makes the case that it’s not natural for US.

    And please no anectodes. Every study carried out on the subject has shown consistent results.

  • 9 Brian Moore // Aug 5, 2009 at 4:34 pm

    I’ve also made the same claim that “health care can’t be a right” — but you make a good point that “reasonable amounts of aid from others” can be a right. Unfortunately, as you note, this doesn’t get us anyone in the actual “should we provide healthcare” debate, since the pro thinks it’s reasonable, and the con doesn’t.

  • 10 You Are What You Eat And What You Are Is A Salad With Bacon Bits « Around The Sphere // Aug 5, 2009 at 5:32 pm

    [...] UPDATE #2: More Sanchez [...]

  • 11 Micha Ghertner // Aug 5, 2009 at 5:51 pm


    I am not a vegetarian and I read this blog. I don’t dissent because (a) I’m lazy, (b) I’ve been through this same argument many times before, and (c) the vegetarians have a stronger case than the meat eaters.


    Veganism is not the same thing as the raw food movement. Veganism is a subset of vegetarianism: some vegetarians eat eggs and dairy products; vegans do not.

  • 12 Julian Sanchez // Aug 5, 2009 at 7:28 pm

    william carlton-
    Stipulate everything you say is factually true; so what? Something could be unnatural, even unhealthy up to a point, and still morally obligatory.

  • 13 RickRussellTX // Aug 6, 2009 at 2:13 am

    I love it when people make statements, as if they were grave medical fact, that are so utterly and thoroughly wrong that it would take no more than 5 seconds perusing Google results to make it clear.


    “Very few foods in nature contain vitamin D.”

    “Most people meet their vitamin D needs through exposure to sunlight.”

    I mean, this guy tried to think of a really good example to stick it to vegans and their non-omnivorous nature, and a completely wrong answer was the *absolute best he could do*. Bravo, I say.

  • 14 Josh Xiong | A Further Note on Positive Rights // Aug 6, 2009 at 10:51 am

    [...] rights doesn’t mean I think government should provide no social services altogether. Back to Julian: If the “right to health care” were really a claim on specific set of goods or services, the [...]

  • 15 RickRussellTX // Aug 6, 2009 at 12:31 pm

    To get back to the subject at hand, I think you could make the assertion that the “right to equal protection under the law” is a positively asserted right of a similar kind. The law certainly can’t offer unlimited protection, and we understand that people with money will always have more options and opportunity to seek protection than those without money.

    Yet, like health care, we can establish a baseline level of protection for everybody and work toward the ideal of maximizing certain key components.

  • 16 Brock // Aug 6, 2009 at 1:51 pm

    Vegans need to take a B12 supplement, not a D supplement.

    As noted above by several commenters, the human body makes its own vitamin D with a bit of sun exposure.

  • 17 William Carlton // Aug 6, 2009 at 3:40 pm

    Re: vegetarianism, I think it’s a reasonable and, in most cases, sustainable moral response to the animal foods problem.

    It’s veganism that doesn’t have a leg to stand on. Maybe I’m wrong about this, but I think we have a higher moral obligation to members of our own species than a host of organisms that wouldn’t be here if it weren’t for our own stewardship in the first place.

    The health care thing: it was an OpEd by Paul Krugman, of all people, that turned me on the issue. He pointed to the eventual acceptance of primary education as a basic civil right—as a valuable investment in human capital, in our infrastructure—as a model for nationalized health care. I thought it was a pretty good argument.

    To this day, it’s the only thing he ever wrote that changed my mind about something.

  • 18 Micha Ghertner // Aug 6, 2009 at 6:22 pm

    William, again, regarding veganism: that word does not mean what you think it means.

  • 19 Kevin // Aug 7, 2009 at 12:52 pm

    Being a little too old and tired to lie, what has become clear to me is that people (including me) begin with a vague sense of right and wrong and, for a variety of unconscious, idiosyncratic reasons expand that into more specific moral beliefs. Then they attempt to construct conscious arguments to defend those beliefs. But they convince themselves that the argument came first and the conclusion came second.

    While this doesn’t invalidate the arguments, it does incline us to overvalue our own arguments and excessively attribute reason and strength to arguments that rest more on a leap of faith than we are typically able to acknowledge.

    I think the meat and morality question is a perfect example of the phenomenon.

  • 20 Kevin // Aug 7, 2009 at 12:54 pm

    a correction:

    excessively attribute reason and strength to “moral positions” that rest more on a leap of faith than we are typically able to acknowledge.

  • 21 William Carlton // Aug 7, 2009 at 5:00 pm

    Thank you, Micha, for your gentle nudging toward a better grasp of what veganism is. Having checked a few sources, it’s obviously not a part of the “raw foods” movement, although there seems to be a subset of veganism that does embrace the principle.

    My general understanding still seems to hold, however, and that is that it represents a more comprehensive effort to avoid exploiting animals than your average vegetarian can claim still eating eggs, wearing wool, etc.

    Now, I DO eat meat and consume other animal products, but don’t have any special emotional attachment to the moral integrity of it that I’m aware of. If it turns out that a firmer committment to animal rights as expressed anywhere along the vegetarian/strict vegan spectrum—widely disseminated—happens to produce a greater degree of human happiness, then I can be counted upon as an activist, public and private.

    Since Julian has made the point that no mainstream vegan or vegetarian he has encountered considers other animals equivalent to Homo sapiens, I shouldn’t think that it’s controversial to make our own interests as a species the determining factor.

  • 22 Pareto-Ideologies // Aug 18, 2009 at 4:46 pm

    [...] it out with respect to specific tenets or principles. As a possible example, let me humbly offer up my own recent post on the popular progressive idea that there’s a “right to health care.” The first [...]

  • 23 Health Care as Distributional Right // Aug 24, 2009 at 3:57 pm

    [...] suggested before that the best version of progressivism—by which I mean, the most internally coherent [...]

  • 24 Health Care as Distributional Right // Aug 24, 2009 at 3:57 pm

    [...] suggested before that the best version of progressivism—by which I mean, the most internally coherent [...]

Leave a Comment