The Puzzling Ethics of Emergency Care
By Bryan Caplan
The disdain most Americans feel for illegal immigrants appalls me, but it does not surprise me. What does surprise me: Even though Americans will call a person a “criminal” for accepting a job from a willing employer, they still think they have a moral obligation to give these so-called “criminals” free emergency medical care.
It’s hard to see the logic. It’s right to forbid a total stranger to earn an honest day’s pay, but wrong to refuse the same stranger expensive charity?
If I had to argue in favor of the standard view, I’d probably invoke something like the legal doctrine of the “last clear chance“:
The last clear chance is a doctrine in the law of torts that is employed in contributory negligence jurisdictions. Under this doctrine, a negligent plaintiff can nonetheless recover if he is able to show that the defendant had the last opportunity to avoid the accident.
For emergency care, analogously, you might say that you have a moral duty to help a stranger if you are the last person around able to save him.
But this story really doesn’t work. When someone needs emergency care he can’t afford, every rich country is packed with people who could help. No one individual has a “last clear chance” to save the day. On the other hand, if you say you’re only obliged to help if no one else is likely to do so, then we’d owe strangers far more than emergency medical care. After all, no one else is likely to help the world’s starving, chronically sick, etc. So why don’t we owe food and non-emergency medical care to every desperate person on earth?
Anyone got a better story? Before you share, please check whether your account is consistent with another popular moral intuition. Namely: That the moral obligation to help nearby people in need of emergency care is a moral justification for keeping such people so far away that your moral obligation doesn’t kick in.