Intent and Actuality

Abstract

A just society should reach beyond self-servingness. A compassionate society will take particular care to lean toward those whom the status quo denies—the old, the disadvantaged, and the young. They need not be adversaries.We should remember that one’s value should not be measured in one’s willingness to sacrifice self so that others may continue to enjoy a full range of services, or their research or clinical goals. Rather, the personal and professional autonomy of some (however well disguised) should cease to be the primary value that drives our health and medical delivery systems.

We should, instead, be concerned most about promoting mutuality, and building a society in which the empowered reach beyond themselves. Such a society will value advocacy for those whose quality of life is limited. Rather than concentrating on the limits of care to the poor, we would be considering what basic health and medical services will be available to all, and what changes we (the empowered) must initiate so that that goal is attained. We should reach for size, for, as Kapp says, we have “…an obligation to suggest and help implement social policies…[that] do a better job of promoting social harmony, protecting the legal liberties and entitlements of individuals, and honoring the ethical precepts of autonomy, beneficence, and distributive justice.”⁵²

The options before us need not disrupt our delicate social balance. Rather, we can reach toward size, a vision that recognizes the import of giving up some personal power so that more can have

access. Theorists have an important role here. As Ernst Bloch has said: “philosophy…especially ought to bear the torch before and not the train behind. ⁵³ It is an important effort and calls for our best energies and our highest commitments.