Rights

So let’s clarify four different kinds of rights and how they can be combined.

Legal/Institutional Recognition

1. Established rights: rights that are recognized by law or legally-recognized institutional policies. These would include, among other things, the rights itemized in the Bill of Rights in the Constitution, the right to privacy recognized in a series of Supreme Court rulings, patient rights that have been enacted into law in some states, or rights stated in legal contracts such as employment contracts, insurance policies, or purchase agreements.
2. Claimed Rights: rights that are claimed and argued, but not formally recognized. Sometimes people will argue about these rights in religious terms, stating that God has already established them. To keep our definitions clear and consistent, however, rights accepted in a particular religion, but not legally recognized , will be considered claimed rights. Some claimed rights would include patients rights in states without any patients rights legislation, a right to assistance in committing suicide, a right to life for an embryo, or a right to confidentiality in certain specified medical situations such as testing positive for syphilis.

Assistance vs. Non-interference

1. Negative rights: the right to be left alone. This is the right emphasized in the first definition of autonomy. It is the type of right recognized repeatedly in the Bill of Rights. Confidentiality is an example of a negative right; it is the right to be left alone to divulge your medical information when and to whom you see fit. The right to refuse medical treatment is another example of an established negative right.
2. Positive rights: these rights involve assistance of some sort and impose an obligation on another person or category of people. These rights are part of both the second and third definitions of autonomy. Medicare and Medicaid are social programs that guarantee certain types of medical assistance to people who are elderly (regardless of income) or who fall below a certain income. Any institution receiving any federal funds has an obligation to provide the specified types of medical assistance to individuals who qualify for either of these programs. The right to informed consent is also a positive right in that it imposes an obligation upon the health provider to fully inform a patient of all information relevant to decision-making.

The types of rights that are argued in medical ethics cases

1. established negative rights
2. established positive rights
3. claimed negative rights
4. claimed positive rights

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