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Letters |

Requirement to Purchase Health Insurance

William Smith, BA
JAMA. 2012;308(16):1628-1629. doi:10.1001/jama.2012.12625.
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To the Editor: Dr Rulli and colleagues1 claimed that a physician's duty to provide acute and emergency care, ie, to rescue, is “not grounded solely in individuals' right to be rescued.” Without this claim, their argument that the duty to rescue grounds a duty to buy insurance is less interesting because if individuals can waive their right to rescue, citizens can escape the duty to buy insurance.

If the duty is not grounded in individuals' right to be rescued, it is either owed to someone else or it is owed to no one. If it is to be owed to someone else, it is unclear to whom. The answer may be society, but the authors explicitly denied that they are taking this option. Alternatively, if it is owed to no one, the argument will be controversial because many moral theorists believe that moral obligations must be owed to someone or something (eg, an animal).2,3 For instance, lawyers' duties are owed to clients; likewise, physicians' duties are owed to patients or the public. If the authors intended this view, they should offer some support for it.


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October 24, 2012
Tina Rulli, PhD; David Wendler, PhD
JAMA. 2012;308(16):1628-1629. doi:10.1001/jama.2012.12628.
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