Abstract
In welfare states, no typical user of health care services is only a patient; and no typical provider of these services is simply a doctor, nurse or paramedic. Occupiers of these roles also have distinctive relations and responsibilities--as citizens--to medical services, responsibilities that are widely acknowledged by those who live in welfare states. Outside welfare states, this fusion of civic consciousness with involvement in health care is less pronounced or missing altogether. But the globalization of a very comprehensive understanding of human rights, including rights to state-provided health care, will make welfare state thinking--for better or worse--more of an orthodoxy worldwide than it is now. Medical ethics needs to reflect this.
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