The value of dignity: Health insurance, ethics and court cases in Brazil

Abstract

This article examines court cases brought by clients against private health insurance companies and against Brazil’s public health system. When clients take private health insurers to court, they successfully claim that the insurer violated their dignity, which entitles them to a moral damage payment. Similar cases against the state did not include moral damage claims. In relation to public healthcare, it is somehow not possible to equate dignity with economic value. One might conclude that the dignity of consumers in the market is worth more than that of citizens vis-à-vis the state. Instead, I argue for a more subtle approach by concentrating on the ethics of incommensurability. What legal and ethical considerations lead to such a fundamental incommensurability between personhood and economic value? How do the actors involved in court proceedings (claimants, prosecutors, judges, and insurers) perceive the differences between cases against insurance companies and against public health authorities? What can we make of the differences between the legal and everyday understandings of dignity and morality?