By Ezio Di Nucci

Thanks to Steven J. Firth and Ivars Neiders for continuing to engage with my ‘absurd’ sexual rights puzzle, according to which ‘universal positive sexual rights are incompatible with universal negative sexual rights’. In this short post I will address their proposed solution to the puzzle, which consists in normalizing sexual rights as healthcare rights: the basic argument being that the puzzle does not work for healthcare rights and that, given that sexual rights are like other healthcare rights, the puzzle does not work for sexual rights either.

The reason I believe this proposed solution to my puzzle is worth discussing is in fact not that it fails. As I show below, it is rather that I am, in principle, sympathetic to such a solution. I would very much like to endorse a view of healthcare that includes a broad conception of healthcare rights which acknowledges sexual rights as full-blown healthcare rights. But sex is complicated, as Firth and Neiders acknowledged themselves at the end of their post, where they concede and anticipate what’s obvious, namely that I would respond to their criticism by pointing to a relevant difference between sexual rights and other healthcare rights: ‘there may still be two ways out for Di Nucci… secondly, he could argue that there is a relevant moral difference between ‘sexual rights’ and ‘health care rights’.

Here it comes: medical professionals have duties of care and those duties of care are positive duties of care. Despite well-motivated exceptions such as for example conscientious objection, there is nothing implausible about positive healthcare duties; and those apply even in cases of conscientious objection, as the relevant healthcare institution has a duty to provide a suitable alternative or substitute.

That’s the basic reason why my puzzle does not come up with other healthcare rights but only with sexual rights. Positive sexual duties are a monstrosity and, again, sexual self-determination and the achievements of #metoo and the sexual liberation movement are too important to risk compromising through a defense of positive sexual duties. Especially given that, as I have argued in the past, there are multiple alternatives that can provide for the sexual needs of people with disabilities or neurodegenerative diseases.

Author: Ezio Di Nucci

Affiliation: Professor of Bioethics and Director of the Centre for Medical Science and Technology Studies at the University of Copenhagen.

Competing interests: None declared.