Citizen-patient/citizen-doctor

In a welfare states, no typical user of health care services is only a pati ent; and no typical provider of these services is simply a doctor, nurse or paramedic. Occupiers of these roles also have distinctive relations and re sponsibilities - as citizens - to medical services, responsibilities that a re 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 globalisation of a very comprehensive understanding of human rights, including rights to state-prov ided health care, will make welfare state thinking - for better or worse - more of an orthodoxy worldwide than it is now. Medical ethics needs to refl ect this.