SACHS J The inescapable fact is that if governments were unable to confer any benefit on any person unless it conferred an identical benefit on all, the only viable option would be to confer no benefit on anybody.5 [54] Health care rights by their very nature have to be considered not only in a traditional legal context structured around the ideas of human autonomy but in a new analytical framework based on the notion of human interdependence. A healthy life depends upon social interdependence: the quality of air, water, and sanitation which the state maintains for the public good; the quality of one’s caring relationships, which are highly correlated to health; as well as the quality of health care and support furnished officially by medical institutions and provided informally by family, friends, and the community.6 As Minow put it: “Interdependence is not a social ideal, but an inescapable fact; the scarcity of resources forces it on us. Who gets to use dialysis equipment? Who goes to the front of the line for the kidney transplant?”7 Traditional rights analyses accordingly have to be adapted so as to take account of the 5 See Brown v British Columbia (Minister of Health) (1990) 48 CRR 137 at 157–8. 6 Minow, participating in an interdisciplinary discussion held at Harvard Law School in 1993, “Session I: Applying Rights Rhetoric to Economic and Social Claims” Economic and Social Rights and the Right to Health (Harvard Law School Human Rights Program, Cambridge MA 1995) 1 at 3. 7 Id. 30

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