In recent days, Utah congressman Jason Chaffetz and Mississippi state congressman Jeff Guice have come under fire for suggesting that constituents redirect their income toward paying for healthcare.

I have some sympathy for these congressmen. Here is how they see the world: Some people make foolish financial and health choices. This is due to ignorance, stupidity, weak values, irresponsibility, or the inability to resist evil temptations. These same people demand public assistance when (surprise surprise) they find themselves in a health or financial crisis. Elsewhere, people who are better educated, smarter, stronger, or more righteous are working hard, living responsibly and austerely to save money. They are dismayed to find their hard-earned and wisely-saved money taxed and then spent on the care and feeding of the stubbornly short-sighted. Even the most bleeding-heart liberal has held this perspective in one circumstance or the other.

Many years ago, I held this perspective in an argument against nationalized healthcare. Why, I asked, should I pay for the lung cancer of a stubborn smoker, the liver failure of a drug abuser, the adult-onset diabetes of a chronic unhealthy eater, or the concussions of a reckless athlete? Then a dear friend stumped me by asking, “On the operating table or in the emergency room, would you withhold life-saving treatment from a dying patient, knowing their history of self-destructive choices?”

I myself could not say “yes” definitively. I knew that my friend would soon join the ranks of physicians who bound themselves to “no” under the Hippocratic Oath. I would later learn that hospitals run by Catholic charities said “no.” Even later, I would learn that a 1986 law, the Emergency Medical Treatment and Active Labor Act, prohibited the transfer or discharge of patients needing emergency care.

The path from a “no” answer to nationalized healthcare is a slippery slope. Treatment has a financial burden. If the patient is unable to bear this burden, then who should? It is ethically and also financially sensible for society (the state) as a whole to bear it. Really the only assumption here is that the society and the patient, unless proven otherwise, prefer life over death.

Personal responsibility is a very noble value. Its power to organize relationships and even to save lives is often underestimated. But even the staunchest conservative must agree that its scope is not infinite, and it must be limited for a society or civilization to exist or be recognized, even in principle.