Bioethics and Tragedy: Reflections on the Luigi Mangione Case and the Assassination of UnitedHealthcare CEO

January 8, 2025

Author: Juan Manuel Palomares Cantero

Versión en español

What does the murder of UnitedHealthcare CEO Brian Thompson tell us about the ethical and social tensions surrounding the healthcare system? Which took place on December 4 in Manhattan, this tragic event has generated debates that go beyond the legal and corporate, touching deep ethical fibers. The alleged perpetrator, Luigi Mangione, expressed a hostility towards the health insurance industry that seems to reflect a collective resentment towards a system perceived as dehumanised. From a bioethical perspective, this fact invites us to ask ourselves how we can reconcile respect for human dignity with a health model that prioritizes business over people, and to reaffirm the inadmissibility of violence as a response to injustices. (1) (2)

From bioethics, the dignity of each person is inviolable and constitutes the core of any ethical reflection. The murder of Brian Thompson is a condemnable act that denies this principle at its root. Violence not only destroys lives, it undermines the social fabric and perpetuates cycles of hatred and misunderstanding. (3)

However, this case also highlights a deeper bioethical dimension: the growing perception that the health system, particularly the insurance model, prioritizes profit over people's lives and well-being. This disconnect between human values and corporate practices intensifies feelings of despair and lack of empathy in society. (4)

The health insurance model in many parts of the world is the subject of constant criticism due to its predominantly commercial approach, which often puts profit above human needs. Luigi Mangione, though never a UnitedHealthcare customer, appears to have channeled into his violent act the collective frustration of millions of people facing denials of coverage, prohibitive costs, and decisions that prioritize financial calculations over patients' health and well-being. This case reflects how a health system perceived as dehumanized can fuel deep resentment, even if it never justifies violence as a response.

Bioethics demands a review of these practices, recognizing that health cannot be treated as just another commodity. Instead, it must be understood as an inherent right of the person, access to which must be guaranteed with justice, empathy and equity. This includes recognizing vulnerability as an essential condition of human existence, marked by interdependence and openness to others. According to Judith Butler, vulnerability should not be limited to exposure to harm, but should be understood as an ethical call to the social minimization of violence. In this way, the health system must be configured not only to protect individual integrity, but also to transform the structures that perpetuate inequalities and exclusions, ensuring that more forms of life are recognized, valued, and respected. (5) (6)

Although the health insurance system is in urgent need of transformations, is it legitimate to turn Luigi Mangione into a kind of modern-day Robin Hood or a Joker who symbolizes rebellion against injustice? To make him an icon would be deeply misguided and ethically untenable. As in the figurations of heroism analyzed in works such as Robin Hood, romanticizing an individual who resorts to violence as a means of protest implies ignoring the ethical and social implications of his actions. The construction of icons based on acts of violence not only perpetuates a cycle of hatred and misunderstanding, but also reinforces narratives that validate extreme behaviors under the guise of fighting against unjust systems. These types of narratives, as Cecilia Inés Luque suggests, risk simplifying the complexities of structural change by focusing on lone heroes and symbolic acts, diverting attention from the collective, cooperative, and nonviolent solutions needed to address underlying problems. (7)

The path to structural change cannot be built on acts that destroy human lives. On the contrary, it requires a collective reflection on how to balance the economic needs of institutions with inalienable respect for the dignity of each person.

This case invites us to rethink the role of health institutions. From a bioethical perspective, companies in the sector cannot be limited to being economic engines; they must be ethical actors committed to human well-being. This means prioritizing fair access to health services, promoting transparent practices, and fostering a culture of empathy for those who depend on them. As the painful lesson of the Tuskegee case demonstrates, ethics in the field of health must focus on the protection of the most vulnerable, respecting their autonomy and ensuring that medical decisions are guided by principles of justice, equity and prudence. Institutions must make an active commitment to avoid practices that can perpetuate inequalities or dehumanize patients, always adopting a sensitive approach that prioritizes the dignity and rights of each person. (8)

The murder of Brian Thompson is a tragedy that reminds us of the importance of defending human dignity in all dimensions of our social life. While Luigi Mangione's case reflects the tensions and frustrations towards a health system that many consider dehumanized, the response cannot be violence or the justification of acts that contradict the fundamental principles of respect and justice.

This case not only underscores the need for structural reforms in health insurance, but also calls for collective reflection on how to build a system based on principles of justice and equity. Adopting models that promote universal accessibility, such as those used in some European countries, could be a starting point for reconfiguring health systems. Only in this way will we be able to move towards a model that recognizes and protects human dignity in all its dimensions.

Juan Manuel Palomares Cantero is a lawyer, master and doctor in Bioethics from the Universidad Anáhuac, Mexico. He was director of Human Capital, director and general coordinator in the Faculty of Bioethics. He currently works as a researcher in the Academic Directorate of Integral Training of the same University. He is a member of the Mexican National Academy of Bioethics and the Latin American and Caribbean Federation of Bioethics Institutions. This article was assisted in its writing by the use of ChatGPT, an artificial intelligence tool developed by OpenAI. 

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Bibliografía

_{1 https://www.uhc.com/ UnitedHealth Group is one of the world's largest privately held health insurers, with nearly 53 million members worldwide. In 2023, Fortune ranked it as the world's most admired company in the insurance and managed care sector.}