KIE: This article is an adaptation of a paper prepared for the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and included in its Securing Access to Health Care, Volume Two: Appendices. Sher analyzes the moral implications of the distinction frequently made in public policy discussions between the 'deserving' and 'undeserving' poor, relating it particularly to claims to medical care. He discusses the need to balance considerations of justice, self determination, and paternalism in determining society's obligation to provide access to health care for the poor.