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Henry Silverman, MD, MA University of Maryland School of Medicine Baltimore, Maryland USA

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Title: Henry Silverman, MD, MA University of Maryland School of Medicine Baltimore, Maryland USA


1
Research and Human Rights
  • Henry Silverman, MD, MAUniversity of Maryland
    School of MedicineBaltimore, Maryland USA

2
Equity
Health
Human Rights
3
The Nature of Rights
  • X has a right to do or to have Z
  • Xs rights entails that some party (Y) has an
    obligation either not to interfere if X does Z or
    to provide X with Z
  • To have a right implies an obligation on someone
    else (Y).

4
What are human rights?
  • General form of a rights-based claim
  • Logical relationship between two agents (x) and
    (y) and a condition (z)
  • Specification of a rights-holder/s (x), duty
    holder/s (y) condition (z)
  • CONDITION
  • RIGHTS
    OBLIGATIONS

5
  • Human rights
  • rights-holders human beings
  • duty-holders governments,
  • conditions fundamental human freedoms

FUNDAMENTAL FREEDOMS HUMAN
GOVERNMENT RIGHTS
OBLIGATIONS
6
Types of Rights
  • Negative Rights
  • A right to be free from some action taken by
    others
  • Role of civil, political, and legal rights is to
    protect individuals from societal intrusions
  • Positive Rights
  • A right to be provided with a particular good or
    service by others (e.g., health care).
  • Role of social, economic, cultural rights

7
Grounds of Rights
  • The grounds of anyones rights are the reasons
    why he or she has that right.
  • Legal rights - laws
  • Institutional rights institutions
  • Professional rights professions
  • Moral rights conferred by moral grounds
    independent of human beliefs or practices

8
Moral Rights
  • Moral Rights human rights
  • Rights that one possesses simply by virtue of
    being human, whether or not they are recognized
    by the institution
  • Natural Law commanded by God
  • Social Utility promote happiness
  • Kant respect for persons
  • Rawls grounded on a hypothetical contract to
    which the members of any society would agree
    unanimously

9
What do we mean by human rights?
  • Human Rights refers to the concept of human
    beings as having universal rights, or status,
    regardless of legal jurisdiction or other
    localizing factors, such as ethnicity,
    nationality, and sex.
  • As is evident in the United Nations Universal
    Declaration of Human Rights, human rights are
    conceptualized as based on inherent human
    dignity, retaining their universal and
    inalienable character.
  • Defines what governments can do to us, cannot do
    to us, and should do for us
  • Primarily about the relationship between the
    individual (groups) and the State

10
5 Types of Human Rights
  • Human rights are traditionally categorized in the
    following five types

11
Civil and Political Rights
  • Civil rights deal with standards of judiciary and
  • penal systems.
  • Political rights deal with specific components of
  • participation in political power.
  • These rights are often focused on when one talks
  • about human rights.

12
ESCR - The neglected half of Human Rights
  • Economic Rights deal with the sphere of human
    beings working, producing and servicing.
  • Social Rights deal with standard of living and
    quality of life for all persons, including those
    not participating in economic activities.
  • Cultural Rights deal with the cultural sphere of
    life including ethnic culture, subcultures, arts
    and science.

13
Universal Declaration
  • On December 10, 1948 the United Nations adopted
    and proclaimed the Universal Declaration of Human
    Rights
  • Article 25 Everyone has the right to a standard
    of living adequate for the health and well-being
    of himself and of his family, including food,
    clothing, housing and medical care and necessary
    social services.

14
UNIVERSAL DECLARATION OF HUMAN RIGHTS (1948)
  • INDEX OF ARTICLES
  • 1-2 Human dignity, equality and
    non-discrimination
  • 3 Life, Liberty and Security
  • 4 Slavery and Slave Trade
  • 5 Torture and Cruel/Inhuman/Degrading Treatment
    or Punishment
  • 6-11 Legal Rights
  • 12 Arbitrary Interference
  • 13 Freedom of Movement and Residence
  • 14/15 Asylum/ Nationality
  • 16/17 Marriage/Property
  • 18-19 Freedom of Thought/ Conscience/
    Religion/Opinion/ Expression
  • 20 Peaceful Assembly and Association
  • 21 Political Rights
  • 22 Social security and general recogntion of
    socio-economic rights
  • 23-24 Employment, Trade Union and Rest
  • ADEQUATE STANDARD OF LIVING ADEQUATE FOR THE
  • HEALTH OF THE FAMILY
  • 26 Eduation
  • 27 Cultural Life

15
The Right to Health
  • WHO Constitution (1948)
  • The enjoyment of the highest attainable standard
    of health is one of the fundamental rights of
    every human being without distinction of race,
    religion, political belief, economic or social
    condition.
  • WHO Constitution (Preamble)
  • Health is a state of complete physical, mental,
    and social well-being, and not merely the absence
    of disease or infirmity.
  • International Covenant on economic, Social and
    Cultural Rights (1966)
  • The States Parties to the present Covenant
    recognize the right of everyone to the enjoyment
    of the highest attainable standard of physical
    and mental health.

16
The Right to Health
  • Health as a human right
  • Both as access to health care and as the right to
    health creating-conditions (such as housing,
    education, a safe environment, etc.)
  • Governments core obligations to health realizing
    the right of access to health care is elaborated
    in General Comment 14 issues by the UN Committee
    for Economic, Social and Cultural Rights

17
Examples of the linkages between health and human
rights
HUMAN RIGHTS VIOLATIONS RESULTING IN ILL-HEALTH
REDUCING VULNERABILITY TO ILL-HEALTH THROUGH
HUMAN RIGHTS
PROMOTION OR VIOLATION OF HUMAN RIGHTS THROUGH
HEALTH DEVELOPMENT
18
Research and Human Rights
  • Every element of a research ethics review
  • Balance of risks and benefits
  • Fair selection of research populations
  • Assurance of rights for individual subjects
  • Can be affected by the political and human rights
    background in which a study is done.

19
Political and Human Rights Context
  • Background Settings
  • Assurance of voluntary consent
  • Prisons, brothels
  • Governmental oversight of studies
  • Protection from outside harm
  • Research Findings
  • Stigmatize country genetic research
  • Refugees
  • Increased child mortality criticism???

20
Political and Human Rights Context
  • Validity of Data
  • False HIV reporting - heterosexual
  • Justice
  • Equity issues ignore health problems of
    disadvantaged
  • Access govt unwilling to fund successful
    interventions
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