Title: Henry Silverman, MD, MA University of Maryland School of Medicine Baltimore, Maryland USA
1Research and Human Rights
- Henry Silverman, MD, MAUniversity of Maryland
School of MedicineBaltimore, Maryland USA
2Equity
Health
Human Rights
3The 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).
4What 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
6Types 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
7Grounds 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
8Moral 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
9What 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
105 Types of Human Rights
- Human rights are traditionally categorized in the
following five types
11Civil 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.
12ESCR - 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.
13Universal 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.
14UNIVERSAL 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
15The 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.
16The 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
17Examples 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
18Research 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.
19Political 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???
20Political 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