Health and Human Rights

Taufik Suryadi,M.D., Sp.FM.(Repr from Unsyiah)

Kulsum,M.D. (Repr from Unaya)
Center For Bioethics, Medical Law, Health
and Human Right in Aceh

Overview
Definition of Health
The Relationship between Health and
Human Rights: Why and What
The Relationship with Bioethics
The Right to Health Under International
Law
Limitations of the Right to Health

WHO Definition of Health

Health is a state of complete physical,
mental and social well-being and not
merely the absence of disease or infirmity.

Bringing Health and Human Rights

Together
Health and Human Rights
The goal of the health and human
rights linkage is to advance the human
well-being beyond that which could be
reached by either the Health or the
Human Rights approach, independently

Health and Human Rights

Promoting and protecting health
is inextricably linked to
respecting, protecting and
fulfilling human rights

Health and Human Rights

Violations or lack of attention to human
rights can have serious health
consequences (e.g. harmful traditional
practices, slavery, torture and inhuman
and degrading treatment, violence against
women and children).

Health and Human Rights

Health policies and programmes can
promote or violate human rights in their
design or implementation (e.g. freedom
from discrimination, individual autonomy,
rights to participation, privacy and
information).

Health and Human Rights

Vulnerability to ill-health can be reduced
by taking steps to respect, protect and
fulfill human rights (e.g. freedom from
discrimination on account of race, sex and
gender roles, rights to health, food and
nutrition, education, housing).

Source: 25 Questions & Answers on

Health & Human Rights, WHO

Medico-Ethicolegal Linkage

Agus Purwadianto2005
truth

Natural Law
ETHICS

Forensic Med

bioethics justice

discipline

Humanity

DR vs DR
Medicine

Law

Human Right

Public law

Goverment
Medicolegal

Ethicolegal

Citizen 1
Penal

Citizen 2
Medical law

Medical
Jurisprudence

Links Between Health,

Biomedical Ethics and
Human Rights
Health

Biomedica
l Ethics

Human
Rights

Four Principles of Bioethics

Autonomy-respect decisions
Beneficence-do good
Nonmaleficence-do no harm
Justice-act fairly and promote fair
allocation of healthcare resources

Human Rights

Individual Health

Biomedical Ethics

Population Health

Commonalities: Biomedical
Ethics and Human Rights
Both Grew out of World War II (Nuremburg
Code)
Both Focus on Individual Rights and Human
Dignity
Both ebbed in 1950s and 1960s and resurged
in the 1980s and 1990s

Commonalities: Biomedical Ethics

and Human Rights
Both have distanced from the philosophical and
moved towards more practical approach
Neither imbued with strong enforcement
capacity (unless encoded into local law)
Both are empowered by their capacity to inspire
policy change in social and professional norms

The History of Health and

Human Rights
In 1945, The United Nations stated that all
people are born free and equal in dignity
and rights
In 1948, The Universal Declaration of
Human Rights was passed by the UN
General Assembly

The Right To Health

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, and the right to
security in the event of unemployment, sickness,
disability, widowhood, old age or other lack of
livelihood in circumstances beyond his control.

International Bill of Human

Rights
Universal Declaration of Human Rights
International Covenant on Civil and
Political Rights (ICCPR)
International Covenant on Economic,
Social and Cultural Rights (ICESC)

International Covenant of
Economic, Social and Cultural
Rights, Article 12(1)
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.

International Covenant of Economic,

Social and Cultural Rights, Article
12(2)

The steps to be taken by the States Parties to the present

covenant to achieve the full realization of this right shall
include those necessary for:
a) The provision for the reduction of the stillbirth rate and of
infant mortality and for healthy development of the child;
b) The improvement of all aspects of environment and industrial
hygiene;
c) The prevention, treatment and control of epidemic, endemic,
occupational and other diseases
d) The creation of conditions which would assure to all medical
service and medical attention in the event of sickness.

General Comment 14 (2000)

The right to the highest attainable standard
of health, ICESCR Article 12
Important interpretation from the Committee on
Economic, Social and Cultural Rights
Health is a fundamental human right indispensable for
the exercise of other human rights
Clearly states that the right to health includes the
determinants of health and NOT THE RIGHT TO BE
HEALTHY

General Comment 14
The right to health contains essential
elements:
Availability
Accessibility
Nondiscrimination
Physical accessibility
Economic accessibility (affordability)

Acceptability
Quality
Participation

International Treaties and Conventions

Relevant to Health and Human Rights
Convention on the Elimination of All Forms of
Discrimination Against Women (1979)
Convention Against Torture and Other Cruel,
Inhuman or Degrading Treatment or Punishment
(1984)
Convention on the Rights of the Child (1989)
International Convention on the Protection of the
Rights of All Migrant Workers and Members of Their
Families (1990)
Convention on the Prohibition and Immediate Action
for the Worst Form of Child Labour (1999)

CEDAW 1979

CEDAW
Convention on the Elimination
of All Forms of Discrimination
Against Women

CEDAW Article 1
For the purposes of the present Convention, the
term "discrimination against women" shall mean
any distinction, exclusion or restriction made on
the basis of sex which has the effect or purpose
of impairing or nullifying the recognition,
enjoyment or exercise by women, irrespective of
their marital status, on a basis of equality of men
and women, of human rights and fundamental
freedoms in the political, economic, social,
cultural, civil or any other field.

Article 12
1. States Parties shall take all appropriate
measures to eliminate discrimination
against women in the field of health care
in order to ensure, on a basis of equality of
men and women, access to health care
services, including those related to family
planning.

Article 12
2. Notwithstanding the provisions of
paragraph I of this article, States Parties
shall ensure to women appropriate
services in connection with pregnancy,
confinement and the post-natal period,
granting free services where necessary,
as well as adequate nutrition during
pregnancy and lactation.

CRC 1989

CRC
Convention on the Rights of
the Child

Article 1
For the purposes of the present
Convention, a child means every human
being below the age of eighteen years
unless under the law applicable to the
child, majority is attained earlier.

Article 24
Article 24
1. States Parties recognize the right of the child
to the enjoyment of the highest attainable
standard of health and to facilities for the
treatment of illness and rehabilitation of health.
States Parties shall strive to ensure that no child
is deprived of his or her right of access to such
health care services.

Article 24 continued
2. States Parties shall pursue full implementation of this
right and, in particular, shall take appropriate measures:
(a) To diminish infant and child mortality;
(b) To ensure the provision of necessary medical
assistance and health care to all children with emphasis
on the development of primary health care;
(c) To combat disease and malnutrition, including within
the framework of primary health care, through, inter
alia, the application of readily available technology and
through the provision of adequate nutritious foods and
clean drinking-water, taking into consideration the
dangers and risks of environmental pollution;

Article 24 continued
(d) To ensure appropriate pre-natal and post-natal
health care for mothers;
(e) To ensure that all segments of society, in particular
parents and children, are informed, have access to
education and are supported in the use of basic
knowledge of child health and nutrition, the advantages
of breastfeeding, hygiene and environmental sanitation
and the prevention of accidents;
(f) To develop preventive health care, guidance for
parents and family planning education and services.

Article 24
3. States Parties shall take all effective and
appropriate measures with a view to abolishing
traditional practices prejudicial to the health of
children.
4. States Parties undertake to promote and
encourage international co-operation with a view
to achieving progressively the full realization of
the right recognized in the present article. In this
regard, particular account shall be taken of the
needs of developing countries.

Indonesian Law
Womens Health: ? (Domestic Violence
Law of 2004)
Child Health: Child Protection Law (2002)

How?

How do vulnerable populations get

protections?

Advocacy for Health Rights

The Roles of Doctors and

Lawyers as Advocates for Change

Mechanisms for Legal Redress of

Human Rights Abuses
National legal judicial system
Regional mechanism
International mechanism

Regional Mechanisms
Regional Human Rights
Mechanisms
Inter-American System
(OAS)

Europe
Council of Europe & EU

Africa

Regional Human Rights

Instruments
American Declaration of the Rights and Duties of Man
(1948)
European Convention for the Protection of Human
Rights and Fundamental Freedoms (1950)
African Charter on Human and Peoples Rights (1981)
Protocol of San Salvador (1988)
Inter-American Convention on the Elimination of All
Forms of Discrimination Against Persons with Disabilities
(1999)

International Human Rights

Mechanisms
The UN System

Tension

Public
Health

Individual
Rights
(Human Rights)

THE END