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Lecture 5

Week 5 readings

7 Pages
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Department
Health Studies
Course Code
HLTA02H3
Professor
Toba Bryant

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Week 5 – Human Rights Approaches
1.) Staying Alive : Chap. 4: Rioux, M. The right to health: Human rights approaches to health.
A human rights and social justice approach enables the use of various categories of rights and recognizes how
rights have to be a concern in thinking about approaches to health and social policy that enhance, rather than
diminish, the well-being of all people.
oHuman rights can include economic, social, political, civil and cultural rights (i.e. right to life, freedom
of opinion, the right to work, social protection and adequate standard of living, education, cultural
freedom etc)
Health as Ethics
Decisions about health are related to how we see ourselves as individuals and societies – our fundamental
values and beliefs.
A shift is taking place – while there continues to be a focus on the individual patient benefit and on questions of
individual rights to medical benefits:
oOur society is more diverse and pluralistic – many diverse views in society. This means we cannot
assume shared values or a common story – there is a competing demand that cannot be resolved at the
individual level (need to focus on community and society)
oScience and biotechnology are progressing at a rapid rate
oThere are obvious inequalities in the way in which health care, health status, biotechnology and drugs
are made available to people.
A Social Imperative
Using human rights is a means to making equitable health outcomes a social imperative
What are the building blocks of health and human rights?
oThe right to the highest attainable standard of health was first introduced in the WHO constitution,
which was adopted by the World Health Conference in 1946
It was reiterated in the 1979 Declaration of Alma Atal and in the World Health Declaration (by
the World Health Assembly in 1998
The General Comment recognized the relationship of the right to health to other rights
including the right to food, housing, work, education, access to information, freedom of
association etc.
The right to health is more than access to health care and applies equally to other social
determinants of health
oThe General Comment set out 4 criteria for evaluating the right to health:
Availability – included adequate public health (including sanitation and safe drinking water) and
health care facilities as well as sufficient trained personnel and essential unexpired drugs
Accessibility – under this criteria, there are 4 categories: non-discrimination: physical
accessibility, economic accessibility, and information accessibility.
Acceptability – is health care provided with attention to criteria of medical ethics, cultural
sensitivity, gender and life cycle needs and confidentiality
Quality
oThese international instruments outline a normative standard for the right to health
Measuring the Right to Health
Paul Hunt (UN Special Rapporteur on health) proposes the following as categories for taxonomy to classify
initiatives:
oThe availability of health facilities, goods and services within jurisdiction
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oThe accessibility without discrimination in law or fact of health facilities, goods and services
oThe physical accessibility of health facilities, goods and services
oThe economic accessibility of health facilities, goods and services
oThe accessibility of health information
oThe cultural acceptability of health facilities, goods and services
oThe quality of health facilities, goods and services
oThe active and informed participation of individuals and groups, especially the vulnerable and
disadvantaged (those living in poverty) in relation to health policies, programs and projects
oThe right to health monitoring and accountability mechanisms that are effective, transparent and
accessible
These indicators can be categorized as:
o Structural indicators – those structures, systems and mechanisms that are necessary to the realization of
the right
o Process indicators – measure the degree to which activities that are necessary to attain certain health
objectives are carried out, and the progress of those indicators over time
oOutcome indicators – measure the results achieved by health-related policies (i.e. mortality rates, disease
patterns, teens with HIV/AIDS etc.)
These also provide a way to monitor good right to health practice at the national and international level and to
measure the degree to which states are in compliance with human rights standards in their policies and
programs
Differential Access to Health and Well-being
Greatest contemporary social injustice that people who live in the most disadvantaged circumstances have
more illnesses, more disability and shorter lives than those who are more affluent
oThis is a result of a number of factors that can include direct discrimination (i.e. individuals with
disabilities are not given same priority for transplants)
More often than the direct discrimination are the instances of indirect or covert discrimination faced by
people who are marginalized – failure of governments and others to put in place policies and programs that
would address the inequalities in health and illness
Recent case in Canada illustrated discrimination in health
oOct, 1997 – Canadian Supreme Court delivered a decision in BC – claim by three deaf applicants
that the legislation governing health care services and hospitals in the province was discriminatory
because it neither included sign language interpreter services as an insured service nor required
hospitals to provide sign language interpreter services
Court ruled the government had violated the equality provisions in the Canadian Charter of
Rights
Disability and the Right to Health
The right to health for people with disabilities is often infringed because of their limited access to health
services
oThey are commonly unable to take advantage of available medical services because of assumptions
about their quality of life and whether it is beneficial to them or to others to provide medical and health
benefits that others receive.
oHealth needs of people with disabilities are regularly limited to curing or improving their impairments,
rather than improving their health
oThey are also particularly vulnerable to standards of living that affect health: poverty, poor housing,
unemployment etc.
There are some particular rights that need to be protected for people with disabilities. These include the quality
and accessibility of services as well as the availability of a range of services, particularly rights related to:
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Description
Week 5 Human Rights Approaches 1.) Staying Alive: Chap. 4: Rioux, M. The right to health: Human rights approaches to health. A human rights and social justice approach enables the use of various categories of rights and recognizes how rights have to be a concern in thinking about approaches to health and social policy that enhance, rather than diminish, the well-being of all people. o Human rights can include economic, social, political, civil and cultural rights (i.e. right to life, freedom of opinion, the right to work, social protection and adequate standard of living, education, cultural freedom etc) Health as Ethics Decisions about health are related to how we see ourselves as individuals and societies our fundamental values and beliefs. A shift is taking place while there continues to be a focus on the individual patient benefit and on questions of individual rights to medical benefits: o Our society is more diverse and pluralistic many diverse views in society. This means we cannot assume shared values or a common story there is a competing demand that cannot be resolved at the individual level (need to focus on community and society) o Science and biotechnology are progressing at a rapid rate o There are obvious inequalities in the way in which health care, health status, biotechnology and drugs are made available to people. A Social Imperative Using human rights is a means to making equitable health outcomes a social imperative What are the building blocks of health and human rights? o The right to the highest attainable standard of health was first introduced in the WHO constitution, which was adopted by the World Health Conference in 1946 It was reiterated in the 1979 Declaration of Alma Atal and in the World Health Declaration (by the World Health Assembly in 1998 The General Comment recognized the relationship of the right to health to other rights including the right to food, housing, work, education, access to information, freedom of association etc. The right to health is more than access to health care and applies equally to other social determinants of health o The General Comment set out 4 criteria for evaluating the right to health: Availability included adequate public health (including sanitation and safe drinking water) and health care facilities as well as sufficient trained personnel and essential unexpired drugs Accessibility under this criteria, there are 4 categories: non-discrimination: physical accessibility, economic accessibility, and information accessibility. Acceptability is health care provided with attention to criteria of medical ethics, cultural sensitivity, gender and life cycle needs and confidentiality Quality o These international instruments outline a normative standard for the right to health Measuring the Right to Health Paul Hunt (UN Special Rapporteur on health) proposes the following as categories for taxonomy to classify initiatives: o The availability of health facilities, goods and services within jurisdiction www.notesolution.com
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