Basic Concept of

Human RightTridjoko HadiantoTridjoko Hadianto

HistoryHistory

NAZI Human ExperimentationNAZI Human Experimentation– Germany in World War IIGermany in World War II– Jews prisoner Jews prisoner – Medical experiments Medical experiments research research

Tuskegee Untreated Syphilis Study Tuskegee Untreated Syphilis Study – in Tuskegee, Alabama 1932 - 1972 in Tuskegee, Alabama 1932 - 1972 – African-American (Negro) MaleAfrican-American (Negro) Male– Clinical study in human Clinical study in human research research

Health and Human RightHealth and Human Right

The link between Health and Human Rights is a The link between Health and Human Rights is a relatively recent phenomenon. In 1945, the relatively recent phenomenon. In 1945, the United Nations stated that United Nations stated that all people are all people are “born “born free and equal in dignity and rights”free and equal in dignity and rights”. . The UN General Assembly in 1948 passed the The UN General Assembly in 1948 passed the Universal Declaration of Human RightsUniversal Declaration of Human Rights and it is and it is in this document that in this document that HealthHealth is first mentioned as is first mentioned as a human right. a human right. Importantly, Indonesia has signed this Importantly, Indonesia has signed this declaration.declaration.

HealthHealth

Health here means more than just Health here means more than just physicalphysical health, but includes the health, but includes the mentalmental and and socialsocial aspects of Health. aspects of Health.

It is stated in the Universal Declaration of It is stated in the Universal Declaration of Human Rights that Human Rights that “everyone has the right to a “everyone has the right to a standard of living adequate for the standard of living adequate for the healthhealth and and well-being of himself and of his family, including well-being of himself and of his family, including food, clothing, housing, and medical care and food, clothing, housing, and medical care and necessary social services and the right to necessary social services and the right to security…”security…”

Promoting Health and Promoting Human Rights are Promoting Health and Promoting Human Rights are distinct and powerful approaches to advancing distinct and powerful approaches to advancing human human well-beingwell-being..Health promotion involves the physical, mental and Health promotion involves the physical, mental and social aspects of health for the individual and for social aspects of health for the individual and for populations. populations. Human rights involve protecting individuals and groups Human rights involve protecting individuals and groups against actions that interfere with against actions that interfere with fundamental freedoms fundamental freedoms and human dignityand human dignity..The goal of the health and human rights linkage is to The goal of the health and human rights linkage is to advance the human well-being beyond that which advance the human well-being beyond that which could could be reached by eitherbe reached by either the Health or the Human Rights the Health or the Human Rights approach, independently.approach, independently.

The relationship between Health and Human RightsThe relationship between Health and Human Rights

These complex linkages can be seen in the conceptual image These complex linkages can be seen in the conceptual image created by the WHO. There are three concentric circles that overlap created by the WHO. There are three concentric circles that overlap in the center. in the center.

The three circles are called:The three circles are called:Human Rights Violations Resulting in Ill-Health.Human Rights Violations Resulting in Ill-Health. – In other words, violations or lack of attention to human rights can have In other words, violations or lack of attention to human rights can have

serious health consequences;serious health consequences;Promotion or Violation of Human Rights through Health Promotion or Violation of Human Rights through Health DevelopmentDevelopment.. – In other words, health policies and programs can promote or violate In other words, health policies and programs can promote or violate

human rights in the ways they are designed or implemented;human rights in the ways they are designed or implemented;Reducing Vulnerability of Ill-Health through Human RightsReducing Vulnerability of Ill-Health through Human Rights. . – In other words, vulnerability and the impact of ill health can be reduced In other words, vulnerability and the impact of ill health can be reduced

by taking steps to respect, protect and fulfill human rights.by taking steps to respect, protect and fulfill human rights.

In the WHO diagram, the outer circle is a set of examples of the three categories involved in the health and human rights relationship.

NoteNoteFirst, when violations of human rights occur, adverse health First, when violations of human rights occur, adverse health consequences can result. consequences can result. – If a child is physically or mentally abused, this child might need medical attention If a child is physically or mentally abused, this child might need medical attention

for fractures of the bones or psychological impairment due to this abuse. His for fractures of the bones or psychological impairment due to this abuse. His rights are violated and he suffers ill health as a result.rights are violated and he suffers ill health as a result.

Second, health policies or programs can violate human rights in their Second, health policies or programs can violate human rights in their design and implementation.design and implementation.– A program designed to educate the general population about HIV/AIDS A program designed to educate the general population about HIV/AIDS

prevention that does not take into account different languages spoken by prevention that does not take into account different languages spoken by different sub-populations is discriminatory and violates the human rights of those different sub-populations is discriminatory and violates the human rights of those who cannot access the information. By violating the human rights of certain who cannot access the information. By violating the human rights of certain populations, their health will be adversely impacted.populations, their health will be adversely impacted.

Third, respecting, protecting and fulfilling human rights, reduces the Third, respecting, protecting and fulfilling human rights, reduces the vulnerability of illness for the individual and for populations. vulnerability of illness for the individual and for populations. – The physically disabled require specially designed access to health facilities in The physically disabled require specially designed access to health facilities in

order to use them. If access is not possible, or more difficult, the handicapped order to use them. If access is not possible, or more difficult, the handicapped person will not be able to access the health system and will, therefore, be more person will not be able to access the health system and will, therefore, be more vulnerable to ill health.vulnerable to ill health.

ImplementationImplementation

Physicians and health care providers play a Physicians and health care providers play a pivotal role in moving the human rights agenda pivotal role in moving the human rights agenda forward through forward through the standards of medical carethe standards of medical care they embrace. Standards such as patient/client they embrace. Standards such as patient/client respect, nondiscriminatory access and care, respect, nondiscriminatory access and care, confidentiality and informed consent are confidentiality and informed consent are important in enhancing the quality of care. important in enhancing the quality of care. These standards are also These standards are also integral to integral to bio(medical)ethicsbio(medical)ethics, and offer an opportunity for a , and offer an opportunity for a bridge from bridge from medical practice to improved human medical practice to improved human rightsrights for populations. for populations.

BioethicsBioethics can serve can serve as a vehicle for increased as a vehicle for increased awareness of human rightsawareness of human rights in the medical in the medical community. community. In time, promotion of these standards of medical In time, promotion of these standards of medical care can provide a substrata upon which legal care can provide a substrata upon which legal advocates can argue for other economic and advocates can argue for other economic and social rights that will promote individual well-social rights that will promote individual well-being and population health. Both the medical being and population health. Both the medical and the legal communities have a part to play in and the legal communities have a part to play in improving health and human rights-and each will improving health and human rights-and each will be more effective by working together in this be more effective by working together in this quest.quest.

The The medical and legal communities must work together medical and legal communities must work together in other waysin other ways. For instance, doctors and other health . For instance, doctors and other health workers are on the frontline to diagnose the health workers are on the frontline to diagnose the health impacts of human rights abuses. In addition to impacts of human rights abuses. In addition to diagnosing, health professionals can treat document and diagnosing, health professionals can treat document and report human rights abuses. In collaboration with their report human rights abuses. In collaboration with their legal counterparts, legal counterparts, protections must be created for these protections must be created for these vulnerable populations in order to prevent further human vulnerable populations in order to prevent further human rights abusesrights abuses. In addition, the legal community in . In addition, the legal community in collaboration with the medical community can draft law collaboration with the medical community can draft law that provides legal redress in circumstances of human that provides legal redress in circumstances of human rights violations.rights violations.

What human rights are?What human rights are?

Human rights are primarily about the relationship Human rights are primarily about the relationship between the individual and the state. International between the individual and the state. International human rights law consists of the human rights law consists of the obligations that obligations that governmentsgovernments have agreed they have in order to be have agreed they have in order to be effective in promoting and protecting our rightseffective in promoting and protecting our rights..

““The enjoyment of the highest attainable standard of The enjoyment of the highest attainable standard of health is one of the health is one of the fundamental rights of every human fundamental rights of every human being without distinction of race, religion, political belief, being without distinction of race, religion, political belief, economic or social conditioneconomic or social condition” (Preamble to the WHO ” (Preamble to the WHO Constitution 1946)Constitution 1946)

Human rights, such as the right to the highest attainable Human rights, such as the right to the highest attainable standard of health, are understood to be progressively standard of health, are understood to be progressively implemented by the state to the “implemented by the state to the “maximum of its maximum of its available resourcesavailable resources.”.”

States must “take steps, individually and through States must “take steps, individually and through international assistance and cooperation, especially international assistance and cooperation, especially economic and technical, to the maximum of its available economic and technical, to the maximum of its available resources, with a view to achieving progressively the full resources, with a view to achieving progressively the full realization of the rights recognized in the [Economic, realization of the rights recognized in the [Economic, Social, and Cultural Rights] covenant by all appropriate Social, and Cultural Rights] covenant by all appropriate means, including the adoption of legislative measures.”means, including the adoption of legislative measures.”

A rights-based approach to health refers A rights-based approach to health refers to the processes of:to the processes of:

Using human rights Using human rights as a framework for health as a framework for health developmentdevelopment..

Assessing and addressing the human rights Assessing and addressing the human rights implications of any health policy, programme or implications of any health policy, programme or legislationlegislation..

Making human rights an integral dimensionMaking human rights an integral dimension of of design, implementation, monitoring and design, implementation, monitoring and evaluation of health-related policies and evaluation of health-related policies and programs in all spheres, including political, programs in all spheres, including political, economic and social.economic and social.