Health and Human Rights最新文献

Economic policies that concentrate wealth and aggravate socioeconomic inequalities often have negative impacts on human rights. For example, evidence points to the unequal impact of austerity measures-such as the defunding and privatizing of health care-on already disadvantaged groups and individuals. Despite its detrimental impacts, austerity often appears as a necessary evil in times when difficult choices must be made. Justified through arguments of trickle-down economics to support growth, the realization of human rights is postponed. Human rights are sidelined as guidelines that inform rather than limit such measures. The assumption that wealth concentration and the consequent reduction of human rights standards may be justified suggests a problematic conception of equality in human rights law. In this paper, I critically examine the way that this assumption informs the exclusion of distributive considerations from the scope of equality within human rights law. I identify and evaluate the emerging interpretations of equality beyond the legal-technical notion of equal treatment and the prohibition of discrimination and the extent to which equality in human rights may take on a distributive function in combating policies of wealth concentration such as austerity.

Given the persistence of health inequities in the United States, scholars and health professionals alike have turned to the social determinants of health (SDH) framework to understand the overlapping factors that produce and shape these inequities. However, there is scant empirical literature on how frontline health and social service workers perceive and apply the SDH framework, or related movements such as the right to health, in their daily practice. Our study seeks to bridge this gap by applying constructs from the sociological imagination and structural competency (an emerging paradigm in health professions' education) to understand the perspectives and experiences of social work case managers, community health workers, legal advocates, and mental health counselors at a maternal and child health center in a large US city. This frontline workforce displayed strong sociological imagination, elements of structural competency, and engagement with the principles of the right to health. Workers shared reflections on the SDH framework in ways that signaled promising opportunities for frontline workers to link with the global movement for the right to health. We offer a novel approach to understanding the relationships between frontline worker perspectives on and experiences with the SDH, sociological imagination, structural competency, and the right to health.

In introducing the Mental Health and Wellbeing Bill of 2022 into Parliament in Victoria, Australia, the state government claimed that the new legislation "delivers on the vision for rights-based mental health and wellbeing laws." This paper examines the new legislation in light of both local human rights legislation and international human rights law. Drawing primarily on the United Nations Convention on the Rights of Persons with Disabilities and the Victorian Charter of Human Rights and Responsibilities Act of 2006, this paper argues that while the new legislation is not, in fact, rights based, it does represent some rights-related improvements over existing legislation. The paper concludes with a discussion of how rights-based legislation could be applied to the Victorian context, using the latest guidance from the World Health Organization and the United Nations.

This paper reflects on the right to health care from the Indigenous research paradigm. We analyze the case of an Aymara wise warmi (woman) who died after the Chilean health care system failed to provide culturally appropriate care. In the wake of her death, our cooperative launched an interdisciplinary and collaborative research project in an effort to file an administrative complaint against the family health center that treated her. We explore the events surrounding her treatment and death, as well as the institutional written response. Our work elucidates the significant differences that exist between institutional and Indigenous perspectives on what constitutes a violation of the right to health care. We demonstrate that in order to establish the existence of such violations, Aymara people are compelled to develop evidence using a naturalistic scientific and legal framework that does not coincide with their ontology. Consequently, some events and violations are not legally recognized as culturally inappropriate health care unless they are viewed through an Indigenous lens. Finally, we reflect on the problem of evidence production, specifically regarding the right to health care. We argue that the fight for the right to health care can benefit from the Indigenous research paradigm-not only for the benefit of Indigenous people but also to provide culturally appropriate care to all people.

Self-managed abortion holds particular promise for revolutionizing people's access to quality reproductive care in Africa, where the burden of abortion-related mortality is the highest globally and where abortion remains criminalized, in violation of various internationally and regionally recognized human rights. Increasingly safe and effective, self-managed medication abortion is still subject to many restrictions, including criminal laws, across the continent. Drawing on recent evidence and human rights developments around self-managed abortion, this paper explores whether and to what extent Africa's regional legal framework builds a normative basis for the decriminalization of self-managed abortion. We conclude that the region's articulation of the rights to dignity, to freedom from cruel, inhuman, and degrading treatment, and to nondiscrimination, among others, provides strong grounds for decriminalization, both concerning individuals who need abortions and concerning the constellation of actors who enable self-management.

Extended life expectancies and shifting dynamics in chronic disease have changed the landscape of public health interventions worldwide, with an increasing emphasis on chronic care. As a result, transition from pediatric to adult care for medically complex adolescents and young adults is a growing area of intervention. Transition medicine is a nascent field whose current emphasis is on middle- and high-income countries, and thus far its methods and discourse have reflected those origins. Through several case-based examples, this paper aims to highlight the possibilities of an analytic approach grounded in structural competency for transforming transition medicine through a human rights-based framework, with an emphasis on imagining a more global framework for transition medicine. Our cases highlight the disparities between patients navigating pediatric to adult-based care, illuminating social stigma, stratification between public and private insurances, engagement in risk-taking behaviors, family conflict, and challenges with transition readiness. To reimagine transition medicine so that it is based on human rights, we must prioritize structural solutions that embrace multisectoral integration and holistic mental health support rather than oppress and marginalize these critical systemic adaptations. We aim to reconfigure this scaffolding to center structures that integrate holistic well-being and imagine alternate realities to healing. Our work contributes to the literature bringing structural competency to new spaces of clinical practice, contextualizing new frontiers for the exploration of chronic diseases across diverse clinical contexts worldwide.

Improving the protection of the right to health of ethnic Roma people is one of the most pressing public health challenges in contemporary Europe, as their life expectancy and health status remain significantly lower than their non-Roma counterparts.¹ This paper analyzes Roma-led accountability initiatives that embrace social accountability and legal empowerment approaches to advocate for equitable fulfillment of the right to health. While these initiatives have led to the elimination of some harmful health practices (such as illegal cash bribes and violent and abusive treatment by medical professionals) and to improvements in health care, and some Roma communities have become driving forces for local and national health system reforms for advancing the fulfillment of health rights, the health inequalities affecting Roma communities remain significant. This issue also remains largely overlooked by European health research and policy experts, who are mostly reluctant to incorporate analyses of ethnicity and racialization into their research on health inequalities in Europe. The COVID-19 pandemic has further exacerbated these health inequalities.