The 50th
Anniversary of the Universal Declaration of Human Rights
Forging the Link
Between Health and Human Rights Editor’s note: The Universal
Declaration of Human Rights (UDHR), adopted by the UN General Assembly on December
10, 1948, has become the foundation of international human rights law.
The Consortium for Health and Human Rights, composed of the François-Xavier
Bagnoud Center for Health and Human Rights, Global Lawyers and Physicians, International
Physicians for the Prevention of Nuclear War, and Physicians for Human Rights,
has been working throughout this 50th anniversary year to promote a better understanding
of, and commitment to, the UDHR throughout the medical, public health, and legal
communities. The statement reprinted here has been prepared by the Consortium
for distribution to medical schools, for publication in journals, and for discussion
at medical meetings. The entire text of the UDHR, along with other resources may
be found at the Consortium
Website.
Fifty years ago the United Nations General Assembly
adopted the Universal Declaration of Human Rights (UDHR) to guarantee all human
beings security, dignity, and well being in every country of the world. Drafted
as a response to the horrors of World War II, the UDHR set the foundation for
dozens of international treaties and laws that protect the rights to life and
the integrity of the person, to health, food, shelter, clothing, and education,
to freedom of expression, to participation in society, and to the benefits of
science, to equality in marriage, to move freely within one’s country and
across borders, to seek a safe haven from persecution, and more. The United
Nations rightly intended that the UDHR be taught at every institution of learning
and at every level of education throughout the world. Health professionals have
a great stake in the UDHR because human rights and health concerns share the common
goals of alleviating suffering and promoting the conditions for health and well
being of all people. These goals represent an ideal that cannot be achieved unless
the fundamental rights set forth in the UDHR are recognized, respected, protected,
and fulfilled. The celebration of the 50th Anniversary of the UDHR, throughout
1998 and culminating on Human Rights Day, December 10, 1998, is an occasion for
institutions concerned with the teaching and training of health professionals
to explore and embrace the critical links between human rights and health. Discrimination
Discrimination against ethnic, religious and racial minorities, as well as on
account of gender, sexual orientation, political opinion or immigration status,
compromises or threatens the health and well being and, all too often, the very
lives of millions. Discriminatory practices threaten physical and mental health
and deny people access to care altogether, deny people appropriate therapies,
or relegate them to inferior care. In extreme forms of discrimination, as exemplified
by Apartheid, ethnic cleansing and genocide, the devaluation of human beings as
“other” has had devastating consequences. Health
Policies That Violate Rights Violations of human rights exist in the design
and implementation of health policies. For example, population policies which
fail to respect the conditions necessary for individual decision making are less
effective. In the past few decades, governments and international agencies have
increasingly recognized that women must be able to make and effectuate free and
informed choices about reproduction. Yet these choices are routinely infringed
in the design and implementation of health policies, including clinical decisions.
The promotion and protection of such human rights as education, information, privacy,
and equal rights in marriage and divorce are necessary if population policies
are to be successful. Torture Torture remains epidemic
in dozens of countries around the world. It brings both acute trauma and long
lasting physical or psychological suffering to victims, their loved ones, and
society at large. Physicians themselves become complicit in torture when they
certify individuals as able to withstand torture or falsify or fail to report
evidence of torture in detention facilities. Physicians, psychologists, and forensic
pathologists have been at the forefront of efforts to document and expose the
practice of torture in dozens of countries. Treatment and prevention programs
are emerging on every continent in response to this epidemic. Compromise
of Medical Independence People seeking health care are often denied the
independent judgment of health professionals when the state imposes demands that
the professional show greater allegiance to state ends than to the needs of the
patient. Prisoners, detainees, undocumented immigrants, military personnel and
others are especially vulnerable to the effects of these conflicts of interest. Lack
of Access to Health Care Throughout the world, in countries rich and poor,
people have no access to basic physical and mental health care and to immunizations
from infectious disease. Some people have no access because they lack the resources
to buy it and the state does not provide it, others because there are no services
available in their communities, and others because of discrimination or social
stigma, such as their status as prisoners, detainees, refugees, immigrants, or
members of a lower class or caste. Victims of displacement, torture, and war,
as a result, receive insufficient help in coping with the physical and psychological
impact of these traumas. Lack of Basic Sustenance
One fifth of the world’s population live in abject poverty. They lack adequate
food, clothing, housing, and social services, and the opportunity to work. Extensive
evidence, moreover, demonstrates that, in addition to absolute poverty, relative
poverty within nations is associated with both diminished access to health care
and to diminished health status. Inhumane Labor Practices
Inhumane labor practices the world over significantly compromise the health of
millions. Women, men, and children toil under brutalizing, unsanitary and hazardous
conditions for long hours or work without wages sufficient to support their families’
basic needs. Oppression of Women In many countries,
women are still denied full participation in society and the protection of basic
rights. Women work more than two-thirds of the world’s working hours, yet
they earn less than ten percent of the world’s income and own less than one
percent of the world’s property. Also, practices harmful to their health,
such as genital cutting, are carried out in some cases to further social policies
or cultural traditions. The effects of discrimination on the health of women is
devastating. Violent Conflict Affecting Civilian Populations
Throughout the world, people are exposed to violent conflicts over which they
have no control. Consequently, in dozens of ongoing civil and international conflicts,
people are suffering the health effects of armed conflict and the systematic disregard
for human rights. Since the fall of the Berlin Wall, violent conflict has claimed
the lives of some four million people. In early 1997 alone, over 35 million people
were refugees or internally displaced as a result of violent conflict and forced
to live in conditions contributing to spread of disease, malnutrition, and early
death. Moreover, these conflicts are often characterized by rampant and gross
disrespect for the principle of medical neutrality, which guarantees the provision
of health care without discrimination to all injured and sick combatants and civilians
during periods of conflict. Indiscriminate Harm from Weapons
Every human being’s right to life is threatened by the existence and active
deployment of the most destructive weapons ever devised--nuclear, biological and
chemical weapons. The lives and health of millions of people are jeopardized daily
by landmines, which kill and maim indiscriminately, and continue to do so for
decades after the cessation of a conflict. Denial of Dignity
Respect for human dignity is an essential element of health and well being of
all people. In clinical settings, failure to respect dignity has stigmatized people
with conditions such as HIV/AIDS and mental or physical disabilities and resulted
in denial of access to appropriate treatment and/or being subjected to inappropriate
clinical interventions or unwarranted long term institutionalization. Unethical
Research Practices Conventional practices in biomedical and behavioral
research all too often violate human rights. Contemporary medical research studies
often lack adequate informed consent procedures and have disproportionate risks
in relationship to benefits. Some members of the medical research community continue
to use disenfranchised and vulnerable populations for human experimentation at
great detriment to their physical and mental health. Lack
of Education Although education is one of the strongest predictors of health
status and an intrinsic quality of well being, more than 900 million adults are
illiterate, two-thirds of whom are women, and more than 300 million children are
not in primary or secondary school. Health professionals should promote adequate
standards of education, which include human rights concerns, because these standards
promote health and dignity of all members of the human family. Exposure
to Dangerous Environment Prevention of environmental hazards, and mitigation
of these hazards where they exist, are critical factors in the promotion of health
and the prevention of illness. Selective pollution of areas in which poor or minority
people or others susceptible to discrimination live, often termed “environmental
injustice,” is an egregious form of denial of human rights. Denial
of Freedom of Expression Promoting and protecting human rights is fundamental
to promoting and protecting health. Too many nations suppress the independence
of the health professions and the uncensored voices of medical and public health
officials, compromising the ability to contain the spread of disease, sustain
vaccination and immunization programs, address humanitarian emergencies, raise
alarms about environmental threats to health, and put into place effective health
policies and programs that reach all members of affected populations. |
