Writing Ethics/ Writing Rights Editorial Team American Journal of Public Health

Writing Ethics/ Writing Rights: The same or different? Sofia Gruskin, JD MIA Department Editor

Confusions About Rights and Ethics in Public Health They are exactly the same thing They are entirely different They can be used to mean all that is good and just in the world They are just words one has to say but really mean nothing at all

Are There Differences Between Human Rights and Health Care Ethics? Institutions and individuals they guide Who drafted them What they focus on

Ethics and Human Rights Build on Similar Principles… Autonomy Beneficience Non-malfeasance Confidentiality Veracity Human Rights Autonomy freedom from repression & oppression Privacy Accountability

…But are Not Identical Ethics Human Rights Governs relations between people/patients and health providers and researchers through Professional codes, review board guidelines, regulations and laws Human Rights Establish obligations of state and non-state actors towards people through International treaties, declarations and national law

Human Rights Legal claims that indviduals have on society simplyon the basis of their being human They are « …what governments can do to you, cannot do to you and should do for you…» Governmental obligations to: Respect rights Protect rights Fulfill rights Human rights are universal, indivisible and inalienable, and interdependent (Vienna, June 1993)

The Value of Human Rights for Health Public origins and accountability Legal standards Advocacy Framework for programming

A 5 Point Agenda for the Health Sector* Institutionalize the application of human rights perspectives to all health sector actions Strengthen public health functions to create the conditions necessary for health Equitable health care financing Ensure that health care services respond effectively to the major causes of preventable ill-health Monitor, advocate and take action to address the human rights implications of development policies in all sectors that affect health *P. Braveman, S. Gruskin, Poverty, Equity, Human Rights and Health. Bulletin of the WHO 2003; 81: 539-45.

The Value of Ethics for Health They reflect health professional and organizational perceptions, academic analysts’ commentaries and, for instance, the contributions of interest groups They provide guidelines and codes of conduct

Health, Ethics and Human Rights A state of physical, mental and social well-being Health Individual and collective concerns to do what’s right and just Human Rights Ethics Governmental obligations towards people

Coming Together distinct values differences in paradigms guidance for the actions of national and international organizations focused on health and development observance, action and enforcement

Ethics and Human Rights for Better Health Ethics are enriched by a diversity of perspectives and adjust quickly to evolving issues and resources Human Rights provide a normative framework and legal mechanisms linking health to human dignity, freedom, well-being and development They often overlap and complement but do not conflict with each-other Their respective and combined added value are intrinsic to progress in health

Ethics Related to the Validity of Research Stewart Landers, JD Associate Editor

The Systematic Assessment of Risks and Benefits (From Belmont Report, 1979) Risks and benefits “in a favorable ratio” Ideal requires justification of research in the thorough “accumulation and assessment of information about all aspects of the research, and to consider alternatives systematically” Judgment of the validity of the presuppositions of the research

Respect and Justice Occur in context of disparities in time, place and population Shift in view of research in prison population Equity in access to standards of care

Current Challenges Increase in data collection of individuals Government linking of funding to data collection Whose ethics matter?

October 2005: Prisons and Health

Ethics Compliance The Journal adheres to the Public Health Code of Ethics* of the American Public Health Association. You are required to state whether you have complied with this code. If you believe you were justified in departing from the code, a short explanation (1-2 sentences) is required. *www.ajph.org