Health Ethics and Human Rights AOHS Global Health Unit 2, Lesson 5 Health Ethics and Human Rights Copyright © 2012–2016 NAF. All rights reserved.

Ethics are beliefs about right and wrong Most people have personal ethics, even if they don’t use that term. Your personal ethics guide your behavior. For example: You know it’s wrong to cheat on a test. That is unethical behavior. You know it’s wrong to steal. That is unethical behavior. Can you think of other examples that are part of your personal code of ethics?

Human rights are rights that justifiably belong to every person The Universal Declaration of Human Rights (UDHR) includes the following rights: The right to freedom of expression The right to peaceable assembly The right to marry of your own free will The right to fair pay and decent working conditions The right to an education Adapted from International Human Rights Funders Group, interviews conducted with board members, 2011. https://www.ihrfg.org/human-rights-funding/faqs-about-human-rights#faq4 (accessed October 20, 2015).

Human rights can express ethical values about health The Universal Declaration of Human Rights states: Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control. (Article 25)

Health ethics are principles that guide the practice of medicine Autonomy Beneficence Justice Dignity Honesty

Autonomy means allowing patients to make their own decisions Around the world, many tribes of indigenous people follow the traditional ways of their ancestors. For doctors, this can sometimes conflict with their attempts to provide complete medical care if complications arise. The ethical principle of autonomy means that patients can decide when, where, and if they receive treatment. Image retrieved from http://commons.wikimedia.org/wiki/File:%C3%8Dndia_da_etnia_Terena.jpg and reproduced here under the terms of the Creative Commons Attribution 3.0 Brazil (http://creativecommons.org/licenses/by/3.0/br/deed.en). Image courtesy of Valter Campanato/ABr. Can you think of other examples of autonomy?

Beneficence means making sure you do more good than harm In Bangladesh, diarrhoea is a major cause of death in children under 5. An NGO wanted to teach illiterate mothers how to provide proper treatment for diarrhoea. Do you think the NGO’s action would cause more good or harm? Can you think of other examples of beneficence?

Justice means being fair and equal in how you provide medical care The Director General of the WHO declared Health for All to be a worldwide goal in 1981. His key points included: Health for All means that health should be within reach of everyone in a given country. Health is defined as a personal state of well-being, not just the availability of health services. This also means addressing obstacles to health: eliminating malnutrition, ignorance, contaminated drinking water, and unhygienic housing.

Dignity means showing respect for every person In some parts of Pakistan, women cannot be taken to a hospital without their husband’s or father’s permission. Imagine a young woman who is sick but her father refuses to have her treated. The ethical principle of dignity means that this woman deserves respect and medical care, whether her father thinks so or not. Image courtesy of Khalid Mahmood and retrieved from http://commons.wikimedia.org/wiki/File:A_Pakistani_Woman.JPG. Reproduced here under the terms of the GNU Free Documentation License (http://commons.wikimedia.org/wiki/Commons:GNU_Free_Documentation_License_1.2). What would you do if you were the health care worker? Can you think of other examples of dignity?

Honesty means telling the truth to patients Imagine you are a health care worker in Guatemala. A woman says she was raped. She is afraid she might be pregnant and asks you to examine her. She says her only concern is to make sure her family never finds out what happened. You determine she is not pregnant, but she has a sexually transmitted disease with long-term serious effects. The ethical principle of honesty means you should tell the woman about the infection. Can you think of other examples of honesty?

Ethical professionals use all of these principles to guide their work Autonomy Beneficence Justice Dignity Honesty