1. Human Rights in Patient Care
Application of General Human Rights Principles in Context of Patient Care
(J. Overall - from Cohen and Ezer Framework Article 2013)

2. HRPC and the Right to Health
HRPC: encompasses additional rights that pertain to the delivery of health care to patients
Right to Health: includes many human rights that fall outside health care delivery context but play a role in determining health outcomes
HRPC: specifically addresses stakeholder rights inside health care settings
HRPC and the Right to Health

3. HRPC and Patient Rights
Alternative to “patients’ rights”
Patients’ Rights: rooted in consumer framework
HRPC: derived from inherent dignity
HRPC: neutrally applies universal, legally-recognized human rights principles
HRPC: protects both patients and providers
HRPC: admits limitations justified by human rights norms
HRPC and Patient Rights

4. HRPC and Patient Rights Differences
Patients’ rights often link to consumer framework, not to human rights framework
Patients’ rights inhere to patients because they are recipients of a transaction – more closely resembling contractual rights
Patients’ rights lack the “inherent,” inalienable,” or “universal” qualities of human rights
HRPC and Patient Rights Differences

5. HRPC and Patient Rights Difference
Patients’ rights omit rights of other stakeholders in health care delivery – the focus is only on the patient
HRPC apply to everyone
HRPC recognize that health care providers enjoy same human rights as everyone else (rather than posing special rights for patients, as against those who provide them with health care
HRPC and Patient Rights Difference

6. HRPC and Patients Rights Differences
Patients’ rights: do not automatically recognize need to place limitations on rights in the health context
HRPC recognizes that rights of no single patient are absolute
HRPC: limitations conform to assessment of factors (appropriate, effectiveness, proportionality, alternative)
Courts: use this analysis in placing limits on human rights in health care context – often in response to express or implied limitation clauses in national constitutitons
HRPC and Patients Rights Differences

7. HRPC and Patient Safety or Quality Medical Care
Patients may have a right to quality care and to freedom from injury
But not all low-quality care rises to the level of a human rights violation for which the state is responsible
Simple negligence: tort against an individual health care provider
To constitute a human rights violation: mistreatment by health care provider(s) must be systemic
HRPC and Patient Safety or Quality Medical Care

8. HRPC and Patient Safety or Quality Medical Care
If systemic, state should address problem systemically: amend policies or regulations; ensure appropriate training; monitoring services; establishing opportunities for complaint and redress; take disciplinary measures when warranted
Human rights do not end with quality care: a patient may have the best medical care, but it was provided without patient consent
HRPC and Patient Safety or Quality Medical Care

9. Recognizes interrelations between patient and provider rights
Particularly in cases of “dual loyalty”
Dual loyalty: health providers face simultaneous obligations to patients and the State- may be pressured to abet human rights violations
HRPC: Interrelations

10. A means to examine SYSTEMIC issues and STATE responsibility
Human Rights principles include right to highest attainable standard of health
But also: Civil and Political Rights (such as freedom from torture and inhumane treatment to liberty and security of person
Attention to: rights of socially-excluded groups to be free from discrimination in delivery of health care
The Human Rights Lens

11. Provider Rights Freedom of association
Enjoyment of decent working conditions
Right to due process
Provider Rights

12. HRPC and Bioethics Complimentary but distinct
HRPC carry legal force and can be applied through judicial action; systemic approach
Bioethics: autonomy, beneficence, justice, non-malfeasance in patient care context (also medical research and public health)
HRPC: complimentary set of legal norms developed through judicial interpretation (freedom, non-discrimination, security of person
HRPC and Bioethics

13. HRPC adds to bioethics a method for arriving at concrete decisions about how to judge complex and ethically challenging clinical interventions – and a set of procedures for enforcing those decisions
HRPC: rooted in a legal framework, has operational norms, and procedures such as courts and human rights commissions, to identify, adjudicate, and remedy abuses
HRPC and Bioethics

14. HRPC and Advocacy HRPC framework brings a focus on advocacy
Through courts, media, or political negotiation - legal remedy or community mobilizing
HRPC provides a “language” to articulate and mobilize around justice concerns
HRPC and Advocacy

15. HRPC and Public Health Ethics (PHE)
Complimentary
PHE: ensures that public health interventions provide benefit and minimize harms, respect individuals’ dignity and rights to greatest extent possible and are implemented fairly
PHE: creates professional codes to self-regulate and to instill public trust in professions
HRPC: targets governments or the policies they endorse
HRPC and Public Health Ethics (PHE)