What does the right to health mean for health professionals and their associations?
Professional associations are a diverse group of organisations. Likewise health professionals work in a variety of contexts, and differ in their role and influence. Not everything outlined here will be applicable ether to every health professional or to all professional associations. In some cases, it might be more profitable for health professionals to work with development or health charities, or other non-governmental organisations to further human rights goals. While some of the recommendations given below can be put into effect immediately, others will remain aspirational. Nevertheless, health professionals come into contact with human rights-related issues in a variety of contexts ranging from everyday clinical practice to participation in the shaping of health policies at the national and international levels.
What is a human rights-based approach to professional practice?
Human rights impose duties on both governments and those in their direct employment. Health professionals working in public health institutions share a direct responsibility to realise the right to health. The most effective way for the majority of health professionals to fulfil their obligations under the right to health is to ensure that they provide the highest possible standard of care and treatment in a way that respects the fundamental dignity of each of their patients. This involves a number of interrelated factors including:
- Being honest, polite and respectful to all patients without discrimination
- Ensuring professional skills are maintained to the highest possible level
- Respecting the right of competent patients to self-determination
- Providing up-to-date and relevant information without discrimination to support patients’ decision-making
- Respecting patient confidentiality
- Treating patients to the highest ethical standards
However, there are several types of human rights abuse that may involve the direct participation of health practitioners. These include:
- some forms of torture
- administration of death penalty
- facilitating cruel and inhuman physical punishment
- forced feeding
- sedation against the will of the person in question
- illegal organ trade
- female genital mutilation and other harmful traditional practices
- forced sterilization and other coercive reproductive health practices.
Another area that involves a heightened risk of human rights abuse is scientific experimentation involving human subjects, and in particular experimentation that involves members of vulnerable groups. While medical research and clinical testing is indisputably a force for the good, it can be misused and should be approached with care, ensuring that relevant national and international ethical codes are respected.
What are the roles of health professionals and their associations?
Human rights education – Some professional associations, and some medical academics may be in a position where they can influence the medical curriculum. Where possible they should try to promote human rights education and consider whether they can:
- Examine the curricula of medical and other health professional training schools, together with the educational requirements of licensing bodies for granting a licence to practice, to identify whether they include appropriate instruction in medical ethics and human rights;
- Advocate, in co-operation with professional associations and licensing bodies, the adoption of an ethical and human rights approach to health care in the training of health professionals at all levels.
Reacting to human rights violations perpetrated by others – Some health professionals have privileged access to sensitive information about vulnerable people, and the conduct of public authorities such as governments, military or law enforcement officers or prison personnel. This provides a valuable opportunity to promote human rights.
Where possible, professional associations should work to ensure that health professionals are aware of the channels though which they can draw attention to the information they have identified and documented. For example, familiarity with ombudsmen institutions, national human rights institutions, the UN system of treaty body reporting, and the work of the UN Special Rapporteurs is essential in this regard.
In their regular practice, health professionals may also encounter evidence of occasional or systemic discrimination that violates of the right to health. Such patterns of discrimination should be documented and reported to appropriate authorities.
Participating in the management of rights-based health care systems and shaping of health policies – Some health professionals, individually and as members of professional associations, work as policy advisers in the organisation and delivery of health services. An important element of promoting and protecting the right to health is for health professionals to work with governments to develop and implement human rights based policies and programmes. They can do this both as partners and as watchdogs of governments. This could include reviewing existing legislation, policies and practices and helping to shape health policies at the national level. Health professionals can similarly give valuable input to the human rights treaty monitoring process, either by contributing to government reports to the UN bodies or by presenting or contributing to a shadow report.
 An excellent source on all of these areas of human rights concern for health professionals is the BMA publication The Medical Profession and Human Rights. Handbook for a Changing Agenda. Zed Books, 2000.
 For guidance on participating in the UN treaty monitoring process, see: Asher J. The Right to Health: A Resource Manual for NGOs. London: COMMAT. 2004: pp 127-141.