Legal Rights and Moral Obligations
In the previous post in the series, I asked the question: is health a human right? The answer seems to be a tentative "yes": there is a human right to health, but it is not a right to be healthy. Instead, we have the right to be as healthy as possible in the context of our own personal circumstances, as well as of the society we live in - and taking into account possible clashes with other human rights. The right to health includes the duty for governments work continuously towards the best possible health status.
All this looks at health as a human right from the perspective of one country. Commenter Jon Shaffer brings up the issue of human rights obligations to enable health efforts in other countries; he contends that health-as-a-human-right includes the obligation for nations to enable health in other nations, which would make governments in the developed world responsible for at least part of the health status in developing countries. He writes, "... speaking of the human right to health is as much a call for poor governments to create effective health policies as it is a moral duty for us to make available the necessary resources and to remove the economic and political structural barriers preventing poor countries from being able to do so."
This is not a new perspective. E.g., in his immensely influential book Pathologies of Power, Paul Farmer introduced the concept of ‘structural violence' (sometimes also called ‘institutional violence'): social and economic inequities directly or indirectly determine who will benefit fully from human rights - and who doesn't. (This actually goes back to 1960s sociologist Johan Galtung, but was brought into the mainstream of H&HR discussions by Farmer's book.) These are cogent and pertinent points in the implementation of human rights.
However, it is now time to refer back to my first post in the series. At the end of that post, I listed a number of definitions in the hope of preventing too many misunderstandings about concepts like (public) health and human rights. This discussion is actually based on one of those misunderstandings. I defined human rights as "... legally enshrined ... protections of human dignity and fundamental freedoms" [emphasis added]. The cop-out here is to say that the human right to health as described by Farmer and Shaffer is not legally enshrined, and hence is not a human right in the sense that I cover here... and then go on to the next subject.
A more nuanced and sophisticated way of looking at it is that, in general use, ‘human rights' is often used as an abbreviation for both legal and moral obligations and rights, as opposed to solely legal ones. In that sense, this obligation is a human right, and a hugely important one at that - especially in the context of global health, which after all tries to look across national boundaries. In next week's post, I will have a closer look at what this means for the discussion around H&HR.
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