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ss nucleus - autumn 2005,  Health and human rights

Health and human rights

This article provides a brief introduction to human rights, particularly as applied to health. Human rights challenges abroad and in the UK will be highlighted and all these issues examined in the light of the Bible.

Human rights are chiefly concerned with setting limits on what governments can and cannot do to their citizens. The concept of rights for certain people is not new; it was seen in Roman times and in documents such as the Magna Carta (1215). However, in the aftermath of the Second World War, it was recognised for the first time at an international level that all people deserve protection. Therefore in 1948 the General Assembly of the UN gathered in Geneva and proclaimed the Universal Declaration of Human Rights (UDHR).[1] This was designed to prevent future atrocities by enshrining various categories of human rights (civil, political, social, cultural and economic) for all people.

Members of the UN agree to abide by the standards set in the UDHR, but as this is not a treaty it is not legally binding. In the meantime six major international treaties have been drawn up, based on the UDHR, which are binding for governments that ratify them. An example of such a treaty is the 1966 International Covenant on Economic, Social and Cultural Rights (ICESCR).[2] These treaties make up the bulk of international human rights law. A number of conventions exist to safeguard human rights in specific situations, such as the 1951 Geneva Convention on Refugees.[3]

Health and human rights

Health is mentioned in most legislation on social rights, most importantly in article twelve of the ICESCR: 'The States party to the present Covenant recognise the right of everyone to the enjoyment of the highest attainable standard of physical and mental health'.[4] There are often complex links between health and human rights, as violations of other rights, for example, torture or a lack of food or clothing, will affect health. The death of approximately two million children per year from diarrhoeal disease in developing countries is an example of how denial of one right, the right to water, causes ill health.[5]

Practical applications of human rights legislation to health include the Millennium Development Goals.[6] These single out HIV/AIDS, malaria and TB, child and maternal mortality, water, sanitation and access to essential medicines as areas that require change. The goals are currently the subject of heated debate, particularly following the recent G8 summit at Gleneagles, Scotland, and the Make Poverty History campaign. How exactly these are to be implemented by developing countries with little or no health care infrastructure is not explained and it remains to be seen how much practical support will be given by governments to achieve these targets by the planned date of 2015.

What does the Bible teach about human rights?

One immediate question Christians face when thinking about human rights is whether we humans have any rights before God. For example, Isaiah issues the stark warning, 'Woe to him who quarrels with his Maker…Does the clay say to the potter, “What are you making?”'[7] However, the original intention behind human rights legislation was not to demand our own rights, but to set limits on governments in order to protect citizens. Certainly, there are some ideas derived from human rights legislation that are egotistical and ungodly and these will be explored later, but let us first examine the original intention.

In the Old Testament we find the concept that certain people need protection, along similar lines to modern human rights. Exodus contains instructions on the rights of women[8] and foreigners.[9] The prophets warn us that God is not pleased when the rights of the poor are ignored.[10] They call us to speak up for the oppressed[11] and be concerned about justice:[12] all key aims of human rights.

The idea of rights is found in the New Testament too. Paul made full use of his rights as a Roman citizen on certain occasions,[13] showing that it is not inherently wrong to claim rights laid out by the law.

Paul also talks about having the rights of an apostle, although he waived them for the sake of the gospel.[14] Amazingly, we even find our greatest privilege described in terms of rights: through Jesus we have the right to become children of God.[15]

Much human rights legislation can line up with Christian teaching. In the first article of the UDHR we find the beautiful statement:

All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.

This encapsulates the attitude of the Good Samaritan whose approach to other people we should imitate.[16] In fact, the biblical basis of human rights is simple – we are all made in the image of God and are therefore equal.[17]

Overstating rights

It seems then that there is no disagreement between Christianity and the concept of human rights legislation. However, some ideas that appear to stem from such legislation do not necessarily match up with Christian belief. In western countries there has been a shift from values that were based, albeit loosely, on Christianity to a culture of consumerism and this is apparent in some interpretations of human rights. There is a fine line between using rights appropriately as laid down by law and abusing this legislation for selfish gain. We live in an increasingly litigious society and there are concerns that litigation will be the driving force shaping human rights law.[18] The behaviour of demanding your rights in all situations conflicts with the way of Jesus: that of self-sacrifice, to which we are also called.[19] The apostle James contrasts heavenly with demonic wisdom and a key difference is a ' willingness to yield' rather than 'envy and self-seeking'.[20]

Rights versus responsibilities

One way to avoid the temptation to a selfish indulgence in demanding our own rights is to think more in terms of responsibilities. Rights and responsibilities go hand in hand – a patient has the right to health care, but also has the responsibility to turn up for the appointment and be compliant with management.

Pharmaceutical companies have the right to make a profit, but this goes along with the responsibility to ensure their drugs are safe, market them responsibly, and in some cases make them more easily available to people who need them (such as antiretrovirals for HIV). We often hear of demands for abortion rights, but much less often of calls for couples to exercise their responsibilities in using reliable contraception or staying faithful to each other long-term.

A key element of Christian teaching is that we should not comply with the world's attitude of 'look after number one'. Throughout the Bible there are examples of how we should exercise our rights with care, because we have a responsibility towards other people. On occasion we are called to give up our rights, particularly when it comes to exercising our freedom in Christ. Paul advised the Roman Christians on issues of whether or not to eat certain foods, concluding

that it is wrong to do anything that causes someone else to stumble, and that we should not exercise our own rights if that would meaning harming the conscience of fellow believers.[21]

Taking this back into the arena of human rights legislation, it would be a more healthy perspective in general for us all to consider our own responsibilities towards others, alongside the responsibilities of governments towards their citizens. This thinking would not stop campaigning for justice issues, but would keep some of the focus on our own lifestyles: do we have responsibilities to buy Fair Trade products, or sponsor a child in a developing country, seeing as we are born in wealthy countries through no merit of our own?

Christians should acknowledge the place that human rights play in protecting the vulnerable, but rather than thinking solely in terms of rights, which is ultimately egotistical, we should have a more balanced view of the responsibilities of those involved, including our own.

Health and human rights in Britain

In the 1998 Human Rights Act the rights of international law were incorporated into UK domestic law. This Act does not specify the right to health, but still is of relevance as article two states that, 'Everyone's right to life shall be protected by law'.[22] Recently this article was used in the case of Leslie Burke vs the General Medical Council (GMC). Mr Burke, who suffers from cerebellar ataxia, initially won the right to prevent doctors deciding in the future to withdraw feeding and hydration if he should become unable to make his wishes known, but in July this year the GMC won their appeal against this ruling.[23]

In the euthanasia debate however this article is mainly avoided. There have also not as yet been any definitive rulings in the abortion debate on whether the unborn child has this right to life, mainly because there is no pan-European consensus on this issue.[24]

One big human rights issue in the UK in recent months has been that of refugees, asylum seekers and migrants. They make up one of the most vulnerable groups in the UK and have poor access to health care services. The government plans to start limiting health care services for 'foreign visitors' to emergency only; this would include failed asylum seekers.[25] Many health care professionals have grave concerns that this would not allow them to fulfill their duty of care, for example this would result in being allowed to treat an acute exacerbation of asthma, but not prescribe the inhalers to prevent it.[26] The issue of asylum is a delicate one, but our government must ensure that vulnerable patients in our country have access to an appropriate level of care, whilst seeing that the system is not willfully abused.

Want to get involved with human rights work?

The WHO series of publications on health and human rights is a good place to start reading about this issue in more depth.[27] Groups such as Amnesty International,[28] Medsin-UK,[29] International Physicians for the Prevention of Nuclear War (IPPNW)[30] and Medact[31] all work in this field and have regular updates and meetings on issues surrounding human rights. More details are found on their websites, referenced below.

It is important to realise that there are issues in human rights debates and organisations that are difficult for Christians – for example abortion is sometimes argued as a basic human right for women. Anyone wanting to get involved with secular organisations must think through how they will respond when these issues arise.

Personally I developed my interest in health and human rights when I joined Medsin-UK and got involved with two projects: Water Aid campaigns for access to clean water and sanitation (and more support would be very welcome).[32] Crossing Borders works with refugees and asylum seekers through various projects across the UK.[33] Other opportunities for service with refugees and asylum seekers can be found with groups such as Student Action for Refugees (STAR).[34] Many are based in London and a list is available from the refugee council website.[35]

Through Medsin-UK I attended a week-long study session on health and human rights, with a special focus on undocumented migrants. This event was run by the International Federation of Medical Student Assocations (IFMSA) and held in Strasbourg this May. I was one of 35 medical students who took part, representing 30 countries as diverse as Serbia and Spain. I found that collectively we shared many ideals, such as the desire to fight injustice, change the world and act for peace. But it was here that I realised that my views were in parts fundamentally different. A trivial illustration that brought this home to me was seeing student members of IPPNW wearing T-shirts with a picture of a computer screen stating, 'The world is not saved', with a box overlying this asking, 'Do you want to save it?' and a cursor positioned to click 'OK'.

Despite the lack of acknowledgement of God in secular organisations and debates, there remains much to be gained through the participation of Christians. Advantages include being proactive for justice, friendship evangelism, an opportunity to influence policies with a Christian perspective and gaining a broadened cultural awareness. I can wholeheartedly recommend getting involved.

Conclusion

Writing this article has led me to the conclusion that I mainly agree with human rights. Admittedly this statement suggests that I have a hidden desire to set up a dictatorship – but let me explain. Human rights are an essential force for the protection of people everywhere. However, whenever human rights terminology or legislation steps beyond this purpose, it steps on biblically shaky ground. Above all we must remember that God is sovereign over our lives and that we live by grace. This should be expressed by our actions towards other people, considering our responsibilities and being prepared to give up our rights when we are called to do so.

References
  1. www.un.org/Overview/rights.html
  2. www.cehat.org/rthc/summary.htm
  3. www.unhcr.org/cgi-bin/texis/vtx/protect?id=3c0762ea4
  4. www.cehat.org/rthc/summary.htm
  5. www.who.int/docstore/water_sanitation_health/Documents/righttowater/righttowater.htm
  6. www.un.org/millenniumgoals/
  7. Is 45:9
  8. Ex 21:7-11
  9. Ex 23:9
  10. Is 10:1,2
  11. Zc 7:9,10
  12. Mi 6:8
  13. Acts 22:25, 25:11
  14. 1 Cor 9:5-15
  15. Jn 1:12
  16. Lk 10:25-37
  17. Gn 1:26,27
  18. Gearty C. Tort law and the human rights act, in Campbell T et al. Sceptical Essays on Human Rights. Oxford: OUP, 2001
  19. Rom 12:1
  20. Jas 3:16,17 (NKJV)
  21. Rom 14:13-23
  22. www.opsi.gov.uk/acts/acts1998/19980042.htm
  23. news.bbc.co.uk/1/hi/health/4721061.stm
  24. Brown AN. Law basics student study guides: Human rights. Edinburgh: Green/Sweet and Maxwell, 2000
  25. www.medact.org/content/refugees/04082267.pdf
  26. Williams, P. Proposals to exclude overseas visitors from access to free NHS primary care services. www.medact.org/article_refugee.php?articleID=357
  27. www.who.int/hhr/activities/publications/en/
  28. www.amnesty.org
  29. www.medsin.org
  30. www.ippnw.org – IPPNW is an NGO dating from the time of the Cold War that still deals with the nuclear issue as well as others. The equivalent organisation in the UK is Medact.
  31. www.medact.org
  32. www.wateraid.org.uk
  33. www.medsin.org/module-pagesetter-viewpub-tid-7-pid-4.html
  34. www.star-network.org.uk
  35. www.refugeecouncil.org.uk/refugeecouncil/vacan/vac001.htm
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