Yamin Alicia Ely
Law and Public Health Program, Department of Health Policy and Management, Havard School of Public Health, Boston, MA 02115, USA.
Am J Public Health. 2005 Jul;95(7):1156-61. doi: 10.2105/AJPH.2004.055111. Epub 2005 Jun 2.
In recent years, there have been considerable developments in international law with respect to the normative definition of the right to health, which includes both health care and healthy conditions. These norms offer a framework that shifts the analysis of issues such as disparities in treatment from questions of quality of care to matters of social justice. Building on work in social epidemiology, a rights paradigm explicitly links health with laws, policies, and practices that sustain a functional democracy and focuses on accountability. In the United States, framing a well-documented problem such as health disparities as a "rights violation" attaches shame and blame to governmental neglect. Further, international law offers standards for evaluating governmental conduct as well as mechanisms for establishing some degree of accountability.
近年来，国际法在健康权的规范性定义方面有了长足发展，健康权既包括医疗保健，也包括健康条件。这些规范提供了一个框架，将对治疗差异等问题的分析从医疗质量问题转向社会正义问题。基于社会流行病学的研究成果，权利范式明确将健康与维持有效民主的法律、政策和实践联系起来，并侧重于问责制。在美国，将诸如健康差异这样有充分记录的问题界定为“权利侵犯”，会让政府的疏忽蒙羞并受到指责。此外，国际法提供了评估政府行为的标准以及建立一定程度问责制的机制。
