Nixon Stephanie, Forman Lisa
Department of Physical Therapy, University of Toronto, 160-500 University Avenue, Toronto, Ontario, M5G 1V7, Canada.
BMC Int Health Hum Rights. 2008 Jan 31;8:2. doi: 10.1186/1472-698X-8-2.
The fields of human rights and public health ethics are each concerned with promoting health and elucidating norms for action. To date, however, little has been written about the contribution that these two justificatory frameworks can make together. This article explores how a combined approach may make a more comprehensive contribution to resolving normative health issues and to advancing a normative framework for global health action than either approach made alone. We explore this synergy by first providing overviews of public health ethics and of international human rights law relevant to health and, second, by articulating complementarities between human rights and public health ethics.
We argue that public health ethics can contribute to human rights by: (a) reinforcing the normative claims of international human rights law, (b) strengthening advocacy for human rights, and (c) bridging the divide between public health practitioners and human rights advocates in certain contemporary health domains. We then discuss how human rights can contribute to public health ethics by contributing to discourses on the determinants of health through: (a) definitions of the right to health and the notion of the indivisibility of rights, (b) emphasis on the duties of states to progressively realize the health of citizens, and (c) recognition of the protection of human rights as itself a determinant of health. We also discuss the role that human rights can play for the emergent field of public health ethics by refocusing attention on the health and illness on marginalized individuals and populations.
Actors within the fields of public health, ethics and human rights can gain analytic tools by embracing the untapped potential for collaboration inherent in such a combined approach.
人权领域和公共卫生伦理领域均致力于促进健康并阐明行动规范。然而,迄今为止,关于这两种正当性框架能够共同做出的贡献,相关论述甚少。本文探讨了一种综合方法如何能比单独采用任何一种方法,为解决规范性健康问题以及推进全球健康行动的规范性框架做出更全面的贡献。我们通过首先概述与健康相关的公共卫生伦理和国际人权法,其次阐明人权与公共卫生伦理之间的互补性,来探究这种协同作用。
我们认为,公共卫生伦理可通过以下方式为人权做出贡献:(a) 强化国际人权法的规范性主张;(b) 加强对人权的倡导;(c) 在某些当代健康领域弥合公共卫生从业者与人权倡导者之间的分歧。然后,我们讨论人权如何通过以下方式为公共卫生伦理做出贡献:通过(a) 健康权的定义和权利不可分割的概念、(b) 强调国家逐步实现公民健康的义务、(c) 认识到保护人权本身就是健康的一个决定因素,来促进关于健康决定因素的讨论。我们还讨论了人权通过将注意力重新聚焦于边缘化个人和群体的健康与疾病,能够在公共卫生伦理这一新兴领域发挥的作用。
公共卫生、伦理和人权领域的行为者可以通过利用这种综合方法中固有的未开发合作潜力,获得分析工具。