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分析政府在健康权方面的进展。

Analysing governments' progress on the right to health.

机构信息

Harvard University, Harvard Law School, 23 Everett Street, Cambridge02138MA, United States of America.

Helena Kennedy Centre for International Justice, Sheffield Hallam University, Sheffield, England.

出版信息

Bull World Health Organ. 2024 May 1;102(5):307-313. doi: 10.2471/BLT.23.290184. Epub 2024 Mar 14.

DOI:10.2471/BLT.23.290184
PMID:38680460
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11046153/
Abstract

OBJECTIVE

To examine the influence of varying articulations of the right to health under domestic constitutions, legislation and jurisprudence on the scope of legal protection for health.

METHODS

We investigated legal recognition of the right to health, by conducting a three-level search. First, we searched databases containing constitutional texts. Second, we did a thematic analysis of those constitutional texts with explicit constitutional recognition of health rights, employing NVivo for coding. For the 54 World Health Organization (WHO) Member States without explicit constitutional provisions, we explored statutory paths, judicial constructions and instances where both methods contributed to the acknowledgement of health rights. Lastly, we confirmed evidence of jurisprudence constructing a right to health based on a combination of domestic law and international human rights norms incorporated directly into the text.

FINDINGS

We identified 140 WHO Member States with a constitutionalized right to health. Our analysis suggests there are notable variations in the legal scope of protection for health, including breadth of entitlements and the possibility of enforcing these rights through the legal system. We also highlight the critical importance of constitutional acknowledgement, legislative measures, and judicial interpretations in shaping the legal entitlements to health-care services, affecting their accessibility and financial support.

CONCLUSION

The analysis offers insights for policy-makers to assess different approaches to health-related entitlements, with implications for health financing and the evaluation of Member States' strides towards universal access to comprehensive care. This analysis also illuminates how distinct formulations of the right to health have varied effects on reducing health disparities.

摘要

目的

研究国内宪法、立法和判例法对健康权的不同表述对健康法律保护范围的影响。

方法

我们通过三级搜索调查了对健康权的法律承认。首先,我们在包含宪法文本的数据库中进行了搜索。其次,我们对那些明确承认健康权利的宪法文本进行了主题分析,使用 NVivo 进行编码。对于 54 个没有明确宪法规定的世界卫生组织(WHO)成员国,我们探讨了法定途径、司法构建以及这两种方法都有助于承认健康权利的情况。最后,我们根据直接纳入案文的国内法和国际人权规范,确认了基于两者结合来构建健康权的判例法证据。

结果

我们确定了 140 个有宪法化健康权的世卫组织成员国。我们的分析表明,健康保护的法律范围存在显著差异,包括权利的广度以及通过法律制度执行这些权利的可能性。我们还强调了宪法承认、立法措施和司法解释在塑造医疗保健服务的法律权利方面的至关重要性,这影响了它们的可及性和财政支持。

结论

该分析为政策制定者评估与健康相关的权利的不同方法提供了参考,对卫生筹资和评估成员国实现全面保健普及的进展具有影响。该分析还阐明了健康权的不同表述对减少健康差异的不同影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4a5/11046153/fe3a3ed340b7/BLT.23.290184-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4a5/11046153/fe3a3ed340b7/BLT.23.290184-F1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d4a5/11046153/fe3a3ed340b7/BLT.23.290184-F1.jpg

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本文引用的文献

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Brazil's unified health system: the first 30 years and prospects for the future.巴西的统一卫生系统:过去 30 年的发展及未来展望。
Lancet. 2019 Jul 27;394(10195):345-356. doi: 10.1016/S0140-6736(19)31243-7. Epub 2019 Jul 11.
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State constitutional commitment to health and health care and population health outcomes: evidence from historical US data.州宪法对健康、医疗保健和人口健康结果的承诺:来自美国历史数据的证据。
Am J Public Health. 2015 Jul;105 Suppl 3(Suppl 3):e48-54. doi: 10.2105/AJPH.2014.302405. Epub 2015 Apr 23.
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Litigating the right to health: what can we learn from a comparative law and health care systems approach.
Bull World Health Organ. 2024 May 1;102(5):299-299A. doi: 10.2471/BLT.24.291722.
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Health Hum Rights. 2014 Dec 11;16(2):E62-72.
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Constitutional rights to health, public health and medical care: the status of health protections in 191 countries.宪法规定的健康权、公共卫生和医疗保健:191 个国家的健康保护状况。
Glob Public Health. 2013 Jul;8(6):639-53. doi: 10.1080/17441692.2013.810765. Epub 2013 Jul 4.
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Litigation as a strategy to hold governments accountable for implementing the right to health.作为一种策略,诉讼可用于追究政府落实健康权的责任。
Health Hum Rights. 2008;10(2):21-36.
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Health systems and the right to health: an assessment of 194 countries.卫生系统与健康权:对194个国家的评估
Lancet. 2008 Dec 13;372(9655):2047-85. doi: 10.1016/S0140-6736(08)61781-X.