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审视当代人的尊严:人权如何演变并重塑健康正义。

Examining Contemporary Human Dignity: How Human Rights Evolve and Reshape Health Justice.

作者信息

Irfan Bilal, Jaber Batool, Awwad Maisa, AlSourani Tareq, Abu Shammala Abdallah

机构信息

Michigan Alzheimer's Disease Center, University of Michigan, Ann Arbor, USA.

Center for Bioethics, Harvard Medical School, Boston, USA.

出版信息

Cureus. 2025 Apr 15;17(4):e82316. doi: 10.7759/cureus.82316. eCollection 2025 Apr.

Abstract

Human rights did not emerge in a political or cultural vacuum; their origins in 20th-century legal frameworks and postcolonial power asymmetries continue to shape evolving notions of dignity and justice. Central to this evolution is the tension between civil and political rights, understood as immediately enforceable, and economic, social, and cultural rights, which are too often neglected or treated as merely aspirational. Securing health as a right requires both negative and positive state obligations, challenging simplistic divisions between public and private spheres and exposing how gendered, racialized, and class-based violence often remains hidden within private realms. Colonial legacies, neoliberal market forces, and structural inequalities further reinforce injustice by rendering marginalized groups undeserving of care. Grassroots movements, from AIDS activists to Indigenous women's campaigns, demonstrate the capacity of collective action to transform law, policy, and social norms. A rights-based approach to health financing demands that societies treat healthcare as a public good and moral commitment rather than as a commodity. At the global level, target-driven frameworks like the Millennium Development Goals have achieved discrete gains but often fail to address the systemic drivers of inequity. Ongoing armed conflicts reveal how militarized violence decimates health infrastructure and entrenches disparities for generations. True health equity and democracy, therefore, require robust institutions, transparent governance, and inclusive participation, all underpinned by the recognition that rights are shaped and reshaped by lived struggles. Only through this holistic lens, one that integrates civil, political, economic, social, and cultural dimensions, can efforts to realize the promise of universal human dignity be brought into practice.

摘要

人权并非在政治或文化真空中出现;其在20世纪法律框架和后殖民权力不对称中的起源,继续塑造着不断演变的尊严和正义观念。这一演变的核心是公民权利和政治权利(被理解为可立即执行)与经济、社会和文化权利之间的紧张关系,后者常常被忽视或仅仅被视为一种愿望。将健康作为一项权利加以保障,既需要国家的消极义务,也需要积极义务,这挑战了公共领域和私人领域之间简单化的划分,并揭示了基于性别、种族和阶级的暴力如何常常隐藏在私人领域之中。殖民遗产、新自由主义市场力量和结构性不平等通过使边缘化群体不值得获得照料,进一步加剧了不公正。从艾滋病活动家到原住民妇女运动等基层运动,展示了集体行动改变法律、政策和社会规范的能力。基于权利的卫生筹资方法要求社会将医疗保健视为一种公共利益和道德承诺,而不是一种商品。在全球层面,像千年发展目标这样的目标驱动框架取得了一些具体成果,但往往未能解决不平等的系统性驱动因素。持续的武装冲突揭示了军事化暴力如何摧毁卫生基础设施,并使几代人的差距根深蒂固。因此,真正的卫生公平和民主需要强大的机构、透明的治理和包容性的参与,所有这些都基于这样一种认识,即权利是由实际斗争塑造和重塑的。只有通过这种整合了公民、政治、经济、社会和文化层面的整体视角,才能将实现普遍人类尊严承诺的努力付诸实践。

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