Abstract
BackgroundThe 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.DiscussionWe 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.SummaryActors 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.
Highlights
The fields of human rights and public health ethics are each concerned with promoting health and elucidating norms for action
We argue that the fields of human rights and public health ethics may enjoy greater conceptual synergy than currently realized
We propose a particular notion of public health ethics that is attentive to global health concerns and power relations between rich and poor countries [5]
Summary
Overview of Public Health Ethics public health practitioners have long faced ethical challenges, the academic field of public health ethics has only recently emerged. Emerging evidence suggests that the use of human rights strategies in combination with social action has achieved changes in domestic governance across a "strikingly different range of regions, countries, socio-economic systems, cultures, and types of political regimes" [30] These outcomes suggest that human rights hold a normative force irrespective of their legal status that can be mobilized to effectively shift some of the political practices that perpetuate and exacerbate current global health challenges (such as access to medicines under the World Trade Organization's trade rules). Relevant is reasoning from critics like Pogge and Benatar et al who argue that the past and present policies of wealthy nations have created and maintained poverty and ill health and, that wealthy nations bear a commensurate responsibility to help alleviate these problems [35] Locating global commitments such as the MDGs within a framework that articulates both legal duties and moral claims offers stronger justifications for their fulfilment, and provides advocates with broader arguments with which to confront non-compliers.
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