Thursday, April 30, 2009

Human Rights Paradigm

A few weeks ago, I attended GlobeMed's annual Global Health Summit in Chicago. This year’s conference, “From Idea to Implementation: Securing Health as a Human Right,” brought together philosophers, economists, physicians, activists, and many others to debate the role of a human rights framework in realizing global health equity. Although most speakers fundamentally agreed that health is a human right, often citing Article 25 of the Universal Declaration of Human Rights, heated debates ensued once the topic drifted to pragmatics.

Between the conference and recent class discussions, I’ve noticed more and more parallels between the struggles for healthcare access and racial equality. Structural violence, unacknowledged privileges, and arguments over semantics create a glass ceiling preventing us from attaining the level of equity outlined in documents such as our own Constitution and the Universal Declaration of Human Rights (UDHR).

I don’t mean to say that the Civil Rights movement was unsuccessful or that the UDHR was not a monumental stride. Clearly we’ve come a long way the past 50 years in terms of written legislation; however, it’s easy to simply pull quotes from these documents and argue that our work is complete. I think most of us would agree that unresolved social, economic, and racial inequalities are systematically buried under the façade of equal opportunity. From the impression of an equal playing field stems the common misconception and generalization that current inequalities can be attributed to a person’s innate ineptitude or laziness. The sick are sick because they don’t care for themselves (not because they lack equal access to preventive healthcare). The poor are impoverished because they lack entrepreneurial skills (not because they lack equal access to education). At the same time, though, somehow we need to recognize the significance of the structural forces at play without lifting accountability off individual shoulders.

Both racism and global health inequity are manifestations of structural violence. Not only does the system self-perpetuate its design and hierarchies, but realization of these sedimented structures can often deter individuals from taking action. General feelings of inevitability and helplessness serve to suppress efforts to dismantle (or at least navigate) the system. This makes perfect sense from an economic perspective. Why invest in something that will likely eat your money?

The assumed role of “investor” is a privileged position. Ability to extend one’s reach to others requires a certain level of health and stability. We gripe about costs of medical care in the US, yet we are incredibly privileged to have access to top-notch hospitals, clean water, food, and other services difficult to obtain in developing countries. Typically, we are not reminded of these benefits on a daily basis, and this is just one example of Western privilege when it comes to healthcare access. For most, the phrase “global health issue” tends to evoke images of starving children in Africa. Global health is often perceived as a Third World plague, with the potential remedy lying in the hands of the West. Likewise, racialism is typically portrayed as a problem for oppressed colored people, with the predominantly white government responsible to grant civil rights. In both cases, the fundamental aspect of privilege involves unconsciously extracting oneself from the issue and assuming the role of caretaker.

Right now, other than good will, there’s not much motivating the West to cure the Rest. This is where I believe the human rights paradigm potentially takes a stronghold over civil rights in the quest for social justice. It’s impossible to conceive of a free-standing right, or one without a corresponding duty. A right always involves two parties at minimum. You have no rights unless someone else acknowledges them, and then the “other” has a duty to act in accordance with those rights. When it comes to enforcing political or civil rights, duty primarily lies in the hands of the state. For human rights, the responsibility belongs to humanity. A couple others have asked about the possible synthesis of Alternative Epistemologies, and I wonder if human rights language may be the source of a universally resonating call to action.


  1. Shannon, You are so right in this blog. I think it is one of the best of the term! I think it is interesting to consider rights versus privileges. Our founding fathers may have said we don't have a right to happiness, rather we should have the right to the pursuit of happiness. Therefore, it could follow that we should only have the right to the pursuit of healthcare. I don't think that is right, I don't think it is what our forefathers meant (especially for health care), nor does it conflict with our forefathers' dreams. The pursuit of happiness is both a social and civil rights issue (of course those same founding fathers were pretty much wimps on the race thing). However, there is no inherent financial cost in trying to achieve happiness. Health care is such a different situation and the pitiful way we deal with it in the US is a "black eye" in the world view. A country as wealthy as ours, with a government as powerful as ours, that has no plan to take care of the health of the poor, the disenfranchised, and the unfortunate should question its own pulse. Without one's health how can someone escape the poverty trap. Health is integral to the pursuit of happiness. We owe it all our fellow Americans, regardless of race, to provide them access to quality health care. The unwillingness of America to do this further widens the racial inequality gap since the poor can't get health insurance or good health care and thus can't escape from their social situation. Our minorities are disproportionately represented in the poor social ranks. Let's hope the time is coming in the near future where we rise up to the level of many of our European allies.

  2. I really, really enjoyed this blog post. You had some very poignant, beautiful phrases that stuck in my mind, such as "unresolved social, economic, and racial inequalities are systematically buried under the façade of equal opportunity," which I feel perfectly hit the nail on the head, to use a poor metaphor.

    "there is no inherent financial cost in trying to achieve happiness." I suppose that is literally true--one could try to achieve happiness while broke, but I think that attempt will inevitibly fail. Today, often when we use the word happiness, we have in mind an emotional state dimension to happiness. While I suppose that is important, I'm more inclined to conceive of happiness as a flourishing human life, similar to the ancient greeks. I do think someone has to have some minimum level of material well being--which does require some sort of financial cost. I definitely don't think money alone can give happiness, but some degree of wealth seems like a needed external good for happiness to be realistically possible. I suspect you agree with me on this point, Cat, so I don't mean to imply that we fundamentally disagree, as your comments on health care are almost perfectly parallel to mine on personal wealth.


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