Health is a human right?

7 February, 2012

Following on from our new President’s assertion that we all have a basic right to material comfort, here are some further thoughts on the creeping enlargement of what is perceived to be the set of human rights.  Specifically, do we all have the right to health, as opposed to the right to healthcare?  Of course not.  Yet there is an increasing, and dangerous, amount of sloppy thinking and writing on this very question.

There are some medical conditions that are not susceptible to treatment, and we don’t (yet!) say that being a victim of such a condition is a breach of one’s human rights for which somebody must be called to account.  If I get incurable cancer, can I sue the State?   No.  If my health deteriorates significantly due to old age, should I join a march protesting at such a flagrant breach of my human rights?  Not unless I want to be ridiculed.

Surely being in a state of health is no more a human right than being talented or good-looking?  Life deals us all a different hand, and civilised countries use the collective resources of society to mitigate the inherent unfairness of this; they do not (or at any rate should not) guarantee to make us all paragons of health and sanity, regardless of the cost or of the limitations of science and medicine.

Having the right of access to healthcare, however, is a different and less controversial issue. Article 25 of the U.N. Universal Declaration of Human Rights (1948) reads:

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.

As an aside,  I wonder was the last phrase “in circumstances beyond his control” intended to qualify the whole paragraph or just the second part?  In other words, if somebody (for instance) has access to reasonably paid work which would allow him/her to provide for an adequate standard of living (including healthcare) for his/her family, yet chooses not to engage in such work, has he/she the right to have others provide such a standard of living?

The question may be in large part academic, as the United Nations International Covenant on Economic, Social and Cultural Rights (1966), which Ireland has ratified, provides that “The States Parties to the present Covenant recognize the right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions”.  So not alone do I have a right to an adequate standard of living (this time not explicitly including healthcare), but I have the right to have that standard raised every year!

Anyway, Article 12.1 of the aforementioned International Covenant on Economic, Social and Cultural Rights provides that “The States Parties to the present Covenant recognize the right of everyone to the enjoyment of the highest attainable standard of physical and mental health.”  This is extraordinary language, and the framers surely cannot have meant it literally. As written, it would mean that I have the right to be as healthy as the healthiest person in the world, both physically and mentally.  A corollary of having a right is that there is somebody I can enforce that right against.  This is ridiculous, obviously. What were they thinking?

Admittedly they attempted in a subsequent commentary (2000) to row back from the widest interpretation of what a “right to the highest attainable standard of health” actually means; but the damage had been done, and one might ask why they didn’t choose their words more carefully in the first place.  If those involved really meant that people should have the right of access to the best reasonally available healthcare, rather than to a state of health itself (and even that proposition has its opponents), they should have said so.

I note that this woolly language and woolly thinking is spreading. Last year, a full house of Irish NGOs published a report (Report on the right to health and the right to housing in Ireland by: Age Action Ireland/Disability Federation Ireland/Make Room Campaign Alliance/Mental Health Reform/Women’s Human Rights Alliance) which recommended inter alia that the right to health be incorporated in the Irish Constitution.  Hard to believe that this has escaped comment.

And so the proliferation and inflation of human rights, and the consequent debasement of the very concept of same, continues apace.

PS…. Too much loose talk about human rights –  I long for the day when we are all asked to sign up to a Universal Declaration of Human Duties!