In a recent position paper published within the Annuals of Internal Medicine, representatives of the American College of Physicians (ACP’s) Ethics, Professionalism, and Human Rights Committee highlight key points on why they imagine health is a human right. Despite the United Nations (UN) recognizing health as a human right in 2000, nations globally have differing views on the subject. Some align with the UN’s mandate, while others consider it a general right, and still others don’t. On this paper, the ACP examines the intersection of ethical obligations, human rights, and health reforms and elucidates why The College affirms that the USA (US) should respect, protect, and fulfill health for all.

Position Paper: Health as a Human Right: A Position Paper From the American College of Physicians. Image Credit: Created with the help of DALL·E 3

What’s a human right, and does health fit the bill?

The United Nations (UN) defines human rights as “inherent to all human beings, no matter race, sex, nationality, ethnicity, language, religion, or another status.” Nevertheless, different people and legal systems the world over interpret human rights uniquely. While torture is nearly unanimously considered a violation of human rights, health and access to health care is more contentious. While some consider health a human right, others consider it a privilege to be earned through merit or financial backing.

These differing views, in turn, shape national policy, with countries like Brazil providing free healthcare to all its residents, contrasting the USA (US), which stays the one developed country without universal healthcare. Alarmingly, healthcare within the US is among the most costly on the earth, exuberated by most Americans lacking any type of medical insurance policy.

UN documents are central to most human rights law and theory. Article 25 of the UN’s Universal Declaration of Human Rights presents that an adequate way of life, including medical care, is a right and hence intrinsic to each human being. To emphasise and make clear this point, the UN Committee in 2000 defined health as a “fundamental human right indispensable for the exercise of other human rights.”

Unfortunately, many countries debated or outright denied this definition, with some, including the US, going to date as to refuse to ratify the International Covenant on Economic, Social and Cultural Rights. While the American College of Physicians (ACP) recognizes that the legality of the International Covenant on Economic, Social and Cultural Rights, and by extension health, contrasts the US’s tradition of people’ freedom from interference, it maintains that health’s ethical and moral considerations should precede legal views.

Concerning the paper

This paper summarizes the ACP’s stance on health as a human right. It elucidates why The College believes that America’s recognition of the identical could bring about positive change in its healthcare policy, thereby supporting and promoting patient-physician relationships.

The event of this paper involved work by the ACP Ethics, Professionalism and Human Rights Committee (EPHRC). Quite a few ACP boards, including the ACP Board of Governors, Council of Early Profession Physicians, Board of Regents, Council of Fellow Members, and the Council of Student Members, reviewed drafts of the paper. On 24 April 2023, the ACP Board of Regret approved the work for publication as its official position on health as a human right.

Key positions

“ACP views health as a human right based within the intrinsic dignity and equality of all patients.”

Of their first position, The College calls attention to human dignity as a primary principle and what this implies for health. They recognize that the human right to health is a super but challenge the critical view of it being utopian. ACP highlights the several many years of progress that the medical field has made in extending human lifespan and luxury and, in doing so, its contribution to human dignity. They borrow from the late Edmund D. Pellegrino, MD, certainly one of America’s most sensible bioethics minds, in referring to the ethical and moral views surrounding health, not only from the physician’s perspective but in addition from society as a complete.

“Recognizing and implementing health as a human right requires ethical and evidence-based medical care but in addition the optimization of social and structural determinants of health.”

Of their second position, the ACP draws on the UN Committee on Economic, Social and Cultural Rights’ key medical care elements – availability, acceptability, and accessibility. They emphasize that recognizing health as a human right shouldn’t be without limits. It doesn’t mean that an individual in need of an organ transplant may demand it from another person or hold the federal government answerable for its unavailability. It doesn’t mean that individuals are allowed to demand prescriptions for any medication they desire. It does mean that medical care is meant to safeguard people from remediable and significant threats to their opportunity for health.

“Understanding health as a human right can inform the moral design, implementation, and evaluation of health care delivery.”

Herein, emphasis is laid on how the moral implications related to health as a human right can inform motion and accountability at national and native levels. A key example of that is how vulnerable, marginalized, and excluded groups are less prone to be denied access to healthcare if the legal framework recognizes and follows a human rights-based healthcare approach.

“Health as a human right aligns with—but doesn’t fully encompass—the moral obligations of physicians, the medical occupation, and a just society.”

Of their final position, ACP summarizes the responsibilities of each physicians and of society in achieving a gold standard in healthcare. While the roles and obligations of medical professionals are self-explanatory, it’s society’s responsibility to assist them of their endeavors, be that resource allocation during pandemics or donating organs postmortem.