Human Rights: Why is it a Doctor’s Business? Ranit Mishori, MHD, MHS, FAAFP, Professor of Family Medicine, Georgetown University School of Medicine

Disclosures I am a paid consultant for Physicians for Human Rights, as part of the program on Sexual Violence in Conflict Zones; the MediCapt program and the Asylum Network.

Objectives (1) Discuss health consequences of human rights violations Review human rights concerns around the world Understand how your clinical, public health and advocacy skills can be used to respond to human rights violations

Objectives (2) Consider opportunities to participate in human rights work in the US and internationally

Have you …. Worked with refugees, immigrants, asylees? Gone on global health missions or electives? Worked in clinics serving the underserved? Done a prison health elective? Worked on ‘social justice’ issues?

What have you seen?

Social Determinants

Human Rights Moral principles that apply to everyone Universal consensus that all persons have the right to live lives filled with dignity A set of international laws, treaties and declarations Governments bear a duty toward individuals to respect, protect, and fulfill their human rights, and that they are accountable when they fail in their obligations.

The Universal Declaration of Human Rights (1948) Article 25: The Right to Health (1) 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. Article 5: No Torture Article 8: Right to Justice Through the Law Article 14: Right to Seek Asylum from Persecution Article 13: the right to freedom of movement Article 20: Right to Peaceful Assembly & Association Article 24, the right to leisure and rest Article 36: the right to education, Article 23: the right to be employed

Cohen, Ezer 2013

Human Rights Based Approach to Health (HRBA) Core Principles: World in which everyone lives with dignity, freedom, justice, equality, and peace. Elimination of all forms of discrimination Gender mainstreaming is a key strategy to achieving gender equality and eliminating all forms of discrimination on the basis of sex.

Human Rights Based Approach to Health Realizing the right to health & other health-related human rights. Health policy making and programming are to be guided by human rights standards and principles Developing capacity of duty bearers to meet their obligations Empowering rights-holders to effectively claim their health rights.

Key Principles HRBA to Health Availability Accessibility Acceptability Quality of Facilities and Services Hunt et al WHO (2013) Participation Equality and non-discrimination Accountability

Maternal Health

Prison Health

Torture

GB Violence

LGBT

Forensic Investigations Colombia extra judicial killing; mass graves in afghanistan

Asylum Evaluations

Health Care Facilities

Why Should Health Professionals Get Involved in Human Rights? health professionals, with their specialized skills, ethical duties, and credible voices, are uniquely positioned to stop human rights violations. Human Rights abuse -- >> Health consequences Credibility & Power of profession Support of colleagues Treatment movement Research needs Science -- Irrefutable evidence

The Declaration of Professional Responsibility Asks physicians to use their skills beyond the bounds of the traditional patient-physician relationship in responding to exceptional global conditions and need for care. Preamble concludes by stating, on behalf of all physicians, that "humanity is our patient."

What We (YOU!) Can Do SD-TASR Screen Document Treat Advocate Support Colleagues Research

Opportunities and Organizations

Physicians for Human Rights PHR chapters Asylum Network Advocacy Campaigns Research and investigations Education

Thank you! Questions? Ranit Mishori mishorir@georgetown.edu