Towards a universal definition of the right to health?*

Medicine and Law

Volumn 17, Issue 3, 1998, Pages 319-332

  Hendriks, Aart ^a   Toebes, Brigit ^b  

^a UNIVERSITY OF AMSTERDAM   (Netherlands)

^b SIM ^*

Author keywords

Human rights; Indicators; Minimum core content; Right to health; State obligations

Indexed keywords

ARTICLE; HEALTH CARE; HEALTH CARE ACCESS; HEALTH CARE DELIVERY; HEALTH CARE NEED; HEALTH CARE ORGANIZATION; HEALTH CARE POLICY; HEALTH ECONOMICS; HEALTH INSURANCE; HUMAN RIGHTS; MEDICOLEGAL ASPECT; PUBLIC HEALTH SERVICE; SOCIAL WELFARE;

EID: 0032468883     PISSN: 07231393     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Article

References (43)

1. General Assembly resolution 217 A (III) of 10 December 1948.
2. General Assembly resolution 421 (V) of 4 December 1950.
3. General Assembly resolution 543 (VI) of 5 February 1952.
4. General Assembly resolution 2200 A (XXI) of 16 December 1966.
5. The ICESCR entered into force on 3 January 1976, whereas the ICCPR entered into force on 23 March 1976.
6. Inter alia, Article 12 Convention on the Elimination of Discrimination Against Women (CEDAW), Article 24 Convention on the Rights of the Child (CRC). In addition, a number of regional human rights documents guarantee the right to health: Article 11 European Social Charter, Article 10 Protocol of San Salvador, and Article 16 African Charter on Human Rights and Peoples' Rights. In the Arab Charter on Human Rights, the right to health is not explicitly mentioned.
7. Article 24 para. 2 CRC refers to (a) diminishing infant and child mortality, (b) medical assistance and health care to all children with emphasis on primary health care, (c) combatting disease and malnutrition through the application of technology and the provision of adequate nutritious foods and clean drinking-water, taking into account the risks of environmental pollution, (d) pre-natal and post-natal care, (e) child-health related information, (f) preventive health care, guidance for parents and family planning education and services. Article 24 para. 3 CRC refers to the abolishment of 'traditional practices'.
8. M. Craven, The International Covenant on Economic, Social and Cultural Rights - A perspective on its development, Clarendon Press, Oxford, 1995, p. 87-89.
9. Cf. A.P.M. Coomans, G.J.H. van Hoof (eds.), The right to complain about economic, social and cultural rights, SIM Special No. 18, Utrecht, 1995.
10. Provided that the State Party has recognised the competence of the Committee to receive and consider State (Art. 41 ICCPR) and individual communications (First Protocol ICCPR).
11. The right to complain at an international level has also been recognized under the International Convention on the Elimination of All Forms of Racial Discrimination (1965) and the Convention against Torture and other Cruel, Inhuman or Degrading Treatment or Punishment (1984).
12. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
13. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
14. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
15. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
16. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
17. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
18. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
19. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
20. See e.g. R. Roemer, The right to health care, in: H.L. Fuenzalida-Puelma, S. Scholle Connor (eds.), The right to health in the Americas, PAHO Scientific Publications No. 509, PAHO, Washington, D.C., 1989, p 17-23; V. Leary, Implications of a right to health, in: K.J. Mahoney, P. Mahoney (eds.), Human rights in the twenty-first century, Kluwer, Dordrecht, 1993, p. 481-493; M.A. Somerville, The right to health: A human rights perspective, in: J. Mann, C. DuPuy (eds.), Sida, santé et droits de l'homme [Aids, health and human rights], Fondation Marcel Mérieux, Lyon, 1993, p. 75-90; J. Mann, L. Gostin, S. Gruskin et al., Health and human rights, Health and Human Rights 1994; 1 (1): 6-23; V. Leary, The right to health in international human rights law, Health and Human Rights 1994; 1(1): 24-57; A. Hendriks, The right to health, European Journal of Health Law 1994; 1 (2): 187-196; D. Giesen, Health care as a right: some practical implications, Medicine & Law 1994; 13 (3-4): 285-296; K. Tomasevski, Health rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 125-142 and A.E. Yamin, Defining questions: situating issues of power in the formulation of a right to health under international law, Human Rights Quarterly 1996; 18 (2): 398-438.
21. See J. Mann, L. Gostin, S. Gruskin. et al. (1994), o.c. note 12.
22. See Report of the eighth and ninth sessions, Official Records 1994, Supplement No. 3, E/1994/23.
23. So far the Committee has adopted eight General Comments: General Comment No. 1 (1989) on the purpose of General Comments; General Comment No. 2 (1990) on international technical assistance measures; General Comment No. 3 (1990) on the nature of States parties obligations; General Comment No. 4 (1991) on the right to adequate housing; General Comment No. 5 (1994) on people with disabilities; General Comment No. 6 (1995) on rights of older persons; General Comment No. 7 (1997) on forced evictions and General Comment No. 8 on economic sanctions and respect for economic, social and cultural rights (1997).
24. Preamble to the Constitution of the World Health Organization (1948), para. 2. It is proposed to change this phrase as follows: 'Health is a dynamic state of complete physical, mental, spiritual and social well-being and not merely the absence of disease or infirmity'. WHO, Review of the Constitution and regional arrangements of the World Health Organization, EB101/7, 101st Session, 14 November 1997.
25. The ample meaning of this right also explains why many commentators maintain that this right can best be referred to as the right to health, instead of using terms such as the right to health care or the right to health promotion. Leary (1993), o.c. note 12.
26. Cf. D. Türk, The realization of economic, social and cultural rights, Final Report by the Special Rapporteur, UN. Doc E/CN.4/Sub.2/1992/16 (3 July 1992), p. 8.
27. See also A.P.M. Coomans, 'Clarifying the Core Elements of the Right to Education', in: A.P.M. Coomans, G.J.H. van Hoof (eds.), The right to Complain about Economic, Social and Cultural Rights, SIM Special No. 18, Utrecht, 1995, p. 11-27, at p. 17.
28. A. Eide, 'Realization of Social and Economic Rights and the Minimum Threshold Approach', Human Rights Law Journal 1989; 10 (1-2): 35-51.
29. With regard to the formulation of indicators in a more general sense, see section 7.
30. Cf. Turk (1992), o.c. note 18.
31. Developments of indicators for monitoring progress towards health for all by the year 2000, WHO, Geneva, 1981. See also WHO, Indicators to measure the realization of the right to health, Background paper for the Seminar on appropriate indicators to measure achievements in the progressive realization of economic, social and cultural rights, UN Centre for Human Rights, Geneva, 1993 and Report of the seminar on appropriate indicators to measure achievements in the progressive realization of economic, social and cultural rights (Geneva, 25-29 January 1993), A/CONF.157/PC/7, 20 April 1993.
32. Further on this issue, K. Tomasevski, Indicators, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A testbook, Nijhoff, Dordrecht / Boston/London, 1995, p. 389-401.
33. For a more extensive description, see A. Hendriks, Promotion and protection of women's right to sexual and reproductive health under the international law: the Economic Covenant and the Women's Convention, The American University Law Review 1995; 44 (4): 1123-1155, on p. 1135-1138.
34. This typology of obligations was originally developed by Professor Asbj0rn Eide and has subsequently gained almost universal recognition. See A. Eide, The new international economic order and the promotion of human rights, Report by the Special Rapporteur on the right to food, UN Doc. E/CN.4/Sub.2/1987/23, p. 14-15, paras. 66-69 and A. Eide, Economic, social and cultural rights as human rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A textbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 21-40. See also H. Shue, Basic Rights, Subsistence, Affluence and U.S. Foreign Policy, Princeton University Press, Princeton, NJ, 1980, p. 51-60.
35. This typology of obligations was originally developed by Professor Asbj0rn Eide and has subsequently gained almost universal recognition. See A. Eide, The new international economic order and the promotion of human rights, Report by the Special Rapporteur on the right to food, UN Doc. E/CN.4/Sub.2/1987/23, p. 14-15, paras. 66-69 and A. Eide, Economic, social and cultural rights as human rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A textbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 21-40. See also H. Shue, Basic Rights, Subsistence, Affluence and U.S. Foreign Policy, Princeton University Press, Princeton, NJ, 1980, p. 51-60.
36. This typology of obligations was originally developed by Professor Asbj0rn Eide and has subsequently gained almost universal recognition. See A. Eide, The new international economic order and the promotion of human rights, Report by the Special Rapporteur on the right to food, UN Doc. E/CN.4/Sub.2/1987/23, p. 14-15, paras. 66-69 and A. Eide, Economic, social and cultural rights as human rights, in: A. Eide, C. Krause, A. Rosas (eds.), Economic, social and cultural rights - A textbook, Nijhoff, Dordrecht / Boston / London, 1995, p. 21-40. See also H. Shue, Basic Rights, Subsistence, Affluence and U.S. Foreign Policy, Princeton University Press, Princeton, NJ, 1980, p. 51-60.
37. Or, as the Social Rights Committee stated: "... the Committee underlines the fact that even in times of severe resources constraints whether caused by a process of adjustment, of economic recession, or by other factors the vulnerable members of society can and indeed must be protected by the adoption of relatively low-cost targeted programmes." General Comment No. 3, The nature of States parties obligations, UN Doc. E/C.12/1990/8, (Fifth session, 1990), para. 12.
38. The Limburg Principles on the implementation of the International Covenant on Economic, Social and Cultural Rights, UN Doc. E/CN.4/1987/17.
39. A. Chapman, A 'Violations approach' for monitoring the International Covenant on Economic, Social and Cultural Rights, Human Rights Quarterly 1996; 18(1): 23-66. An adaptation of this paper was published in the ICJ Review 1995; 55: 23-37.
40. A. Chapman, A 'Violations approach' for monitoring the International Covenant on Economic, Social and Cultural Rights, Human Rights Quarterly 1996; 18(1): 23-66. An adaptation of this paper was published in the ICJ Review 1995; 55: 23-37.
41. Workshop held in early 1997, on the occasion of the 10th anniversary of the Limburg Principles (see above, note 29). See C. Flinterman, The Maastricht Guidelines on violations of Economic, Social and Cultural Rights (Annex II), Netherlands Quarterly of Human Rights 1997; 15 (2): 244-252.
42. C. Flinterman, o.c., note 30.
43. Cf. P. Hunt, The right to health: engaging the international human rights system, Paper presented on the 2nd International Conference on Health and Human Rights, Cambridge, MA, 3-5 October 1996.