College aantekeningen
Lecture notes Health, Globalisation and Human Rights (AM_470818)
This contains notes from all lectures given for Health, Globalisation and Human Rights during MPA.
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Lecture 1: Intro HGHRUniversal human rights (irrespective of religion and beliefs), inclusive (for everyone),
supranational (governments do not have exclusive rights, it’s the moral duty of everyone to
intervene when human rights are ignored).
→ 4 principles of human rights: dignity (don’t humiliate), equality (don’t discriminate), freedom
(don’t silence others) and security (feeling safe/at home, no fear) → are self-evident (no reason
given for these principles) → by human intuition we share these principles.
Human rights are the unwanted child, most governments never wanted universal rights → states
do their best to restrict the application of those rights → state-centurism.
→ BUT, are fundamental and should be universal → governments hold on to nationalism → not
enough to have the right to freedom, should also have the equipment for this freedom.
United Nations is insignificant, not a good guardian of human rights, because the UN became an
association of states, which makes it impossible to defend human rights → very bureaucratic.
Nationalism is dangerous for human rights and leads to inequality for people with different
backgrounds.
Moral man in immoral society? → everyone needs to reflect → immorality not only in clear
corruption FEX., but also that society gets spoiled in all layers → contagious process → how do
we stay moral?
Global health is related to unequal outcomes → more disease burden in poor areas of the world
→ huge gap in life expectancy between Africa and Europe → unequal resources → out-of-pocket
expenditure (medical expenses paid for by yourself, such as eigen risico) much higher in poor
countries → problematic, because the costs are the same, so poor people are disadvantaged (it is
regressive) → the poor suffer much more than the rich.
Catastrophic health expenditure = when you spend at least 50% of your income on health
expenditures → total health expenditure pp: more than €5,000 in rich countries, but less than
€50 for poor people.
There is also national inequality → women get older than men, but also a higher life expectancy
for high income and education groups with regard to low income and education groups → they
live 15 years more in good health and get older.
→ these differences are also continuous (perpetuous) → more likely to end up with poorer health
when you grow up in a poor household and neighbourhood.
Global health = an area for study, research and practice that places a priority on improving
health and achieving equity in health for all people → international health + public health.
- International health = healthcare that crosses boundaries, health problems have
similarities across countries, solutions require global cooperations.
- Public health = healthcare for populations → changing societal determinants is much
more effective then medical interventions → equity (reducing inequalities by providing
the same outcome, equality of outcome), but best to remove the boundaries or factors
that cause inequality → interdisciplinarity and transdisciplinary.
→ human rights forms the framework through which we can practice global health → is
universal, requires compassion, needs dignity, equality, freedom and security → often problems
with freedom and dignity (covid pandemic).
Right to health = everyone has the right to a standard of living adequate for the health and
wellbeing of himself and of his family → right of everyone to enjoyment of the highest attainable
standard of physical and mental health.
, → the right to health embraces a wide range of socio-economic factors that promote conditions
in which people can lead a healthy life.
Health = state of complete physical, mental and social well-being, and not merely the absence of
disease or infirmity, is a fundamental human right and that the attainment of the highest level of
health is a most important worldwide social goal whose realisation requires the action of many
other social and economic sectors in addition to the health sector.
→ Siracusa principles say we can limit human rights for the sake of global health (FEX. stay at
home to avoid corona infection).
Human rights based approach to health: discrimination and coercive tools, such as compulsory
testing, named reporting, travel restrictions, and isolation or quarantine were
counterproductive, increased stigma (violating freedom and dignity) → there is a need for more
human rights based approach.
Global health is universal, but contextual → human rights are universal and contextual → health
interventions may work in one situation, but not in another → global health and human rights
both relate to context (how we perceive something as humiliating or discriminating may be
perceived differently in another place or what is regarded as equal, even across persons).
There is no supranational body state that punishes when people cross the line → a human right
(international assistance) or a citizen right (access to quality services of migrants - nations
determine their own rules).
Lecture 2: Right to health
The right to health is the right to live in conditions that the WHO describes as the state of
complete physical, mental and social well-being.
Healthcare should be: available, affordable, acceptable (practices of healthcare should be
respected, Western countries should not dictate other countries what the right healthcare is;
still have to liberate healthcare from colonization), accessible
Human rights quality (HRQ) = 4 principles (dignity, freedom, safety, equality).
Major complications: institutionalization (only species that create business, schools) → everything
in an internationalization should be
- Efficient (hospital wants to get rid of patients as soon as possible)
- Calculability (If medicine for disease is too expensive to make/buy you die)
- Predictability (Nurses spend more time with computers than with patients)
- Rationality (replace humans with machines) → not a good thing for institutional
healthcare → protocol has become more important than the health of a patient → do not
listen to intuition anymore.
- Commercialisation (healthcare becomes big business, ask yourself whether a market
based healthcare is good for your health and leads to too much diagnosis (over testing)).
Human Rights Market
Equality Inequality
Inclusivity Exclusive
Convivial (enjoy) Competition
Compassion Calculation
“It doesn’t mean a thing if it ain’t got that swing” → need harmony/good group work for synergy.
How do you make choices? → classical ways:
- Deontology = you have duties and need to act in accordance to your duties → FEX. if you
agree that there is a duty not to lie but then a friend is sought by secret police and your
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