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Human rights and informed consent in clinical practice: beyond the right to health

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Author(s)
Gianella, Gonzalo
International Federation of Health & Human Rights Organizations (IFHHRO). Amsterdam, Holanda. Unidad de Cuidados Intensivos y Servicio de Neumología, Clínica Ricardo Palma. Lima, Perú. Médico cirujano especialista en Neumología.
Keywords
Informed consent; Human rights; Right to health; Ethics, clinical; Medical care
Consentimiento informado; Derechos humanos; Derecho a la salud; Ética clínica; Atención médica

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URI
http://hdl.handle.net/20.500.12424/253354
Online Access
http://www.rpmesp.ins.gob.pe/index.php/rpmesp/article/view/211
Abstract
Providing medical care is us a complex process that requires a strict respect for human rights. In countries like Peru, despite of having regulations and specific laws, patient´s autonomy is not a common currency and certainly paternalism and beneficence generally overrule in physicians decision making. In this type of reality the requirement to health care professionals for respecting fundamental rights should be considered crucial, far more than in societies where citizens are really empowered. But to achieve the full respect of human rights, especially when providing a health care service, there is the need to go much further than just advocating for appropriate legislation and regulatory frameworks. In this article I argue that the violation of certain rights as the informed consent process by health care providers, is rooted in how these professionals, specially medical doctors trained in the western tradition, establish priorities and arrive to moral judgments. In this scenario I consider the need of a change in the way the Human Rights framework is being used to improve fundamental rights respect in health care.
Proporcionar una atención médica es un proceso complejo que requiere de un estricto respeto de los derechos humanos. En países como el Perú, a pesar de contar con normas y leyes específicas, el ejercicio de la autonomía del paciente no es común y, ciertamente, el paternalismo y la beneficencia son priorizados al momento de tomar decisiones médicas. En este tipo de realidad, exigir a los profesionales de la salud que se respeten los derechos fundamentales de las personas debe ser considerado crucial, mucho más que en las sociedades donde los ciudadanos están realmente empoderados. Pero para lograr el pleno respeto a los derechos humanos, especialmente en la prestación de un servicio de salud, existe la necesidad de ir mucho más allá de la defensa de una legislación apropiada y de marcos normativos. En este artículo se argumenta que la violación de ciertos derechos, como el proceso de consentimiento informado, por parte de los proveedores del cuidado de la salud, se evidencia en cómo estos profesionales, especialmente médicos formados en la tradición occidental, establecen prioridades y llegan a juicios morales. En este escenario hay que considerar la necesidad de un cambio en la manera en la que se entienden los derechos humanos para mejorar el respeto hacia ellos durante las atenciones de salud.
Date
2014-02-10
Type
info:eu-repo/semantics/article
Identifier
oai:ojs.192.168.64.26:article/211
http://www.rpmesp.ins.gob.pe/index.php/rpmesp/article/view/211
10.17843/rpmesp.2013.302.211
Copyright/License
Copyright (c) 2013 Revista Peruana de Medicina Experimental y Salud Pública
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Health Ethics

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 the application of human rights standards in context and
 relate essentially to measuring human rights realization,
 both qualitatively and quantitatively. They offer an
 empirical or evidence-based dimension to the normative
 content of human rights legal obligations and provide a
 means of connecting those obligations with empirical data
 and evidence and, in this way, relate to human rights
 accountability and the enforcement of human rights
 obligations. Human rights indicators are important for both
 assessment and diagnostic purposes: the assessment function
 of human rights indicators relates to their use in
 monitoring accountability, effectiveness, and impact; the
 diagnostic purpose relates to measuring the current state of
 human rights implementation and enjoyment in a given
 context, whether regional, country-specific, or local. This
 paper offers a preliminary review of the foregoing in the
 development context and a general perspective on the
 significance of human rights indicators for development
 processes and outcomes. It is not intended to be
 prescriptive and does not provide specific operational
 recommendations on the use of human rights indicators in
 development projects. Nor does it advocate a particular
 approach or mode of integrating human rights in development
 or argue for a rights-based approach to development. This
 paper is designed to provide development practitioners with
 a preliminary view on the possible relevance, design, and
 use of human rights indicators in development policy and
 practice. It also introduces a basic conceptual framework
 about the relationship between rights and development,
 including in the World Bank context. It then moves to
 methodological approaches on human rights measurement,
 exploring in general terms different types of human rights
 indicators and their potential implications for development
 at three levels of convergence or integration. The paper
 therefore offers a theoretical introduction to a complex
 area of growing relevance in a number of areas of
 development that may be of interest to practitioners and
 scholars in a variety of institutional settings.
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