Human Rights in Health Law

Legal Literacy - This article highlights the complexities human rights in health law modern, with a focus on access, quality, and medical services. Investigating the concept of human rights from a legal and health perspective, this writing invites readers to consider the importance of a comprehensive understanding of patient rights and the responsibilities of governments and health workers in ensuring equality and justice in healthcare services.

Advances in modern medical technology and current social developments demand a review of the implementation of human rights within the healthcare system. Various healthcare service issues such as accessibility, availability of facilities, costs, and quality of care often become obstacles in the implementation of the right to healthcare services. Therefore, a review and reconsideration of the existing healthcare system is appropriate, especially concerning rights in the medical field in general, and patient rights in particular.

The Concept of Human Rights

Basic human rights, better known as Human Rights (HAM), are a concept that was born in response to various social and political developments that occurred in the world. Historically, many documents regulate human rights, including the Magna Carta (1215), the English Bill of Rights (1689), the French Declaration on Human Rights and Citizens (1789), as well as the United States Constitution and Bill of Rights (1791). Even long before that, various religious scriptures implicitly and explicitly regulated human rights.

The modern concept of human rights began to be universally accepted after the end of World War II, two years after the establishment of the United Nations (UN). At the end of 1948, UN member states formally adopted the Universal Declaration of Human Rights (UDHR) in response to post-war humanitarian developments and provided recognition of universal rights for all individuals. The rights and freedoms listed in the UDHR include a complete set of rights, be they civil, political, cultural, economic, and social rights of each individual, as well as several collective rights (Rhona K. M. Smith, et al, Yogyakarta, 2008, 89). The principles of the UDHR, which have been adopted by member states, including Indonesia, are now being realized in national laws and regulations and various government actions.

Human Rights in Health Law

To enforce the UDHR, the UN Human Rights Commission formulated two important agreements, namely the International Covenant on Economic, Social, and Cultural Rights (ICESCR) and the International Covenant on Civil and Political Rights (ICCPR). The ICESCR focuses on issues in the areas of food, education, health, and housing, while the ICCPR focuses on fundamental rights such as the right to life, freedom of speech, religion, and voting. Each agreement has been ratified by the Indonesian government through Law No. 11 of 2005, and Law No. 12 of 2005.

Based on these international provisions, broadly speaking, two basic human rights are recognized in the field of health, namely basic social rights and basic individual rights.

Basic Social Rights

The prominent basic social right in the field of health is The Right to Health Care. Regarding this right, the World Health Organization (WHO) explains that there are at least four important elements, namely:

a. Availability

Availability means the adequacy of health facilities, goods, and services needed by everyone and readily available.

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b. Accessibility

Accessibility means that health facilities, goods, and services are accessible to everyone. Accessibility has four dimensions: non-discrimination, physical accessibility, economic accessibility (affordability) and information accessibility.

c. Acceptability

Acceptability means that health facilities, goods, services, and programs are people-centered and meet the specific needs of diverse population groups and respect medical ethics and culture.

d. Quality

Quality means that health facilities, goods, and services must meet high scientific and medical standards and be of good quality, including the presence of skilled medical personnel, medicines, and hospital equipment that have been scientifically proven, and adequate sanitation.

Basic Individual Rights

In addition to the social right of The Right to Health Care, there is an individual right called The Right to Medical Service, which is mutually supportive and runs parallel to social rights. The most prominent fundamental individual right here is The Right of Self-determination (TRoS), which is in line with international provisions, including:

Article 3 of the UDHR: Everyone has the right to life, liberty, and security of person.

Article 1 of the ICCPR: All peoples have the right of self-determination.

Article 7 of the ICCPR: No one shall be subjected to torture or to cruel, inhuman or degrading treatment or punishment. In particular, no one shall be subjected without his free consent to medical or scientific experimentation.

The Right of Self-determination is also the source of other individual rights, such as the right to privacy and the right of a person over their own body. In its development, these two rights have become key to the operation of health services.

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a. Right to privacy

The right to privacy is commonly applied in the health sector, especially in relation to patient status records or medical records. The Hippocratic Oath, recorded since 400 years before Christ and a reference for medical profession oaths worldwide, states:

And whatsoever I shall see or hear in the course of my profession, as well as outside my profession in my intercourse with men, if it be what should not be published abroad, I will never divulge, holding such things to be holy secrets.

This oath was adopted in Indonesia as the fourth doctor's oath: I will keep secret everything I know because of my profession. However, the right to privacy in law in health is not absolute. There are several things that are excluded by law, such as interests for investigation, limited research, and insurance.

b. A person's right over their own body

A person's right over their own body derives other rights such as the right to informed consent, the right to choose a doctor or hospital, and the right to refuse medical treatment/action. This right provides the basis that a medical action must be carried out with the patient's consent, unless in certain conditions it is permitted without consent by law, for example in the event of an emergency.

The concept of the right to one's own body has been an endless debate to this day. In its application, each region or country has different perspectives influenced by moral, religious, and ethical values. This has a significant impact on the development of health services and issues, including those related to trans-sexuality, abortion, euthanasia, and suicide.

The principles of human rights, both in fundamental social rights and fundamental individual rights, are an important foundation in implementing the health system. Enforcement of human rights must continue to be a focus in the development and implementation of health policies. Therefore, the government as a regulator, doctors and health workers as health service providers, and patients need to have a complete understanding of human rights so that the health system is in line with humanitarian values.