Reproductive Health and Human Rights Integrating Medicine, Ethics, and Law,9780199241323

Reproductive Health and Human Rights Integrating Medicine, Ethics, and Law

by ; ;
ISBN13: 9780199241323
ISBN10: 0199241325
Format: Hardcover
Pub. Date: 2003-06-19
Publisher(s): Clarendon Press
List Price: $229.33

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Summary

Rebecca Cook, Bernard Dickens, and Mahmoud Fathalla, leading international authorities on reproductive medicine, human rights, medical law, and bioethics, integrate their disciplines to provide an accessible but comprehensive introduction to reproductive and sexual health. They analyze fifteen case-studies, representing a wide array of recurrent problems, focusing particularly on resource-poor settings. Approaches to resolution are considered at clinical and health system levels. They also consider the kinds of social change that would relieve the underlying conditions of reproductive health dilemmas.

Author Biography

Rebecca J. Cook and Bernard M. Dickens are Professors of Law at the University of Toronto Mahmoud F. Fathalla is Professor of Obstetrics and Gynaecology at Assiut University, Egypt

Table of Contents

List of Tables
xxiii
List of Abbreviations
xxiv
Biographical Notes xxvi
Part I. Medical, Ethical, and Legal Principles
Introduction and Overview
3(5)
Reproductive and Sexual Health
8(26)
Overview
8(3)
Reproductive Health
11(2)
The concept
11(1)
A definition
12(1)
A global concern
13(1)
Sexual Health
13(1)
Reproductive Health: A Woman's Concern
14(3)
Gender differentials in health
14(1)
The unfair burden on women in reproductive health
15(2)
Women's health is more than reproductive health
17(1)
Men Have Reproductive Health Needs Too
17(1)
Determinants of Reproductive Health
18(1)
Reproductive Health Indicators
19(3)
A Global Overview of Reproductive Health
22(9)
Safe motherhood
22(1)
Availability of essential basic and comprehensive health care
22(1)
Deliveries by skilled birth attendants
22(1)
Access of pregnant women to prenatal care
23(1)
Maternal mortality
23(1)
Perinatal mortality
24(1)
Anaemia
25(1)
Fertility by choice
25(1)
Total fertility rate
25(1)
Contraceptive prevalence
26(1)
Abortion
26(2)
Sexually transmitted infections
28(1)
Not including HIV
28(1)
HIV infection
28(1)
Female genital cutting (circumcision/mutilation)
29(1)
Infertility
30(1)
Cervical cancer
30(1)
Progress and Challenges
31(3)
Health Care Systems
34(27)
Overview
34(2)
The Health Care System and the Right to Health
36(1)
Special Considerations in Reproductive Health Care
37(3)
Dealing with healthy people
38(1)
Dealing with more than one `client'
38(1)
Dealing mostly with women
39(1)
Dealing with society
40(1)
Shortcomings in the Performance of the Reproductive Health Care System
40(8)
Imbalance in the health care system
40(1)
Health facilities
40(1)
Human resources
41(1)
Hospital beds
42(1)
Inefficiency in the health care system
42(2)
Inadequate responsiveness to women's expectations and perspectives
44(1)
A health system that cares
44(1)
Women as ends and not means
45(2)
A fragmentary response to a totality of needs
47(1)
Mainstreaming the Gender Perspective in the Health Care System
48(1)
Challenges in the Implementation of Reproductive Health Care
48(1)
Health Care Systems and the Law
49(4)
Legal principles governing health care delivery
49(1)
Obstructive laws
50(2)
The health profession and human rights law
52(1)
Literacy in human rights law
52(1)
Compliance with human rights law
52(1)
Advocacy for human rights
53(1)
The Question of Resources
53(6)
Overall resources
53(3)
Fair allocation of resources
56(1)
Priorities in the allocation of resources
56(1)
Reproductive health is special
57(1)
The cost of not providing reproductive health services
57(2)
The Commitment
59(2)
Ethics
61(34)
Overview
61(2)
The Origins of Bioethics
63(2)
The Role of Bioethics
65(1)
Bioethical Orientations
66(2)
Duty-based bioethics
66(1)
Consequentialist or utilitarian bioethics
67(1)
Feminist bioethics
67(1)
Other bioethical orientations
68(1)
Principles of Bioethics
68(6)
Respect for persons
69(1)
Autonomy of capable persons
69(1)
Protection of persons incapable of autonomy
70(1)
Beneficence
70(1)
Non-Maleficence
71(2)
Justice
73(1)
Levels of Bioethical Analysis
74(3)
The microethical level
74(1)
The macroethical level
75(1)
The mesoethical level
76(1)
The megaethical level
76(1)
Reproductive and Sexual Health Ethics
77(6)
Research Ethics
83(4)
Ethics and the Law
87(3)
Ethics and Human Rights
90(2)
Ethics Review
92(3)
Legal Origins and Principles
95(53)
Overview
95(2)
The Role of Law and of Lawyers
97(3)
Legal Reform for Reproductive Health
100(2)
The Evolution of Reproductive Health Law
102(5)
From morality to democracy
103(1)
From crime and punishment to health and welfare
104(1)
From health and welfare to human rights
105(2)
Legal Principles Governing Reproductive Health Care
107(2)
Decision-Making
109(11)
Informed decision-making
109(4)
Free decision-making
113(2)
The role of third parties
115(1)
Partner authorization
115(1)
Parental consent
116(2)
Substitute decision-making
118(2)
Regulation of Information
120(8)
Privacy
120(1)
Confidentiality
121(1)
Unauthorized disclosures
122(1)
Disclosure to patients
123(1)
Authorized disclosures
124(1)
Related concerns
125(1)
Third-party interests
125(1)
Third-party peril
126(2)
Competent Delivery of Services and the Law of Negligence
128(11)
Relation between legal and professional standards
129(3)
Standards for determining professional competence
132(2)
Delegated authority
134(2)
Evidence for determining professional competency
136(1)
Sexual misconduct
137(2)
Conscientious Objection
139(3)
Safety and Efficacy of Products
142(2)
Criminal Law
144(4)
Human Rights Principles
148(68)
Overview
148(2)
Sources and Nature of Human Rights
150(4)
Rights Relating to Reproductive and Sexual Health
154(4)
Evolution of reproductive rights
154(2)
Duties to implement reproductive rights
156(1)
Restrictions and limitations of rights
157(1)
The Application of Human Rights to Reproductive and Sexual Health
158(57)
Rights relating to life, survival, security, and sexuality
159(1)
The right to life and survival
160(1)
Essential obstetric care
161(1)
Anti-retroviral and associated treatment
162(2)
The right to liberty and security of the person
164(1)
Unsafe abortion
164(1)
Female genital cutting
165(1)
Confidentiality
166(2)
Compulsory diagnostic testing
168(2)
The right to be free from inhuman and degrading treatment
170(1)
Rape and the subsequent denial of justice
170(1)
Denial of abortion services (including following rape)
171(1)
Involuntary sterilization
172(1)
Denial of adequate medical treatment
173(1)
Sexuality
173(2)
Rights relating to reproductive self-determination and free choice of maternity
175(1)
The right to decide the number and spacing of one's children and the right to private and family life
175(1)
Denial of contraceptive sterilization
176(1)
Choice of termination of unintended pregnancy
177(1)
Putative father's veto
177(1)
Same sex intimacy
178(1)
The right to marry and to found a family
179(2)
`The family is entitled to protection by society and the State'
181(1)
Marriageable age
182(1)
Health and social effects of child marriage
182(2)
Free and full consent
184(1)
The right to maternity protection
185(1)
The right to maternity protection during employment
186(1)
Rights relating to health and the benefits of scientific progress
187(1)
The right to the highest attainable standard of health
187(3)
Available resources and their fair allocation
190(2)
Health sector reform
192(2)
The right to the benefits of scientific progress
194(2)
Rights to non-discrimination and due respect for difference
196(2)
Sex and gender
198(1)
Sex and gender non-discrimination in the family
199(1)
Sex and gender non-discrimination in health
200(2)
Marital status
202(1)
Age
203(2)
Race and ethnicity
205(2)
Health status/disability
207(2)
Sexual orientation
209(1)
Rights relating to information, education, and decision-making
209(1)
The right to receive and to impart information
209(2)
The right to education
211(2)
The right to freedom of thought, conscience, and religion
213(2)
Progress and Challenges
215(1)
Implementation of Legal and Human Rights Principles
216(39)
Overview
216(1)
Human Rights Needs Assessment
217(4)
Clinical care
218(1)
Health systems
218(1)
Underlying conditions, including social, economic, and legal conditions
219(2)
Development of Legal Claims
221(9)
Identify the wrong, its causes, and the wrongdoer
221(1)
Document the alleged wrongs
222(2)
Determine which laws are implicated
224(1)
Identify standards by which to determine whether and how laws are violated
225(3)
Assess how to pursue effective remedies
228(1)
Determine which agencies or individuals are bound to provide remedies
229(1)
Advancement of Legal Claims
230(25)
National procedures
230(1)
Implementation of legal and human rights principles
231(3)
Courts of law
234(2)
Criminal law approaches
236(2)
Civil (non-criminal) law approaches
238(2)
Alternative dispute resolution
240(2)
Regulatory and disciplinary approaches
242(1)
The international exception
243(2)
Legislative approaches
245(2)
Human rights commissions
247(1)
Ombudsmen
247(1)
Regional and international approaches
248(1)
Reporting procedures
249(1)
Complaint procedures
250(1)
Inquiry and communications procedures
251(4)
Part II. From Principle to Practice
Overview
255(7)
Methodology
256(3)
Choice and Sequence of Case Studies
259(3)
Female Genital Cutting (Circumcision/Mutilation)
262(14)
Background
262(2)
Medical Aspects
264(2)
Ethical Aspects
266(2)
Legal Aspects
268(2)
Human Rights Aspects
270(2)
Approaches
272(4)
Clinical duty
272(1)
Health care systems obligations
273(1)
Social action for underlying conditions
273(1)
The health approach
273(1)
The cultural approach
273(1)
The women's empowerment approach or the development/gender approach
274(1)
The ethical/legal/human rights approach
274(2)
An Adolescent Girl Seeking Sexual and Reproductive Health Care
276(11)
Background
276(2)
Medical Aspects
278(3)
General points
278(1)
Sexuality
278(1)
Sexually transmitted infections and contraception in adolescents
279(1)
Adolescent pregnancy
279(2)
Ethical Aspects
281(1)
Legal Aspects
282(1)
Human Rights Aspects
283(1)
Approaches
284(3)
Clinical duty
284(1)
Health care systems obligations
285(1)
Social action for underlying conditions
286(1)
Sexual Assault and Emergency Contraception
287(11)
Background
287(2)
Medical Aspects
289(1)
Ethical Aspects
290(1)
Legal Aspects
291(2)
Human Rights Aspects
293(2)
Approaches
295(3)
Clinical duty
295(1)
Health care systems obligations
295(2)
Social action for underlying conditions
297(1)
Hymen Reconstruction
298(7)
Background
298(1)
Medical Aspects
299(1)
Ethical Aspects
299(1)
Legal Aspects
300(1)
Human Rights Aspects
301(1)
Approaches
302(3)
Clinical duty
302(1)
Health care systems obligations
303(1)
Social action for underlying conditions
303(2)
A Request for Medically Assisted Reproduction
305(10)
Background
305(1)
Medical Aspects
306(1)
Ethical Aspects
307(2)
Legal Aspects
309(2)
Human Rights Aspects
311(1)
Approaches
312(3)
Clinical duty
312(1)
Health care systems obligations
313(1)
Social action for underlying conditions
314(1)
Involuntary Female Sterilization
315(8)
Background
315(1)
Medical Aspects
316(1)
Ethical Aspects
317(1)
Legal Aspects
318(1)
Human Rights Aspects
319(1)
Approaches
320(3)
Clinical duty
320(1)
Health care systems obligations
320(1)
Social action for underlying conditions
321(2)
Counselling and Caring for an HIV-Positive Woman
323(13)
Background
323(1)
Medical Aspects
324(1)
Ethical Aspects
325(3)
Legal Aspects
328(1)
Human Rights Aspects
328(1)
Approaches
329(7)
Clinical duty
329(2)
Health care systems obligations
331(1)
Social action for underlying conditions
332(4)
HIV Drug Research and Testing
336(9)
Background
336(1)
Medical Aspects
337(1)
Ethical Aspects
337(2)
Legal Aspects
339(1)
Human Rights Aspects
340(1)
Approaches
341(4)
Clinical duty
341(1)
Health care systems obligations
342(1)
Social action for underlying conditions
343(2)
Responding to a Request for Pregnancy Termination
345(11)
Background
345(2)
Medical Aspects
347(1)
Ethical Aspects
348(2)
Legal Aspects
350(1)
Human Rights Aspects
351(2)
Approaches
353(3)
Clinical duty
353(1)
Health care systems obligations
353(1)
Social action for underlying conditions
354(2)
Prenatal and Pre-Implantation Genetic Diagnosis for Risk of Dysgenic Inheritance
356(7)
Background
356(1)
Medical Aspects
357(1)
Ethical Aspects
357(1)
Legal Aspects
358(1)
Human Rights Aspects
359(1)
Approaches
360(3)
Clinical duty
360(1)
Health care systems obligations
361(1)
Social action for underlying conditions
361(2)
Sex-Selection Abortion
363(9)
Background
363(1)
Medical Aspects
364(1)
Ethical Aspects
365(2)
Legal Aspects
367(1)
Human Rights Aspects
368(1)
Approaches
369(3)
Clinical duty
369(1)
Health care systems obligations
370(1)
Social action for underlying conditions
370(2)
Treating a Woman with Incomplete Abortion
372(6)
Background
372(1)
Medical Aspects
373(1)
Ethical Aspects
374(1)
Legal Aspects
374(1)
Human Rights Aspects
374(1)
Approaches
375(3)
Clinical duty
375(1)
Health care systems obligations
376(1)
Social action for underlying conditions
377(1)
Confidentiality and Unsafe Abortion
378(7)
Background
378(1)
Medical Aspects
379(1)
Ethical Aspects
380(1)
Legal Aspects
381(1)
Human Rights Aspects
381(1)
Approaches
382(3)
Clinical duty
382(1)
Health care systems obligations
383(1)
Social action for underlying conditions
384(1)
Domestic Violence
385(8)
Background
385(1)
Medical Aspects
386(1)
Ethical Aspects
387(1)
Legal Aspects
388(1)
Human Rights Aspects
389(1)
Approaches
390(3)
Clinical duty
390(1)
Health care systems obligations
391(1)
Social action for underlying conditions
391(2)
A Maternal Death
393(12)
Background
393(1)
Medical Aspects
394(1)
Ethical Aspects
395(2)
Legal Aspects
397(1)
Human Rights Aspects
398(1)
Approaches
399(6)
Clinical duty
399(1)
Health care systems obligations
399(1)
Social action for underlying conditions
400(5)
Part III. Data and Sources
Reproductive Health Data
405(23)
World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects
428(5)
Human Rights Treaties and UN Conference Documents
433(4)
International Human Rights Treaties
433(1)
Regional Human Rights Treaties
434(2)
UN Conference Documents
436(1)
Human Rights Relating to Reproductive and Sexual Health
437(8)
States Parties to Human Rights Treaties
445(18)
Human Rights Treaty Committees: General Recommendations/Comments
463(47)
Committee on the Elimination of Discrimination against Women, General Recommendation 19: Violence against Women
463(6)
Committee on the Elimination of Discrimination against Women, General Recommendation 24: Women and Health (Article 12)
469(8)
Committee on Economic, Social and Cultural Rights, General Comment 14: The Right to the Highest Attainable Standard of Health (Article 12)
477(22)
Human Rights Committee, General Comment 28: Equality of Rights between Men and Women (Article 3)
499(8)
Committee on the Elimination of Racial Discrimination, General Recommendation 25: Gender Related Dimensions of Racial Discrimination
507(3)
Summary of the International Guidelines on HIV/AIDS and Human Rights (1996)
510(3)
Sample Application to Petition a Human Rights Treaty Body
513(4)
Annotated Table of Cases 517(9)
Select Bibliography by Chapter 526(6)
Annotated Listing of Relevant Websites 532(11)
Index 543

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