Human Rights and Global Justice

Question 1

What is the main consequence of trachoma infection.

Answer 1

Blindness.

Question 2

What are some statistics associated with trachoma infection. (3)

Answer 2

Causes blindness in approximately 1.2 million people.
Up to 8 million people visually impaired.
Approximately 70 million sufferers worldwide.

Question 3

Where is trachoma most prevalent? (2)

Answer 3

Africa.

Latin America.

Question 4

How many new trachoma cases are there per year?

Answer 4

2 million.

Question 5

What is the causative organism of trachoma?

Answer 5

Chlamydia trachomatis.

Question 6

What fly is responsible for the spread of trachoma infection.

Answer 6

Musca sorbens.

Question 7

Where does the musca sorbens fly breed?

Answer 7

Human faeces.

Question 8

What is the natural history of trachoma infection.

Answer 8

Infection causes inner eyelid inflammation.
Repeated infection causes scarring and eyelids turn inwards, scarring cornea and causing pain and eventual blindness and disfigurement.

Question 9

Who is most at risk of sight threatening disease in trachoma infection.

Answer 9

Women are 3 times more likely to suffer sight threatening disease than men.

Question 10

What is the underlying cause of the prevalence of trachoma?

Answer 10

Lack of access to clean water.

Question 11

What is the treatment for late stage trachoma.

Answer 11

Eyelid surgery.

Question 12

What is the infant mortality in Africa.

Answer 12

Up to 35%

Question 13

What and where is the highest life expectance.

Answer 13

Japan - 83.7 years.

Question 14

What and where is the lowest life expectancy.

Answer 14

Sierra Leone - 50.1 years.

Question 15

What is the libertarian position? (3)

Answer 15

Individual liberty is the primary moral value.
The duty of the state is the protect individual liberty.
There is no moral duty to help others.

Rationale: If I choose to work hard, it is right that I should reap the profits….Provided my gains are honestly earned I have no moral obligation to help those less fortunate….Any form of redistribution is unjust and equivalent to theft.

Question 16

What is the libertarianism stance on ‘bad luck’?

Answer 16

That some people are born into poverty and extreme hardship due to bad luck….It is up to us as individuals to make the most of our talents and to overcome our weaknesses.

Question 17

What is the libertarianism stance on global health inequalities? (2)

Answer 17

Global health inequalities are unfortunate, but are not an ethical concern.
There is no moral obligation to help those less fortunate but, individuals are at liberty to help those in need of charity.

Question 18

What are the benefits of charity? (2)

Answer 18

Charity fosters kindness and empathy.

Such kindness fosters a sense of interdependence and makes communities morally and socially richer.

Question 19

What is the problem with charity? (2)

Answer 19

With charity recipients are dependent on the action of donors. They have no entitlement to such assistance.
If individuals are dependent on charity to meet their basic needs, the autonomy of the recipient is undermined

Question 20

What is the utilitarian approach? (2)

Answer 20

The morally right thing to do is that which brings about the maximum happiness or well being overall.
All other things being equal, utilitarianism requires us take the actions which save more lives or reduce the most suffering.

Question 21

What is the utilitarian stance on acts and omissions? (2)

Answer 21

Under any consequentialist approach we are as morally responsible for our omissions as we are for our actions if the net result is the same.
Therefore, if we fail to take a particular action to prevent suffering, we are as morally responsible as if we had directly caused that suffering.

Question 22

What is the utilitarian stance on global health?

Answer 22

Rather than using our resources to improve our already comfortable lives, a utilitarian approach would require us to divert all out resources until all health inequalities had been removed.
It does not recognise an individual rights to health.

Question 23

Define solidarity.

Answer 23

A sense of standing together when individuals or the community are threatened.

Question 24

What are the principles of solidarity? (3)

Answer 24

The group shares risks, burdens, threats.
Does not require analysis of consequences.
Requires sense of shared values.

Question 25

What are the principles of justice (3)

Answer 25

Justice is concerned with the reciprocal relationship between individuals and society. It carries the fundamental notion that all humans are equally values. Justice requires that equals are treated equally.

Question 26

How does justice apply to global health? (3)

Answer 26

Amartya Sen has argued that if we value all human lives equally then justice requires that we ensure that all individuals have an equal capability to flourish/pursue lives of value. Decent health and access to health care are necessary to achieve a minimally decent life. Therefore, decent access to healthcare is fundamental to individual flourishing and therefore is a matter of justice

Question 27

How does justice relate to human rights? (4)

Answer 27

Human Rights exist as both moral claims and legal entitlements. Moral rights are a special form of moral claim which impose a moral obligation on others to ensure such claims are upheld. These rights apply to everyone whether or not the individuals are aware that the right exists. Legal rights are legally enforceable entitlements

Question 28

What is the Human Rights Act 1998?

Answer 28

It incorporates the European Convention on Human Rights into English Law.

Question 29

Who is the 1998 HRA enforceable against?

Answer 29

Public authorities, NOT individuals or private bodies.

Question 30

What areas of the NHS are affected by the HRA? (6)

Answer 30

``` Refusal of treatment. Medical confidentiality. Compulsory treatment and detention. Withdrawal of life sustaining treatment. Abortion. Assisted suicide. ```

Question 31

What are the most important articles of the HRA? (4)

Answer 31

Articles 2, 3, 5, 8.

Question 32

What is Article 2 of the HRA?

Answer 32

Right to life. The right is absolute with respect to intentional killing. Not all avoidable death counts as intentional killing. There is no absolute obligation to provided life saving treatment. Withdrawal of futile treatment will not breach article 2. The right does not extend to the foetus.

Question 33

What is Article 3 of the HRA?

Answer 33

Prohibition of torture. This right is absolute - lack of resources, manpower are not justifications for inhuman or degrading treatment. Non-consensual treatment of an incompetent individual may contravene article 3 if it is not therapeutically necessary. Excessive restraint may contravene article 3. Failure to stop an individual’s suffering will only breach article 3 if the suffering is inhuman and due to the State’s actions.

Question 34

What is Article 5 of the HRA?

Answer 34

Right to liberty. This right is not absolute. Detention is lawful if necessary for a mental illness. Individuals must have access to an effective and speedy means of challenging detention - Appeal process under Mental Health Act; Deprivation of Liberty Safeguards.

Question 35

What is Article 8 of the HRA?

Answer 35

Right to a private life. This right is not absolute. Protects a patient’s right to confidentiality. Protects the right to refuse medical treatment even if life saving. Article 8 will not be contravened if a breach is in accordance with the law AND is necessary in a democratic society.

Question 36

B is a 61 year old man who attends A+E with a history of fever and cough. He is a heavy smoker but denies any previous health problems. The on call FY2 Dr R sustains a needlestick injury whilst taking an arterial blood gas. Dr R’s consultant is informed and asks B if he would be willing to have an HIV test. B refuses. Dr R does not want to take post exposure prophylaxis unless it is necessary. How would you advise Dr R? 1. Dr R should go back and try to persuade B to consent to the test. 2. Performing the HIV test without consent would breach B’s article 8 rights. 3. Dr R should ask the lab to do a CD4 count instead. 4. B must consent to the test as otherwise it would be a breach of Dr R’s human rights under Article 3. 5. The hospital must perform the HIV test otherwise it will contravene Dr R’s right to life under article 2.

Answer 36

2. Performing the HIV test without consent would breach B’s article 8 rights

Question 37

What is the Universal Declaration of Human Rights 1948 Article 25.

Answer 37

Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services…

Question 38

What country had the second highest number of HIV/AIDS cases in the world in the 1990s?

Answer 38

Brazil.

Question 39

What does the World Bank advocate for in terms of HIV/AIDS?

Answer 39

Investment in prevention programs rather than treatment of infected individuals.

Question 40

What legislation did Brazil pass in 1996?

Answer 40

Statutory requirement for free universal access to anti-retrovidal therapy. However, high cost of anti-retrovirals threatened sustainability of the programme - Manufacture of antiretrovirals locally. Challenge to WTO TRIPS (Trade Related aspects of Intellectual Property Rights) agreement --> Mobilisation of global political will to find fair solution, led to new interpretation of TRIPS in 2001 WTO Doha. Intellectual property rights could be waived in the face of a national public health emergency. Allowed Brazil to manufacture generic antiretrovirals saving $100million/year. HIV mortality reduced by 50%. Hospitalisation for HIV/AIDS reduced by over 70%.

Question 41

What is the 1961 Suicide Act.

Answer 41

Acts capable or intended to encourage or assist suicide or attempted suicide are unlawful.

Question 42

What was result of the Dianne Pretty case.

Answer 42

2001 House of Lords judgement ruled article 2,3 and 8 not engaged. 2002, European Court of Human Rights said that article 8 was engaged, but not contravened.

Question 43

What was the reasoning of the Debbie Purdy case?

Answer 43

115 people had travelled to Switzerland for assisted suicide between 1999-2009. Only 8 cases referred to Crown Prosecution Service. No prosecutions. House of Lords judgement - Failure to provide public guidance on criteria for prosecution contravenes article 8.