Round table: Liberté, égalité and fraternité in public health - A Human rights approach to Public (Mental) Health
Authors:   Organised by: EUPHA, EUPHA (PMH), EUPHA (ETH) Chair persons: Jutta Lindert - EUPHA (PMH)
Published: November 2019

Abstract

A human rights based approach to Public Health and to Public Mental health offers an opportunity to realize the right to health for all. However, a human rights-based approach to Public Health will require new inter-disciplinary approaches and an innovative frame. This frame should include the use of international human rights standards as a framework for research, policy and practice; the participation of target groups; and the enhancement of inclusion and respect for all. This workshop follows up from the Ljubljana 2018 workshop on human rights and public (mental) health and aims to test the requirements needed to ensure a human rights based approach to public health. For this, a panel of a researcher, ethicist, lawyer and a patient is set up to evaluate three practical cases. What are they advising in these specific cases and what does this mean for the international human rights framework. The outcomes of the panel discussion will be presented by the chair of the workshop.

Case 1
Coerced sterilization in the UK
The parents of a 21-year old woman with Down’s syndrome in the UK contacted a doctor to have their daughter sterlised our of fear that she may become pregnant. The woman did not have a bodyfriend nor expressed an interest in starting a sexual relationship. The parents stated that - as she had grown up - she had become more aware of the opposite sex and could be “overfamiliar” with people. Therefore sterilisation was needed to protect her in the future. A specialist supported the parents, but a second doctor suggested various methods of contraception as an alternative.

Case 2
Euthanasia in the Netherlands
A 74-year old incapacitated women with dementia stated several times that she does not want to live anymore. But she has also been heard saying that she likes her life. Under Dutch law, euthanasia is possible if the patient clearly indicates this, the so-called living-will. In this case, the doctor performed euthanasia based on her living will, which was given years earlier, before she was struck by dementia.

Case 3
Rape in Northern Ireland
A 12-year-old girl from Northern Ireland is raped. Abortion is not possible in this case due to the strict laws prohibiting abortion unless the woman’s life is in danger or there is a permanent or serious risk to her mental or physical health. The girl has to travel to England under police escort to have an abortion, so that a police officer could seize the ‘samples’ from the procedure for evidence.

Key messages
A human rights based approach to Public Health and to Public Mental health offers an opportunity to realize the right to health for all. It is critical that we do not risk losing the right to health in the rhetoric of the SDGs and ensure that we respond to the need of improving research methods on the promise of leaving no one behind.
Mauro Giovanni Carta
Contact: mgcarta@tiscali.it
Dineke Zeegers Paget
Contact: d.zeegers@euphaoffice.org
Els Maeckelberghe
Contact: e.l.m.maeckelberghe@umcg.nl