PERSONS WITH DISABILITIES AND THEIR SEXUAL,REPRODUCTIVE, AND PARENTING RIGHTS: AN INTERNATIONAL AND COMPARATIVE ANALYSIS

Despite important gains in human rights, persons with disabilities — and in particular women and girls with disabilities — continue to experience significant inequalities in the areas of sexual, reproductive, and parenting rights. Persons with disabilities are sterilized at alarming rates; have decreased access to reproductive health care services and information; and experience denial of parenthood. Precipitating these inequities are substantial and instantiated stereotypes of persons with disabilities as either asexual or unable to engage in sexual or reproductive activities, and as incapable of performing parental duties. The article begins with an overview of sexual, reproductive, and parenting rights regarding persons with disabilities. Because most formal adjudications of these related rights have centered on the issue of sterilization, the article analyzes commonly presented rationales used to justify these procedures over time and across jurisdictions. Next, the article examines the Convention on the Rights of Persons with Disabilities and the attendant obligations of States Parties regarding rights to personal integrity, access to reproductive health care services and information, parenting, and the exercise of legal capacity. Finally, the article highlights fundamental and complex issues requiring future research and consideration.     

Civic Conscience,Selective Conscientious Objection and Lack of Choice

Most democratic states tolerate, to various extents, conscientious objection. The same states tend not to tolerate acts of civil disobedience and what they perceive as selective conscientious objection. In this paper it is claimed that the dichotomy between civil disobedience and conscientious objection is often misguided; that the existence of a “civic conscience” makes it impossible to differentiate between conscientious objection and civil disobedience; and that there is no such thing as “selective” conscientious objection—or that classifying an objection as “selective” has no significant moral or practical implications. These claims are supported by a preliminary, more general argument according to which conscientious objection is and should be tolerated because the objector lacks the ability to choose his conscience and to decide whether to act upon it. The lack‐of‐choice argument, it is claimed, applies equally to all types of conscientious objection, including those that are mistakenly called “selective” objection. It also applies to one type of civil disobedience. As a result, if a state is willing to tolerate non‐selective conscientious objection, it may and at times must also tolerate selective conscientious objection and (one type of) civil disobedience and to a similar degree (all other things being equal).     

Human rights dynamics of abortion law reform

The legal approach to abortion is evolving from criminal prohibition towards accommodation as a life-preserving and health-preserving option, particularly in light of data on maternal mortality and morbidity. Modern momentum for liberalization comes from international adoption of the concept of reproductive health, and wider recognition that the resort to safe and dignified healthcare is a major human right. Respect for women's reproductive self-determination legitimizes abortion as a choice when family planning services have failed, been inaccessible, or been denied by rape. Recognition of women's rights of equal citizenship with men requires that their choices for self-determination be legally respected, not criminalized.     

Doctors and allocation decisions: a new role in the new Medicare

The role of the physician in the allocation of health care resources has come under renewed scrutiny in recent years. Doctors have always had to face the reality of scarce resources and to do their work in the context of social injustices. With the advent of Medicare and Medicaid came the rhetoric of universal access and the "right to health care." At the same time the field of bioethics was emerging and contributing ideas about other kinds of rights, such as the right to die with dignity. Physicians during this time did not see their role as that of gatekeeper, but rather as advocate for the best care for each individual patient. The 1980s has brought a new awareness of limited resources and the necessity for a rationale for allocation of resources. These social and professional shifts have confronted physicians with the need for yet another shift in their ethical stance. If they are to take part in allocation decisions, for the continued well-being of their patients and of the public health, they will need a new perspective on biomedical ethics. This role can be an ethical one for physicians providing certain criteria are met: there must be universal access to a basic minimum level of care, physicians' levels of income must not be directly related to treatment choices, there must be a closed financial system within which meaningful trade-offs can be made, and there must be an ethically acceptable framework for decision-making.     

Charter rights & health care funding: a typology of Canadian health rights litigation

Canadian health consumers have increasingly relied on the Charter of Rights and Freedoms to demand certain therapies and reasonably timely access to care. Organizing these cases into a 5-part typology, we examine how a rights-based discourse affects allocation of health care resources. First, successful Charter challenges can, in theory, lead to courts granting and enforcing positive rights to therapies or to timely care. Second, courts may grant a right to certain health services; however, subsequently government fails to deliver on this right. Third, successful litigation may create negative rights, i.e. rights to access care or private health insurance without government interference. Fourth, consumers can fail in their legal pursuit of a right but galvanize public support in the process, ultimately effecting the desired policy changes. Lastly, a failed lawsuit can stifle an entire advocacy campaign for the sought-after therapies. The typology illustrates the need to examine both legal and policy outcomes of health right litigation. This broader analysis reveals that the pursuit of health rights seems to have caused largely a regressive rather than progressive impact on Canadian Medicare.     

Decriminalisation of abortion performed by qualified health practitioners under the Abortion Law Reform Act 2008 (Vic)

In 2008, the Victorian Parliament enacted the Abortion Law Reform Act 2008 (Vic) and amended the Crimes Act 1958 (Vic) to decriminalise terminations of pregnancy while making it a criminal offence for unqualified persons to carry out such procedures. The reform legislation has imposed a civil regulatory regime on the management of abortions, and has stipulated particular statutory duties of care for registered qualified health care practitioners who have conscientious objections to terminations of pregnancy. The background to, and the structure of, this novel statutory regime is examined, with a focus on conscientious objection clauses and liability in the tort of negligence and the tort of breach of statutory duty.     

Rules for Rights: European Law,Health Care and Social Citizenship

Social citizenship is about equality. The obvious problem for European social citizenship in a very diverse Union is that Member States will not be able or willing to bear the cost of establishing equal rights to health care and similar aspects of social citizenship. Health care is a particularly good case of this tension between EU citizenship and Member State diversity. The European Court of Justice (ECJ) strengthened the right to health care in other Member States, but this cannot create an equal right to health care when Member States are so different. In its efforts to balance a European right, the Court has formulated ‘rules for rights’—not so much European social citizenship rights, as a set of legal principles by which it judges the decisions of the Member States.     

Pediatric Assent: Subject Protection Issues among Adolescent Females Enrolled in Research

Re-assent of adolescent females enrolled in clinical research through the onset of puberty is necessary to respect their rights to access sexual and reproductive health information, their rights under HIPAA as well as assuring compliance with the Common Rule.     

Claiming the Right to Health in Brazilian Courts: The Exclusion of the Already Excluded?

The aim of this article is to test a widespread belief among Brazilian legal scholars in the area of social rights, namely, the claim that courts are an alternative institutional voice for the poor, who are usually marginalized from the political process. According to this belief, social rights litigation would be a means (supposedly “a better means”) of realizing rights such as the right to health care, since supposedly both the wealthy and the poor have equal access to the courts. To probe the consistency of this belief, we analyzed the socioeconomic profiles of plaintiffs in the city of Sao Paulo (Brazil) who were granted access to specific medications or medical treatments by judicial decisions. In this study, the justiciability of social rights has not proven to be a means of rendering certain public services more democratic and accessible.     

Reproductive choice: screening policy and access to the means of reproduction

The practice of screening potential users of reproductive services is of profound social and political significance. Access screening lacks a defensible rationale, is inconsistent with the principles of equality and self-determination, and violates individual and group human rights. Communities that strive to function in accord with those principles should not permit access to screening, even screening that purports to be a benign exercise of professional discretion. Because reproductive choice is controversial, regulation by law my be required in most jurisdictions to provide effective protection for reproductive rights. In Canada, for example, equal access can, and should be, guaranteed by federal regulations imposing strict conditions on the licenses of fertility clinics.     

Evidence on women trafficked for sexual exploitation: A rights based analysis

The aim of this paper is to investigate which factors influence the pattern of enforcement (violation) of basic rights among women trafficked for sexual exploitation. A conceptual framework is adopted where the degree of agency and the possibility to influence the terms of sex-based transactions are seen as conditional on the enforcement of some basic rights. Using data collected by the International Organization for Migration (IOM) on women assisted by the organization after having been trafficked for sexual exploitation, we investigate the enforcement (violation) of five uncompromisable rights, namely the right to physical integrity, to move freely, to have access to medical care, to use condoms, and to exercise choice over sexual services. By combining classification tree analysis and ordered probit estimation we find that working location and country of work are the main determinants of rights enforcement, while individual and family characteristics play a marginal role. Specifically, we find that (1) in lower market segments working on the street is comparatively less ‘at risk’ of rights violation; (2) there is no consistently ‘good’ or ‘bad’ country of work, but public awareness on trafficking within the country is important; (3) the strength of organised crime in the country of work matters only in conjunction with other local factors, and (4) being trafficked within one’s country, as opposed to being trafficked internationally, is associated with higher risk of rights violation.     

论作为人权的医疗卫生服务保障权

健康权的争议性首先表现在健康权概念名称的争议性上。现有健康权、医疗权、卫生保健权等概念名称上的分歧,是因为忽略了各种权利所指向的义务对象和设定的义务内容的不同。作为基本人权针对国家并使国家承担建立医疗保障体系和公共卫生服务体系、保障和促进人民健康义务的积极权利是医疗卫生服务保障权,而不是健康权或其它权利。     

论性的私法调整

私法对性保护的缺失导致对性权利保护的不足,性权利本质上是私权,私法应该对性权利加以调整并创设性人格权.性人格权由性自主权、生育权构成.创设了性人格权后,可以解决实践中许多问题如:婚内强奸问题、强奸后精神损害赔偿问题等.     

Idle Rights: Employees' Rights Consciousness and the Construction of Sexual Harassment Policies

This article analyzes women's legal consciousness in responding to unwanted sexual attention in the workplace. By focusing on a particular social problem, this study is situated in the particular legal domain of sexual harassment laws and in a specific organizational context. Taking the perspective of the intended beneficiaries of sexual harassment policies and procedures—women with complaints about sexual conduct in the workplace—I show that the implementation of grievance procedures creates powerful obstacles to women's efforts to assert those rights. Moreover, the practices implementing the policies can alter the very definition of sexual harassment in that setting. Thus, in enacting grievance procedures, women and supervisors construct a legality in particular workplaces that offers only limited protection for women's rights.     

The right to refuse treatment and the movement for mental health reform

The right to refuse treatment is the most controversial of the rights of mental patients, and usually polarizes the movement for mental health reform between providers of care and external activist reformers. A broad alliance supported earlier struggles for recognition of patients' rights, but most professionals oppose recognizing this most extreme right of treatment refusal. Professional opposition to treatment refusal is not based on a wide extent of actual refusal; rather it derives from a defense against challenges to professional and institutional autonomy, an opposition to legal interference, and a belief that the community as well as the patient must be protected. These three reasons for opposition are examined by reviewing studies of attitudes toward patients' rights, knowledge about patients' rights, and implementation of patients' rights. Finally, the implications of these studies for future directions in the movement for patients' rights are examined.     

What is the goal of access to health care?

This article first examines the justifications for the goal of access to health care and the variations between health systems in their endorsement of individuals' rights to health care irrespective of income, ethnicity, age and other characteristics. It then examines the meanings of the goal of "access" to health care and considers four key dimensions--service availability ("having" access), service utilisation ("gaining" access), the relevance and effectiveness of services and equity of access. These dimensions provide a common framework that can be applied across countries and health systems and employed to assess the extent to which access to health care is actually achieved.     

The health and human rights movement: progress and obstacles

There is a new maturity about the health and human rights movement as it endeavours to integrate human rights into health policies at the national and international levels. In addition to the traditional human rights techniques, such as "naming and shaming", the movement is also using new approaches such as indicators, benchmarks and impact assessments. However, it is confronted with a range of major obstacles and this article focuses on two of them: the inadequate engagement within the health and human rights movement of (i) established human rights non-governmental organisations and (ii) health professionals. This article argues that established human rights non-governmental organisations should work on health and human rights issues, such as maternal mortality, just as vigorously as they already campaign on disappearances, torture and prisoners of conscience. Also, it emphasises that health and human rights complement and reinforce each other. Nevertheless, many health professionals have never heard of the right to the highest attainable standard of health. The article argues that there is no chance of operationalising the right to health without the active engagement of many more health professionals, and it makes some preliminary observations about steps that might be taken to deepen health professionals' engagement in the health and human rights movement.     

Regulating surrogacy--a contravention of human rights?

On the 2nd of October 2000, The Human Rights Act 1998 came into full force, signalling the incorporation of The European Convention on Human Rights into U.K. law. Areas of law believed to be inconsistent with the Convention may now be challenged in both The European Court of Human Rights and domestic courts. This article considers whether existing laws on the regulation of access to infertility services, in particular surrogacy, will be deemed incompatible with the ECHR. Human rights as enshrined within Articles 8 and 12 will be examined in light of recent suggestions that there may arise legal challenges by those who have had access to reproductive services restricted or denied. It will be shown that, although existing and potential future controls may arguably infringe these rights, it is nevertheless unlikely that they will be held to be in contravention of The Human Rights Act 1998.