Right to Health

Historically, the right to health was one of the last to be proclaimed in the Constitutions of most countries of the world. 

At the International level, the Universal Declaration of Human Rights established a breakthrough in 1948, by stating in Article 25: “Everyone has the right to a standard of living adequate for the health and well-being of himself and his family.” 

The Preamble to the WHO Constitution also affirms that “it is one of the fundamental rights of every human being to enjoy the highest attainable standard of health”. 

Inherent in the right to health is the right to health or medical care. Some countries have used the term “right to health protection” which is assured by a comprehensive system of Social Insurance that provides material security in cases of illness or accident and free medical education, medicaments and other necessary materials and the right to be cared for by society in old age .

In an increasing number of societies, health is no longer accepted as a charity or the privilege of the few, but demanded as a right for all. However, when resources are limited (as in most developing countries), the Governments cannot provide all the needed health services. Under these circumstances the aspirations of the people should be satisfied by giving them equal right to available health care services.

The concept of “right to health” has generated so many questions, viz, 

1. right to medical care, 

2. right to responsibility for health, 

3. right to a healthy environment, 

4. right to food, 

5. right to procreate (artificial insemination included), 

6. right not to procreate (family planning, sterilization, legal abortion), 

7. right of the deceased persons (determination of death, autopsies, organ removal) 

8. right to die (suicide, hunger strike, discontinuation of life support measures)

Many of these issues have been the subject of debate. It is left to the lawyers, ethicists and physicians to formulate a general outline of what is acceptable and what is unacceptable in human society.

Ecology of Health

Ecology is a key word in present- day health philosophy. It comes from the Greek “Oikos” meaning a house. Ecology is defined as the science of mutual relationship between living organisms and their environments. Human ecology is a subset of more general science of ecology.

A full understanding of health requires that humanity be seen as part of an ecosystem. The human ecosystem includes in addition to the natural environment, all the dimensions of the man-made environment — physical, chemical, biological, psychological. Disease is embedded in the ecosystem of man. Health, according to ecological concepts, is visualized as a state of dynamic equilibrium between man and his environment.

By constantly altering his environment or ecosystem by such activities as urbanization, industrialization, deforestation, land reclamation, construction of irrigation canals and dams, man has created for himself new health problems. For example, the greatest threat to human health in India today is the ever—increasing, unplanned urbanization, growth of slums and deterioration of environment. As a result, diseases at one time thought to be primarily “rural” (e.g., filariasis, leprosy) have acquired serious urban dimensions. The agents of a number of diseases, for example, malaria and kala—azar, which were effectively controlled have shown a recrudescence. The reasons for this must be sought in changes in the human ecology. Man’s intrusion into ecological cycles of disease has resulted in zoonotic diseases such as kyasanur forest disease, rabies, yellow fever, monkeypox, Lassa fever, etc. The Bhopal gas tragedy in 1984 highlights the danger of locating industries in urban areas. The nuclear disaster in Soviet Russia in April 1986 is another grim reminder of environmental pollution. The construction of dams, irrigation systems and artificial lakes has created ecological niches favouring the breeding of mosquitoes, snails and spread of filariasis, schistosomiasis and Japanese encephalitis. In fact, ecological factors are at the root of the geographic distribution of disease. Therefore it has been said that good public health is basically good ecology.

It is now being increasingly recognized that environmental factors and ecological considerations must be built into the total planning process to prevent degradation of ecosystems. Prevention of disease through ecological or environmental manipulations or interventions is much safer, cheaper and a more effective rational approach than all the other means of control. It is through environmental manipulations that diseases such as cholera, typhoid, malaria and hookworm disease could be brought under control or eliminated. The greatest improvement in human health thus may be expected from an understanding and modification of the factors that favour disease occurrence in the human ecosystem. Professor Rene Dubos believes that man’s capacity to adapt himself to ecological changes is not unlimited. Man can adapt himself only in so far as the mechanisms of adaptations are potentially present in his genetic code.