The work of advancing human rights on the part of physicians is often portrayed as laudable but supererogatory to the daily demands of the medical profession in the United States. Much of this sentiment can be traced to the mistaken belief that human rights issues are only present abroad and can only, therefore, be addressed in foreign contexts. It is my goal to address this perceived separation of human rights knowledge and work from the good practice of medicine in hopes of elucidating how inextricably linked the two truly are.
Perhaps the easiest way to demonstrate the centrality of advocacy to the proper practice of medicine is to shine a light on the practical value of human rights knowledge to a physician. A brief glance through the Universal Declaration of Human Rights illuminates several medical cases such as pregnancy complications “When a child is married off before her body has matured (a violation of Article 16)” or the denial of the right of free assembly to those with HIV. While we often think of situations like this as foreign both to our nation and our experience an awareness of them is essential to American practice. America is, after all, a nation of immigrants meaning many potential patients bring with them scars both physical and psychological from around the globe.
Pressing as the cases physician’s handle with respect to their immigrant patients are, it is vital and perhaps even more powerful to evaluate the profession’s duty with respect to the human rights issues found squarely within our own borders. Perhaps the most striking of these is human trafficking. Each year approximately 1 million adults and 400,000 children are presumed to be at risk for sex trafficking on American soil. These statistics make it very clear that trafficking is very much an American human rights issue, one for which the import of physician knowledge and appropriate response cannot be underestimated as approximately a substantial percentage of trafficked persons have contact with a healthcare provider. ER physicians may treat a broken bone or STD, dentists may see a victim for a chronic issue that needs to be addressed, while surgeons may unwittingly perform cosmetic operations designed to improve a victim’s attractiveness and overall value. Another rights issue perhaps less attention-grabbing yet equally present in our own communities that of infant mortality. The U.S. lags other developed countries with respect to this issue in large part due to significant gaps in access to and utilization of prenatal and preconception care often associated with the history of racial and ethnic disparities in maternal and infant outcomes in the U.S. As with so many health conditions black women and their infants are at the greatest risk and have the highest rates of poor outcomes. What this reality makes plain is that even if they simply strive to be more effective and vigilant with respect to their patient care physicians are in fact applying and benefiting clinically from human rights frameworks.
As I have hopefully conveyed even in the best circumstance an awareness of human rights issues plays a key role in the practice of medicine. Presently, however, we are not in the best circumstance and so this commitment is even more important as we work to address deleterious issues like human trafficking and profound health disparities. Hippocrates once asserted that “Wherever the art of medicine is loved, there is also a love of humanity.” To this should be added the amendment that where humanity is imperiled there should also be medicine pushing back.