Access to health care kiev lecture 2015
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This document outlines the challenges to the right to health care from a comparative legal perspective. It discusses the meaning of the right to health care under international law, focusing on developments in general comments and monitoring obligations. It also examines how the right is incorporated into national laws globally and trends toward more explicit recognition. Case studies are presented on litigation of health care access at the European Court of Human Rights regarding issues like medical treatment for prisoners and rationing decisions by national courts. Future challenges are discussed such as expanding the definition of human rights in health, the role of courts and guidelines in addressing rationing dilemmas, and ensuring fair processes for decision-making. Relevance for Ukraine is also noted.
Access to health care kiev lecture 2015
- 1. Challenges to the Right to Health Care. A Comparative Perspective. Andr辿 den Exter
- 2. Outline Background Meaning of the Right to Health Care in International Law: Recent Developments The Right to Health Care in National law The Justiciability of Health Care Access: Case studies Future Challenges Relevance to the Ukraine?
- 3. Background Economic crisis & Increase health care costs Health care market reforms Rationale Health care access as a recognised human right Litigating healthcare access Rationing Role of the Legislature
- 4. Meaning of the Right to Health Care in International Law: Recent Developments Art. 12 (1) ICESCR highest attainable standard of physical and mental health Art 12(2) Steps to be taken to achieve the full realisation of this right, in particular .... General Comment on Health No. 14: - Minimum core obligations - Typology of obligations - AAAQ - Progressive realisation & no retrogressive measures Monitoring health care access and human rights indicators
- 5. The Right to Health Care in National law: Global Trends Constitutional / Statutory Right Explicit or implicit recognition Constitutional commitments: - equitable distribution and non-discriminatory access - treaty obligations outlined in international law - irrespective the health care model Monitoring and review system (accountability)
- 6. The Justiciability of Health Care Access: Case studies at the European Human Rights Court Medical asylum seekers D. v. UK, App. no. 30240/96 (St Kitts): Deportation AIDS infected patient subject to inhuman treatment? Prisoners G. v. France, App no. 27244/09: Lack specialized treatment/ psychiatric supervision and inappropriate conditions detention: Inhuman degrading treatment Non-listed treatment methods Panaitescu v Romania, App no 30909/06 (ECtHR, 10 April 2012): denial of life saving medicine; breach right to life Hristozov v. Bulgaria, App no 47039/11 and 358/12 (ECtHR, 13 November 2012: no obligation to regulate access to unauthorised medicines
- 7. The Justiciability of Health Care Access: Rationing by national courts UK: Swindon NHS Primary care Trust (Herceptin litigation) Netherlands: Cost sharing under Health Insurance Act annuled under ILO Convention 102/ECSS provisions (29-5- 1996, 8-9-2006) Poland and Czech R.: Introduction HIS and Co-payments: (restricting benefits); (K 8/96, 275 and K7/95, 414; Pl. US 1/08, 23 September 2008) Austria: Viagra and Human Rights; OGH (10 ObS 12/06x):
- 8. The Justiciability of Health Care Access (2): Tragic cases New medical technologies and limited cost-effectiveness Germany: BVG 6 Dec 2005 (Nikolaus Beschluss): lifesaving (experimental) medicine Constitutional rights & likely positive effect on the course of the disease Switzerland: Fed. Supreme Crt. (Myozyme case), 23 Nov 2010 Cost-effectiveness threshold 100.000 CHF QALY Policy Implications: Transparent criteria & Rationing Procedure
- 9. Future Challenges Rationing and Role Judiciary Innovative approach: Expanding definition human rights & measuring States progressive realisation Courts referral to and applying Oviedo Convention, art. 3 Role of the EU Court Justice and EU Human Rights Charter Democratic debate on Rationing decision-making and moral dilemmas Importance of professional guidelines/protocols, adressing both clinical and cost-effectiveness & human rights arguments Fair rationing
- 11. References A. den Exter, Health care Law-making in CEE. Review of a Legal- Theoretical Model, Maklu Press (2002) A. den Exter and M. Buijsen (eds.), Rationing Health Care. Hard choices and unavoidable trade-offs, Maklu Press (2010) A. den Exter (ed). Compendium of European Health Law, Maklu Press (2016) /www.bmg.eur.nl/english/research/eu_projects/jean_monnet_programme / Contact: denexter@bmg.eur.nl