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From Health or Human Rights
to Health and Human Rights:
Where Do We Go From Here?

Nahid F. Toubia, M.D.
Excerpted from  International Journal of Health and Human Rights, vol. 1, no. 2, 1995
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(from text presented at the First International Conference on Health and Human Rights,
Harvard University, Cambridge, MA, USA, 24 September 1994)

NOHARMM feels that the following passages are especially meaningful to the discussion of male genital cutting customs.

  "Adoption of a human rights paradigm has the potential to revolutionize the health field. The human rights principle that "all human beings are born free and equal in dignity and rights" is a powerful concept in spite of its simplicity. By applying the principle of equality to health, we have no choice but to examine the relationship between the individual and all those who have power to affect his or her health."

  "In general, the medical literature reports only on disease resulting from ‘natural’ causes, while physical and psychological ill-health resulting from violations by the state, society or the family are rarely cited."

  "In the field of preventive medicine, we are often faced with the difficult choice between fostering public good and sustaining individual choice. …Forced abortions and sterilizations, abuse of injectables, implants and other provider controlled methods have all been reported."

  "The field of health and human rights will, in many cases, examine long-standing and recognized health issues from a new angle. …The use of the human rights paradigm will require combining health knowledge with knowledge of law and ethics."

"In order to develop new human rights principles or revise old ones, the health and human rights field will have to go the source: ethicists and thinkers, both religious and nonreligious, from all cultures. Their recruitment will be necessary in advancing the field of health and human rights beyond existing laws and treaties."

  "The human rights field operates in such a way as to protect the individual from the vicissitudes of power that impact his or her life. In the field of health, this power may be the state; international policies and programs; multinational and local drug companies; the medical establishment; and finally, the family and community."

  "Individuals and groups who wield least power need increased social and legal protection. Particularly vulnerable are women, the illiterate and poor, the disabled, ethnic and racial minorities, indigenous people and children. In our research and analysis of health and human rights, we must be particularly mindful of the vulnerability of these groups, and of other power imbalances that may prevail in a particular society."

  "A major and common conflict that should be addressed by those developing rights principles is the conflict between individual and group rights. Because human beings live in community with one another, there must be a limit at which individual rights end and group rights begin. On the other hand, group rights are often invoked to suppress individual freedoms and the right to self-determination. Human rights professionals must invoke a dialogue between citizens of Western societies (particularly in the United States, where individual rights are asserted to the maximum) and citizens of Eastern societies (where communal and group values predominate). Each system has its benefits and drawbacks, and both have valuable contributions to make to global human rights principles."

  "This brings us to another major conflict in the human rights field: that of universality vs. cultural relativism. Undoubtedly, many cultures differ as to what constitutes a right, a voluntary common courtesy, or a violation. …The best approach to such cultural differences is to involve individuals from different cultures and religions committed to establishing human rights principles in a constructive process - one that transcends differences and emphasizes the human rights principles common to all cultures and belief systems. Those developing the mechanism for such a process must curtail the prevailing biases in Western cultures, including a certain degree of dominance in the human rights field and attitudes of cultural superiority."

  "Better definition of health rights concepts: For example, what do we mean by guardianship, and to what extent is the guardian of a minor allowed to make decisions on that minor’s behalf? The issue of circumcision for both female and male children may be a good example to pursue. For another, the age of consent itself needs to be better defined and standardized."

  "Consent is another concept that should be explored, on the basis of age, ability to make sound decisions and presence of overt or subtle coercions. Probably the most difficult to define, social and economic coercion could be the strongest and most common forms of coercion worldwide."

Nahid Toubia, M.D. is a physician and surgeon from Sudan, and currently Associate Professor at Columbia University, School of Public Health, New York. She is director of the women’s reproductive health organization RAINBO.

More Pages Related to Male & Female Circumcision

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