Mandatory Public Health Programs: To What Standards Should They Be Held?

Abstract

Implicitly and explicitly, human rights have played a significant role in public health debates for decades. At the turn of the century, when health department officials in the United States were debating measures to control sexually transmitted diseases, it was argued that "the progress of preventive medicine has been a history of the conflict between the so-called rights of the individual and the higher rights of the community."' In the U.S., the government has historically treated human rights in the area of infectious disease control differently than in any other area of social policy. In comparing the Department of Health to other municipal departments in New York, Stephen Smith, a Department of Health member from its establishment in 1868 until 1875, wrote: "The Department of Health of the City of New York is an anomaly. It has the power to make laws, to execute those laws and to sit in judgment on its own acts. Its acts within this sphere of its jurisdiction can not be interrupted or even reviewed by the courts."2 W. A. Purrington commented further: "salus populi suprema lex. .. there is no branch of the law in which, of late years, individual liberty has been curtailed more than in sanitary legislation."3 While the roles of public health departments have

‘Even if You're Positive, You Still Have Rights Because You Are a Person’: Human Rights and the Reproductive Choice of Hiv‐positive Persons

“…However, it is also recognised that public health programmes may pose significant challenges to the realisation of human rights, where meeting the interests of broader society in achieving health objectives results in restrictions of rights of individuals. 30 Indeed, some have argued that all public health programmes should be regarded as rights-restrictive until shown otherwise, 31 and it might well be contended that there are compelling public health and ethical reasons, such as the risk of transmission to HIV-negative spouses and children, to favour restrictions on the fertility of HIV-positive persons. For example, ethical arguments have been made that 'just because one has a biological capacity to reproduce doesn't mean it's okay to do so in any circumstances.'…”