新 Pae Ora健康期货法案, 将于7月1日生效, will be a once-in-a-generation chance to reset 新西兰的 public health system. 这是一种受欢迎的保护措施, 促进和改善所有新西兰人的健康, reduce health disparities (in particular for Māori) 而且 give effect to Te Tiriti o Waitangi.
These aims align with the international legal framework of human rights 而且 the rights of 原住民. 然而，新西兰人将继续错失机会, 因为新法案没有明确纳入健康权.
This would have provided another (legal) mechanism to hold the government 而且 its various health authorities accountable for their actual delivery on those noble objectives.
The act will set out a series of obligations 而且 expectations for health providers 而且 consumers, 哪些是值得称赞的. But how can we know if these new initiatives are delivering without a clear underst而且ing of the basic rights of individuals?
毕竟, those obligations are based on 而且 informed by everyone’s right to fair 而且 equitable treatment in the health system. 如果没有履行义务，可以采取什么措施?
健康是一项人权
The failure to include the right to health may derive from a view that this is not a “real” right. Various reasons are advanced to support such a view, but they can be refuted.
首先，健康权被庄严载入 世界人权宣言 1948 (thanks in part to the efforts of the then New Zeal而且 prime minister, Peter Fraser). It became a legally binding obligation when the United Nations adopted the 《澳博体育app》 in 1966.
The right is also contained in human rights law instruments relating to 比赛, 女性, 孩子们, 残疾人士 而且 原住民. Aotearoa New Zeal而且 has agreed to protect 而且 respect the rights contained in each of these legal instruments.
One argument in Aotearoa New Zeal而且 is that the specialist decision-making involved in complex 而且 expensive economic 而且 social policy is (perhaps underst而且ably) the purview of the government 而且 not the courts.
Nonetheless, the courts do retain a scrutinising role in such matters. The explicit incorporation of the right to health in the legislation would have further facilitated this role.
Pae Ora法案需要将健康列为一项法律权利, 这给了新西兰人一种让卫生系统负责任的方式.
盖蒂图片社
成本不应该是一个不可逾越的障碍
费用是不尊重健康权的另一个原因. 这是一个合理的担忧, 太, especially as the financial burdens that accrued to the district health boards seem to have been a significant factor driving the law change.
然而，这种逻辑只能让澳博体育app走到这里. The massive costs that go into an effective court system are not an argument for not upholding the right to a 公正的审判例如，.
And international law actually allows countries a fair amount of leeway in upholding the right to health. 以他们的 可用的资源, they must show progress is being made in implementing health rights.
It’s also argued that the right to health is 太 vague; that it’s impossible for the courts, 例如, 来确定它的法律意义. 但这也可以被反驳.
To begin with, the right to health doesn’t mean the right to be healthy. 它的意思是每个人都有自由和权利 确保他们能享受 "能达到的最高身心健康标准".
健康的4个关键要素
联合国经济委员会, Social 而且 Cultural Rights breaks these rights 而且 obligations down even further into 四个关键要素:
- availability: countries must have sufficient functioning public hospitals 而且 other medical facilities, 商品和服务, 还有一些项目
- 无障碍:每个人都必须能够利用卫生设施, 商品和服务 without discrimination – 可访问性 doesn’t just mean physical access, 去医院(例如), 这也意味着医疗保健必须负担得起
- 可接受性:例如, 卫生保健必须对文化信仰敏感, 还有年龄和性别
- 质量:例如, 获得熟练医务人员的权利, 科学认可的药物和医院设备.
健康作为一项人权包括四个关键要素:可获得性, 可访问性, 可接受性和质量.
鲁本·博尼拉·贡萨洛/盖蒂图片社
法院在健康方面发挥着作用
As with all human rights, the rights to equality 而且 non-discrimination underpin the right to health. 新西兰的 人权法案 还禁止基于各种理由的歧视.
Underst而且ing the right to health in this way can lead to improved healthcare practices, as well as practical 而且 constructive efforts to ensure a more robust 而且 effective health system. 这似乎与新法案的目标相一致.
This doesn’t mean the battle to recognise New Zeal而且ers’ right to health is totally lost. The presumption must remain that parliament didn’t intend the Pae Ora健康期货法案 – like any legislation – to be contrary to international law 而且 新西兰的 international obligations.
We must believe that the courts, where possible, will uphold those rights. But the failure to incorporate the right to health denies the ultimate recipients of health care – the people themselves – a clear legal mechanism to uphold their right to health.
It also serves to limit the accountability of the government 而且 its new health entities for the kinds of failures that led to the need for new legislation in the first place.
