Promoting Human Rights in Patient Care: Practitioner Guides in Law and Health

Legal, ethical, and human rights norms are an increasingly important component of the delivery of quality medical care. However, the Open Society Foundations’ work on behalf of society’s most marginalized persons—injection drug users, people living with HIV, sex workers, Roma and other ethnic minorities—has shown that health systems can too often be places of punishment, coercion, and violations of basic rights to consent and confidentiality, rather than places of treatment and care. At the same time, doctors and health practitioners are often constrained in their ability to provide quality care to their patients, or are unaware of how to incorporate ethical and human rights norms into their work. There is an urgent need to support legal and administrative remedies for individual and systemic human rights abuse in health settings, and at the same time to establish non-punitive mechanisms of incorporating normative principles into patient care.

To this end, Law and Health Initiative, in partnership with Human Rights and Governance Grants Program, Health Media Program, Russia Program, and national foundations in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Moldova, and Ukraine, have supported the development of a series of Practitioner Guides and a companion website for lawyers interested in taking patient rights cases. 

The Practitioner Guides are practical, how-to manuals, covering both litigation and alternative mechanisms such as ombudspersons and medical licensing bodies. They examine patient and provider rights and responsibilities and procedural mechanisms at national, regional, and international levels. 

The guides have been or are being produced in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Moldova, Russia, and Ukraine. Once published, Practitioner Guides are used as a basis for training and litigation support. They show particular potential as a resource in clinical legal education programs. 

Although legal practitioners are the primary audience for this guide, they are further useful for medical professionals, public health managers, Ministries of Health and Justice personnel, patient advocacy groups, and patients themselves. In addition to Practitioner Guides, Open Society Foundations has also produced an analytical compendium based on research in developing the Practitioner Guides in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Russia, and Ukraine.

Follow-up activities for this project include trainings for lawyers and judges, patient-friendly versions of the Guide with a focus on marginalized populations, and potential law reform to address gaps identified by the Practitioner Guide working groups. 

Additionally, a Legal Fellow in Human Rights in each country is undertaking the updating of each Guide, coordination of trainings, and work on patient-friendly versions. Fellows are recent law graduates based at a local NGO with expertise and an interest in expanding work in law, human rights, and patient care. To learn more about the fellowships, please visit http://www.health-rights.org/fellowships/.

Patient-friendly versions of the Practitioner Guides are available for Armenia and Georgia at: http://cop.health-rights.org/trainings/119/ and http://cop.health-rights.org/trainings/120/.

Additional country resources can be found online at:

International: http://www.health-rights.org/

Armenia: http://www.healthrights.am/
Georgia: http://www.healthrights.ge/
Kazakhstan: http://health-rights.kz/ 
Kyrgyzstan: coming soon
Macedonia: http://www.healthrights.mk/
Russia: http://health-rights.ru/
Ukraine: http://www.healthrights.org.ua/