Recorded presentation

Leonard S. Rubenstein, JD, Physicians for Human Rights, 1156 15th Street NW, Suite 1001, Washington, DC 22301, 202 728 5335, lrubenstein@phrusa.org, M. Gregg Bloche, JD, MD, Georgetown University Law Center, 600 New Jersey Ave. NW, Washington, DC 20001, John H. Bryant, MD, Aga Khan University (Emeritus); Johns Hopkins School of Public Health, P.O. Box 177, Moscow, VT 05662, and Laurel Baldwin Ragaven, MD, Henry R. Luce Professor of Health and Human Rights, Trinity College, 71 Vernon Street, Hartford, CT 06106.

Fidelity to the patient is a cornerstone of the ethics of health practice and central to the teaching of ethics in medical education. Yet health professionals are increasingly called upon to subordinate the patient's interest to some social objective or third party objectives, sometimes at the expense of the human rights of the patient, his well-being and good practice. This problem of dual loyalty can be especially problematic in practice settings where human rights violations are potentially common, such as in prison and detention facilities, in the military, at the workplace, and in the treatment of vulnerable populations. Human rights violations occur as well in day-to-day practice, such as in occupational health services, or where public health policy constrains choices of health professionals for economic, social or political reasons. The problem of dual loyalty and human rights has lacked attention in medical ethics. To address this problem, an international working group of bioethicists, educators, clinicians and human rights experts from Africa, Asia, Europe, the Middle-East and North and South America analyzed the problem in a human rights and ethics framework and proposed both clinical practice guidelines and institutional mechanisms The proposals are available at http://www.phrusa.org/healthrights/dual_loyalty.html. This session will a) address the manner in which human rights can be an effective approach to the problem of role conflict; b) provide contemporary examples; c) discuss proposals for guidelines and institutional mechanisms by the international working group, and d) consider how the guidelines apply in clinical settings and community practice.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Understand and describe circumstances and practice settings where conflicting obligations to patients and third parties can result in human rights violations against patients.
• Identify practice guidelines that can protect the human rights of patients.
• Identify institutional mechanisms that an eliminate the conflict or provide support to health professionals who are subject to them.

Keywords: Ethics, Human Rights

Related Web page: www.phrusa.org

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Physicians for Human Rights University of Cape Town Health Sciences Faculty
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Recorded presentation