Human rights standards
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There are many human rights that support the notion that women have a human right to access full range of medical technologies related to abortion, including medication abortion. These rights include the right to health, the right to life, the right to privacy and the right to benefit from scientific progress. Corresponding state obligations include ensuring the availability, accessibility and acceptability of quality reproductive health care services. Ensuring availability of medication abortion is critical for respecting women’s choices, for their privacy and dignity, and for ensuring access to services in more remote or rural locations. However, the issue of the right to access medication abortion as a human right has only been indirectly addressed in the context of ensuring access to medicines that are on the WHO Essential Medicines List (see below).
The following General Recommendations and Comments reflect state obligations in ensuring access to quality health care services that can be applied to the issue of guaranteeing access to medication abortion. UN Treaty Body General Recommendations/Comments:
- Committee on Economic, Social and Cultural Rights, General Comment 14, The right to the highest attainable standard of health (2000) (2000)
- The right to health encompasses the right to sexual and reproductive health. Furthermore, governments should ensure that all drugs on the WHO Model List of Essential Medicines, which include, mifepristone and misoprostol, be made accessible. (paras. 43(d), 44(a)).
- The right to health in all its forms and at all levels contains the following interrelated and essential elements: (a) Availability. Functioning public health and health-care facilities, goods and services, as well as programs, have to be available in sufficient quantity within the State party. They will include…hospitals, clinics and other health-related buildings, trained medical and professional personnel receiving domestically competitive salaries, and essential drugs, as defined by the WHO Action Programme on Essential Drugs. (b) Accessibility. Health facilities, goods and services have to be accessible to everyone without discrimination on any of the prohibited grounds, they must also be physically accessible, especially to vulnerable populations, such as adolescents, and in rural areas. Health facilities, goods and services must also be economically affordable for all. (c) Acceptability. They must also be acceptable to all and be respectful of medical ethics and sensitive to gender and life-cycle and be culturally appropriate, and respect confidentiality. (d) Quality. Health facilities, goods and services must also be scientifically and medically appropriate and of good quality. This requires, inter alia, skilled medical personnel, scientifically approved and unexpired drugs and hospital equipment, safe and potable water, and adequate sanitation. (Para. 12).
- CEDAW General Recommendation 24, Women and Health (1999) .
- States have an obligation to eliminate barriers that women face in accessing health care services, including reproductive health care services, and to ensure women can access the full range of high quality, affordable health care. Barriers include, but are not limited to authorization requirements, distance from health facilities, costs, etc. States have a duty to ensure women's right to safe motherhood and emergency obstetric services and they should allocate to these services the maximum extent of available resources. The Committee states that the principle of equity demands that poorer households should not be disproportionately burdened with health expenses as compared to richer households. Additionally, the Committee recommends that States should ensure that the training curricula of health workers include comprehensive, mandatory, gender-sensitive courses.