(Adapted from a talk given at the PHR Mid-Atlantic and Southern Regional Advocacy Institute on November 13, 2010.)
In medical school, we are often taught to think of things in terms of their value-added: for example, what is the added value of attending this lecture instead of watching it on 2x speed at home? More seriously, this algorithmic approach influences almost everything we do: studying, balancing academics and extracurriculars, clinical decisions, and, most significantly, patient care. We make choices and tradeoffs every hour of every day. In professional lives that are so busy and can so often get entangled in these algorithms, it is important to take moments, or a day like this, to confer with like-minded colleagues and consider non-algorithmic approaches to medicine.
At the same time, in order to effect change within our field, we must speak its language. So I ask you, what is the added value of incorporating health and human rights education into health professional education? I ask because this is the argument that opponents of HHRE have used in the past, and will continue to use. Health students are already overstretched: there isn’t nearly enough time in our academic schedules to include yet more coursework. The right to health, while codified in the UDHR and other international statutes, can seem ephemeral next to the tangible facts of physiology or genetics. How can we teach a concept so intangible, and, even more importantly, what difference will it make?
I realize that in speaking to this group, I’m preaching to the human rights choir. Nonetheless, it seems important to take a step back, examine our goals for health and human rights education, and understand the arguments and resistance we may face. In a March 2010 article in The Lancet, Gunilla Backman and Joseph Fitchett made a strong case for HHRE, stating that “Educating health-care workers in human rights and the practical applications of the right to health is not only imperative for social justice, it is a morally powerful approach capable of transcending borders and directing health systems for the improvement of health.” They cited several UK studies, including the 2008 Human Rights in Healthcare Evaluation, which showed measurable improvements in patient care when health providers were educated in human rights. The findings, among others, included increased caregiver willingness to challenge established (but not necessarily adequate or well-received) health norms. The field of HHRE is an ever-growing one, and there is a fresh and incisive body of literature on why such curricular reform is truly necessary to meet ancient and emerging challenges in health care.
As part of PHR’s ongoing commitment to HHRE, we are working on identifying “core competencies,” essential concepts without which no health professional student should graduate. In addition, we must link human rights education to other disciplines, and build the evidence base that supports its importance. Finally, and perhaps of most interest, the field is becoming the area of scholars as well as advocates and activists. Bridging advocacy, research, and teaching, HHRE reform would herald a sea change in the way we think about health, from the first day we step in the classroom.
So this is really a call to action, because we cannot build this movement without national and international collaboration, without local chapters and regional connectivity. As health students, you are uniquely situated to work from within the system, within the profession. Many of you have already been involved in curricular change, whether by implementing electives on health and human rights or lobbying deans for larger-scale reform. I leave you with the challenge of maintaining momentum and pushing even further, because the value added of human rights education might just be so significant that it is unmeasurable.