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APHA Scientific Session and Event Listing

Recorded presentation

Leslie London, Professor, Health and Human Rights Programme, School of Public Health and Family Medicine, University of Cape Town, Anzio Rd, Observatory, Cape Town, 7925, South Africa, + 27 21 406 6524, ll@cormack.uct.ac.za, Leonard Rubenstein, JD, Physicians for Human Rights, 1156 15th St NW, Suite 1001, Washington, DC 20005, and Lauren Baldwin Ragaven, Trinity College, 71 Vernon Street, Hartford, CT 06106.

Dual loyalties, whereby a health practitioner experiences a simultaneous conflict of accountability to their patient and to a third party, is a pervasive problem in health care practice, and may, under particular circumstances, lead to a violation of the rights of those seeking or needing health care. Ethical guidelines for health practitioners aim to provide some measure of guidance for problem solving clinical dilemmas but may not adequately grasp the importance of human rights standards or the conception of health as a right. This presentation will outline a framework for approaching the problem of Dual Loyalty and outline guidelines and institutional mechanisms developed by an international working group to address the human rights and ethical challenges. In the public health context, Dual Loyalties is further complicated by the centrality of population approaches to health, and by the lack of a coherent ethical framework in public health. When faced with trade offs between public (health) good and infringements of rights of individuals or groups, health practitioners responsible for policy and its implementation need guidelines that will enable them to adequately protect the full spectrum of human rights, including both civil/political and socio-economic rights, whilst realizing population health objectives. The applicability of the Dual Loyalty guidelines and institutional mechanisms for public health policy and practice will be further explored to identify elements for a toolkit for use by public health practitioners.

Learning Objectives: By the end of this session participants will be able to

• Understand the concept of Dual Loyalty in health care settings
• Identify the nature, extent and causes of violations of human rights that arise from Dual Loyalty situations in health care provision and health policy.
• Describe the similarities and differences between rights-based and ethics-based approaches to Dual Loyalties.
• Describe guidelines and institutional mechanisms to prevent human rights violations arising from Dual Loyalty in the health care setting.
• Appreciate the particular challenges facing public health practitioners dealing with Dual Loyalty in health care provision and health policy

Keywords: Human Rights, Ethics

Presenting author's disclosure statement:

Any relevant financial relationships? No

Recorded presentation