Core Competencies in Human Rights for Health Professionals

1. Core Competencies in Human Rights for Health Professionals Towards a Generic Core Curriculum for Human Rights & Ethics Training Workshop By : Adv Boyce Mkhize, CEO HPCSA UCT Upper Campus 05 July 2006

2. Human Rights & Ethics Core Curriculum • Practice of medicine raises ethical and legal issues and demands understanding of both • Understanding of ethical and legal issues facilitates decision-making and its processes and creates a better basis for knowing what should be done in any given situation and why

3. Human Rights & Ethics Core Curriculum • Growing realization that there is a core of skills and knowledge related to ethics that is as fundamental to the practice of medicine as basic sciences or clinical skills. • Focus on the practice of medicine seems to be shifting more towards softer people skills to shape positive attitudes for best clinical intervention

4. Human Rights & Ethics Core Curriculum • Hippocratic oath commentary highlights the important distinction between treating an ailment and treating a person with an ailment • Literature suggests that healing is expedited where there is an appreciation that an individual is being treated rather than their ailment

5. Human Rights & Ethics Core Curriculum • Humanity has a set of entitlements, such as a right to be treated with dignity and this right becomes even more pronounced when one deals with vulnerable groups such as the sick, elderly, women, children etc • Practitioners’ unguarded and cold application of clinical skills might erode the essence of people’s rights

6. Human Rights & Ethics Core Curriculum • South Africa, a country that has a legacy of disregard for human rights and ethics particularly needs to build a shared understanding of human rights & ethics concepts • Bill of rights needs contextual interpretation and application in the practice of medicine

7. Historical Challenges • Complicity of some health professionals with the apartheid system • Failure of the SAMDC to deal decisively or at all with the health professionals who directly or indirectly supported the apartheid system • Failure by SAMDC to provide guidelines and policy direction to health professionals in dual loyalty positions

8. Historical Challenges • Ethics training provided on an ad hoc, non-uniform and unstructured basis to medical students • No system of continuing medical education and no guidance on how to apply human rights and ethics training to the daily practices of medical practitioners

9. HPCSA Disciplinary Statistics

10. Historical Challenges • Lack of courage or will to take proper action for professional misconduct [particularly where it involved possibly crossing paths with the State] • Misuse of medical expertise and information • Medical cover ups to support an evil system

11. Historical Challenges • Lack of a human rights discourse culture • Lack of appropriate structures to defend independence of practitioners • Lack of a culturally balanced representation in SAMDC • Lack of a human rights based society and a democratic constitution

12. Human Rights & Ethics Core Curriculum Global Challenges • Traditional medical curriculum has often made the teaching of ethics and law both eclectic and scarce • Tutors have in certain instances not been adequately qualified to teach on the subject—lacking moral philosophy, moral theology or law backgrounds

13. Human Rights & Ethics Core Curriculum • Teaching of ethics and law in some instances optional or not formally assessed and at times not even formally timetabled • Ethics and human rights have not been regarded as an integral part of practice of medicine

14. Human Rights & Ethics Core Curriculum • No consensus as to what ethics should be taught, how it should be taught and who should teach it • Diverse forms of thinking about and analysing ethical issues in the practice of medicine ranging from a principlist approach to virtue ethics, narrative ethics and ethics of care

15. Human Rights & Ethics Core Curriculum International Benchmarks • Australia and New Zealand adopted a common framework for teaching of ethics • Australian Medical Council specifies that graduates completing basic medical education should know and understand ethics related to health care and legal responsibilities of a medical profession

16. Human Rights & Ethics Core Curriculum • Australia and New Zealand stress that graduates should have an appreciation of the complexity of ethical issues related to human life and death, including the allocation of scarce resources • UK teachers of medical ethics and law reached consensus on skills and attitudes graduates should possess

17. Human Rights & Ethics Core Curriculum • As part of the global village and human rights and ethics being a universal concept, a need to establish a generic core curriculum cannot be overstated • Curriculum should be academically rigorous and clinically relevant for presentation of both ethics and the law in medicine

18. Human Rights & Ethics Core Curriculum • Teaching should stress the overall aims of medical education, the creation of good doctors who will enhance and promote the health and medical welfare of the people they serve in ways which fairly and justly respect their dignity, autonomy and rights.

19. Human Rights & Ethics Core Curriculum • A core curriculum of ethics knowledge must address both the foundations of ethics and specific ethical topics. • Ethical awareness, moral reasoning, communication and collaborative action skills • Attitudes to develop ie. honesty, integrity, empathy, respect etc

20. Declaration of Tokyo “it is the privilege of a medical doctor to practice medicine in the service of humanity, to preserve and restore bodily and mental health without distinction as to persons, to comfort and to ease suffering of his/her patients. The utmost respect for human life is to be maintained even under threat and no use made of any medical knowledge contrary to the laws of humanity”

21. The Future?? • TOWARDS A UNIFORM CORE CURRICULUM ON HUMAN RIGHTS AND ETHICS!!!