To the Editor: Recent trends in medical education have emphasized cultural competency and patient-centeredness. However, issues related to human rights are frequently overlooked. In 2009, 76% of deans at U.S. MD-granting schools believed that education on human rights was important, but only 37% of respondents indicated that their schools offered any such education.1 (Although there are many types of human rights, we focus on rights related to health, particularly of the populations mentioned below.)
Although some physicians may argue that a human rights perspective is not helpful to their practice, globalization continues to increase physician encounters with human rights issues, both abroad and domestically. Physicians bear witness to the unique health care needs of increasing numbers of immigrants, migrants, refugees, and asylum seekers in the United States.2 More physicians are aiding in international disaster sites and conflict zones.3 However, good intentions do not necessarily correlate with good clinical outcomes, as evidenced by failures in the international medical response to the 2010 Haiti earthquake.4 Adequate human rights education can better empower physicians in these settings.
There are many possible ways to incorporate human rights training into medical education. In addition to formal course work, one effective strategy is to bring together students, faculty, and community organizations to discuss human rights issues, particularly issues that students may encounter when they become physicians, including working in conflict zones, medical needs of refugees and torture survivors, and gender-based violence, among others. Students at our school have used this approach; this year, over 100 medical students and house staff were in attendance at a one-day symposium. But medical schools’ curricula must incorporate such issues to reach all medical students.
Jonathan Mann5 wrote,
Awareness of the limits of medicine and medical care, growing recognition of the health impacts of societal structure and function, globalization and consequent interdependence, and the sometimes active, sometimes ineffectual actions of nation-states, all intersect to lead toward a new vision of health.
To enable physicians to thrive within this new vision of health, increasing attention to human rights is more necessary than ever.
Jamie E Anderson, MPH, Matthew Cappiello, Samuel Keller, Katherine Chia-Shyuan Lee, and Ashlin Mountjoy
All are third-year medical students at the University of California, San Diego, School of Medicine; firstname.lastname@example.org
1. Cotter LE, Chevrier J, El-Nachef WN, et al. Health and human rights education in U.S. schools of medicine and public health: Current status and future challenges. PLoS ONE. 2009;4:e4916
3. Maki J, Qualls M, White B, Kleefield S, Crone R. Health impact assessment and short-term medical missions: A methods study to evaluate quality of care. BMC Health Serv Res. 2008;8:121
4. Jobe K. Disaster relief in post-earthquake Haiti: Unintended consequences of humanitarian volunteerism. Travel Med Infect Dis. 2011;9:1–5
5. Mann JM. Medicine and public health, ethics and human rights. Hastings Cent Rep. 1997;27:6–13