La interculturalidad vacía: derecho a la salud intercultural de los pueblos indígenas y personas migrantes en Chile / Empty interculturality: the right to intercultural health of indigenous peoples and migrants in Chile / A interculturalidade vazia: direito à saúde intercultural dos povos indígenas e pessoas migrantes no Chile

Resumen: Este trabajo analiza el desarrollo de la perspectiva intercultural en la protección y garantía del derecho a la salud en pueblos indígenas y población migrante en Chile desde el punto de vista jurídico. Revisa las prácticas y experiencias prevalentes en el ámbito de la salud pública en Chile, para establecer la forma y alcance de la interculturalidad en la protección del derecho a la salud y la manera en que tributa a la interculturalidad. La perspectiva intercultural en el acceso a la justicia en Chile es débil, formal, se trata de iniciativas incipientes en el caso de los pueblos indígenas, mientras en el caso de las personas migrantes apenas abordan barreras idiomáticas.

Abstract: This work analyzes the development of the intercultural perspective in the protection and guarantee of the right to health in indigenous peoples and migrant population in Chile from the legal point of view. It reviews the prevalent practices and experiences in the field of public health in Chile, to establish the shape and scope of interculturality in the protection of the right to health, and the way in which it contributes to interculturality. The intercultural perspective on access to justice in Chile is weak, formal, these are incipient initiatives in the case of indigenous peoples while in the case of migrants, they hardly address language barriers.

Resumo: Este trabalho analisa o desenvolvimento da perspectiva intercultural na proteção e garantia do direito à saúde nos povos indígenas e população migrante no Chile do ponto de vista jurídico. Revisa as práticas e experiências prevalentes no âmbito da saúde pública no Chile, para estabelecer a forma e alcance da interculturalidade na proteção do direito à saúde e à forma com que contribui à interculturalidade. A perspectiva intercultural no acesso à justiça no Chile é débil, formal, tratando-se de iniciativas incipientes no caso dos povos indígenas, enquanto que no caso das pessoas migrantes apenas abordam barreiras idiomáticas.

Ciencia, responsabilidad y derecho a la salud en el diagnóstico de la COVID-19 / Science, responsibility and the right to health in the diagnosis of COVID-19

Introducción: El Coronavirus ha golpeado a la humanidad en la segunda década del siglo XXI, y propagado el terror, la crisis económica y la muerte. Su expansión en todo el planeta ha juzgado las políticas y las prácticas en ciencia y salud de todos los Estados. En Ecuador, el panorama aún es incierto, y muestra un sistema científico y de salud insuficiente para enfrentar el desafío planteado por la naturaleza. Objetivo: Exponer, desde el principio de responsabilidad, el papel de la ciencia en el derecho a la salud en el contexto del diagnóstico de SARS-CoV-2 en Ecuador. Desarrollo: El deber, como parte del principio de responsabilidad, alienta a la ciencia a alcanzar el estado de bienestar humano. Actuar para que haya un verdadero futuro en el campo de la medicina debe orientarse hacia una mayor cobertura de salud, minimizar los riesgos potenciales contra el bienestar integral del hombre, prevenir la aparición de nuevas enfermedades, aumentar la tecnología para el diagnóstico y tratamiento de enfermedades presentes y futuras, aumentar el arsenal terapéutico disponible y hacer que los servicios de salud sean accesibles y equitativos. Conclusiones: Garantizar el derecho a la salud requiere que los Gobiernos promuevan la investigación en salud, adopten políticas públicas y asignen recursos en toda su extensión para que el acceso y la equidad en este campo constituyan los medios para implementar el derecho a la auténtica vida humana en el presente y el futuro(AU)

Introduction: Coronavirus has hit humanity in the second decade of the 21st century, and spread terror, economic crisis and death. Its expansion throughout the planet has judged the policies and practices in science and health of all states. In Ecuador, the panorama is still uncertain, and it shows that the scientific and health system is insufficient to face the challenge posed by nature. Objective: To present the role of science, from the principle of responsibility, in the right to health in the context of the diagnosis of SARS-CoV-2 in Ecuador. Main body: Duty, as part of the principle of responsibility, encourages science to achieve the state of human well-being. Acting so that there is a true future in the field of medicine should be oriented towards greater health coverage, minimizing potential risks against the comprehensive well-being of man, preventing the appearance of new diseases, increasing technology for the diagnosis and treatment of current and future diseases, increasing the therapeutic resources available and making health services accessible and equitable. Conclusions: Guaranteeing the right to health requires that governments promote health research, adopt public policies, and allocate resources in their entirety so that access and equity in this field constitute the means to implement the right to authentic human life in the present and the future(AU)

The disability-rights perspective within the bioethics agenda.

The life perspectives of persons with disabilities have been neglected in many countries and particularly in lower- and middle-income countries that have fewer resources to adequately address the societal needs of these persons. Bioethics purports normative standards for the way in which we treat with others, and the virtue of care should be at the heart of everyday life. Human rights are norms that aspire to protect all persons everywhere. Within this milieu, persons with disabilities who make up a significant portion of all societies worldwide meet many social barriers that inhibit their quality of life and leave them greatly disadvantaged in comparison to able-bodied persons. This article focuses on the notion of quality of life, the presumed perspectives of biomedicine and bioethics on disability, the neglect of the lived experience of persons with disabilities, and the discrimination underlying the struggle for equal rights and opportunities for persons with disability. It argues for equal access to social and beneficial medical interventions for persons with disabilities; that persons with disabilities should be seen as different but equal; that their contributions to societal deliberations would enhance the richness of thought, views, narratives and perspectives; and that society should stop using the term disability and use instead the less value-laden term anomaly. Finally, it recommends educational campaigns to change negative attitudes towards persons with predicaments or anomalies, the respecting of human diversity, collaboration between upper-income and lower- and middle-income countries to develop strategies that seek to change negative attitudes towards persons with anomalies, and the inclusion worldwide of all these matters as a part of a bioethics agenda that advocates for respecting the human rights of persons with anomalies.

Human rights mechanisms for anti-corruption, transparency and accountability: enabling the right to health.

Background: The presence of corruption in State institutions and broader society presents a significant obstacle to the right to the enjoyment of the highest attainable standard of health. The Universal Periodic Review, a Member State-led peer review system administered by the Human Rights Council, is a core tool of human rights, including the right to health accountability. This paper builds on existing research to examine processes that support State engagement on the issue of corruption. We identify opportunities for States to use the Universal Periodic Review to support anti-corruption, transparency and accountability to control corruption in the health-care sector.Objectives: This paper focuses on health sector how human rights mechanisms, and particularly the Universal Periodic Review, can be a tool for greater accountability for the right to health for corruption in the health sector.Methods: The research team applied qualitative content analysis methods to analyze all 135 Universal Periodic Review documents produced during 2018 in order to analyze how human rights mechanisms address the impact of corruption on the realization of the right to health.Results: Although health rights violations are often addressed within human rights mechanisms such as the UPR, corruption remains under-addressed, suggesting that there are gaps in understanding how corruption can seriously undermine the right to health.Conclusion: Human rights mechanisms should drive greater attention to the importance of addressing corruption in health. In order to make the UPR more effective, this paper suggests that there is a need to generate more awareness of corruption-based violations of the right to health in order to promote greater health accountabilityPractical tools such as strategic litigation and social audits can also contribute to creating greater transparency and accountability in dealing with corruption.

Who controls your future: The convention on the rights of persons with disabilities from a service user focused perspective.

Although notions of personal autonomy are increasingly enshrined as the primary principle of ethical medical practice, psychiatry appears to have real difficulty in applying this. Notions such as compulsory treatment and mental health legislation serve to reinforce paternalism. This may not be in the interests of either the patient or the doctor. The Convention on the Rights of Persons with Disabilities (CRPD), although providing no new rights to mental health patients, has led to guidance as to what existing rights entail and how they should be applied. While service users were involved in the drafting of the Convention on the Rights of Persons with Disabilities, what is lacking is service user focused perspectives in the critique and debate that has ensued in response to the Convention on the Rights of Persons with Disabilities committee's informed guidance as to the correct interpretation of the rights. Furthermore, consideration of how to translate the rights into practice is also lacking. This co-produced viewpoint aims to contribute to this debate and provides a brief overview of a novel educational approach to translating the Convention on the Rights of Persons with Disabilities committee's guidance into clinical practice.

Unproven stem cell therapies: is it my right to try?

BACKGROUND: Nowadays one of the most critical aspects of innovative cell-based therapies is the unregulated industry, as it is becoming a competitor of the regulated system. Many private clinics, worldwide, advertise and offer cell-based interventions treatments directly to the consumer and this poses a risk to both vulnerable patients and health systems. Several countries have implemented Compassionate Use Programmes (CUP) that provide patients with medicines that have not yet completed the approval pathway, in the event that no reasonable alternative exists. Recently, in the public discourse, compassionate use has been increasingly associated with a patient's right to try. Thus, the aim of this study was to assess public knowledge of the clinical trials process with specific reference to innovative stem cell treatments, and trust in the institutions responsible for regulatory activities. We also asked people about their "right" to use unregulated therapies. METHODS: We developed an ad hoc questionnaire on three main areas of concern and administered it to 300 people in the patient waiting room at an Italian university hospital. RESULTS: Our findings suggest that people have a good knowledge of the clinical trials process and trust in healthcare institutions. Nonetheless, one person in two believes it is a right to use unregulated therapies. CONCLUSIONS: We stress the need, in the age of cellular therapies, for a commitment to support vulnerable patients and to strengthen awareness among the public about the substantial boundary that differentiates experimental therapies from unproven therapies. There should not be a "right to try" something that is unsafe but rather approved treatments and in line with good clinical practice. The trend, which emerged on this issue from our study, is quite different, confirming the urgent need to improve health information so that it is as complete as possible.

The Right to Accessible and Acceptable Healthcare Services. Negotiating Rules and Solutions With Members of Ethnocultural Minorities.

The right to health implies, among other things, that individuals and communities must be allowed to have a voice in decisions concerning the definition of their well-being. The article argues for a more active participation of ethnocultural minorities in healthcare decisions and highlights the relevance of strategies aimed at creating a bottom-up engagement of people and groups, as well as of measures aimed at a broader organizational flexibility, in order to meet migrants' and minorities' needs. Finally, the article clarifies that these strategies are not simply the outcome of a welcoming attitude of the Western healthcare system but may be interpreted as a specific duty resulting from the notion of "particularly vulnerable groups," as formulated by the ECtHR in its case law: when vulnerable groups are at stake, every decision about state actions and rules regarding healthcare should start from an a consideration of the specific conditions and needs of people belonging to vulnerable minority groups.