The right to health, which embraces sexual and reproductive health, is recognized in various human rights documents and other consensus documents, such as in Article 12 of the International Covenant on Economic, Social and Cultural Rights where States Parties recognize "the right of everyone to the enjoyment of the highest attainable standard of physical and mental health." Both the Universal Declaration of Human rights and the International Covenant on civil and Political Rights protect the right of life, which includes the right to health. The Beijing Platform for Action adopted by Governments during the Fourth World Conference on Women (1995) recognizes that women's right to the enjoyment of the highest attainable standard of physical and mental health is "vital to their life and well-being and their ability to participate in all areas of public and private life."
The World Health Organization (WHO) has defined health as "a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity." This definition is adopted in both the Cairo document and the Beijing Platform for Action ( 1995). The Beijing Platform of Action goes further to state that "women's health involves their emotional, social and physical well-being and is determined by the social, political and economic context of their lives, as well as by biology." It recognizes that " a major barrier for women to the achievement of the highest attainable standard of health is inequality, both between men and women and among women in different geographical regions, social classes and indigenous and ethnic groups."
This recognition is consistent with the mandate of the Convention on the elimination of all Forms of Discrimination Against Women (Women's Convention) that States Parties must take "appropriate measures to eliminate discrimination against women in the field of health care in order to ensure, on a basis of equality of men and women, access to health care services, including those related to family planning." The United Nation's Committee on the Elimination of Discrimination Against Women (CEDAW), the body that monitors compliance with the Women's Convention, declared under its General Recommendation on Women and Health, that States Parties should "ensure universal access for all women to al full range of high quality and affordable health care, including sexual and reproductive health services."
The Cairo document echoes the definition of health in its definition of reproductive health:
"Reproductive health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters relating to the reproductive system and to its functions and processes. Reproductive health therefore implies that people are able to have a satisfying and safe sex life and that they have the capability to reproduce and the freedom to decide if, when and how often to do so. Implicit in this last condition are affordable and acceptable methods of family planning of their choice, as well as other methods of their choice for regulation of fertility which are not against the law, and the right of access to appropriate health care services that will enable women to go safely through pregnancy and childbirth and provide couples with the best chance of having a healthy infant. In line with the above definition of reproductive health, reproductive health care is defined as the constellation of methods, techniques and services that contribute to reproductive health and well-being by preventing and solving reproductive health problems. It also includes sexual health, the purpose of which is the enhancement of life and personal relations, and not merely counseling and care related to reproduction and sexually transmitted diseases."
"Bering in mind the above definition, reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents. These rights rest on the recognition of the basic right of all couples and the individuals to decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so, and the right to attain the highest standard of sexual and reproductive health. It also includes their right to make decisions concerning reproduction free of discrimination, coercion and violence, as expressed in human rights documents."
Pursuant to the interdependence and indivisibility of human rights as recognized in the Cairo document, and the recognition that "reproductive rights embrace certain human rights that are already recognized in national laws, international human rights documents and other consensus documents," the Reproductive Rights Resource Group-Philippines (3RG-Phils.) advocates for the recognition, respect, protection and promotion of the following human rights as sexual and reproductive rights:
The right of life
Which includes the right not to have one's life put at risk by reason of pregnancy, gender, or the lack of access to sexual and reproductive health care information and services.
The right to liberty and security of person
Which includes the right to determine, control and enjoy one's sexual and reproductive life, and decide freely and responsibly on matters related to sexuality and reproduction free of discrimination, coercion and violence; the right to be free from coercion or violence in one's sexual life and in all sexual decisions, such as rape and other forms of sexual violence, female genital mutilation, and forced sterilization that infringe upon women's sexual and reproductive self-determination; the right to be free from any medical intervention except with full, free and informed consent; the right to be free from externally imposed fear, shame, guilt and beliefs based on myth and other psychological factors inhibiting a person's sexual response or impairing her sexual relationship; the right to be free from forced pregnancy, sterilization and abortion; the right to demand equality, full consent, mutual respect and shared responsibility in sexual relationships.
The right to equality and to be free from all forms of discrimination
Which includes the right to have control and make decisions over one's sexuality and fertility as an essential ingredient of equality of persons and equal participation in all spheres of life; the right not to be discriminated against by any legislation, regulation, program, cultural norm or practice in respect of sexual and reproductive health information and services because of gender, age, poverty, civil status, sexual orientation or practice, mental or physical ability, religion, ethnicity or other condition or status; the right to be free from sexual violence.
The right to privacy
Which includes the right to make autonomous decisions regarding one's sexual and reproductive life; and the right to privacy in the provision of sexual and reproductive health care services, such as to confidentiality of information given during the consultation and care.
The right to freedom to thought
Which includes the right to make decisions about sexual and reproductive health and rights; the right to seek, receive and impart information about sexual and reproductive health; and the right to be protected from restrictions to access to sexual and reproductive health education, information and services by reason of dominant religious beliefs in society.
The right to information and education
Which includes the right to complete, appropriate, correct, gender-sensitive information and education that can enable a person to make and give free and informed decisions and consent; and the right to information as to the relative benefits, risks and effectiveness of all methods of fertility regulation and prevention of unplanned pregnancies.
The right to choose whether or not to marry and to found and plan a family
Which includes the right to protection against any compulsion or requirement to marry without the person's free and full consent; and the right of all couples and individuals to decide freely and responsibly the number, spacing and timing of their children.
- The right to decide whether and when
to have children
Which includes the right to have the information, education and means to do so.
The right to health care and health protection
Which includes the right to the highest possible standard of sexual and reproductive health care that is accessible, comprehensive, appropriate, gender-sensitive, and the respectful of human rights; and the right to sexual and reproductive health care which includes (a) family planning information, counseling and services, (b) prenatal, postnatal and delivery care, (c) health care for infants, (d) prevention and treatment of sexually transmitted diseases (STDs) and reproductive tract infections (RTIs), (e) safe abortion services, where it is legal, and management of abortion-related complications, (f) prevention and treatment of infertility, (g) information, education and counseling on human sexuality, reproductive health and parenthood.
The right to benefits of scientific progress
Which includes the right to enjoy the benefit of and have access to reproductive health technology, including that related to infertility and contraception.
The right to freedom of assembly and political participation
Which includes the right to pursue and promote sexual and reproductive health and rights through political involvement and the formation of organizations; and the right to participate in the leadership, planning and decision-making, management, implementation, organization and evaluation of reproductive health care programs and services.
The right to be free from torture and inhuman and degrading or ill treatment
Which includes the right to be protected from all forms of exploitation, degrading treatment and abuse in relation to sexuality and reproduction, including involuntary motherhood or forced pregnancy, domestic servitude and violence.
The right to development
Which is a universal and inalienable right and an integral part of fundamental human rights.
It has been said that the advancement of sexual and reproductive rights requires abiding by three ethical principles that underpin women's sexual and reproductive health and rights: (1) the principle of bodily integrity and self-determination, not as individualistic concerns, but as "inseparable from women's full and equal participation in all aspects of human life;" (2) the principle of equality, including equal participation in all spheres of life, whose essential ingredient is women's ability to make decisions over their sexuality and fertility; and (3) the necessity of enabling conditions, which means assuring basic economic and social rights, such as adequate food, shelter, education, in livelihood, medical care and necessary social services, and security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond one's control, in order to create an environment that is essential for the genuine exercise of free choice.
The Philippine Government has committed to respect, protect and promote sexual and reproductive health and rights, particularly of women. This commitment also has a constitutional basis, and thus, is given binding effect by the 1987 Philippine Constitution which has declared the State's commitment to a just and dynamic social order, social justice, human rights, gender equality, health, and an integrated and comprehensive approach to health development.
The specific constitutional policies related to sexual and reproduction health and rights are:
"The State shall promote a just and dynamic social order that will ensure the prosperity and independence of the nation and free the people from poverty through policies that provide adequate social services, promote full employment, a rising standard of living, and an improved quality of life for all." (Art. II, Sec. 9)
"The State shall promote social justice in all phases of national development." (Art. II, Sec. 10)
"The State values the dignity of every human person and guarantees full respect for human rights." (Art. II, Sec. 11)
"The State recognizes the vital role of the youth in nation-building and shall promote and protect their physical, moral, spiritual, intellectual, and social well-being." (Art. II, Sec. 13)
"The State recognizes the role of women in nation-building, and shall ensure the fundamental equality before the law of women and men." (Art. II, Sec. 14)
"The State shall protect and promote the right to health of the people and instill health consciousness among them." (Art. II, Sec. 15)
"The State shall adopt an integrated and comprehensive approach to health development which shall endeavor to make essential goods, health and other social services available to all the people at affordable cost. There shall be priority for the needs of the underprivileged sick, elderly disabled, women, and children. The State shall endeavor to provide free medical care to paupers." (Art. XIII, Sec. 11).
"The State shall defend:The right of spouses to found a family in accordance with their religious convictions and the demands or responsible parenthood;
- The right of children to assistance, including proper care and nutrition, and special protection from all forms of neglect, abuse, cruelty, exploitation, and other conditions prejudicial to their development;
- The right of the family to a family living wage and income; and
- The right of families or family associations to participate in the planning and implementation of policies and programs that affect them." (Art. XV, Sec. 3)
The promotion of health, including sexual and reproductive health, as a human right entails addressing the social, economic, political and cultural conditions of the country that undeniably impact on people's particularly women's health. When the Philippine Constitution mandates an "integrated and comprehensive approach to health development," it requires, among others, "better food and housing, better education, and increased purchasing power" of the people, in addition to "more access to health services, higher allocation of resources to health, more active people's participation in health efforts, a reorientation of the health development strategies and the political will to act on policies and plans."
Under Cairo and other human rights instruments and other consensus documents, and pursuant to the foregoing constitutional policies, the Philippine government is obliged to undertake positive steps in advance sexual and reproductive health and rights particularly in the following key areas:(1) changing laws, policies, and attitudes that continue to inhibit the full exercise of reproductive and sexual rights, particularly of women; this will include what the Committee on the Elimination and Discrimination Against Women calls "barriers to women's access to appropriate health care," such as laws that restrict access to contraception, practices that require a spouse's consent for a woman to obtain contraception, discrimination in the delivery of sexual and reproductive health services, gender violence, and economic policies and programs that lead to poverty;
(2) enforcing gender-sensitive laws and policies, and raising awareness among boys and men of their responsibility for promoting equity and equality in relations with girls and women; this will include effective enforcement of laws against gender-based violence and those that promote women's empowerment in social, economic, cultural and political life, and education men and boys toward eliminating gender-based violence;
(3) strengthening health infrastructures to make comprehensive care more widely available, and putting priority on financing for sexual and reproductive health care, as well as spending funds more efficiently and effectively.
In working in these three areas, Government, decision-makers in health care, and health service providers must not forget the three ethical principles that underpin women's sexual and reproductive health and rights, and women's human right in general: bodily integrity and self-determination, equality, and necessity of enabling conditions that take into account women's specific needs and situations.
Author: Evalyn G. Ursua
is a feminist lawyer who has been working on women's human
rights for 11 years
Source : Rights Vol. 1 No. 1&2 Special Double Issue , July to December 2001 & January to June 2002
"Human Rights and Women's Sexual and Reproductive Health and Rights" pp 6-10.