Human Rights Syllabi: Institute of International Studies, University of California, Berkeley
Harvard Medical Schoool
Medicine, Human Rights, and the Physician
Fall 1998- Course No.: H0701.0
Insructors:Carola Eisenberg, MD, (617) 868-0112
Kris Heggenhougen, PhD, (617) 432-2561
Kari Hannibal, MA (617) 667-7028 (teaching assistant)
Room MEC448, Thursdays, 3:30 - 5:30 pm
Course Description:
The course examines the links between health, health care, and human rights. Through lectures and class discussions, the course aims to empower students with the knowledge and skills necessary to recognize, prevent, and alleviate the human suffering caused by human rights violations. It presents an overview of the extent of human rights violations in the world and an analysis of their physical and psychological consequences on the health of victims, their families, and communities. The class will examine the ethical obligations of physicians in the face of violations, and provides a framework for the protection of human rights by physicians. The class will discuss the pro-active role of the physician in documenting the health consequences of human rights violations, treating survivors of trauma, identifying the impact of health policies on human rights, and participating in human rights education and advocacy. The special needs of women and children will be highlighted. Particular attention will be paid to the experience of the physician working in the United States. Course participants will also learn to recognize and mediate secondary traumatic stress.
Required Books:
- 1998 Course Readings
- Twenty Five Human Rights Documents. Center for the Study of Human Rights, Columbia University, NY, 1994.
- Ethical Codes and Declarations Relevant to the Health Professions. 3rd edition (London: Amnesty International, 1993.)
Assignments:
By the middle of the course, students will choose a topic related to some aspect of human rights as covered in the course. Each student will be expected to present orally a research study proposal and a one-page description of their topic that includes: a research question, background information, significance, methods, and a plan of action. At the end of the course, students will submit their research paper and present their work in class for 15-20 minutes.
Evaluation:
Students' conceptual understanding and knowledge will be assessed through their participation in class and by their oral and written presentation of their research project.
Hours of the Course:
- 14 sessions of 2 hour/session formal class teaching28
- 2 hours/session of required outside-the-classroom Readings28
- Preparation and research involved in research project20
- 76 hours or 2 credits
Outline
Session 1: September 17
Carola Eisenberg, MD; H.K. Heggenhougen, PhD
Course Introduction and requirements
Susannah Sirkin, MEd
How Does Medicine Apply to Human Rights Issues?
A presentation of the health effects of human rights violations and an overview of the health professional contributions to the documentation and prevention of human rights violations.
Readings:
- UN Declaration of Human Rights, from 25 Human Rights Documents, and other international declarations on health and human rights from the World Medical Association.
- Commentaries: Health and Human Rights Call to Action. JAMA 280:5, pp.462-464.
- Geiger, H.J. and Cook-Deegan, R.M. The Role of Physicians in Conflicts and Humanitarian Crises: Case Studies from the Field Missions of Physicians for Human Rights, 1998to 1993. JAMA (Aug. 4, 1993) 270:5, pp. 616-620.
- Optional Reading4) Weston, B. "International Human Rights: Overview" in Human Rights in the World Community: Issues and Actions, 2nd edition. Philadelphia: University of Pennsylvania Press, 1992.
Session 2: September 24
Kris Heggenhougen, PhD
Structural Violence and its Implications for Health and Human Rights
Review of the impact of structural violence on populations, obstacles to improvement of health, constraints and leverage of the medical community in these situations.
Readings:
- Farmer, P. On Suffering and Structural Violence: A view from below. Daedalus 125:1:261-84.
- Heggenhougen, H.K. The epidemiology of functionalapartheid and human rights abuses. Social Science and Medicine 40:3:281-84.
Session 3: October 1
Felton Earls, MD, and Mary Carlson, PhD
Human Rights and Children: The Interconnection between Human Rights and Medical Research - Case Examples from Romania.
Readings:
- Frank, D.A., Klass, P.E, Earls, F., Eisenberg, L. Infants and Young Children in Orphanages: One View from Pediatrics and Child Psychiatry. Pediatrics (April 1996) 97:4.
- Carlson, M., and Earls, F. Psychological and Neuroendocrinological Sequelae of Early Social Deprivation in Institutionalized Children in Romania. Annals (New York Academy of Sciences).
Session 4: October 8
Carola Eisenberg, MD; H.K. Heggenhougen, PhD; Kari Hannibal
Historical Perspective on Human Rights:
The development of human rights law and humanitarian law. Review of human rights documents with emphasis on their relationship to health. Overview of scope and patterns of human rights violations in the world and the response of the health professional community around the world.
Readings:
- Zwi A., Ugalde A. Towards an Epidemiology of Political Violence. Social Science and Medicine (1989) 28:7:633-642.
- Henkin, L. Introduction: The Human Rights Idea. The Age of Rights. (New York: Columbia University Press, 1990).
Optional Reading:
- Prescription for Change: Health Professionals and the Exposure of Human Rights Violations, Amnesty International, May 1996.
Session 5: October 15
Sofia Gruskin, JD, MIA
Reproductive Health and Women's Rights:
How does gender discrimination manifest as abuses of women's human rights? Review of the definition of reproductive health, definition of the right to information, and the impact the right to information has on reproductive rights.
Readings:
- Freedman, LP. Censorship and Manipulation of Reproductive Health Information. In Coliver S (ed.) The Right to Know. (Philadelphia: University of Pennsylvania Press, 199?.)
- Beijing Declaration and Platform for Action from Fourth World Conference on Women, 15 September 1995.
- Programme of Action of the United Nations International Conference on Population and Development, 19 September 1994.
- Bunch, C. Women's Rights as Human Rights: Towards a Re-Vision of Human Rights. Human Rights Quarterly (1990) 12:486.
Session 6: October 22
H. Jack Geiger, MD
Race, Health, and Human Rights in the U.S.
Readings:
To be determined
Session 7: October 29
Roberta Apfel, MD, and Bennett Simon, MD
Children and War
Asylum and Medical Documentation
Role of the physician in the asylum process in the United States. Assessment of evidence of physical and psychological abuse. Special approaches to taking a medical history of an asylum applicant. Relevance of historical information. Work with interpreters. Referrals for ongoing treatment.
Readings:
- Westermeyer, J. and Wahmanholm, K. ôRefugee Children,ö in Apfel, R. and Simon, B. Minefields in their Hearts: The Mental Health of Children in War and Communal Violence (New Haven: Yale University Press, 1996).
- Fischman, Y. ôInteracting with Trauma: CliniciansÆ Responses to Treating Psychological Aftereffects of Political Repression.ö American Journal of Orthopsychiatry (April 1991) 61:2.
Session 8: November 5
Indochinese Psychiatry Clinic; Kathleen Allden, MD
Metal Health and Human Rights: The Indochinese Psychiatry Clinic
Students will meet with Kathleen Allden, MD; Thang Pham, LICSW; and a group of patients from the Indochinese Psychiatry Clinic. The group will consist of seven former political detainees who were imprisoned in ôre-educationö camps for 8-10 years following the Vietnam War. They all suffered torture, starvation, isolation, and hard labor.
Readings:
- Mollica R.F.; McInnes, K.; Pham. T.; Fawzi, M.C.S.; Murphy, E.; Lin, L. The Dose-Effect Relationships betweennn Torture and Psychiatric Symptoms in Vietnamese Ex-Political Detainees and a Comparison Group. Journal of Nervous and Mental Disease, in press.
Optional Readings:
- Mollica, R.F. "The Trauma Story: The Psychiatric Care of Refugee Survivors of Violence and Torture" in Post-Traumatic Therapy and Victims of Violence.
- Allden, K et al. Burmese Political Dissidents in Thailand: Trauma and Survival of Young Adults in Exile. AMJPH (1996) 86:11:1561-1567.
- Mollica, R.F. et al. The Effect of Trauma and Confinement on Functional Health and Mental Health Status of Cambodians Living in Thailand-Cambodia Border Camps. JAMA (1993) 270:5:581-586.
Session 9: November 12
Elaine Alpert, MD
Domestic Violenc e as a Human Rights Violation
Current perspectives on the documentation of domestic violence, with a focus on its analysis as a human rights violation. The responsibility of the government to act to protect victims of domestic violence. Health professional responses to domestic violence.
Readings:
To be determined
Session 10: November 19
Peter Rosenblum, JD
International Humanitarian Humanitarian Law and Health consequences of Armed Conflicts
What are the immediate and long-term effects of attacks on civilian populations, destruction of infrastructure, disruption of supplies of food, water, housing, health services during times of war and civil conflict? What are the immediateand long-term health needs triggered by mass migrations of people during armed conflict? What constitutes appropriate health care in these circumstances? What methods are used to monitor the health effects of human rights violations in these conflicts? Examination of international humanitarian law and issues of medical neutrality, ethical dilemmas in responding to human rights issues, and role destruction between human rights workers and relief workers.
Readings:
To be determined
Session 11: December 3
Pumla Gobodo-Madikizela
Case Study: Response of the South African Medical Profession to Human Rights Violations
Readings:
To be determined
Session 12: December 10
Human Rights Day
Student Presentations
Sessiom 13: December 17
Student Presentations and Course Wrap-up
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