Evaluation of Public Health Practices in Terms of Right to Health and Human Rights

States long ago were managed in autocratic and repressive ways. Throughout history, various totalitarian tyrants first restricted the rights of their own people and then turned towards the lives of people living in other dormitories. It is argued why the dictators in question applied these practices and why they become a subject of the bloody pages of history, but there is only one truth that should not change. This fact is that everyone has the right to live freely (Dayton, et al., 2019). This fact has been better understood after facing the bloody consequences of World War II. Although the concept of human rights is based on Magna Carta, the Universal Declaration of Human Rights, which is the subject of this article, was published in 1948. The United Nations Human Rights Commission drafted the declaration in June 1948 and, with several changes, it was adopted as 30 articles after the UN General Assembly meeting in Paris on 10 December 1948. II. World War after, states united in guaranteeing the rights and freedoms granted to individuals. One of the reasons for this is the idea that granting freedom to people can prevent wars that, if continued, could be the end of civilizations. Considering how much damage the world wars and cold war caused, it cannot be said that this thought is not appropriate. Despite this, some socialist countries, especially autocratic states, abstained from the declaration. For example, the Cold War overshadowed human rights and polarization has taken place in this regard (Mor, 2013). While the West argued that civil and political rights should be prioritized, the Eastern Bloc argued that rights to food, health and education come first, while civil and political rights come second. Hence, international human rights treaties interest the states that have signed them, but declarations are not binding. Since the declarations are not binding, it is seen that some countries still experience problems in the implementation of the 30 articles put forward in this declaration. The subject of Public Health, which is another subject of this article, allows even the eastern bloc of the Cold War and the western block mentioned above to meet at the midpoint. States need people to survive, so every state must protect its people from any disease or attack. Some states use public health as an excuse to limit human rights practices. Thus, public health practices should be evaluated in terms of human rights.

Faced with the bad consequences of the Second World War, the international community accepted the Universal Declaration of Human Rights (UDHR, 1948). However, while states were trying to make the terms of the Declaration binding legal provisions, the Cold War overshadowed human rights and led to polarization in two separate parties (East and West Blocks). As a result of the conflicts faced by the countries in the Cold War environment, many agreements, declarations and similar legal documents have been accepted since then. Human rights are summarized here in these documents. Within the scope of these documents, the following can be said about the Declaration of Human Rights: • International human rights conventions interest the states that have signed them. • Declarations are not binding. • Guaranteed by international standards. • Protected by law. • Focuses on human dignity; • Protects individuals and groups. • It obliges the state and government officials. • Indispensable and cannot be extorted. • They are interdependent and interconnected. • It is universal. In summary, human rights are legally guaranteed by human rights law in order to protect individuals and groups from actions that would damage their fundamental freedoms and human dignity. Human rights include what are known as civil, cultural, economic, political and social rights. Human rights are mainly related to the relations between the individual and the state. Governments' obligations regarding human rights are broadly covered by the principles of respect, protect, fulfil. Other issues that can be considered in relation to human rights are health, right to health and public health. The World Health Organization (WHO, 2013) defines health as "it is not just not being sick or disabled, it is a state of complete physical, mental and social well-being". Also, in national and international law sources, the term health is not only the case of not being sick; at the same time, as WHO states, it is accepted to mean “a state of complete physical, mental and social well-being”. The right to health takes health as a subject. Article 25 of the Universal Declaration of Human Rights, accepted in 1948; "1. Everyone has the right to food, clothing, housing and medical care for the health and well-being of himself and his family. Everyone has the right to security in the event of unemployment, sickness, disability, widowhood, old age and financial difficulties arising from circumstances beyond his will. 2. Special care and assistance are special rights of mothers and children. All children, whether born in wedlock or out of wedlock, benefit from the same social security." With these articles, the right to health is included within the framework of "the right to life", which is the most fundamental right. Health, which is the value protected by the right to health, is not only a value that requires the provision of services for correction when it deteriorates. On the contrary, it is also a value that must be respected and protected, just like bodily integrity. The point here is not to provide some services for the health of the person, but to not conduct an activity that is clearly harmful to the health of the person or not to be carried out by third parties (Temiz, 2014). According to Leary (1994), the abbreviation "right to health" emphasizes the connection of health status with dignity, non-discrimination, justice and participation issues. The term "right to health" is used as an abbreviation in the context of human rights, referring to the more detailed language contained in international treaties and to fundamental human rights principles. The precise terminology of "right to health" is not used in most provisions of health conventions without further explanation. For example, reference can be made to the "right to property" in fundamental rights literature; the meaning acquired is not that everyone has the right to claim some property, but that no one can be arbitrarily deprived of their property. In this context, no one will be arbitrarily deprived of their health. According to Backman (et al., 2008), the foundation for the right to the highest attainable standard of health was laid in the Universal Declaration of Human Rights. Characteristics of the right to health are not only good governance, justice or humanitarianism, but also obligations under human rights law. The right to the highest attainable standard of health encompasses medical care, access to safe drinking water, adequate sanitation, education, health information and other underlying determinants of health. At the same time, the right to health, which encompasses physical and mental health, imposes obligations on governments regarding health care and key determinants of health. Among these liabilities, there are elements such as clean water, adequate sanitation, nutritious food, adequate shelter, education, and a safe environment. The right to health is subject to progressive implementation and resource availability. Therefore, international human rights law recognizes that the right to the highest attainable health standard cannot be realized immediately. Because, the health standard can be achieved gradually. This means that a country must consistently improve its human rights performance. According to Metin (2017), it is stated that the right to health is a social right and a positive status right. The right to health is not regulated as an independent article in the constitution. The right to health is in connection with the right to life and bodily integrity guaranteed in the Constitution. It is clear that the right to health imposes obligations on states as stated in the relevant article of the constitution. These are obligations to respect, protect and fulfil. It is within the scope of the obligation to respect that the state does not violate the right to health. Preventing the violation of the right to health by others is also under the responsibility of protection. The obligation to fulfil also means that the state takes the necessary actions to benefit from the right to health. The protection of health is provided by legal regulations that determine that this is a right in social life. In this context, the right to health; it is a mandatory right for an individual to survive. A human being can lead a humane life only if he / she is physically, mentally and socially healthy. The importance of the right to health in terms of public health shows itself in the equality of use of the facilities that determine health services. Everyone has the right to the highest attainable standards of health in order to live in dignity. The right to health is a necessary and indispensable right for the survival of people and the implementation of other human rights. So much so that it becomes impossible for the individual whose right to health is violated to exercise his other rights. The consequences of the violation of the right to health cause the violation of the right to life of the individual at the same time. Because there is a direct relationship between the right to life and the right to health. According to Karakul (2017), it is accepted that the right to health can be realized in different degrees. In addition, it is clear that health is a dynamic process that must be constantly improved. Protecting the health of all peoples is the basis for ensuring peace and security. The realization of this depends on the full cooperation of individuals and states.

When the right to health is examined in general terms with the help of the literature review, its relation with human rights and public health is better understood. Protecting public health is also one of the duties of the state, such as giving a person the right to access health. In line with this purpose, various practices applied for public health purposes have been opened to discussion. However, in this context, with international conventions, states have been allowed to force in various human actions supported by human rights. For example, the "Covenant on Economic, Social and Cultural Rights" is accepted as the second important document on Human Rights. It is a continuation of the Universal Declaration of Human Rights and a document detailing it. With the signatures of the states, it has become a "national domestic law rule" belonging to that country. Article 12 of the aforementioned convention imposes obligations on states regarding public health under the heading "Right to health standard". This obligation is the prevention, treatment and control of epidemic diseases, local diseases, occupational diseases and other diseases. Under the title of "Right to Health Protection", article 11 of the European Social Charter, which entered into force in 1965, it is among the obligations of states to eliminate the causes of health deterioration as much as possible and to prevent the spread of epidemics and other diseases. In the 12th article of the Constitution, the sentence "The body integrity of the person cannot be touched except for medical obligations and the cases written in the law" clearly reveals that the human body can be intervened in case of medical necessities. From this point of view, states can restrict actions that can be identified with human rights for both the individual and the public in the case of medical requirements. This situation makes the restriction steps that can be taken in the national and international legal environment legal. Backman (et al., 2008) argues in his article that, in narrowly defined conditions and as a last resort, the enjoyment of certain human rights can be intervened in order to achieve a public health goal. Because quarantine for a serious infectious disease such as Ebola fever is necessary for the public good and legal under human rights, even if, under certain conditions, it limits an individual's freedom of movement. Another example is the fight against alcoholism in terms of public health. Everyone can consume alcohol, but alcohol taxes, alcohol availability restrictions and measures against drunk driving, and evidence-based preventive measures are in place at both individual and population levels (Room et al., 2005).  However, the most important point here is that the interference with fundamental human rights is applied as a last resort, even if the reason for health conditions. States should implement interventions, such as curfews, travel restrictions, or the closure of various businesses, as a last resort. However, some states have been found to restrict people's rights on the pretext of health concerns, for various political or other reasons. Therefore, in order to maintain the legal legitimacy of a possible epidemic management, it should be rational, human and human rights oriented. In addition, the main factor in determining whether the necessary protections are provided when rights are restricted at the point of public health is whether each of the five criteria of the Siracusa Principles are met (Sun, 2020). Even where restrictions are permitted on the basis of protecting public health, these restrictions should be limited in time and subject to periodic review. The legitimacy of a public health practice / restriction in accordance with the Siracusa Principles depends on the following conditions: The restriction should be lawfully imposed; The restriction must be to achieve a legitimate aim of public interest; The restriction must be absolutely necessary to achieve a useful purpose in a democratic society; Less compelling and restrictive methods to achieve the same goal should not be found; The restriction should not be prepared and imposed in an arbitrary way, that is, in a way that would be unreasonable or otherwise discriminatory. Considering all these issues, it can be said that the restrictions that can be applied to protect public health are legitimate in accordance with the laws, but can protect their legitimacy with internationally accepted principles. When these restrictions are applied in accordance with accepted principles, they will restrict the rights of individuals for a certain period, but they will protect the right to access health.

REFERENCES

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Dayton, R., Alvarez, B., Morales, J. R. A., Faccini, M., Gomez, B., & Wilcher, R. Everyone has the right to live free of violence.

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Mor, J. S. (Ed.). (2013). Human rights and transnational solidarity in Cold War Latin America. University of Wisconsin Pres.

Room, R., Babor, T., & Rehm, J. (2005). Alcohol and public health. The lancet, 365(9458), 519-530.

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Temiz, Ö. (2014). Türk hukukunda bir temel hak olarak sağlık hakkı.

World Health Organization (WHO). A state of complete physical mental and social well-being and not merely the absence of disease or infirmity. 2013.