Human rights, public health and COVID-19 in Canada

2020

Effective pandemic management requires a clear and straightforward structure of communication and accountability. Yet the political realities of Canadian federalism preclude this. The fundamental theme of pandemic management in Canada is thus the tension between the need to make clear, coherent, and timely decisions, on the one hand, and the need to involve an exceptionally large array of political actors across different levels of government, on the other. The sudden outbreak of SARS in 2003 exposed several problems in coordinating the public health system. This led to a major restructuring of public health institutions in Canada. The 2009 H1N1 pandemic tested these reforms and identified new issues underlying the coordination of governmental actors. This chapter presents the legal and institutional context within which COVID-19 has emerged, and identifies both lessons learned from the past and the challenges that remain. * McCulloch Professor of Political Science, Dalhousie Univer...

FACETS

The COVID-19 pandemic has highlighted the challenges governments face in balancing civil liberties against the exigencies of public health amid the chaos of a public health emergency. Current and emerging pandemic response strategies may engage diverse rights grounded in civil liberties, including mobility rights, freedom of assembly, freedom of religion, and the right to liberty and security of the person. As traditionally conceived, the discourses of civil rights and public health rest on opposite assumptions about the burden of proof. In the discourse of civil and political rights of the sort guaranteed under the Canadian Charter of Rights and Freedoms, the onus rests on government to show that any limitation on rights is justified. By contrast, public health discourse centers on the precautionary principle, which holds that intrusive measures may be taken—lockdowns, for example—even in the absence of complete evidence of the benefits of the intervention or of the nature of the r...

A Bioethical Perspective on the COVID-19 Pandemic, ACU Saglik Bil Derg 2020; 11(3):365-371, 2020

Infectious diseases are characterised as capable of animal-to-human or human-to-human transmission. They may be diagnosed, treated or prevented and recovery from such diseases is a possibility. Since they are a source of morbidity, disability and mortality in humans, combating infectious diseases is a key priority. When we examine the problem from a medical or scientific historical perspective, it is evident that humankind has been able to achieve great advances in combatting infectious diseases through immunisation. The novel coronavirus, SARS-CoV-2, was first identified in December 2019 in China. This virus is the cause of the acute respiratory infective illness termed COVID-19. In a brief period of time, this disease has spread across the globe, becoming a pandemic and creating difficulties for society and the economy. Alongside the need for an understanding of what to do to combat the pandemic, there should co-exist enquiry into how such action should be undertaken: to put it another way, what attitudes and behaviours should come into play. There is a need to investigate the ethical dimension of the problem. In combatting the pandemic, an evidence-based scientific and medical approach should continue, whilst from the bioethical perspective, there should be openness, transparency and realism in the way that developments are shared with the public. Everyone should be treated equally. In situations calling for quarantine and isolation, it is necessary that any sacrifice of personal autonomy be proportionate to the requirements of public health and call for a reasonable level of self-sacrifice; that individuals, hospitals, organisations and countries will act in solidarity and support each other co-operatively; that governments be accountable for the response they give to the requirements of their people and that economic life be supported with reciprocal collaboration and solidarity. The response should preserve human rights and dignity. It is recommended that the pandemic be managed in a way that is humane and pluralist, whilst maintaining attitudes and behaviours that are respectful and responsible towards the environment, the biosphere, biodiversity and future generations.

Canadian Journal of Public Health

In 2019, the Canadian Government released a national dementia strategy that identified the need to address the health inequity (e.g., avoidable, unfair, and unjust differences in health outcomes) and improve the human rights of people living with dementia. However, the novel coronavirus disease 2019 (COVID-19) pandemic is having an inequitable impact on people with dementia in terms of mortality and human rights violations. As the new Omicron COVID-19 variant approaches its peak, our commentary highlights the need for urgent action to support people living with dementia and their care partners. More specifically, we argue that reducing COVID-19 inequities requires addressing underlying population-level factors known as the social determinants of health. Health disparities cannot be rectified merely by looking at mortality rates of people with dementia. Thus, we believe that improving the COVID-19 outcomes of people with dementia requires addressing key determinants such as where people live, their social supports, and having equitable access to healthcare services. Drawing on Canadian-based examples, we conclude that COVID-19 policy responses to the pandemic must be informed by evidence-informed research and collaborative partnerships that embrace the lived experience of diverse people living with dementia and their care partners. Résumé Dans sa stratégie nationale sur la démence publiée en 2019, le gouvernement canadien définissait le besoin de redresser les iniquités en santé (p. ex. les différences évitables, inéquitables et injustes dans les résultats cliniques) et de mieux faire respecter les droits humains des personnes vivant avec la démence. La pandémie de la nouvelle maladie à coronavirus 2019 (COVID-19) touche cependant de façon inéquitable les personnes atteintes de démence sur le plan de la mortalité et des violations des droits humains. À l'heure où le nouveau variant Omicron de la COVID-19 est sur le point d'atteindre son pic, nous faisons valoir qu'il faut appliquer des mesures urgentes pour aider les personnes vivant avec la démence et leurs partenaires soignants. Plus précisément, pour atténuer les effets inégaux de la COVID-19, il faut aborder les facteurs populationnels sous-jacentsles déterminants sociaux de la santé. Les disparités de l'état de santé ne peuvent pas être corrigées par la simple observation des taux de mortalité chez les personnes atteintes de démence. Nous croyons donc que pour améliorer les résultats cliniques de la COVID-19 chez ces personnes, il faut aborder les grands déterminants comme leurs milieux de vie, leurs soutiens sociaux et l'équité d'accès aux services de soins de santé. À partir d'exemples canadiens, nous concluons que les interventions stratégiques contre la pandémie de COVID-19 doivent être éclairées par des études fondées sur des données probantes et par des partenariats de collaboration qui tiennent compte du vécu de toutes sortes de personnes vivant avec la démence et de leurs partenaires soignants.

Reviews in Cardiovascular Medicine

Canadian Journal of Bioethics

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An increasing number of Canadians are concerned about how the COVID-19 crisis was handled by our governments and institutions. We are alarmed by the serious consequences of their decisions and, at times, their apparent indifference to the costs. Those consequences include tragic impacts on the personal lives of many, violations of constitutionally guaranteed rights and freedoms in the name of health security, and economic impacts of lockdown measures, which subjected millions of Canadians to business closures, loss of income, and unemployment.Canadians are asking many questions: Were the measures taken by governments in Canada appropriate to the perceived threat? Were they based on sufficient clinical and statistical evidence? Were they suitably focused? How effective were they? Were there any conflicts of interest at play? Was there enough emphasis on prevention and early treatment? On informed consent? Was sufficient debate permitted? In attempting to prevent COVID-19, what other ...

Independent Panel on Pandemic Preparedness and Response, 2021

Canadian Journal of Political Science, 2020

Emergencies can undermine human rights by disrupting societies, increasing vulnerabilities, and prompting extraordinary responses from governments and other actors. During the COVID-19 public health emergency, Canada's federal, provincial and territorial human rights commissions (HRCs) have mobilized to advocate for upholding human rights. Based on an original dataset and content analysis of HRCs' official statements in response to COVID-19, this research note examines the points of consistency and variation in HRCs' advocacy for human rights during the COVID-19 crisis. It shows how HRCs have highlighted core human rights issues and obligations, and advocated for various policies and practices that promote respect for human rights during the COVID-19 crisis. In an emergency typically framed in terms of public health and safety, aggregating and comparatively analyzing these Canadian human rights authorities' advocacy provides a foundation for deliberating whether and how a human rights approach to COVID-19 response should be pursued.