Title: Rights and obligations
Course: Health Management, Ethics and Research - Ethiopia (Full)

Rights and obligations

The rights and obligations of individual people can be thought of as the rules that each person needs as they relate to other people within the wider human community. People have rights to certain basic provisions and services; meeting these needs places obligation or responsibilities on others. Making a human community work so that each person can live and develop to their maximum potential can be thought of as a balance between rights and responsibilities. The list of individual rights claimed in today's world is almost endless. Rights, as entitlements, are claimed to privacy, to life, to a healthy environment and to healthcare. Sometimes people may not be able to claim rights for themselves and a community or society may decide that these groups of people need special protection. For this reason special rights may be claimed by various groups such as: children (including the unborn child), the poor, people living with illness, the elderly and the dying.

Within the health service itself people should be able to rely on a certain level of service that is based on their rights. For example a person attending for healthcare has the right not to be assaulted or insulted by the Health Extension Practitioner. On the other side of the coin, the Health Extension Practitioner has the obligation not to assault or insult the client and a duty to avoid doing them harm. A client has the right to your safe and competent service while under your care and you have a corresponding legal and moral obligation to provide safe and competent healthcare (Figure 9.1).

Figure 9.1 Each healthworker has a duty to maintain their level of competence. (Photo: Ali Wyllie)

These rights and obligations extend to the general level of service that is provided by healthworkers such as Health Extension Practitioners (Box 9.1). For example, you may have made an agreement with your community to supply insecticide treated bed nets (ITNs) and it is therefore your duty or obligation to make sure that these are supplied in an effective and timely manner. In the same way the community has the right to receive these nets from the health service as a result of your work.

Imagine that you are a Health Extension Practitioner working in a rural community where there are lots of health problems. What are your obligations? What are the rights of your community?

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In simple terms it is your obligation to provide the very best health service that you are able to provide. The community also has the right to receive the best health service possible within the constraints of the service.

Box 9.1 Definitions and types of rights and obligations

1. Rights are generally defined as something that is owed to an individual according to just claims, legal guarantees, or moral or ethical principles. The two main categories of rights includes:
  - Legal rights are based upon a legal entitlement to some good or benefit. These rights are guaranteed by laws and if violated can be punished by the legal system.
  - Ethical rights are based upon moral or ethical principles. Ethical rights usually do not have the power of law to enforce the claim.
2. Obligations are demands made upon individuals, professions, society, or government to fulfill and honour the rights of others. The two main categories of obligation include:
  - Legal obligations are those obligations that have become formal statements of law and are enforceable under the law. For example,all healthworkers have a legal obligation to provide safe and competent care for patients assigned to them.
  - Moral obligations are those obligations that are based upon moral or ethical principles, but are not usually enforceable under the law. For example, there is no legal obligation for a health provider on a vacation trip to stop and help an automobile accident victim. (Adapted from: Aiken, T. and Catalano, J. (1994) Legal, Ethical and Political Issues in Nursing. Philadelphia: F.A.Davis & Co. pp. 25–6.)

Look again at Box 9.1. What is the main difference between ethical rights and legal rights?

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Legal rights have the force of the law behind them. If these items are not delivered the law can become involved. Ethical rights, on the other hand, do not usually have the power of the law behind them. The same can be applied to the difference between moral and legal obligations, in which case only legal obligations have the power of the law to back them up.