Friday
Feb272009
International Commission of Jurists: U.S. needs to put an end to its human rights violations
Friday, February 27, 2009 at 1:30PM
The ICJ held a panel today at the Brookings Institution consisting of human rights experts, judges, and lawyers from around the world, who for the past three years have investigated over forty countries treatment of human rights in counterterrorism efforts. The report found that counterterrorism policies put international legal respect for human rights in jeopardy. The panel was the first presentation of the report to a U.S. audience, thus the focus was on U.S. obligation to end its practices since the “war on terrorism” was coined, that the state of war provides justification to set aside human rights safeguards.
The panel reports that human rights violations in counterterrorism come in many forms. Individuals are abducted and held in secret prisons, being tortured and ill treated, not given access to lawyers, courts, or fair trial. Additionally, the culture of secrecy has become pervasive to the point where “innocent victims find themselves with no avenue for redress.”
Suzanne Spaulding, Principal of Bingham Consulting Group, explained that by declaring a “war on terror,” the U.S. put human rights into jeopardy because collateral damage is accepted much more in war time and the president is given significant power and fewer checks and balances. Of the increase in presidential power, Spaulding stated, “I think that is one of the most damaging consequences of our having taken this very broad, global ‘war on terror’ approach.” Spaulding concluded that she feels very “gratified” that President Obama has not used the term “war on terror.”
Robert Goldman, Professor of Law at American University, outlined the process that should be taken when a human rights violation occurs. “When there is a serious human rights violation the remedies are clear. One, there has to be effective access to court.” When the government tries to plead “state secrecy” for actions which it knew were illegal, it is “utterly inconsistent with human rights law.” Second, in order to go along with international human rights law, each case deserves “thorough and impartial investigation.”
Arthur Chaskalson, former Chief Justice of South Africa, presented the fact that some U.S. representatives have argued that human rights law does not apply in times of war. He then read the recommendation of the panel to the United States as a response to this point of view: “The incoming U.S. administration should reaffirm the U.S.’s historic commitment to fully uphold and faithfully apply international humanitarian law, the laws of war, during situations of armed conflict and recognize that human rights law does not cease to apply in such situations.” The concluding argument is that while the U.S. is at war, and must use force, this force needs to be “necessary and appropriate.”
The panel reports that human rights violations in counterterrorism come in many forms. Individuals are abducted and held in secret prisons, being tortured and ill treated, not given access to lawyers, courts, or fair trial. Additionally, the culture of secrecy has become pervasive to the point where “innocent victims find themselves with no avenue for redress.”
Suzanne Spaulding, Principal of Bingham Consulting Group, explained that by declaring a “war on terror,” the U.S. put human rights into jeopardy because collateral damage is accepted much more in war time and the president is given significant power and fewer checks and balances. Of the increase in presidential power, Spaulding stated, “I think that is one of the most damaging consequences of our having taken this very broad, global ‘war on terror’ approach.” Spaulding concluded that she feels very “gratified” that President Obama has not used the term “war on terror.”
Robert Goldman, Professor of Law at American University, outlined the process that should be taken when a human rights violation occurs. “When there is a serious human rights violation the remedies are clear. One, there has to be effective access to court.” When the government tries to plead “state secrecy” for actions which it knew were illegal, it is “utterly inconsistent with human rights law.” Second, in order to go along with international human rights law, each case deserves “thorough and impartial investigation.”
Arthur Chaskalson, former Chief Justice of South Africa, presented the fact that some U.S. representatives have argued that human rights law does not apply in times of war. He then read the recommendation of the panel to the United States as a response to this point of view: “The incoming U.S. administration should reaffirm the U.S.’s historic commitment to fully uphold and faithfully apply international humanitarian law, the laws of war, during situations of armed conflict and recognize that human rights law does not cease to apply in such situations.” The concluding argument is that while the U.S. is at war, and must use force, this force needs to be “necessary and appropriate.”
First Things First
There are many blocks in the arch of medical reform, but Health Information Technology is the keystone, according to a panel of policy makers who spoke and answered questions at the Brookings Institution. Everything from electronic medical records, to electronic ordering, to integrated billing, to error reduction and decision support, won’t fix medicine by itself, the experts concluded.
Presenters at the event included: U.S. Sen. Sheldon Whitehouse (D-RI); former Rep. Nancy Johnson (R-Conn.) and Chairman of Health IT Now! Coalition; and Charles P. Friedman, Ph.D., Deputy National Coordinator for HIT Department of Health and Human Services. to discuss the current administration’s plans to upgrade the use of information technology in medicine.
“We are at a preposterous level of health information primitiveness,” White said.
According to moderator Darrell M. West, Vice President and Director, Governance Studies, Brookings Institution,, only one major business in the U.S. is less computerized than medicine; mining.
West co-wrote Digital Medicine: Healthcare in the Internet Era, published by Briikings. He said only one major business in the U.S. is less computerized than medicine; mining.
"Amazon can tell me what I’ve bought before, what I looked at today, and what I might like to buy tomorrow,” he said, adding that the majority of U.S. hospitals still keep manually-written, and, potentially life-saving, patient records in paper form.
According to the Institute of Medicine, only one in five clinicians in the U.S. are using electronic medical records.
West said the most optimistic projections are for savings of about $120 billion per year, but he believes the figure will be less.
Whitehouse quoted estimated healthcare savings as high as $320 billion per year , and he thinks that number could be a trillion.
The panelists agreed that interoperability is the first hurdle for the technology. Many, or most, of the computerized systems that exist now in hospitals can not share data with other computers.
This is intentional, Johnson said, because the competitive private business model favors a proprietary approach to information.
West said his doctor was using EMR now, but would never integrate the last 26 years of notes, “because that would cost too much.”
"Having HIT on a doctor’s desk is like having a car in the garage. you can enjoy the radio, air-conditioning and cigarette lighter but without a good road, you’re not going anywhere,” Whitehouse said.
The infrastructure, lines, connectivity and hardware all have to support the data flow, he said.
He pointed out that just moving data is not enough, “We need information aggregation, cross-checking, error reduction, decision support” and portability. The patient must be able to take data from system to system when traveling.
“Medicaid alone is approaching a $37 trillion obligation, not counting Medicare, VA benefits, S-CHIP, and similar entitlements. HIT is a necessary first step toward avoiding a healthcare cost tsunami,” he said.
Johnson discussed the tension between making the new healthcare more individuated and patient centered and avoiding the sort of consumerism that lets patients cow doctors into ordering expensive but unneeded tests and procedures.
She also pointed out the enormous proportion of healthcare costs that go to hopeless or marginal care, such as end-of-life care, or the prolongation of the lives of non-viable newborns. “No other country counts one breath as ‘live birth,’” she said. Many require hours, days, up to one year of life before being considered “live births”, she finished.
Friedman said the outlines of healthcare reform are clear and unlikely to change, but many details are still being worked out, not least a carrot and stick program to encourage and/or coerce stakeholders to adopt and “meaningfully use” HIT. “Meaningfully” is still being defined, but refers to applying this technology to actually improve clinical outcomes.
Whitehouse said that Republican opposition to Clinical Effectiveness Research surprised him. “No company would attempt a transformation one one-hundredth this complex” without Quality Assurance and accountability. “Someone has to be in charge."