Example 3: Training and Litigation Guides: The Practitioner Guide Project 

Project Type: Training and Litigation

The Organization 

Open Society Foundation, Public Health Program, New York, USA
Web: http://www.opensocietyfoundations.org/about/programs/public-health-program 

Health Rights: Human Rights in Patient Care
http://www.health-rights.org

Health Rights: Practitioner Guides
http://cop.health-rights.org/PractitionerGuides

The Practitioner Guide Project is an Open Society Foundations (OSF) project spearheaded by the Law and Health Initiative (LAHI) of the Public Health Program in collaboration with the Human Right and Governance Grants Program; Health Media Initiative; Roma Health Project; Russia Project; and National Foundations in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Moldova, and Ukraine.

OSF works to build vibrant and tolerant democracies whose governments are accountable to their citizens. Working with local communities in more than 70 countries, OSF supports justice and human rights, freedom of expression, and access to public health and education.

The Public Health Program aims to build societies committed to inclusion, human rights, and justice, in which health-related policies and practices reflect these values and are based on evidence. The program works to strengthen the capacity of organizations and leaders who represent marginalized communities to advocate for better health policies and practices. It also pushes for greater government accountability and transparency in health care.

LAHI supports the use of legal strategies to advance the health and human rights of marginalized and vulnerable groups. It advances this mission by applying the health and human rights framework to new issues and priority regions; developing individual and organizational leadership in the field of health and human rights; piloting innovative access to justice tools as health-related human rights interventions; advocating for rights-based legal environments that support the health of marginalized groups; and leveraging sustainable funding for efforts that advance this mission. The crux of this initiative is focused on the implementation of laws that protect the rights of both patients and providers.

The Problem 

Human rights norms are an increasingly important component of the delivery of quality medical care. OSF’s work on behalf of society’s most marginalized persons—people with disabilities, people living with HIV, people who use drugs, sex workers, Roma and other ethnic minorities—has shown that health systems can too often be places of punishment, coercion, and violations of basic rights to privacy and confidentiality, rather than places of treatment and care. At the same, health providers suffer from a lack of independence, decent working conditions, and due process protections. Laws in Eastern Europe and Central Asia have the potential to ensure accountability and address these violations, but they are rarely implemented. Additionally, in many of these countries, laws are rapidly in flux, and there is a dearth of materials providing updated guidance to navigate the various laws, as well as procedures for protection of rights through both the formal court system and alternate mechanisms, such as ombudspersons and ethics review committees.

Actions Taken 

LAHI, in collaboration with OSF partners, has supported the development of a series of Practitioner Guides and companion websites for lawyers interested in taking human rights in patient care cases—albeit patient rights or provider rights cases. The Practitioner Guides are practical how-to manuals covering both litigation and alternative dispute mechanisms. They examine patient and provider rights and responsibilities and procedural mechanisms at the national, regional, and international levels. Guides have been or are being produced in Armenia, Georgia, Kazakhstan, Kyrgyzstan, Macedonia, Moldova, Serbia, Romania, Russia, and Ukraine. They can be accessed at http://cop.health-rights.org/PractitionerGuides.

Results and Lessons Learned 

Once published, Practitioner Guides are used as a basis for training and litigation support. They show particular potential as a resource in clinical legal education programs. Although legal practitioners are the primary audience for these guides, they are also useful for medical professionals, public health managers, Ministry of Health and Justice personnel, patient advocacy groups, and patients themselves.

Follow-up activities for this project include trainings for lawyers and judges, patient-friendly versions of the guides with a focus on marginalized populations, and potential law reform to address gaps identified by the Practitioner Guide working groups.

Since human rights in patient care are constantly evolving, electronic versions of the guides are periodically updated. The international home page, www.health-rights.org, links to country websites, which provide additional resources gathered by the country working groups that prepared each guide. These resources include relevant laws and regulations, case law, tools and sample forms, and practical tips for lawyers. The websites also provide a way to connect lawyers, health providers, and patients concerned about human rights in health care. Each website provides a mechanism for providing feedback on the guides.