Equitable access, appropriate quality. Twenty years after the Oviedo Convention

Abstract

The right to protection of health, which includes access to health care services, is enshrined in many Declarations and other normative documents at the international level. The reference to equity is usually meant to deal with the constraint of available resources and not elude the reality of persisting inequalities. The reference to appropriateness is to underline the role of professional competence and scientific knowledge and progress in order to fit real needs, but also to optimize the use of resources. Article 3 of the Oviedo Convention aims at protecting both human rights and the dignity of the human being and still offers a fruitful starting point to elaborate on some of the most valuable conceptual and juridical tools that have been refined over these last decades to address this challenge: the principle of progressive realization, which can trigger and strengthen an emancipatory dynamic; the exercise of balancing principles, interests and goods both in the case law of Constitutional Courts and in policies; the concept of the core content of the right (entitlement) to health care services. These solutions are now confronted with the applications of new, unprecedented advancements of biomedical science, such as precision medicine. At the same time, the reference by the Convention to the jurisdiction of the Parties (the States) as the institutional framework within which obligations are undertaken needs to be further articulated against the global scope of the commitment to ‘protect’ human dignity and human rights.