A Question of Commitment: Children’s Rights in Canada

4. A Right to Health: Children's Health and Health Care Through a Child Rights Lens

Cheryl van Daalen-Smith, School of Nursing, York University Holding another person’s life in one’s hand, endows this metaphor with a certain emotional power that we have the power to determine the direction of something in another person’s life. We’re to a large extent inescapably dependent upon one another. We are mutually and in a most immediate sense in one another’s power. —Knud Logstrup, 19971 Introduction: Holding Another in Our Hands The Danish philosopher Knud Logstrup reminds us that we “hold another in our hands,” and in this way we find our ethical responsibilities. He states that our existence demands that we protect the lives of those who lay themselves open to us and who place themselves in our hands.2 The health of Canadian children lies in our hands, and while it may seem a tall order, the UN Convention on the Rights of the Child (CRC) is a beacon that can surely guide us in our policies and practices regarding children’s health and health care. This chapter on children’s rights to health and health care is firmly rooted in hope. For hope is central to health and quality of life. Canada’s health care system for children and youth is ripe for dialogue concerning the provision, protection, and participation rights of children.3 Canadian pediatric nurses, pediatricians, child psychologists, and others have a rich history as highly motivated advocates for children, youth, and their families. 4 A Right to Health Children’s Health and Health Care through a Child Rights Lens Cheryl van Daalen-Smith 73 The analysis provided here invites a broad adoption of the CRC on all issues concerning children’s health and health care. It separates children ’s rights to health from their right to health care; it is the latter that tends to dominate most health discourses. While article 24 of the CRC and the 2003 Concluding Observations of the UN Committee on the Rights of the Child serve as important pivots for this chapter, a broader application of the CRC will be urged. This chapter has three sections: (1) children’s rights to health, (2) children’s rights to health care, and (3) children’s rights in health care. The aims of this chapter are two: to urge the broadest application in Canada of the CRC for child health initiatives, and to urge health care practitioners and policy-makers to think beyond article 24 and view the entire Convention as a health convention. Children and youth have a right to health, to health care, and most assuredly—while engaged with health care services and programs—to other basic rights. Rights should not be dependent on age, geography, level of well-being, or status. Every child has an intrinsic right to health and well-being. Children’s Rights to Health Health is the increased becoming of who we are most deeply. —Anonymous In signing the CRC, Canada was agreeing that children have a right to health and health care. An entire text could be written about the state’s responsibility to protect and promote children’s health. Understood in the broadest terms, from autonomy, dignity, and justice to education and freedom from harm, “health” underpins the CRC. The key article in the Convention that describes children’s health rights is article 24. This article describes the right of the child to the enjoyment of the highest attainable standard of health and to facilities for the treatment of illness and rehabilitation of health. In addition, under article 2, the principle of non-discrimination requires that these health rights be accessible to every child regardless of his or her situation or status, and, under article 3, all decisions affecting the health or health care of the child require that the best interests of the child be a primary consideration. However, a broader definition of health would encompass all the substantive rights in the CRC. Defining Health In order to understand how health is ensured through the implementation of the CRC, a broad conceptualization is necessary. The word “health” 74 Cheryl van Daalen-Smith is derived from the Old English word “hael,” meaning whole. According to the World Health Organization (WHO), health is much more than the mere absence of disease. Health is most often experienced as harmony of body, mind, spirit, and environment.4 Health is a state of physical, mental , and social well-being.5 According...