Health and Aged Care

Lewis, Bridget; Purser, Kelly; Mackie, Kirsty

doi:10.1007/978-981-15-6735-3_10

Bridget Lewis⁴,
Kelly Purser⁴ &
Kirsty Mackie⁵

834 Accesses

Abstract

The ability to enjoy human rights more broadly, including economic, social and cultural rights, is influenced heavily by one’s state of health. There are numerous international and regional instruments in relation to the right to health, and the literature is extensive. Notwithstanding this, there is often a poor understanding of the interdependence of the right to health with other human rights, the obligations arising from these rights and the standards required to meet them, particularly in relation to older persons. Issues arising in relation to the right to health and other health-related rights are especially significant for older persons given the ageist assumptions and practices prevalent in health and aged care settings. Older persons continue to face diverse challenges in accessing affordable, appropriate and quality health and aged care services. This chapter is designed to complement the existing body of knowledge through demonstrating how fundamental human rights principles ought to guide legal frameworks in facilitating access to affordable and quality care. It argues for the adoption of a multisectoral person-centred approach embedding the core values of respect for dignity, liberty, participation and autonomy, while also delivering specific safeguards where appropriate. A holistic approach to health is necessary, incorporating determinants such as economic, social and environmental factors, while recognising the importance of functional ability and capacity. This chapter specifically considers the global context of the right to health, issues arising in relation to health and aged care systems, and barriers to accessing care.

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Notes

1.
Beard et al. (2016), 163; European Network of National Human Rights Institutions (2017), 1.
2.
Baer et al. (2016), 206.
3.
See, for example: Universal Declaration of Human Rights (1948), art 25 (‘UDHR’); International Covenant on Economic, Social and Cultural Rights (1966), art 12 (‘ICESCR’); Convention on the Elimination of All Forms of Racial Discrimination (1965), art 5(e)(iv); Convention on the Elimination of All Forms of Discrimination Against Women (1979), arts 11(1)(f), 12 and 14(2)(b) (‘CEDAW’); Convention on the Rights of the Child (1989), art 24; Convention on the Protection of the Rights of All Migrant Workers and Members of their Families (1990), arts 28, 43(e) and 45(c); Convention on the Rights of Persons with Disabilities (2006), art 25 (‘CRPD’); African Charter of Human and Peoples’ Rights (1981), art 16; European Social Charter (1996), art 11; Additional Protocol to the American Convention on Human Rights in the Area of Economic, Social and Cultural Rights (1988), art 10.
4.
Sadana et al. (2016), 181.
5.
See, for example: Gostin et al. (2018); Harrington and Stuttaford (2010); Tobin (2012); Hunt (2016).
6.
Baer et al. (2016), 206.
7.
European Network of National Human Rights Institutions (2017), 2.
8.
Ibid.
9.
World Health Organization (2018); Beard et al. (2016), 163; Chatterji et al. (2015).
10.
World Health Organization (2018); Beard et al. (2016), 163.
11.
World Health Organization (2015), 49.
12.
For more on this, see: World Health Organization (2015), 49–51.
13.
Royal Commission into Aged Care Quality and Safety (2019).
14.
World Health Organization (2015), 94–5.
15.
Beard et al. (2016), 163.
16.
Ibid.; Lloyd-Sherlock et al. (2012).
17.
World Health Organization (2015), 64–6; Beard et al. (2016), 163.
18.
World Health Organization (2015), 64–6; Beard et al. (2016), 163.
19.
Pot et al. (2018).
20.
Royal Commission into Aged Care Quality and Safety (2019).
21.
Beard et al. (2016), 163; Staudinger et al. (2016).
22.
Fried (2016), 167.
23.
Committee on Economic, Social and Cultural Rights (2000).
24.
Baer et al. (2016), 208; World Health Organization (2015), 27.
25.
World Health Organization (2018).
26.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
27.
World Health Organization (2019); World Health Organization (n.d.).
28.
World Health Organization (n.d.).
29.
Committee on Economic, Social and Cultural Rights (2000).
30.
UDHR, arts 22 and 25; ICESCR, art 9.
31.
ICESCR, art 11.
32.
United Nations Principles for Older Persons (1991), Principle 7 (‘UN Principles’); Kornfeld-Matte (2017), para 13.
33.
UDHR, art 25(1).
34.
See, for example, CRPD, art 3.
35.
World Health Organization (2019); World Health Organization (n.d.).
36.
World Health Organization (2015), 28.
37.
Ibid., 65.
38.
Ibid.
39.
Ibid.; Purser and Rosenfeld (2014); Purser (2017).
40.
On measuring and analyzing this trajectory see, for example: World Health Organization (2015), 65–7. See also: Cosco et al. (2014).
41.
World Health Organization (2017a).
42.
Staudinger et al. (2016), 281.
43.
World Health Organization (2018); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
44.
World Health Organization (2018).
45.
Beard et al. (2016), 164.
46.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1; United Nations Department of Economic and Social Affairs, Population Division (2015); World Health Organization (2018); See also: World Health Organization (2015), 62–4.
47.
World Health Organization (2018).
48.
World Health Organization (2015), 26.
49.
World Health Organization (2018).
50.
World Health Organization (2015), 26.
51.
Ibid.
52.
United Nation Department of Economic and Social Affairs Programme on Ageing (2018), 1; World Health Organization (2018); Beard et al. (2016), 164; Dannefer (2003); Sadana et al. (2016), 179.
53.
United Nation Department of Economic and Social Affairs Programme on Ageing (2018), 1; United Nations Department of Economic and Social Affairs, Population Division (2015); Courtin and Knapp (2017).
54.
Foebel and Pedersen (2016); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
55.
World Health Organization (2018); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1; Beard et al. (2016), 164; Sadana et al. (2016), 179; Dannefer (2003).
56.
World Health Organization (2017b); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
57.
Sadana et al. (2016), 179; United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1, 3.
58.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 5; World Health Organization (2018); See also in World Health Organization (2015), 58–62.
59.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 5. See also St. Sauver et al. (2015).
60.
World Health Organization (2015), 26.
61.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3; United Nations Department of Economic and Social Affairs, Population Division (2015).
62.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3–4.
63.
Ibid.
64.
See, for example: LaVeist (2005).
65.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 4.
66.
Ibid.; World Health Organization (2015).
67.
World Health Organization (2017a), United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 4; World Health Organization (2015).
68.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 4.
69.
Ibid., 5; World Health Organization (2018); World Health Organization (2015), 53–64.
70.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3; World Health Organization (2015), 54, 57.
71.
World Health Organization (2015), 57; United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 5.
72.
World Health Organization (2015), 57.
73.
Ibid., 55.
74.
Ibid.
75.
Ibid.
76.
Ibid.
77.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
78.
Beard et al. (2016), 164.
79.
ICESCR, art 12.
80.
World Health Organization (2015), 14; Baer et al. (2016), 209; Committee on Economic, Social and Cultural Rights (2000).
81.
The availability of user-friendly information in the Australian aged care system was heavily criticised in Royal Commission into Aged Care Quality and Safety (2019), 2. See also Committee on Economic, Social and Cultural Rights (2000), para 12.
82.
World Health Organization (2015), 14; Baer et al. (2016), 209.
83.
Baer et al. (2016), 211.
84.
Ibid.
85.
Ibid.
86.
Ibid., 208.
87.
Hunt (2016).
88.
International Covenant on Civil and Political Rights (1966), art 6 (‘ICCPR’).
89.
Ibid., arts 7 and 9.
90.
Ibid., art 12.
91.
Ibid., art 26.
92.
Ibid., art 17.
93.
UN Principles, Principle 7; Kornfeld-Matte (2017), para 13.
94.
ICCPR, art 18.
95.
ICESCR, art 9. See also: European Network of National Human Rights Institutions (2017), 7.
96.
ICESCR, art 12; Committee on Economic, Social and Cultural Rights (2000).
97.
Baer et al. (2016), 207.
98.
CRPD, arts 3, 19 and 25; Committee on the Rights of Persons with Disabilities (2017); European Network of National Human Rights Institutions (2017), 7.
99.
Baer et al. (2016), 206.
100.
World Health Organization (2015), 14.
101.
Baer et al. (2016).
102.
European Network of National Human Rights Institutions (2017), 7.
103.
Ibid.
104.
Ibid., ii, 17.
105.
Ibid., ii. See also: Royal Commission into Aged Care Quality and Safety (2019).
106.
European Network of National Human Rights Institutions (2017).
107.
Ibid. On hospital-based elder abuse interventions see, for example: DuMont et al. (2015).
108.
European Network of National Human Rights Institutions (2017), ii, 3.
109.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
110.
World Health Organization (2015), 15, 27; Baer et al. (2016), 208. The obligation of progressive realization is set out in article 2 of the ICESCR.
111.
World Health Organization (2015), 15.
112.
Ibid.; Royal Commission into Aged Care Quality and Safety (2019), 79.
113.
European Network of National Human Rights Institutions (2017), 13.
114.
Ibid.
115.
Ibid., 15–6.
116.
Madrid International Plan of Action on Ageing (2002).
117.
World Health Organization (2002).
118.
The others being economic, behavioural, personal, social, and the physical environment: World Health Organization (2015), 5.
119.
Ibid.
120.
Ibid., 4.
121.
Ibid.
122.
Ibid.
123.
Ibid.
124.
Ibid.
125.
United Nations General Assembly (2015) Goal 3 (‘UNSDGs’); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
126.
World Health Organization (n.d.); International Labour Organization (2017), 101.
127.
Gostin et al. (2018), 2733–4.
128.
UNSDGs Goal 5; United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
129.
UNSDGs Goal 10; United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1.
130.
World Health Organization (n.d.).
131.
Ibid.; International Labour Organization (2017), 101; Burholt and Dobbs (2012).
132.
International Labour Organization (2017), 101.
133.
Ibid.
134.
Ibid.
135.
Ibid.
136.
Ibid.
137.
Ibid.
138.
Ibid.
139.
Ibid.
140.
World Health Organization (2017b).
141.
World Health Organization (2019).
142.
World Health Organization (2015), 49.
143.
World Health Organization (2019).
144.
World Health Organization (2018).
145.
Ibid.
146.
Ibid.; World Health Organization (2017a, b).
147.
World Health Organization (2018).
148.
Ibid.
149.
Ibid.
150.
World Health Organization (2019).
151.
World Health Organization (2015), 6; Beard et al. (2016), 164. On the abuse of older people see, for example: Pillemer et al. (2016).
152.
World Health Organization (n.d.).
153.
Beard et al. (2016), 164; Baer et al. (2016).
154.
World Health Organization (n.d.).
155.
UN Women (2017), 3.
156.
International Labour Organization (2017), 102.
157.
World Health Organization (n.d.).
158.
European Network of National Human Rights Institutions (2017), ii, 3.
159.
Ibid.
160.
World Health Organization (2015), 137; Royal Commission into Aged Care Quality and Safety (2019), 134–5. For more on assistive technologies for older people see, for example: Garçon et al. (2016).
161.
Bennett et al. (2017), 749.
162.
Garçon et al. (2016), 293, 295.
163.
Francis et al. (2019); Australian Digital Inclusion Index.
164.
Lewis et al. (2018), 17.
165.
Bennett et al. (2017).
166.
Waycott et al. (2019); Baez et al. (2019).
167.
Kornfeld-Matte (2017), para 13.
168.
Ibid., para 14; Lewis et al. (2018), 17; Batti and ul Haq (2017).
169.
Sharkey (2012).
170.
Kornfeld-Matte (2017), 10.
171.
Button and Cross (2017).
172.
Australian Law Reform Commission (2017), Recommendation 5.3.
173.
World Health Organization (2015), 6.
174.
This can lead to costly acute services being used to meet chronic care needs and a failure to fully foster the functioning of older people receiving long-term care: World Health Organization (2015) 23, 25.
175.
Ibid., 93.
176.
Ibid.
177.
Ibid.
178.
Ibid.
179.
Ibid., 6.
180.
Ibid.
181.
Ibid.
182.
World Health Organization (2015), 6.
183.
Ibid.
184.
Ibid., 93.
185.
Ibid., 10; Royal Commission into Aged Care Quality and Safety (2019).
186.
Morris (2010).
187.
World Health Organization (2015), 6.
188.
Ibid.
189.
Ibid.
190.
Ibid.
191.
As discussed in Chap. 9, an arbitrary distinction has been made mainly for manageability between health and aged care, discussed here, and accommodation options, discussed in that chapter.
192.
World Health Organization (2015), 129.
193.
Ibid.
194.
Ibid.
195.
Ibid.
196.
Ibid.
197.
Ibid.; Low and Fletcher (2015); Szanton et al. (2015).
198.
World Health Organization (2015), 36.
199.
Barbosa Neves et al. (2019); Australian Institute of Health and Welfare (2019).
200.
See, for example: Australian Government Department of Health, Aged Care Sector Committee Diversity Sub-Group (2019); World Health Organization (2015), 36.
201.
European Network of National Human Rights Institutions (2017), 12.
202.
Ibid.
203.
See, for example: Royal Commission into Aged Care Quality and Safety (2019).
204.
Ibid., 12.
205.
Ibid., 1, 5.
206.
Ibid.
207.
Ibid., 3–4.
208.
Ibid., 10.
209.
Ibid., 6.
210.
Ibid., 7, 8, 12.
211.
Ibid., 193.
212.
ICCPR, arts 7, 9 and 12; Royal Commission into Aged Care Quality and Safety (2019), 194.
213.
Royal Commission into Aged Care Quality and Safety (2019), 193.
214.
Ibid; Australian Government (2019).
215.
Royal Commission into Aged Care Quality and Safety (2019), 10.
216.
World Health Organization (2015), 133; Meyer et al. (2009); Feng et al. (2009).
217.
Human Rights Watch (2019).
218.
Ibid.
219.
Royal Commission into Aged Care Quality and Safety (2019), 216.
220.
Ibid., 201; Human Rights Watch (2019).
221.
Royal Commission into Aged Care Quality and Safety (2019), 195.
222.
Ibid., 5, 111, 114–5.
223.
Ibid., 73ff; Carnell and Paterson (2017).
224.
World Health Organization (2015), 133; Johannesen and LoGiudice (2013).
225.
World Health Organization (2015), 129; Pot (2013).
226.
World Health Organization (2015), 129; Pot (2013).
227.
World Health Organization (2015), 129.
228.
Ibid.; De Bruin et al. (2010); Verbeek et al. (2012); Willemse et al. (2014); Smit et al. (2014); te Boekhorst et al. (2009).
229.
World Health Organization (2017a).
230.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 1, 2.
231.
Ibid., 2; HelpAge International (2011).
232.
World Health Organization (2015), 89–90.
233.
Ibid.
234.
Ibid.
235.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
236.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d.), 4.
237.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2; United Nations Secretary—General (2012).
238.
World Health Organization (2015), 129.
239.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d.), 4.
240.
Ibid; World Health Organization (2015).
241.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d.), 4; World Health Organization (2015).
242.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d.), 4; World Health Organization (2015).
243.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d), 4; World Health Organization (2015) Fig. 4.3.
244.
World Health Organization (2015); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 4.
245.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d.), 4.
246.
Ibid., 2; Cox (2015), 46.
247.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
248.
United Nations Department of Economic and Social Affairs Programme on Ageing (n.d.), 4.
249.
Ibid.
250.
Sadana et al. (2016), 179.
251.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
252.
Ibid.
253.
Ibid.; United Nations Secretary-General (2012); HelpAge International (2011).
254.
World Health Organization (2015), 129; Low and Fletcher (2015); Szanton et al. (2015).
255.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3.
256.
Ibid.; Terraneo (2015).
257.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3; Equality and Human Rights Commission, Age Concern and Help the Aged (2009).
258.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3.
259.
UN Women (2017).
260.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3; Equality and Human Rights Commission Age Concern and Help the Aged (2009).
261.
World Health Organization (2015), 133.
262.
Royal Commission into Aged Care Quality and Safety (2019), 6, 60; Carnell and Paterson (2017). See also World Health Organization (2015), 133.
263.
World Health Organization (2015), 133.
264.
United Nations Secretary—General (2015); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 3.
265.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
266.
World Health Organization (2015), 129. For a recent example see: Royal Commission into Aged Care Quality and Safety (2019) 9, 10.
267.
World Health Organization (2015), 120–130.
268.
Ibid., 129–130.
269.
Ibid., 130.
270.
Ibid., 130–1.
271.
Ibid., 131.
272.
European Network of National Human Rights Institutions (2017), 32.
273.
World Health Organization (2015), 130–131; International Labour Organization (2017), 101.
274.
International Labour Organization (2017), 101.
275.
For more on this, see: World Health Organization (2015), 131–3.
276.
Ibid., 131.
277.
Ibid.
278.
Ibid.
279.
Ibid.
280.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 5.
281.
Ibid.
282.
World Health Organization (2015), 130–1.
283.
Alzheimer’s Disease International (2012), cited in United Nations Secretary-General (2013); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
284.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
285.
Ibid.
286.
See BBC News (2009), cited in United Nations Secretary-General (2012); United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
287.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
288.
Ibid.; Beard et al. (2016), 165.
289.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2; United Nations Secretary-General (2015).
290.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 2.
291.
Ibid., 2–3; Weaver Williams (2009).
292.
See ICESCR, art 2 for the general obligations of states.
293.
Committee on Economic, Social and Cultural Rights (2000), para 31.
294.
Brennan et al. (2019).
295.
This is incredibly topical in Australia, for example, with Victorian legislation legalising voluntary assisted suicide commencing in that state in 2019. Queensland and Western Australia are currently debating introducing legislation as well. On the history of voluntary assisted suicide and physician assisted suicide in Australia see, for example: McGee et al. (2018); Willmott et al. (2016); White et al. (2019a, b).
296.
Committee on Economic, Social and Cultural Rights (2000), para 25.
297.
Nowak (2009), para 72; Mendez (2013), para 56.
298.
Committee on Economic, Social and Cultural Rights (2000), para 25. For more on the terminology adopted in this context see, for example: McGee et al. (2018), 1371–2 and Willmott et al. (2016), 6–7.
299.
Baer (2016), 209.
300.
Ibid.
301.
Ibid.; Human Rights Watch (2011).
302.
Royal Commission into Aged Care Quality and Safety (2019), 117.
303.
There is a wealth of literature on advance health directives, see, for example: Detering et al. (2019); White et al. (2019a, b); Willmott et al. (2010).
304.
World Health Organization (2018).
305.
Ibid.
306.
Beard et al. (2016), 165; European Network of National Human Rights Institutions (2017), 18.
307.
Beard et al. (2016), 165; European Network of National Human Rights Institutions (2017), 18.
308.
United Nations Department of Economic and Social Affairs Programme on Ageing (2018), 5.
309.
Ibid.; World Health Organization (2015), 6.
310.
Beard et al. (2016), 165.
311.
Ibid.; World Health Organization (2015), 8.
312.
Beard et al. (2016), 164.
313.
Ibid.
314.
Ibid., 165.
315.
World Health Organization (2015), 6.
316.
Beard et al. (2016), 165. For hypothesized trajectories, see: World Health Organization (2015), 31. See also: Cosco et al. (2014).
317.
World Health Organization (2015), 93.
318.
Ibid., 128.
319.
Beard et al. (2016), 165.
320.
Ibid.
321.
European Network of National Human Rights Institutions (2017) 18.

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Australian Centre for Health Law Research, Faculty of Law, Queensland University of Technology, Brisbane, QLD, Australia
Bridget Lewis & Kelly Purser
Faculty of Law, University of the Sunshine Coast, Sunshine Coast, QLD, Australia
Kirsty Mackie

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Lewis, B., Purser, K., Mackie, K. (2020). Health and Aged Care. In: The Human Rights of Older Persons. Springer, Singapore. https://doi.org/10.1007/978-981-15-6735-3_10

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DOI: https://doi.org/10.1007/978-981-15-6735-3_10
Published: 08 August 2020
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