Rapid incorporation of new genetic technologies may be limited by the availability of genetic counseling, concerns regarding inclusion of clinically mild disorders, results of unknown significance, and costs.
Striking the correct balance between providing only worthwhile testing and ensuring individual patients' reproductive choice will be a major challenge and it is important to begin to address the many ethical issues that NIPD raises.
This article considers the experience of the South African Truth and Reconciliation Commission (TRC) in promoting intergroup forgiveness and reconciliation focusing on the participation of victims in the TRC process and their response. It utilizes a variety of sources of empirical data collected during a 6-year collaborative project between the Science and Human Rights Program of the American Association for the Advancement of Science and the Centre for the Study of Violence and Reconciliation for which I served as the project director. The article analyzes transcripts of the TRC human rights violations hearings and amnesty hearings and follow-up focus groups with participants conducted as part of the project. These data show the limitations of the TRC in promoting forgiveness and reconciliation in a meaningful way. The TRC had difficulties in conceptualizing forgiveness and reconciliation on an intergroup level and concentrated instead on relationships between individual victims and perpetrators. Former victims and members of their families who testified at the violations hearings rarely mentioned these topics unless prompted to do so, and those who did were generally not inclined to forgive perpetrators. At the amnesty hearings perpetrators were reluctant to acknowledge their wrongdoing or to offer meaningful apologies, expressions of regret, or some form of compensation to those who had suffered. In light of these data the article questions the efficacy of the TRC’s approach to forgiveness and healing and the capacity of transitional justice mechanisms in postconflict societies to promote forgiveness and reconciliation.
Globalization, a process characterized by the growing interdependence of the world's people, impacts health systems and the social determinants of health in ways that are detrimental to health equity. In a world in which there are few countervailing normative and policy approaches to the dominant neoliberal regime underpinning globalization, the human rights paradigm constitutes a widely shared foundation for challenging globalization's effects. The substantive rights enumerated in human rights instruments include the right to the highest attainable level of physical and mental health and others that are relevant to the determinants of health. The rights stipulated in these documents impose extensive legal obligations on states that have ratified these documents and confer health entitlements on their residents. Human rights norms have also inspired civil society efforts to improve access to essential medicines and medical services, particularly for HIV/AIDS. Nevertheless, many factors reduce the potential counterweight human rights might exert, including and specifically the nature of the human rights approach, weak political commitments to promoting and protecting health rights on the part of some states and their lack of institutional and economic resources to do so. Global economic markets and the relative power of global economic institutions are also shrinking national policy space. This article reviews the potential contributions and limitations of human rights to achieving greater equity in shaping the social determinants of health.
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