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The International Covenant on Economic, Social and Cultural Rights (ICESCR) obligates states to "take steps individually and through international assistance and co-operation. to the maximum of ¿their available resources" to realize the right to health. This obligation, however, is often dismissed because (1) realizing rights through "international assistance" is thought to intrude on state sovereignty and (2) it is impossible to say what is demanded by the "maximum of. available resources." These problems can be circumvented by "reading down" the mutual assistance clause, so that it demands only that steps be taken on a state's own territory, with its pecuniary resources. Industrialized states could use public funds to research diseases such as malaria, AIDS, and tuberculosis, but they have failed to consider their ICESCR obligations in making science funding decisions. These failures point to ubiquitous and grievous violations of international law.

Although several international and regional human rights instruments, including the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights, give explicit recognition to a broad right to health, this right, at present, offers little real protection to interests in individual and community health, including reproductive and sexual health. This is so, the author argues, because the mechanisms now in place for supervision and enforcement of this and other "social human rights" are extremely weak. In these circumstances, better protection is available indirectly, through enforcement of certain "classical human rights," such as the right to life, the right to be free from inhuman and degrading treatment, and the right to found a family, that contribute to--and depend upon--realisation of a right to health.

The rights of a human being constitute the deepest basis of social obligations towards a suffering person. A list of these rights, apart from the basic right to live, enumerates many ithers. For a suffering person the most important ones are: the right to social welfare, protection against suffering, spiritual development. In John Paul IIs social teaching special emphasis is put on the issue of the rights of a suffering person, which constitutes a part of the civilisation of life which the Pope promulgates.

The drafting of the Universal Declaration of Human Rights was a crucial step in the recognition of a legal right to health. Although the past 50 years have revealed weaknesses in the Declaration, it has been an important catalyst for social and legal change worldwide and for new thinking about public health. Recently, the struggle against the HIV/AIDS epidemic has taught us that protecting the human rights of those most at risk is, in fact, a most effective means of preventing the spread of HIV. Traditional public health problems, as well as those involving new biotechnologies, must today be addressed with specific attention to human rights.

International agreements recognizing different forms of violence as violations of human rights and the definition provided by the 1993 UN Declaration on the Elimination of Violence against Women are taken as a starting point and its implications analyzed, emphasizing gender roles and stereotypes. Violence against women is related to violence in general, to the so-called culture of violence. Factors influencing a culture of violence are discussed, as well as the differences between public and private violence, emphasizing the need to understand their interaction to be effective in preventing violence against women. It is concluded that all violence stems from unbalanced exercise of power, creating injustice and lack of real democratic interaction. When left unchallenged such situations become part of the culture of individuals and societies, reinforcing the use of violence to solve conflicts. Hence, preventing violence against women requires cultural, social, economic, and political changes that are only possible by mobilizing society as a whole.

Psychiatry is a discipline which poses particularly sophisticated and subtile requirements from the point of view of professional ethics, as well as general morality, especially when a psychiatrists is a forensic court expert. The necessity of freeing oneself from the temptation to succum to one's distance, and preserve a suitable professional perspectives, with a simultaneous understanding of another human being, often forces the forensic expert to face the toughest and doctor. One also has to bear in mind the specific triple responsibility of the forensic psychiatrists: before the examined person, the confidence in him and whose interests also need to be respected and protected. Another deontological problem is the issue of keeping professional secrets which should belong to the duties of every psychiatrists and psychologists, and particularly that of a forensic expert. The issue of professional secrets in medicine is discussed in the Code of Medical Ethics (1993) and in Act on the Protection of Mental Health (1995). Finally, the deontological problems of forensic psychiatry and psychology can be analyzed at the most general level, when for instance, totalitarian states abuse institutions whose aim is to bring assistance to people with mental disturbances, for political purposes. Such accusation were never made with relation to Poland.

As a part of the strategy to promote the Regional Plan of Action on Violence and Health, the First Conference on Society, Violence, and Health was held at the headquarters of the Pan American Health Organization in Washington 16-17 November 1994. The objectives of the Conference were to: 1) Draft a declaration calling upon the heads of state of the American States to mobilize resources in order to prevent violence: 2) Create a consensus among the national and international cooperation organizations on methods and procedures to achieve effective support for democratic values and the respect of the human rights in societies living in peaceful coexistence: 3) Promote a regional movement of nongovernmental and other organizations in order to create nonviolent communities; 4) Urge the governments of the Hemisphere to commit themselves individually and through international organizations to allocate financial resources capable of reversing the trend toward violence. The Conference had five panels: 1) Violence as a Public Health Issue; 2) Towards a Democracy without Violence; 3) The Political Economy of Non-Violence; 4) a Culture of Peace for the XXI Century; and 5) Building Non-Violent Social Relations. Distinguished speakers representing various institutions related to the subject area participated in each. As part of the objectives, the participants approved a Declaration that considered the nature of violence, examined its multiple causes and different expressions, and specified the structures of the most vulnerable social groups. Explicit reference was made to the need for carrying out efforts in order to strengthen democracy, seek healthier forms of life, and strive for a culture of peace and coexistence.(ABSTRACT TRUNCATED AT 250 WORDS)

The rate of proliferation of health care reform proposals makes it impossible to consider them all adequately; whatever plan is finally legislated, there will be many who are not satisfied with it, and clamor for change is likely to be a prominent feature of health care politics for a long time. This article takes a brief look at the health care reform process in the United States, including some of the impediments to development of a plan that would address both contemporary and future issues. Some traditional ethical viewpoints and cultural values, having to do with concepts of justice, are seen as inimical to long-range program development. The need for alteration of traditional views is regarded as urgent, to facilitate cultural movement in directions that will not only permit development of workable health care programs, but will extend broadly to address other compelling societal issues. The impetus for advantageous cultural movement originates among perceptive individuals who are regarded by society as legitimately influential. Many physicians still are accorded this sort of recognition, and the considered input of medical professionals is essential.