David J. Rothman is Bernard Schoenberg Professor of Social Medicine and History at the Columbia College of Physicians and Surgeons and president of the Institute on Medicine as a Professor. »

Trust is Not Enough

Bringing Human Rights to Medicine

By David J. Rothman
By Sheila M. Rothman

During the last half-century many international declarations have proclaimed health care to be a fundamental human right. But high aspirations repeatedly confront harsh realities, in societies both rich and poor. To illustrate this disparity, David and Sheila Rothman bring together stories from their investigations around the world into medical abuses. A central theme runs through their accounts: how the principles of human rights, including bodily integrity, informed consent, and freedom from coercion, should guide physicians and governments in dealing with patients and health care.

Over the past two decades, the Rothmans have visited post-Ceausescu Romania, where they uncovered the primitive medical practices that together with state oppression caused hundreds of orphans to develop AIDS. They have monitored the exploitative international traffic in organs in India, China, Singapore, and the Philippines. One of the most controversial questions they explore is experimentation on human beings, whether in studies of the effects of radioactive iron on pregnant women in 1940s Tennessee or in contemporary trials of AIDS drugs in the third world. And they examine a number of rulings by South Africa's Constitutional Court that have suggested practical ways of reconciling the right to health care with its society's limited resources.

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