Par : Édith Gaudreau-Lebel
When health goes, everything goes. This maxim might be simplistic, but it is a good representation of how our society views the primacy of health and its interdependence to various other rights. If health is so important, especially for the proper development of children, how do we ensure that “no child is deprived of his or her right of access to […] health care services,” as it is prescribed in the Convention on the Rights of the Child (OHCHR, 2017)?
While it seems that a broader understanding of the concept of health would allow for a more holistic protection, examples such as the European Pediatric Association guidelines for the evaluation of health present a narrow perspective of a scientific protocol that does not completely take into account the human dimension of health and healing.
While reflecting on this tension between technical and contextualised evaluation, I found an article that depicts a Canadian example where the rules and standardized policies have taken over the more logical and sensible side of a situation. The newspaper article, called “Ottawa spent $110K in legal fees fighting over $6K dental procedure,” describes how a young indigenous girl, living with excruciating pain relating to teeth problems, was denied the payment for orthodontic treatment (Tasker, 2017). While the treatment would have cost $6,000, the court battle that was initiated subsequently cost the federal government more than $110 000.
In the aforementioned article, Cindy Blackstock raises some concerns that clearly portray the tensions between technical rationality and practical judgement: “We are saying, if there’s a medical need, and where the alternative is a far more costly intervention [such as surgery], that the government would pay for any event, why not take the lower-cost item that’s actually in the child’s best interest?” (Tasker, 2017). In this example, the courts act as the instrument of control, using legal procedures to standardize access to health through governmental funding. What is left out of the equation is the long-term perspective of non-immediate treatment, but most importantly, the human dignity of this suffering child who was not listened to.
The article also mentions how the First Nations health program justified its decision by consulting four different orthodontists of its own choosing, but none of them physically examined the young girl. In this particular situation, it is evident that the specialists cared more about a technical/biomedical evaluation (i.e. if the claimant has “severe and functionally handicapping malocclusion”) than a more “child-centred” analysis of the consequences of not treating the children right away.
In the end, two of the most important concerns from a children’s rights perspective were not regarded in this instance: that the best interests of the child should be a primary consideration (Article 3) and that the child has a right to be listened to (Article 12), which means that he or she should be consulted about his/her own health to ensure that the most appropriate treatment is applied to his/her particular situation. No matter the cost and without any discrimination, every child, including first nations (If that is the emphasis, if not, keep it like that) should enjoy the “highest attainable standard of health” (Article 24) in order to give them the best opportunity to participate in a fair society.
OHCHR. (2017). Convention on the Rights of the Child: Article 24. Retrieved from http://www.ohchr.org/EN/ProfessionalInterest/Pages/CRC.aspx
Tasker, J.P. (2017, September 29). Ottawa spent $110K in legal fees fighting over $6K dental procedure. CBCNews. Retrieved from http://www.cbc.ca/news/politics/health-canada-legal-fees-first-nations-girl-dental-coverage-1.4310224