Human Rights as a Contingent Foundation: The Case of Physicians for Human Rights¹

I thank the members of Physicians for Human Rights USA and Israel for their cooperation and assistance, as well as Catherine Rottenberg, Jacinda Swanson, and Thomas Cushman for their constructive comments on earlier drafts. The research for this article benfited from the financial support of the Israeli Academy for the Sciences and the Minerva Institue for Human Rights at Hebrew University.

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Notes

I thank the members of Physicians for Human Rights USA and Israel for their cooperation and assistance, as well as Catherine Rottenberg, Jacinda Swanson, and Thomas Cushman for their constructive comments on earlier drafts. The research for this article benfited from the financial support of the Israeli Academy for the Sciences and the Minerva Institue for Human Rights at Hebrew University.

In the section describing its methods of action, Amnesty International notifies the public that it “at all times makes clear its impartiality as regards countries adhering to the different world political ideologies and groupings” (http://www.web.amnesty.org January 31, 2001). This claim is probably accurate in the sense that Amnesty does not take into account the political leanings of the government or the political prisoner. But if one were to examine the claim in a broader sense, one notices that Amnesty International for many years confined its mandate to political prisoners, extrajudicial executions, and “disappearances,” all of which are implicated in the liberal emphasis on civil and political rights. Along the same lines, Helsinki Watch (in due course became part of Human Rights Watch), which was established following the 1975 Helsinki Accords to monitor the treaty's human rights–related articles, failed to underscore the violation of economic and social rights even though there is reference to them in the Accords. For a discussion of the general reluctance of human rights organizations to advance economic and social rights, consult Muzaffer (1993), Beetham (1995), Alston (1997), Jocknick (1999), Stammers (1999), and Gordon et al. (2000).

After the publication of the Universal Declaration of Human Rights in 1948, the West underscored the significance of political and civil rights, whereas the East stressed the importance of economic and social rights. The ideological differences between the two blocs actually created an impasse. The deadlock was finally overcome in 1966 with the concurrent publication of two covenants: The International Covenant of Economic, Social and Cultural Rights and the International Covenant of Political and Civil Rights. Despite the approval of these covenants, tensions between the blocs remained intact, and whereas the West continued to criticize the Soviet Union, China, and their satellites for the violation of such rights as freedom of speech and due process, the Soviet bloc accentuated economic and social rights and condemned capitalist countries for tolerating unemployment and for failing to offer universal health care. Yet, the division between political and civil rights, on the one hand, and economic, social, and cultural rights, on the other, is not so clear-cut; e.g., without food and a decent education one cannot really enjoy the right to freedom of speech. This point was emphasized in the 1993 Vienna Declaration that states, “All Human rights are universal, indivisible, and interdependent and interrelated,” Vienna Declaration Article 5 reprinted in Ishay (1997: 482); also consult Donnelly (1985), Muzaffer (1993), Beetham (1995), and Alston (1997).

The term ideology is not used here in its economistic sense, as an epiphenomenon of the economic base used to camouflage ontologically privileged material forces. Rather, following Antonio Gramsci, ideology is conceived as ontologically indistinguishable from material forces. Chantal Mouffe and Ernesto Laclau stress this point, claiming that the Gramscian notion of ideology cannot be distinguished from the structure, it is no longer “identified with ‘a system of ideas’ or with ‘false consciousness’ of social agents; it is instead an organic and relational whole, embodied in institutions and apparatuses, which welds together a historical bloc around a number of basic articulatory principles” (1985: 67).

Regarding the question of the ideological underpinnings of human rights in general, the views vary considerably. By contrast to John Rawls (1971), who considers rights to be untainted by ideology, Stephen Hopgood (2000), for example, claimed that rights are implicated in Western liberalism and actually reflect a specific culture.

Gramsci's expanded notion of the state helps explain why human rights organizations did not emerge in the Soviet bloc or in China, where the state power structure were based primarily on a coercive apparatus (military, police, etc.) and not on leadership. The few groups that did organize were under constant danger. In September 1982 the Moscow Helsinki group was forced to disband after ongoing intimidation, whereas members of Charter 77 were constantly harassed and even arrested. It simultaneously explains why they were allowed to operate in the West, where the consensual aspect of power is pervasive, a power that seldom operates by forcefully annihilating antagonistic forces but constantly strives to induce and persuade them. A Gramscian analysis also reveals how oppositional political parties, unions, private organizations, and in our case rights groups are always already implicated by the hegemonic power structures, because he shows how their resistance is always informed by the dominant structures.

By corporate interests Gramsci means “the immediate and narrowly selfish interests of a particular category” (1971: 181–182).

The integral state is comprised by civil society, which in the context of Gramsci's writings means the network of associations and organizations ranging from churches and educational institutions to unions and rights groups. Gramsci also includes the media, intellectuals, and other instruments of opinion formation, which are distinct from the traditional Marxist conception of the state (1971: 342). Although one should not identify Gramsci's civil society with the liberal conception of the private realm, the two do overlap. For the difference between Gramsci's understanding of civil society and the quotidian use of the term, as well as how it differs from the liberal conception of the private realm, consult Buttigieg (1995).

Jacinda Swanson cogently observes that particular ideas and values can be simultaneously commonsensical and contested, their status changing with the particular context in which they function. See Jacinda Swanson, “Economic Common Sense and Capitalist Hegemony in the United States,” forthcoming in Historical Materialism.

Underlying determinants of health include access to safe and potable water and adequate sanitation, an adequate supply of safe food, nutrition and housing, healthy occupational and environmental conditions, and access to health-related education and information, including informational on sexual and reproductive health. Another important aspect is the participation of the population in all health-related decision making at the community, national, and international levels (CESCR 2000, Article 11).

Consult also Black et al. (1982) and Acheson (1998).

On the one hand, I agree with Wendy Larner, who argues that neoliberalism is not merely a policy or an ideology but also a form of governmentality; it is constituted by different configurations, which amount to “a complex and hybrid political imaginary, rather than the straightforward implementation of a unified and coherent philosophy” (2000: 12). However, I also believe there are certain philosophical underpinnings characterizing neoliberalism, because without some form of categorization there is no sense in offering definitions.

Cited in Caleb Daniloff, What a difference a digit makes: a neighborhood-by-neighborhood look at infant mortality in New York City. In Inequality.Org http://www.inequality.org/arno.html November 14, 2000.

The development and expansion of the dominant group is conceived of, and presented, as being the motor force of a universal expansion, of a development of all the “national” energies (1971: 182).

I examine the year 1999 because after the eruption of the second Intifada in 2000 the organization has put more emphasis on the Occupied Territories and therefore an analysis of its activities during the past five years would be somewhat skewed.

TNCs account for almost half of the top one hundred economies in the world, and a mere 200 of them are estimated to control over a quarter of the world's productive assets (Jochnick 1999: 65).

Two Lexis Nexis searches were conducted looking at articles published between December 1, 1999 and December 1, 2000. One search looked for articles that mentioned both “health” and “human rights” and the second looked at articles that mentioned “health services.” The first search came up with forty-five articles, of which only three referred to health as a human right. Health services were mentioned seventy-five times, not once in relation to human rights, whereas access to health services was mentioned twice.

A Lexis Nexis search using the term “human rights” from December 1, 1999 to December 1, 2000 in New York Times articles and editorials but disregarding paid notices.

According to Norbert Goldfield, “the defeat of the Truman national health insurance legislative proposal marked the last time an American president has attempted to pass universal health care coverage as part of a health care reform package. While readers may recall Clinton holding up a sample universal coverage card at a State of the Union speech, none of his proposals included the step-by-step specifics of how to achieve universal coverage” (Goldfield 2000: 83).

Using Lexis Nexis, we searched for “Physicians for Human Rights” in the New York Times from January 1988 until December 1, 2000.

Using Nexis Lexis two searches were conducted examining articles between December 1, 1999 and December 1, 2000, one with the terms “health” and “human rights” and the other with “health services.” The first search came up with twenty articles, of which all but one referred to health as a human right. Health services were mentioned seventy-six times, once in relation to human rights, whereas access to health services mentioned four times.

A Lexis Nexis search from December 1, 1999 to December 1, 2000 in Jerusalem Post articles and editorials mentioned the term “human rights” two hundred forty times, of which fifty-one articles (twenty-one percent) discussed human rights violations outside Israel and the occupied territories. Although the New York Times is much more of an international newspaper, the willingness of each newspaper to report violation in its home country is considerably different: eighty percent of human rights violations reported in the Jerusalem Post occur in the paper's home country versus the ten percent reported by the New York Times.

Using Lexis Nexis, we searched for “Physicians for Human Rights” in the Jerusalem Post from January 1988 until December 1, 2000. The total number of articles mentioning the group was thirty-two.