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The universal human rights of freedom of speech, thought and action within the law are an essential principle in health care. Health care is at the interface between policy and practice and as such must have a strong foundation in the rights of patients and populations as human beings. In recent years there has been a political shift wherein hate speech and divisive rhetoric by key political leaders have served to ‘unleash the dark side of human nature’. This political shift has been the subject of a report by Amnesty International (2017), which has brought to stark attention the ‘dark forces’ which are changing the geo-political environment … wherein more and more politicians call themselves anti-establishment and wield a politics of demonization that hounds, scapegoats and dehumanizes entire groups of people to win the support of voters.

This rhetoric will have an increasingly dangerous impact on actual policy. In 2016, governments turned a blind eye to war crimes, pushed through deals that undermine the right to claim asylum, passed laws that violate free expression, incited murder of people simply because they use drugs, legitimized mass surveillance, and extended draconian police powers. (Amnesty International, 2017: https://www.amnesty.org/en/latest/research/2017/02/amnesty-international-annual-report-201617/)

The report also refers to the fact that some countries have implemented intrusive security measures, such as prolonged emergency powers in France and unprecedented surveillance laws in the UK. Another feature of ‘strongman’ politics has been the rise of anti-feminist and anti-LGBTI rhetoric, such as efforts to roll back women’s rights in Poland (Amnesty International, 2017).

Changes to the geo-political framework towards an openly political agenda that supports division, inequality, discrimination, scapegoating and stigma are likely to ripple across into health and social care. All who work in health care face everyday difficult decisions that profoundly impact upon people’s lives. The embedding of such decisions in a human rights-based ethical foundation of ‘do no harm’ becomes ever more relevant if the current climate continues.