Читать книгу The Movement for Reproductive Justice - Patricia Zavella - Страница 12

The notion that those who are marginalized by society in the United States deserve human rights and that these rights were linked to the Declaration of Independence and the Constitution was first articulated by the social reformer Frederick Douglass in the 1850s. He also argued that access to economic, social, and cultural rights should accompany human rights.¹¹¹ Yet it was not until the post–World War II era that the United Nations issued guidelines for government activity related to human rights.¹¹² The Constitution of the World Health Organization declared in 1946 that the right to health includes public health, sanitation, occupational and environmental conditions, education and nutrition, and medical treatment provided in a nondiscriminatory manner, expressing the idea that human rights are inextricably intertwined.¹¹³ Women have pushed for the notion that “women’s rights are human rights,” a slogan first used at the UN World Conference on Human Rights in Vienna in 1993. The United States ratified three international human rights treaties that protect women’s reproductive rights: the International Covenant on Civil and Political Rights, the International Convention on the Ratification of All Forms of Racial Discrimination, and the Convention against Torture. The United States also signed the Convention on the Elimination of All Forms of Discrimination against Women and the International Covenant on Economic, Social, and Cultural Rights, which confer important reproductive rights such as the right to health.¹¹⁴ However, there is no right to be healthy under international or national law.¹¹⁵ The right to health care is not mentioned in the US Constitution, and states are not required to pay medical expenses of indigents, though most provide some health coverage for the elderly and people with disabilities.¹¹⁶ Nonetheless, the World Health Organization’s definition of optimal health care was a critical intervention, a “step toward denaturalizing the suffering produced by social causes.”¹¹⁷

Increasingly, social movements have taken up the cause of ensuring that states provide access to health care for all, which includes confirming that health facilities, goods, and services are available, sensitive to ethnic and cultural concerns, of high quality, and based on scientific evidence.¹¹⁸ The moral foundations of health systems that provide universal coverage—seen as the highest standard of health-care delivery—are solidarity, community, equity, and dignity: “Respect for human dignity demands that no one refrain from seeking medical care due to fear of the consequences of doing so, and that no one suffer financial adversity as a result of having sought care.”¹¹⁹ This view was also expressed by Pope Francis, who declared, “health care is a right, not a privilege.”¹²⁰ However, evoking human rights in the United States often carries more moral authority than legal efficacy when international agreements are unenforceable.¹²¹

Activists attempting to further the human right to health care aim to foster understanding of social problems that contribute to human rights violations and their moral implications as well as to mobilize shame so as to generate change in policies and practice.¹²² The scholarship on human rights directs our attention to “the governments, armies, corporations, or other entities that are violating rights,” yet the political scientist Rosalind Petchesky reminds us that “today ‘human rights’ covers a much broader swathe of issues than egregious … crimes.”¹²³ The study of human rights by ethnographers initially focused on debates about whether universal rights were salient in relation to particular cultural groups and historically specific conditions.¹²⁴ Given the variability and historical specificity of human rights claims, ethnographers have moved toward an understanding of human rights as “a type of politically consequential normative framework that is constituted through social practice.”¹²⁵ Ethnographers encourage us to present descriptive analyses in a framework where people build what the anthropologist Meg McLagan calls a “formidable transnational communications infrastructure through which ‘local’ actors’ claims … are formatted into human rights ‘issues.’”¹²⁶ Thus scholars should specify what human rights mean for different social actors and how they relate to transnational assemblages—material, collective, and discursive relationships in which “the forms and values of individual and collective existence are problematized … so they are subject to technological, political, and ethical reflection and intervention.”¹²⁷

Human rights activism is a key reframing in the movement for reproductive justice. As the human rights activist Malika Dutt clarifies, “understanding human rights as the right to be human underscores the fact that the paradigm is not a language game but a mechanism through which we understand that we cannot take rights seriously without taking human suffering seriously.”¹²⁸ Further, according to the feminist historian Jennifer Nelson, “A human rights discourse moves the conversation beyond the dichotomy of the ‘right to choose’ abortion or carry a pregnancy to term versus the absence of that choice to an understanding that real choices require economic, cultural, and social environments that ensure a real range of options.”¹²⁹ Indeed, Rosalind Petchesky argues that human rights, reproductive health, and economic justice are indivisible and that “reproductive and sexual rights for women will remain unachievable if they are not connected to a strong campaign for economic justice and an end to poverty.”¹³⁰ Thus, reproductive justice advocates emphasize the historically specific conditions in which different categories of women of color are denied access to health care and other rights and push for accountability by the state and relevant social actors.¹³¹ Loretta Ross and her colleagues affirm, “rights are legal articulations of claims to meet human needs and protect human freedoms.”¹³²

There are tensions related to melding an intersectionality framework, which highlights structurally based inequalities that disproportionately affect vulnerable people, and human rights discourse that often uses neoliberal logic seeking redress for the universal individual subject.¹³³ Native Americans, for example, are the beneficiaries of the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP), passed in 2006, that supports human and civil rights. However, that declaration does not have the force of law and only establishes a “moral high ground” where signatories are obliged to uphold the standards of the UNDRIP for indigenous people seeking cultural, political, or economic goals, but implementation takes place within nation-states that may not honor indigenous sovereignty.¹³⁴ Further, UNDRIP does not define indigeneity or recognize political self-government from indigenous nations, which limits their ability to consent to upholding human rights protections.¹³⁵

These tensions are problematic in the United States, where settler colonists claimed that indigenous peoples, African slaves, and other groups were racially inferior and treaty rights with Native Americans have not been honored.¹³⁶ Further, in the contemporary era there are debates about whether people have the right to health or to health care that take place in a context in which legislation, the marketplace, medical training and research institutions, and “alternative” medicine shape how care is delivered.¹³⁷ Indeed, pushing for the human right to health care may seem quixotic when many Americans would lose coverage through repeal of the ACA, designed with the belief, according to Barack Obama, “that health care is not a privilege for a few, but a right for all.”¹³⁸ The ACA included coverage of reproductive health care (contraception, mammograms, and annual gynecological exams) without copayments, ended the insurance-industry rating system that charged women more than men, banned insurers from refusing coverage to people with preexisting conditions, and included preventative health services like screening for colon cancer for adults over fifty, well-child visits, flu shots for all children and adults, and many more services.¹³⁹ However, an estimated eleven million undocumented immigrants in the United States were barred from Medicaid and the Children’s Health Insurance Program, and the undocumented (along with those with Temporary Protected Status and Deferred Action for Childhood Arrivals) could not purchase private insurance from health insurance exchanges. In a study done in 2014 with thirty-three independent health agencies across nineteen states, one in four American Indian and Alaska Native people under age sixty-five had no health insurance, a rate three times higher than that for non-Hispanic whites, and the rate of uninsured youth was over three times higher than the rate of non-Hispanic white children.¹⁴⁰ These exclusions were rarely mentioned in the national debates about the ACA.¹⁴¹

Another tension in using a human rights framework is that some activists may feel pulled to concentrate their efforts within international venues such as the United Nations, which may detract from their local work. The “NGO-ization” of social movements or reliance on the “nonprofit industrial complex” may lead to diminished immersion in grassroots organizing.¹⁴² Indeed, human rights may become “the specialized language of a select professional cadre with its own rites of passage and methods of certification.”¹⁴³ However, a human rights framework provides the basis for seeking redress on behalf of structurally vulnerable people to lead healthy lives with dignity.¹⁴⁴ Malika Dutt clarifies, “When one moves to define rights as fundamental human rights, one claims the notion of a self in relation to others, a claim which, for historically disempowered groups of people, is an important step in declaring their humanity.”¹⁴⁵ Moreover, social activists work as cultural translators; according to the anthropologist Sally Engle Merry, they “present their initiatives in cultural terms that will be acceptable to at least some of the local community” by translating “local grievances … into the powerful language of transnational human rights.”¹⁴⁶ A key component in human rights training is capacity building with structurally vulnerable populations.¹⁴⁷ Cultural translators help to forge symbols, ideologies, or organizational forums in which participants are trained in the human rights framework and provide a means for their implementation. As community members become aware of human rights violations related to health, they may experience a profound shift in their subjectivities.

As we will see, the reproductive justice movement is innovative in its use of human rights and emphasizes its radical implications. It builds on the thinking of indigenous human rights activists who embrace a collectivist view toward human rights, which according to the cultural theorist Rosa-Linda Fregoso, “long spearheaded the transformation of existing human rights norms to incorporate more complex and flexible understandings of human rights.”¹⁴⁸ The notion of the right to have rights extends to nature as well, such that bodies of water, forests, or mountains should be protected along with humans.¹⁴⁹ Reproductive justice activists also claim women’s right to cultural citizenship and to use their preferred language and cultural expressions in public.¹⁵⁰ Reproductive justice activists collaborate proactively at different scales—local, state, national, and international—regarding the interconnections of multiple human rights issues.¹⁵¹ They craft alternative meanings about the rights of women, focusing on women of color, and mobilize the enactment of policies, practices, and narratives that ensure that those rights are realized. As Loretta Ross and her colleagues clarify, “Intersectionality is our process; human rights are our goals.”¹⁵² By emphasizing that different social categories become structurally vulnerable while simultaneously asserting the claim to equality, freedom, and dignity, these activists construct a politics rooted in difference. Further, the movement for reproductive justice self-consciously and strategically problematizes collaboration and advocates wholeness of body/mind/spirit among activists and participants. The approach to change constructed by advocates of reproductive justice, situated in intersectionality and human rights praxis, is fluid and complex and leads them to craft particular strategies.