Chapter 1: Introduction
Health Rights: The Phenomenon and the Problem
The Existing Literature
The Current Project
Part I: Conceptualizing and Measuring the Right to Health Care
Chapter 2: Health Rights: A Taxonomy
Introduction
Rights and Duties
A Brief Taxonomy of Health Rights (and Health Rights Projects)
The Present Project’s Place in the Taxonomy
Problems Facing Existing Health Rights
Conclusion
Chapter 3: The Case for a Pluralist Conception of the Right to
Health Care
Introduction
A Pluralist Model is Necessary to Account for the Right’s
Uncontroversial Features
(a) The Goods Necessary for a Dignified Existence Jointly
Constitute a Necessary Component of the Right to Health Care
(b) The Goods Necessary for a Dignified Existence Alone Do Not
Capture All That Should Be Under the Right to Health Care
(c) Procedural Fairness in Health Care Allocation is a Necessary
Component of the Right to Health Care
(d) Procedural Fairness Alone Does Not Capture All That Should Be
Under the Right to Health Care
(e) A Functioning Health Care System is a Necessary Component of
the Right to Health Care
(f) A Functioning Health Care System Alone Does Not Capture All
That Should Be Under the Right to Health Care
The Pluralist Model Has Further Advantages
The Pluralist Model Can Withstand (Other) Serious Criticisms One
May Raise Against It
(a) Objection 1: The Minimum Floor Remains Subject to Problems
Plaguing Any Attempt at Specifying Content
(b) Objection 2: The Pluralist Model Cannot Identify a Traditional
Right
(c) Objection 3: Dignity Cannot Form the Basis of a Justiciable
Right
(d) Objection 4: Health Outcomes Should Be Primary
(e) Objection 5: Applying Constitutional Standards is
Preferable
Conclusion
Chapter 4: The Pluralist Right to Health Care and International
Human Rights Law
Introduction
Methodology
The Core Components of the International Right to Health Reflect
Concerns with Each Element of the Pluralist Right to Health Care
and Instantiate the Pluralist Right
(a) Universal Access to Health Care
(b) Prioritization of Certain Goods and Peoples
(c) Progressive Realization of Other Aspects of the Right
(d) Modes of Domestic Implementation
(e) Remedies
(f) Improved Health Outcomes
Conclusion
Appendix 1: A (Non-Exhaustive) List of Key Sources for Identifying the International Right to Health Care
Chapter 5: Metrics for Realization of the Right to Health
Care
Introduction
International Law and Empirical Metrics
Metrics for Right to Health Care Realization
(A) Health Care System/Policy Markers
(B) Self-Defined Benchmarks and Indicators
(C) Coverage of and Access to Essential Goods
(D) Daniels and Sabin’s Fairness Markers
(E) Rates of Access to the Goods Selected in the Process from
(d)
(F) Progressive Realization
Dual Application of the Metrics
Putting the Metrics to Work
Objections and Replies
(a) Objection 1: These Metrics Do Not Easily Map onto the
Components of the Pluralist Right
(b) Objection 2: No State Can or Should Be Expected to Score Well
on All These Metrics
(c) Objection 3: These Metrics Break with An Important Development
in International Law
(d) Objection 4: These Metrics Ignore the Perspective of Rights
Holders
Conclusion
Appendix 2: Metrics for Comparative Analysis of Right to Health Care Implementation
Part II: The Right to Health Care in Canada: A Case Study in Realization
Chapter 6: The Mainstream Canadian Health Care System and the
Pluralist Right to Health Care
Introduction
An Introduction to the Canadian Health Care System
The Mainstream Canadian Health Care System Does Not Ensure Access
to Many Goods Necessary for a Dignified Existence
The Mainstream Canadian Health Care System Fulfills Some, But Not
All, Aspects of Accountability for Reasonableness
The Mainstream Canadian Health Care System Does Not Have All the
Systemic Elements Demanded by the Pluralist Right to Health
Care
Canada’s Progressive Realization of the Right is Difficult to
Assess and Substantive Progress Appears Minimal
Conclusion
Chapter 7: Vulnerable Populations in Canada and the Pluralist
Right to Health Care
Introduction
An Introduction to Two Vulnerable Population-Specific Programs: The
IFHP and the NIHBP
The IFHP and NIHBP Fill Some Gaps in Essential Goods Coverage for
Some Persons, but Barriers to Access Remain
The IFHP and NIHBP Do Not Fulfill All Procedural Demands of the
Pluralist Right to Health Care
The IFHP and NIHBP Help Fill in Some Gaps in Canada’s Realization
of the Systemic Component of the Pluralist Right to Health Care
The NIHBP is Gradually Progressively Realizing the Right
The IFHP Required Multiple Interventions to Avoid Serious
Deliberate Retrogression in Right to Health Care
Realization
Conclusion
Chapter 8: Tools for Better Realizing the Pluralist Right to
Health Care in Canada
Introduction
Three Branches of Canadian Public Law
(a) Constitutional Law
(b) Human Rights Law
(c) Non-Human Rights-Based Administrative Law
Possible Legal Paths Forward
(a) Constitutional Law
(b) Human Rights Law
(b) Non-Human Rights-Based Administrative Law
Conclusion
Conclusion: Next Steps
Chapter 9: Concluding Thoughts and the Path(s) Forward
Introduction
Summary
Directions for Future Research
Michael Da Silva is the Alex Trebek Post-Doctoral Fellow
in Artificial Intelligence and Healthcare at the University of
Ottawa.
"Despite growing constitutional recognition and the calls of
individual claimants and organized movements around the world, the
human right to health care still attracts sceptics. Michael Da
Silva's important book provides an analytical corrective to this
scepticism and a basis for engagement that is grounded in both
legal and political thought." --Katharine G. Young, Professor of
Law, Boston College
"Michael Da Silva successfully bridges the scholarship on health
rights and on the strengths and weaknesses of the Canadian health
care system in providing the substance of the content of a right to
health care. This book connects theoretical arguments for a right
to health care with the field of health system performance metrics,
measurement, and evaluation. The scholarship is not only sound but
impressive in its breadth." --William Lahey, President and
Vice-Chancellor of the University of King's College, and former
Professor in the Schulich School of Law, Dalhousie University
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