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Publication Print Send by mail Making Reproductive Rights and Sexual and Reproductive Health a Reality for All Reproductive Rights and Sexual and Reproductive Health Framework Author: UNFPA No. of pages: 40 Publication date: 2011 Publisher: UNFPA Available languages: English Available formats: electronic only Download PDF UNFPA_SRH_Framework_FinalVersion.pdf Autonomy Autonomy means the right of a woman to make decisions concerning her fertility and sexuality free of coercion and violence. Much turns on our understanding of coercion and violence. Key to this is the notion of choice. In health care contexts, the rights to informed consent and confidentiality are instrumental to ensuring free decision making by the client. These rights impose certain correlative duties upon health care providers and deliverers of services. They are bound to disclose information of proposed treatments and their alternatives so as to obtain the informed consent of the client, and they must respect her right to refuse treatment. Likewise, they are bound to maintain secrecy so as to allow her to make private decisions without the interference of others whom she has not chosen to consult, and who might not have her best interests at heart. “Autonomy” also means that a woman seeking health care in relation to her fertility and sexuality is entitled to be treated as an individual in her own right – the sole client of the health care provider, and fully competent to make decisions concerning her own health. This is a matter, among other things, of the woman’s right to equality before the law as to her legal capacity. As mentioned earlier, the human right of women to control their fertility and sexuality free of coercion is guaranteed implicitly by the Women’s Convention. The right to autonomy in making health decisions in general, and sexual and reproductive decisions in particular, derives from the fundamental human right to liberty. The word “autonomy” itself is not mentioned expressly in the Convention, but the value of autonomy is certainly implicit in the fundamental freedoms it guarantees to women, on a basis of equality with men. Autonomy is intimately and intrinsically connected with many fundamental human rights, such as liberty, dignity, privacy, security of the person, and bodily integrity. These form the basis for asserting rights to informed consent and confidentiality in relation to health services and health care. Moreover, article 15 guarantees women’s right to equality before the law and to full legal capacity. This includes women’s right to make free and informed decisions about health care, medical treatment and research. Women have the right to be fully informed of their options in health care, including likely benefits and potential adverse effects of proposed methods of treatment and available alternatives, including the option of refusing treatment. One of the most eloquent explications of the meaning of “autonomy” is that of Isaiah Berlin in his essay, Two Concepts of Liberty. For Berlin “liberty” in the ordinary sense is a “negative” right to freedom, in that one is entitled to be free in certain areas from the interference of others. “I am normally said to be free to the degree to which no man or body of men interferes with my activity.” But “liberty” also has a “positive” sense. It is not merely freedom “from” but freedom “to”. This positive right to freedom is “autonomy”, in the sense that one is entitled to recognition of one’s capacity, as a human being, to exercise choice in the shaping of one’s life. “This ‘positive’ sense of the word ‘liberty’ derives from the wish on the part of the individual to be his own master. I wish my life and decisions to depend on myself, not on external forces of whatever kind. I wish to be the instrument of my own, not of other men’s, acts of will. I wish to be a subject, not an object; to be moved by reasons, by conscious purposes, which are my own, not causes which affect me, as it were, from outside. I wish to be somebody, not nobody; a doer – deciding, not being decided for, self-directed and not acted upon by external nature or by other men as if I were a thing, or an animal, or a slave incapable of playing a human role, that is, of conceiving goals and policies of my own and realizing them. This is at least part of what I mean when I say that I am rational, and that it is my reason that distinguishes me as a human being from the rest of the world. I wish, above all, to be conscious of myself as a thinking, willing, active being, bearing responsibility for my choices and able to explain them by references to my own ideas and purposes. I feel free to the degree that I believe this to be true, and enslaved to the degree that I am made to realize that it is not.” Equality, Discrimination and Difference The second concept that deserves some explication is that of discrimination. Equality implies non-discrimination, and discrimination is violation of the right to equality. Article 1 of the Convention defines the term ‘discrimination against women’ as any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field” (emphasis added – CS). Two comments are in place. First, the Convention adopts an “effect” approach, whereby discrimination is condemned even if it is not purposeful. This is of particular significance in the area of health, where much of the discrimination is evident in differences in the health status of women and men, but is the result of certain patterns of behavior, sometimes described as “natural”. These patterns persist by the mere inertia of habit if no intervention is undertaken for the removal of discriminatory barriers, or if we fail to pay attention to the factors that comprise the “real” differences – some biological or physiological, and some social – between women and men in relation to their health. It should be mentioned in this context that the Committee has noted that discrimination under the Convention is not restricted to action by or on behalf of governments. This means that states may also be responsible for acts of discrimination perpetrated in the private sphere by non-governmental actors, including health care providers. The second comment is that the definition of discrimination under the Convention applies to all women, irrespective of their marital status. This is of significance in two respects. First, it expresses the underlying recognition of the institution of marriage as constructing women’s social status, which is relevant in the health area, where women are sometimes denied care and services because they are not married. Second, it also gives expression to an underlying theme of feminist theory on gender equality – that equality is not a matter of a woman’s personal relations with men, but rather a matter of women’s discrimination, as a group, in a society that is structured collectively by gendered patterns of power (one of which is the traditional marital relation). The area of health is particularly interesting in terms of equality theory because of what has already been noted: “real” differences between women and men – some biological (or physiological), and some social. Women’s health needs are different from men’s due to both biological differences and societal factors. This is particularly true as regards women’s reproductive and sexual health, not only because biological differences are of the essence, but also because discrimination against women is closely associated with prejudices and stereotypes based on patriarchal notions of women’s sexual and reproductive roles and functions. …. by Dr. Carmel Shalev, expert member, CEDAW* Excerpt – CEDAW UNFPA A Celebration of Women Filed Under: WOMEN GENDER EQUITY ISSUES Tagged With: A Celebration of Women, Maternal health, Take Action, UN, UNFPA, universal maternal health, WOMEN of ACTION™, women taking action, women.Copyright 2022 @ A Celebration of Women™ The World Hub for Women Leaders That Care
Making Reproductive Rights and Sexual and Reproductive Health a Reality for All Reproductive Rights and Sexual and Reproductive Health Framework
Autonomy Autonomy means the right of a woman to make decisions concerning her fertility and sexuality free of coercion and violence. Much turns on our understanding of coercion and violence. Key to this is the notion of choice. In health care contexts, the rights to informed consent and confidentiality are instrumental to ensuring free decision making by the client. These rights impose certain correlative duties upon health care providers and deliverers of services. They are bound to disclose information of proposed treatments and their alternatives so as to obtain the informed consent of the client, and they must respect her right to refuse treatment. Likewise, they are bound to maintain secrecy so as to allow her to make private decisions without the interference of others whom she has not chosen to consult, and who might not have her best interests at heart. “Autonomy” also means that a woman seeking health care in relation to her fertility and sexuality is entitled to be treated as an individual in her own right – the sole client of the health care provider, and fully competent to make decisions concerning her own health. This is a matter, among other things, of the woman’s right to equality before the law as to her legal capacity. As mentioned earlier, the human right of women to control their fertility and sexuality free of coercion is guaranteed implicitly by the Women’s Convention. The right to autonomy in making health decisions in general, and sexual and reproductive decisions in particular, derives from the fundamental human right to liberty. The word “autonomy” itself is not mentioned expressly in the Convention, but the value of autonomy is certainly implicit in the fundamental freedoms it guarantees to women, on a basis of equality with men. Autonomy is intimately and intrinsically connected with many fundamental human rights, such as liberty, dignity, privacy, security of the person, and bodily integrity. These form the basis for asserting rights to informed consent and confidentiality in relation to health services and health care. Moreover, article 15 guarantees women’s right to equality before the law and to full legal capacity. This includes women’s right to make free and informed decisions about health care, medical treatment and research. Women have the right to be fully informed of their options in health care, including likely benefits and potential adverse effects of proposed methods of treatment and available alternatives, including the option of refusing treatment. One of the most eloquent explications of the meaning of “autonomy” is that of Isaiah Berlin in his essay, Two Concepts of Liberty. For Berlin “liberty” in the ordinary sense is a “negative” right to freedom, in that one is entitled to be free in certain areas from the interference of others. “I am normally said to be free to the degree to which no man or body of men interferes with my activity.” But “liberty” also has a “positive” sense. It is not merely freedom “from” but freedom “to”. This positive right to freedom is “autonomy”, in the sense that one is entitled to recognition of one’s capacity, as a human being, to exercise choice in the shaping of one’s life. “This ‘positive’ sense of the word ‘liberty’ derives from the wish on the part of the individual to be his own master. I wish my life and decisions to depend on myself, not on external forces of whatever kind. I wish to be the instrument of my own, not of other men’s, acts of will. I wish to be a subject, not an object; to be moved by reasons, by conscious purposes, which are my own, not causes which affect me, as it were, from outside. I wish to be somebody, not nobody; a doer – deciding, not being decided for, self-directed and not acted upon by external nature or by other men as if I were a thing, or an animal, or a slave incapable of playing a human role, that is, of conceiving goals and policies of my own and realizing them. This is at least part of what I mean when I say that I am rational, and that it is my reason that distinguishes me as a human being from the rest of the world. I wish, above all, to be conscious of myself as a thinking, willing, active being, bearing responsibility for my choices and able to explain them by references to my own ideas and purposes. I feel free to the degree that I believe this to be true, and enslaved to the degree that I am made to realize that it is not.” Equality, Discrimination and Difference The second concept that deserves some explication is that of discrimination. Equality implies non-discrimination, and discrimination is violation of the right to equality. Article 1 of the Convention defines the term ‘discrimination against women’ as any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field” (emphasis added – CS). Two comments are in place. First, the Convention adopts an “effect” approach, whereby discrimination is condemned even if it is not purposeful. This is of particular significance in the area of health, where much of the discrimination is evident in differences in the health status of women and men, but is the result of certain patterns of behavior, sometimes described as “natural”. These patterns persist by the mere inertia of habit if no intervention is undertaken for the removal of discriminatory barriers, or if we fail to pay attention to the factors that comprise the “real” differences – some biological or physiological, and some social – between women and men in relation to their health. It should be mentioned in this context that the Committee has noted that discrimination under the Convention is not restricted to action by or on behalf of governments. This means that states may also be responsible for acts of discrimination perpetrated in the private sphere by non-governmental actors, including health care providers. The second comment is that the definition of discrimination under the Convention applies to all women, irrespective of their marital status. This is of significance in two respects. First, it expresses the underlying recognition of the institution of marriage as constructing women’s social status, which is relevant in the health area, where women are sometimes denied care and services because they are not married. Second, it also gives expression to an underlying theme of feminist theory on gender equality – that equality is not a matter of a woman’s personal relations with men, but rather a matter of women’s discrimination, as a group, in a society that is structured collectively by gendered patterns of power (one of which is the traditional marital relation). The area of health is particularly interesting in terms of equality theory because of what has already been noted: “real” differences between women and men – some biological (or physiological), and some social. Women’s health needs are different from men’s due to both biological differences and societal factors. This is particularly true as regards women’s reproductive and sexual health, not only because biological differences are of the essence, but also because discrimination against women is closely associated with prejudices and stereotypes based on patriarchal notions of women’s sexual and reproductive roles and functions. …. by Dr. Carmel Shalev, expert member, CEDAW* Excerpt – CEDAW
Autonomy
Autonomy means the right of a woman to make decisions concerning her fertility and sexuality free of coercion and violence. Much turns on our understanding of coercion and violence. Key to this is the notion of choice. In health care contexts, the rights to informed consent and confidentiality are instrumental to ensuring free decision making by the client. These rights impose certain correlative duties upon health care providers and deliverers of services. They are bound to disclose information of proposed treatments and their alternatives so as to obtain the informed consent of the client, and they must respect her right to refuse treatment. Likewise, they are bound to maintain secrecy so as to allow her to make private decisions without the interference of others whom she has not chosen to consult, and who might not have her best interests at heart. “Autonomy” also means that a woman seeking health care in relation to her fertility and sexuality is entitled to be treated as an individual in her own right – the sole client of the health care provider, and fully competent to make decisions concerning her own health. This is a matter, among other things, of the woman’s right to equality before the law as to her legal capacity.
As mentioned earlier, the human right of women to control their fertility and sexuality free of coercion is guaranteed implicitly by the Women’s Convention. The right to autonomy in making health decisions in general, and sexual and reproductive decisions in particular, derives from the fundamental human right to liberty. The word “autonomy” itself is not mentioned expressly in the Convention, but the value of autonomy is certainly implicit in the fundamental freedoms it guarantees to women, on a basis of equality with men. Autonomy is intimately and intrinsically connected with many fundamental human rights, such as liberty, dignity, privacy, security of the person, and bodily integrity. These form the basis for asserting rights to informed consent and confidentiality in relation to health services and health care. Moreover, article 15 guarantees women’s right to equality before the law and to full legal capacity. This includes women’s right to make free and informed decisions about health care, medical treatment and research. Women have the right to be fully informed of their options in health care, including likely benefits and potential adverse effects of proposed methods of treatment and available alternatives, including the option of refusing treatment.
One of the most eloquent explications of the meaning of “autonomy” is that of Isaiah Berlin in his essay, Two Concepts of Liberty. For Berlin “liberty” in the ordinary sense is a “negative” right to freedom, in that one is entitled to be free in certain areas from the interference of others. “I am normally said to be free to the degree to which no man or body of men interferes with my activity.” But “liberty” also has a “positive” sense. It is not merely freedom “from” but freedom “to”. This positive right to freedom is “autonomy”, in the sense that one is entitled to recognition of one’s capacity, as a human being, to exercise choice in the shaping of one’s life.
“This ‘positive’ sense of the word ‘liberty’ derives from the wish on the part of the individual to be his own master. I wish my life and decisions to depend on myself, not on external forces of whatever kind. I wish to be the instrument of my own, not of other men’s, acts of will. I wish to be a subject, not an object; to be moved by reasons, by conscious purposes, which are my own, not causes which affect me, as it were, from outside. I wish to be somebody, not nobody; a doer – deciding, not being decided for, self-directed and not acted upon by external nature or by other men as if I were a thing, or an animal, or a slave incapable of playing a human role, that is, of conceiving goals and policies of my own and realizing them. This is at least part of what I mean when I say that I am rational, and that it is my reason that distinguishes me as a human being from the rest of the world. I wish, above all, to be conscious of myself as a thinking, willing, active being, bearing responsibility for my choices and able to explain them by references to my own ideas and purposes. I feel free to the degree that I believe this to be true, and enslaved to the degree that I am made to realize that it is not.”
Equality, Discrimination and Difference
The second concept that deserves some explication is that of discrimination. Equality implies non-discrimination, and discrimination is violation of the right to equality. Article 1 of the Convention defines the term ‘discrimination against women’ as any distinction, exclusion or restriction made on the basis of sex which has the effect or purpose of impairing or nullifying the recognition, enjoyment or exercise by women irrespective of their marital status, on a basis of equality of men and women, of human rights and fundamental freedoms in the political, economic, social, cultural, civil or any other field” (emphasis added – CS).
Two comments are in place. First, the Convention adopts an “effect” approach, whereby discrimination is condemned even if it is not purposeful. This is of particular significance in the area of health, where much of the discrimination is evident in differences in the health status of women and men, but is the result of certain patterns of behavior, sometimes described as “natural”. These patterns persist by the mere inertia of habit if no intervention is undertaken for the removal of discriminatory barriers, or if we fail to pay attention to the factors that comprise the “real” differences – some biological or physiological, and some social – between women and men in relation to their health. It should be mentioned in this context that the Committee has noted that discrimination under the Convention is not restricted to action by or on behalf of governments. This means that states may also be responsible for acts of discrimination perpetrated in the private sphere by non-governmental actors, including health care providers.
The second comment is that the definition of discrimination under the Convention applies to all women, irrespective of their marital status. This is of significance in two respects. First, it expresses the underlying recognition of the institution of marriage as constructing women’s social status, which is relevant in the health area, where women are sometimes denied care and services because they are not married. Second, it also gives expression to an underlying theme of feminist theory on gender equality – that equality is not a matter of a woman’s personal relations with men, but rather a matter of women’s discrimination, as a group, in a society that is structured collectively by gendered patterns of power (one of which is the traditional marital relation).
The area of health is particularly interesting in terms of equality theory because of what has already been noted: “real” differences between women and men – some biological (or physiological), and some social. Women’s health needs are different from men’s due to both biological differences and societal factors. This is particularly true as regards women’s reproductive and sexual health, not only because biological differences are of the essence, but also because discrimination against women is closely associated with prejudices and stereotypes based on patriarchal notions of women’s sexual and reproductive roles and functions. …. by Dr. Carmel Shalev, expert member, CEDAW*
Excerpt – CEDAW
UNFPA
A Celebration of Women
Copyright 2022 @ A Celebration of Women™ The World Hub for Women Leaders That Care
