Healthcare systems and the practice of medicine is an area ripe with paradoxes. We live in a period of human history that has seen some of the most rapid advancements in medicine, and yet, large portions of the world’s population remain unable to access health care with even minimum standards of quality. These advances in medicine translate into health systems that, in many parts of the world, offer groundbreaking treatment for chronic diseases, yet nearly every health system fails to deliver such treatments to the most vulnerable and fails to sufficiently address prevention. Medical research in recent decades has amassed an enormous evidence base in support of non-coercive health interventions, psycho-social care, safe abortion, and harm reduction [2, 3]. Yet health laws, policies, and systems systematically deny access to these interventions and, in many countries, demand treatment protocols that contradict both science and evidence. Medical professionals are increasingly armed with comprehensive education on the practice and ethics of modern medicine, yet around the world, egregious violations of bodily integrity and human dignity are occurring at the hands of these same professionals and in the name of medicine .
The paradox that is perhaps the progenitor of the above examples—which I have spent countless hours pondering—is the disconnect between the provision of care in everyday medical practice and the respect for human rights principles, enshrined in the Universal Declaration of Human Rights, the International Bill of Rights, other international treaties, national laws, and constitutions.
One of the effects of this paradox is that in each country, a majority of health care professionals lack literacy of and/or enthusiasm for human rights, forcing practitioners who embrace the human rights movement to the margins. In some parts of the world, particularly countries emerging from totalitarian rule, the medical profession is deeply entrenched within the political and ideological state machinery that is allergic to the seeds of human rights. As a result, human rights lack mainstream legitimacy within the medical profession. Those wishing to utilize human rights are constrained by dual and competing loyalties and without independence to effectively integrate them into their practice.
The majority group works hard to use the tools offered by science and the practice of medicine for the care of their patients. To the most skeptical professional, human rights is empty rhetoric with no tangible benefit to the medical profession, while for others, human rights are associated with adversarial and onerous monitoring tools, which are an obstacle to their everyday work. By understanding human rights as adversarial and counterproductive, the tools offered by human rights to strengthen the practice of medicine and improve health outcomes are remain in the shadows. When members of professional medical organizations view human rights as a vessel to “revolutionize” the practice of medicine, the response is defensive, with the majority retreating to the comfort and protection of reasserting ever more vigorously those principles, long regarded as fundamental to their profession, now perceived as being under threat. This misunderstanding breeds recalcitrance, undermining the protection of human rights and impacting the health and well-being of societies across the globe (see Meier  for an overview of the political history leading up to the World Health Organization's invocation of human rights as a normative framework for global health governance).