154.
The Inter-American Court has indicated: “the [American] Declaration contains and defines the
fundamental human rights referred to in the Charter. Thus, the Charter of the Organization cannot be
interpreted and applied as far as human rights are concerned without relating its norms, consistent with the
practice of the organs of the OAS, to the corresponding provisions of the Declaration.” Accordingly, the
American Declaration represents one of the relevant instruments for identifying the economic, social and
cultural rights to which Article 26 of the American Convention makes reference. As has already been indicated,
having recourse to other international instruments may be necessary for noting the derivation of a right based
on a measure or public policy objective included in an economic, social, cultural, educational, or scientific
provision of the OAS Charter. 295
155.
Based on the foregoing, the Commission considers it clear that the right to health constitutes
one of the economic and social provisions mentioned in Article 26 of the Convention, and in that sense the
states parties are under the obligation to seek to achieve its progressive development as well as to respect,
ensure, and adopt the measures necessary for upholding that right.
156.
On the contents of the right to health, the Committee on Economic, Social and Cultural Rights
has indicated that all health services, goods, and facilities should meet the requirements of availability,
accessibility, acceptability, and quality. 296 Both the Commission and the Court have taken into account these
concepts and have incorporated them into the analysis of various cases. 297 In that context, and bearing in mind
the facts described above, for the IACHR the states should ensure the availability of adequate mental health
establishments and services, which should be integrated to the general social services, limiting the approach of
segregated, centralized, and long-term psychiatric care. 298
157.
In this respect, the United Nations Rapporteur on the right of everyone to the enjoyment of
the highest attainable standard of physical and mental health, Dainius Pūras, has recently indicated with
respect to mental health services: “Overreliance on pharmacological interventions, coercive approaches and
in-patient treatment is inconsistent with the principle of doing no harm, as well as with human rights. Human
rights capacity-building should be routinely provided to mental health professionals.” 299 In that regard, for the
IACHR the states, through their health systems, should empower the persons with particular mental health
needs, prioritizing the defense of their own interests, seeking greater control and independence over their
health, promoting their inclusion in the community, and offering treatments based on their rights and
psychosocial support that protect them from harmful medical practices that contribute to their exclusion or
mistreatment.
158.
In addition, the IACHR has recognized that the right of access to information, which in turn is
encompassed in Article 13 of the American Convention 300, is an essential element for persons to be able to be
in a position to make free decisions grounded in respect for intimate aspects of their health, body, and
personality 301, including decisions on the application of medical procedures or treatments. In this regard,
Particularly important are the International Covenant on Economic, Social and Cultural Rights, the Additional Protocol to the American
Convention on Human Rights in the area of Economic, Social and Cultural Rights (Protocol of San Salvador) and even other treaties such as
the Convention on the Rights of the Child, the Convention on the Elimination of All Forms of Discrimination against Women and the
conventions of the International Labor Organization.
296 United Nations, Committee on Economic, Social and Cultural Rights. General Comment No. 14, E/C.12/2000/4, August 11, 2000, para.
12.
297 IACHR. Report No. 2/16. Case 12,484. Merits. Cuscul Pivaral et al. Guatemala, April 13, 2016, para. 106; I/A Court HR. Case of Poblete
Vilches et al. v. Chile. Merits, Reparations and Costs. Judgment of March 8, 2018. Series C No. 349, para. 120.
298 Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental
health, UN Doc. E/CN.4/2005/51, February 14, 2005, para. 14; 298. Report of the Special Rapporteur on the right of everyone to the
enjoyment of the highest attainable standard of physical and mental health, UN Doc. A/HRC/35/21, March 28, 2017, paras. 39, 55, 61, and
94.a.
299 Report of the Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental
health, UN Doc. A/HRC/35/21, March 28, 2017, para. 58.
300 I/A Court HR, Case of Claude Reyes et al. v. Chile, Merits, Reparations and Costs, Judgment of September 19, 2006, Series C No. 151, para.
77.
301 IACHR. Report No. 72/14. Case 12,655. Merits I.V. Bolivia. August 15, 2014. Para 115. Citing, IACHR, Access to Information on
Reproductive Health from a Human Rights Perspective, November 22, 2011; IACHR. Guidelines for Preparation of Progress Indicators in the
Area of Economic, Social and Cultural Rights, July 19, 2008, indicators on the right to health, p. 48.
295
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