Publications

As the United States (“US”) approaches its 4th Universal Periodic Review (“UPR”), individuals’ sexual and reproductive health and rights have significantly deteriorated across the country, particularly with regard to abortion and related healthcare. Following the Supreme Court’s 2022 decision, Dobbs v. Jackson Women’s Health Organization,1 a growing number of states have implemented complete bans or aggressive restrictions on abortion, resulting in millions without access to care. Many seeking care, particularly in the South, are now forced to travel long(er) distances, seek medication through additional formal and informal means, or continue pregnancies against their will. Simultaneously, states are increasingly hostile to and criminalizing abortion seekers and providers, third parties who help individuals access care, and/or circumstances surrounding pregnancy, with laws that impose harsh penalties including fines, prosecution, and imprisonment.

Health and care workers play an essential role in realizing the human right to health for all people globally. In fact, the right to “the highest attainable standard of physical and mental health” enshrined in Article 12 of the International Covenant on Economic, Social and Cultural Rights would be meaningless without health and care workers. As noted by the UN Special Rapporteur on the Right to Health, these individuals are “key protectors of the right to health” and should be protected as human rights defenders. The Global Justice Center (GJC) submits the following information for consideration as the UN Special Rapporteur on the Right to Health prepares her report to the Human Rights Council, 59th Session, focusing on “health and care workers as key protectors of the right to health.” GJC applauds the Special Rapporteur for identifying the human rights of healthcare workers and their ability to protect the rights of others as strategic priorities.

Link to original letter with list of signatories We come together as international civil society organizations spanning a range of sectors and geographies to oppose the global gag rule (also known as the Mexico City Policy) and call for a permanent end to this harmful policy. This policy prohibits U.S. assistance for critical global challenges to certain organizations if they provide, counsel, refer, or advocate for legal abortion services in their own country, even if these activities are protected by local law, despite being supported solely with non-U.S. funds. Since 1984, the policy has come and gone with changes in the U.S. presidency, leaving the health and lives of millions of people vulnerable to political whims. As a result of this policy, lifesaving health services have been dismantled in communities around the world, many of which already face systematic barriers to care. Clinics have been forced to close, outreach efforts to underserved populations have been eliminated, and people have lost access to contraception and many other essential health services, resulting in more unintended pregnancies, more unsafe abortions, and more deaths. Implementing organizations who comply with the global gag rule face costly, risky, intensive administrative burdens that limit efficient program implementation and partner cooperation. When in effect, the global gag rule restricts the medical information that health care providers can offer, limits free speech, and stifles local advocacy efforts by prohibiting people from participating in public policy debates. Numerous research studies over the course of decades and the direct experiences of organizations working in diverse settings demonstrate that the global gag rule impedes access to a range of health services – including reproductive, maternal and child health care, HIV prevention and treatment, tuberculosis, malaria and even some nutrition programs – by cutting off funding for experienced providers. Even when the global gag rule is rescinded, the policy’s chilling effect persists due to fear that it will be reinstated by a future U.S. president. Even when presidents lift the global gag rule immediately upon taking office, high-quality health partners face long delays in resuming participation in U.S. global health programs. Permanent repeal of the policy is urgently needed to promote sustainable progress in global health and to build and maintain long-term partnerships between the U.S. government, local organizations, and the communities that they serve. We must end this destructive cycle of widespread fear and confusion that disrupts local advocacy efforts and long-standing partnerships, and undercuts the vital work of organizations on the ground. Ending the global gag rule for good would lift the threat of reinstatement and allow U.S.-funded programs to reach their full potential, thus ensuring that the needs and rights of people around the world are fulfilled. We are in solidarity with those opposing the global gag rule and those harmed by it. Together, we call for urgent action to end this policy once and for all and to advance health, human rights, and gender equality across the globe.

Idaho’s “Defense of Life Act” (“Act” or “Idaho’s Law”), a near-total abortion ban, restricts access to necessary emergency reproductive healthcare, exacerbating preventable maternal mortality and morbidity and otherwise negatively impacting pregnant people. The law’s narrow exception for life-saving care will not prevent or mitigate these harms and will leave patients without access to emergency reproductive healthcare. The United States has ratified several human rights treaties that require it to guarantee access to safe and legal reproductive health services, in particular in emergencies or acute medical crises governed by the Emergency Medical Treatment and Active Labor Act (“EMTALA”). Under these treaties, the U.S. is required to respect, protect and fulfil the rights to life; freedom from torture and cruel, inhuman and degrading treatment; non-discrimination; and privacy. Idaho’s draconian abortion law fails to respect these rights and violates the U.S.’s treaty obligations. This violation of the U.S.’s treaty obligations militates in favor of affirming the preliminary injunction issued by the District Court. Causing the U.S. to violate its international obligations will result in irreparable harm and is not in the public interest.

Summary of Argument Idaho’s near-total abortion ban restricts access to necessary emergency reproductive healthcare, exacerbating preventable maternal mortality and morbidity and otherwise negatively impacting people capable of pregnancy in Idaho. The law’s narrow exception for life-saving care will not prevent or mitigate these harms in practice, and will leave patients in Idaho without access to emergency reproductive healthcare. The United States has ratified several human rights treaties—including the International Covenant on Civil and Political Rights (ICCPR), the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD), and the Convention Against Torture (CAT)—which require it to guarantee access to safe and legal abortion services, in particular in emergencies or acute medical crises governed by the Emergency Medical Treatment and Active Labor Act (EMTALA). In accordance with the United States’ obligations under these treaties, the federal government—and therefore each state—is required to respect, protect and fulfil individuals’ international human rights to life; health; privacy; non-discrimination; and to be free from torture, cruel, inhuman and degrading treatment. These rights are directly jeopardized by Idaho’s draconian abortion law.

On October 17-18 in Geneva, the United States government faced questions from civil society and the Human Rights Committee on the country’s compliance with the International Covenant on Civil and Political Rights (ICCPR). In addition to questions on immigrants’ rights, racial discrimination, and more, US officials were pressed repeatedly on the state of abortion access in the wake of the US Supreme Court’s ruling in Dobbs v. Jackson Women's Health Organization.

The June 2022 Supreme Court decision Dobbs v. Jackson Women’s Health Organization eliminated federal constitutional protection for access to abortion in the United States. Following Dobbs, more than a dozen states fully banned abortion, and many others passed or proposed increased restrictions. On October 17-18, 2023, the Human Rights Committee will review US compliance with the International Covenant on Civil and Political Rights (ICCPR), including the impact of Dobbs on its human rights obligations.

On Friday, April 7, 2023, Texas-based U.S. District Court Judge Matthew Kacsmaryk delivered his decision in Alliance for Hippocratic Medicine et al v. U.S. Food and Drug Administration et al, ruling that mifepristone should be pulled from the market. On Wednesday, April 12, 2023, a three-judge panel for the Fifth Circuit Court of Appeals partly overruled Kacsmaryk’s decision, stating that the FDA’s approval of mifepristone remains valid while also ruling to reinstate medically unnecessary restrictions to accessing the medication.  This decision could result in a devastating, nationwide ban on mifepristone — even in states where abortion is legally protected — and compromise access to medication abortion across the country. USOW and our partners across the country are mobilizing behind a united message to our judiciary: reverse this harmful decision, respect science, and uphold the law. Read the full brief

Executive Summary Following the United States (US) Supreme Court decision in Dobbs v. Jackson Women’s Health Organization in June 2022, people in the US who can become pregnant are facing an unprecedented human rights crisis. In Dobbs, the Supreme Court overturned the constitutionally protected right to access abortion, leaving the question of whether and how to regulate abortion to individual states. Approximately 22 million women and girls of reproductive age in the US now live in states where abortion access is heavily restricted, and often totally inaccessible. This briefing paper details the intensifying human rights emergency caused by the decision, and discusses the ways that Dobbs contravenes the US’ international human rights obligations. The consequences of the Dobbs decision are wide ranging. Restrictions on access to healthcare places women’s lives and health at risk, leading to increased maternal mortality and morbidity, a climate of fear among healthcare providers, and reduced access to all forms of care. Dobbs also enables penalization and criminalization of healthcare, with providers, patients, and third parties at risk of prosecution or civil suit for their involvement in private healthcare decisions. Relatedly, the decision opens the door to widespread infringement of privacy rights as digital surveillance is expanded to detect violations of new regulations. New bans also infringe on freedom of thought, conscience and religion or belief, restricting the ability of physicians to counsel patients and clergy to provide pastoral care to their congregants. Finally, the harms of Dobbs violate principles of equality and non-discrimination; they fall disproportionately on marginalized populations including Black, indigenous, and people of color; people with disabilities; immigrants; and those living in poverty. By overturning the established constitutional protection for access to abortion and through the passage of restrictive state laws, the US is in violation of its obligations under international law, codified in a number of human rights treaties to which it is a party or a signatory. These human rights obligations include, but are not limited to, the rights to: life; health; privacy; liberty and security of person; to be free from torture and other cruel, inhuman, or degrading treatment or punishment; freedom of thought, conscience, and religion or belief; equality and non-discrimination; and to seek, receive, and impart information. A version of this briefing paper was submitted to UN special procedures mandate holders in March 2023. The submission, cosigned by nearly 200 human rights, reproductive justice, and other concerned groups and individuals, requested urgent action from the UN mandate holders to examine the situation, engage with civil society, and call on the US to uphold its international human rights obligations. Less than a year on from this catastrophic legal decision, it is now apparent that the consequences are even worse than feared. Women and girls in need of reproductive healthcare are being met with systematic refusals, onerous financial burdens, stigma, fear of violence, and criminalization. Thousands are being forced to remain pregnant against their will. Part II of this briefing paper outlines the consequences of Dobbs on the fundamental human rights of women and girls, as well as the disproportionate impact it has on certain demographics made vulnerable by systemic oppressions. This factual summary includes input from physicians in various states as part of fact-gathering efforts conducted by a number of organizations involved in this submission. Part III discusses the ways in which Dobbs contravenes the US’ international obligations. Part IV sets forth our Conclusion and Calls to Action.