committees are importing notions of health into the meaning of the right to security of the person, and, for example, the right to be free from inhuman and degrading treatment. The Inter-American Commission on Human Rights envisions a right to the satisfaction of basic health needs as part of a right to personal security. The Commission has explained that: the essence of the legal obligation incurred by any government… is to strive to attain the economic and social aspirations of its people by following an order that assigns priority to the basic needs of health, nutrition and education. The priority of the “right to survival” and “basic needs” is a natural consequence of the right to personal security (10). Data on persistently high levels of maternal mortality and morbidity, or of abortion-related mortality and morbidity, put states on notice that they may be in breach of their obligations to take effective measures to protect women’s right to security. Other human rights that are closely associated with the right to liberty and security of the person include the right to private and family life, which some con22 REBECCA J. COOK Book ch.02.qxd 11.2.2005 10:36 Page 22 stitutions explicitly refer to as the right to decide on the number and spacing of one’s children. National courts have applied these rights to require governments to reform restrictive abortion laws or to remove barriers to access to abortion services, such as partner authorization requirements. The right to be free from inhuman and degrading treatment Courts and commissions are beginning to apply the right to be free from inhuman and degrading treatment in the health context generally, and with regard to the abortion services specifically. Courts are moving beyond the traditional application of the right, which only required states to treat prisoners in humane ways, to ensure that the inherent dignity of women is respected, protected and fulfilled. The Human Rights Committee, established to monitor compliance with the International Covenant on Civil and Political Rights (the Political Covenant) addressed the inhuman and degrading nature of denial of abortion in cases of rape in considering a report submitted by the Government of Peru. When examining what the country had done to bring its laws, policies and practices into compliance with the Covenant, the Committee addressed the human rights of women, including the rights denied them by Peru’s restrictive criminal abortion law. In its Concluding Observations, the Committee expressed its concern “ that abortion gives rise to a criminal penalty even if a woman is pregnant as a result of rape and that clandestine abortions are the main cause of maternal mortality ” (11). The Committee found that the restrictions of the criminal law subjected women to inhuman treatment. Moreover, the Committee explained that this aspect of the criminal law was possibly incompatible with the rights of men and women to enjoyment of other rights set forth in the Covenant. The Committee said this would include women’s right to life, since men could request medical care of a life-endangering condition or for their subjection to violence without fear that they or their care-providers would face criminal investigation and prosecution. The Committee recommended that “ necessary legal measures should be taken to ensure compliance with the obligations to respect and guarantee the rights recognised in the Covenant ” (12). Moreover, the Committee explained that the “ provisions of the Civil and Penal Codes [ of Peru ] should be revised in light of the obligations laid down in the Covenant, ” particularly the right of women to humane treatment and to equal enjoyment of the rights under the Covenant (13). The requirement that a country conform to human rights standards, if necessary by 23 ABORTION, HUMAN RIGHTS AND THE ICPD Book ch.02.qxd 11.2.2005 10:36 Page 23 24 REBECCA J. COOK amending national laws, shows that governments can be expected to comply with the duties they have assumed to protect rights relating to reproductive and sexual health. A state is responsible, at a minimum, to require its health care providers and facilities to ensure women’s freedom from inhuman and degrading treatment by reasonable access to safe abortion and related health services, as its law permits. Moreover, where a national law that strictly penalises abortion is shown to result in inhuman treatment of women and undue maternal mortality by enforced continuation of hazardous pregnancy, the state is obliged to consider legal reform so that its law complies with human rights standards for women’s health and dignity. A new national policy could be expressed in law that more adequately balances limitations on abortion with women’s several rights to protect their lives and dignity, their security in health, and their freedom from inhuman and degrading treatment. The right to health A landmark achievement of the Cairo Programme of Action was its development of the WHO concept of health into an internationally adopted concept of reproductive health. The World Health Organization describes “ health ” as a state of physical, mental and social well-being. On this basis, the Cairo Programme states that reproductive health is: a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity, in all matters