PHR Contributes to International Human Rights Treaty Review of the United States

PHR is in Geneva this week to spotlight evidence of human rights violations in the United States before one of the most wide-ranging international human rights treaties. 

The International Covenant on Civil and Political Rights (ICCPR) touches on a wide array of rights ranging from the freedoms of assembly and expression to freedom from torture to equality under the law. On October 17 and 18, the United States will undergo its next regular review under the ICCPR, which it ratified in 1992. The review will be conducted by the Human Rights Committee (CCPR), the treaty body created to oversee monitoring and reporting on states parties’ compliance with the treaty. While scheduled for every five years, the United States has not undergone a review since 2014, after the process was delayed first by request of the U.S. government and then due to the COVID-19 pandemic.  

The review process is an opportunity to advance PHR’s U.S. advocacy priorities on asylum and immigration detention, U.S. policing reform, and reproductive justice. Among the key advocacy goals are: (1) defending clinicians and their work in a human rights framework; (2) debunking the racist pseudoscience of “excited delirium”; (3) increasing regulation of “less-lethal weapons”; and (4) protecting the right to abortion. 

PHR has engaged in formal submissions consultations, and briefings to confront the U.S. government’s human rights record and support the work of the CCPR. PHR has collaborated with many key U.S. civil society partners to increase our strategic impact throughout the process. 

Today marks the beginning of the two-day formal CCPR review session for the United States, where a delegation of U.S. government officials must respond to questions and concerns raised by the Committee on how the United States has failed to meet its treaty obligations under the ICCPR. The Committee will ultimately issue a series of concluding observations and will recommend reforms for the United States to implement to address the concerns raised during the review.  

Asylum and Immigration Detention  
Since the 2014 review, the U.S. asylum system has been drastically undermined by policies, including “Zero Tolerance,” “Migrant Protection Protocols,” “Title 42” and, more recently, the introduction of “Circumvention of Legal Pathways,” all of which create undue barriers to asylum. The physical and legal barriers violate the principles of domestic and international law, and continue to cause significant physical and psychological harm, at times amounting to torture, which PHR has extensively documented.    
The U.S. asylum system fundamentally does not support a trauma-informed approach, including a needless reliance on systems of detention. U.S. immigration detention lacks independent oversight, and PHR has documented violations of domestic and international standards of care. While PHR has long supported noncustodial, community-based case management alternatives to immigration detention, we are deeply concerned that new policy initiatives that claim to represent “alternatives to detention,” in fact represent an expansion to the total number of people under some form of government control or surveillance.  

One of the key advocacy goals for the review session will be to guard against further deterioration of the U.S. asylum system and work toward a system that abides by international human rights principles as well as U.S. and international law.  

Policing and Use of Force  
PHR has extensively reported on the health and human rights impacts of various forms of “less-lethal weapons” used in policing, as well as police use of force in crowd-control settings. In response to racial justice protests in 2020, PHR documented how various law enforcement agencies in cities like Portland and New York indiscriminately deployed crowd-control weapons that caused significant injuries as well as rights abuses. The United States should work to mainstream UN-backed international standards on the use of force, including on the use of crowd-control weapons. Current police standards and oversight mechanisms across much of the United States are insufficient.   

Since publishing a groundbreaking 2022 report, PHR has been campaigning to end the use of the discredited diagnosis known as “excited delirium,” which has been used in a wide range of contexts to deny police accountability for excessive force and deaths in police custody. “Excited delirium” is an unscientific term with racist origins that has become a catch-all explanation for many deaths occurring in the context of law enforcement restraint, often coinciding with mental illness. It has disproportionately been used to explain the deaths of Black men in police encounters. Today, the term lacks support from any major medical association. PHR has concluded that “excited delirium” is not a valid medical or psychiatric diagnosis and should not be used by clinicians, attorneys, or law enforcement.  
PHR has also noted that deaths in law enforcement custody, including in-custody deaths wrongly attributed to “excited delirium,” are undercounted across the United States, including by multiple federal agencies. The U.S. Department of Justice must take drastic steps to fulfill its reporting requirements under the 2013 Death in Custody Reporting Act.    

Reproductive Justice 
Another goal for the review session will be to re-establish and strengthen federal reproductive health, rights, and justice protections. The U.S. Supreme Court’s decision in Dobbs v. Jackson Women’s Health Organization marked the most widespread rollback in the protection of previously recognized constitutional rights in the country’s history. The loss of federal protection for the right to abortion has made access to abortion care much more fragmented and limited across the country and has contributed to a wider chilling effect on reproductive and maternal health. Additionally, abortion bans in restrictive states contribute to a strain on abortion care systems in haven states.   
State bans leave clinicians in a situation known as “dual loyalty,” a position where they must navigate arbitrary and punitive state laws while also seeking to comply with their ethical duty to provide the appropriate standard of care for their patients and ensure patient autonomy. In addition to undermining the provision of care, abortion bans undermine providers’ ability to provide — and patient’s ability to access — accurate information from their trusted health care providers about safe and legal abortions.  
Prior to Dobbs, Black, indigenous, and Latinx populations already experienced stark inequities in access to reproductive health care in the United States; these disparities are likely to be further exacerbated as abortion access becomes increasingly limited.  

PHR calls on the U.S. federal and state governments to restore and strengthen abortion rights to ensure access without discrimination. PHR further calls on the federal government to adopt legal measures to shield clinicians from prosecution and other penalties for providing safe abortion-related information and care, and to utilize its oversight authority to monitor the impact of abortion bans on the provision of reproductive health care and on health disparities, and the effectiveness of legislative measures. Finally, PHR calls on the U.S. government to meaningfully engage with heightened criminalization and retrogression in abortion rights as a human rights crisis. 

What’s Next? 

After two days of scrutiny and interrogation of the U.S. government delegation on the country’s human rights record, the Committee will issue a series of concluding observations and recommendations at the conclusion of the 139th CCPR session on November 3. These observations and recommendations will inform the U.S. government on steps that need to be taken to bring U.S. policy, law, and practices in line with its international human rights treaty commitments. These obligations under international law will be a critical tool that civil society, the media, activists, and the general public will use to hold the government accountable and advocate for change to advance universal human rights and freedoms in the United States.  

See the full text of the PHR submission here.  

See the full text of the PHR joint submission with CRR, Lift Louisiana and RH Impact here.

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