This month, the United States received a stinging indictment of its human rights record spanning the Trump and Biden administrations. As a signatory to the International Covenant on Civil and Political Rights (ICCPR), the United States must periodically report to the United Nations Human Rights Committee on its efforts to respect, protect, and fulfill basic civil and political rights. In its Concluding Observations, the Committee found that the United States failed to uphold human rights obligations in over 30 distinct thematic issues.
Several areas of concern include the human rights and health harms of U.S. immigration policies, violations of medical ethics and the right to health caused by abortion bans, and the excessive use of force by law enforcement against individuals in police custody and peaceful protestors.
Based on the evidence PHR shared in two formal submissions to the Committee and conversations with Committee members and U.S. government officials in Geneva, it is apparent that despite some good faith efforts, the United States still falls short in upholding some basic international human rights standards. Several areas of concern include the human rights and health harms of U.S. immigration policies, violations of medical ethics and the right to health caused by abortion bans, and the excessive use of force by law enforcement against individuals in police custody and peaceful protestors, among other issues.
The United States is obliged to respond within a year and explain how it will comply with its human rights obligations under the ICCPR.
Immigration
Immigration policies adopted under the Trump and Biden administrations violate the human right to seek asylum, according to the Committee. Administrative rule “Circumvention of Lawful Pathways,” the CBP One mobile application, the “enhanced expedited removal” procedure, and the “Zero Tolerance Policy” were specifically criticized by the Committee for causing discrimination on the basis of nationality and risking the safety of asylum seekers, including their unlawful repatriation to potentially dangerous environments (refoulement). The Committee also flagged that reports of the U.S. government’s extensive use of solitary confinement and poor health conditions for detained asylum seekers violate international standards.
The Committee’s Concluding Observations align with evidence submitted by PHR that the “Zero Tolerance Policy” led to psychological trauma and constituted torture for asylum seekers. Our submission to the Committee highlighted that:
More than 5,000 children were forcibly separated from their parents at the U.S.-Mexico border – 860 of whom remain separated from their parents – causing lasting physical and mental trauma for families.
We also shared evidence of inhumane conditions, medical neglect, and abusive treatment in immigration detention, including during the height of the COVID pandemic in PHR’s report “Praying for Hand Soap and Masks: Health and Human Rights Violations in U.S. Immigration Detention during the COVID-19 Pandemic” and in our subsequent report “Behind Closed Doors: Abuse and Retaliation Against Hunger Strikers in U.S. Immigration Detention.”
We urged the Committee to take a stronger stance toward the United States by calling for the end of immigration detention and adopting alternative, non-surveillance, community-based measures. We concur with the Committee that the United States also must improve accountability for excessive use of force and poor conditions in detention and provide reparations to families affected by family separation policies.
Reproductive Rights
The assault on reproductive rights in the United States, particularly in the aftermath of the Dobbs v. Jackson Women’s Health Organization decision, was another area of concern for the Committee. In its Concluding Observations, the Committee stated that it
“is alarmed at the increase of legislation, barriers and practices at the state level that impede women’s access to safe and legal abortion, inter alia, the criminalization of various actors linked to their role in providing or seeking abortion care, including health care providers.”
These barriers, it explained, violate the rights to “life, privacy, and not to be subject to cruel and degrading treatment” which disproportionately impact women and girls with low incomes from vulnerable groups. Committee members cautioned that restricting access to reproductive health services will greatly exacerbate maternal mortality rates – a significant concern given that the United States already has the highest rate of maternal mortality among developed countries.
The Committee’s conclusions come as no surprise. PHR’s report “No One Could Say: Accessing Emergency Obstetrics Information as a Prospective Prenatal Patient in Post-Roe Oklahoma” found that state laws criminalizing abortion in Oklahoma have caused widespread fear and confusion among medical personnel when providing obstetric services and limit patients’ abilities to access information about care options. These findings reflect a growing trend across the United States and highlight the country’s backsliding on sexual and reproductive health and rights.
The federal government must take a more active role in challenging state bans and strengthening shield laws that protect cross-state travel and clinicians’ medical licenses across states. The United States should also redouble its efforts to prevent maternal mortality and eliminate health care disparities, particularly racial and ethnic disparities, as highlighted by the Committee.
Torture
The Committee made it apparent that the United States has not fully reckoned with and ensured accountability for its use of torture. In 2019, PHR helped bring to light that in the Guantánamo Bay Detention Facility, detainees’ medical needs were regularly subordinated to security functions, medical records were incomplete and withheld from prisoners, and health services were often insufficient.
The Committee decried “the lack of specialist care and facilities to address the complex health issues of detainees” at the Guantánamo Detention Facility and called on the United States to hold perpetrators of torture in the Armed Forces criminally accountable. It recommended investigating allegations of torture using the Istanbul Protocol, the international standard for documentation of torture which PHR helped develop. It is alarming that the United States has no formal human rights mechanism to investigate these allegations as exists in many other countries.
Policing
The Committee also decried the United States’s policing practices that violate the rights to nondiscrimination and freedom of assembly. As noted by the Committee, racial profiling is still used by law enforcement and leads to the overrepresentation of racial minorities in the criminal legal system. PHR’s research has demonstrated that deaths in police custody, particularly of people of African descent, are undercounted across the country and that the use of excessive force against peaceful protestors is most pronounced against the same group of people.
Similarly, the Committee called on the United States to comply with international standards on the use of force and to improve accountability by mandating that law enforcement agencies report all excessive or deadly use of force to the public. “Less lethal” crowd-control weapons used by law enforcement can cause serious health and human rights harms and can constitute collective punishment. Nonetheless, these weapons are often used indiscriminately against peaceful protestors in the United States and throughout the world. These demands for accountability align with PHR’s research and recommendations, such as in the 2023 report “Lethal in Disguise 2: How Crowd-Control Weapons Impact Health and Human Rights.”
As raised in our submission to the UN Human Rights Committee, almost 40 percent of records sent to the U.S. Department of Justice by law enforcement bodies in 2021 did not include the required descriptions of the circumstances surrounding deaths in custody. Even when reported, the baseless medical diagnosis of “excited delirium” is often misused as a legal defense by law enforcement agencies despite being unscientific and rooted in racist stereotypes. While we align with the Committee’s calls for transparency and accountability, we further recommend that the United States support state efforts to ban “excited delirium” as a cause of death, as was achieved in California, and invest in alternative models of mental and behavioral health crisis response.
Next Steps
In conclusion, the United States urgently needs to improve its policies on immigration, reproductive rights, accountability for torture, and excessive force by law enforcement, among other areas. That is not to say that the government has made no efforts to rectify its human rights record – several initiatives shared with the Human Rights Committee represent promising, albeit limited, policy improvements. We encourage the U.S. government to take the Human Rights Committee’s concluding observations seriously to protect the health, safety, and rights of those currently neglected or abused. PHR will continue to monitor and document U.S. adherence to the ICCPR and other international human rights obligations in these crucial areas.
Photo: PHR Medical Director Dr. Michele Heisler speaks at the 6th civil society consultation in advance of the October 17-18 ICCPR periodic review at the United Nations. Credit: United States mission in Geneva.