In light of the Inter-American Court of Human Rights’ recent recognition of care as a universal human right, Karla Giacomin, president of Cuidadosa (Brazilian Care Association) in Brazil, shares her reflections in this article on what this landmark decision means for the future of integrated care.
Is it time to change our mindset about care as a human right?
In recent years, the discussion on the right to care has gained global prominence, emerging as a central theme in legal, social, ethical, and practical debates. This article seeks to explore the multidimensionality of the right to care, arguing that its implementation is a non-negotiable pillar for the construction of more just, equitable, and dignified societies. In this short paper, the legal, social, ethical and practical facets of care will be analysed, demonstrating how the intersection of these dimensions is crucial for the full realisation of this fundamental right.
The relevance of the theme is accentuated in a global scenario marked by demographic challenges, such as population aging, and by social crises that expose the fragility of support networks and the invisibility of a large part of care work. This article’s main argument is that the right to care, in its multiple manifestations, is an imperative for human dignity and social justice, requiring an integrated and intersectoral approach for its full realisation.
Some observers might see the idea of a “right to care” as adding to an already crowded field of human rights linked to different needs, identities and vulnerabilities. The real challenge is to ensure that these rights translate into meaningful action that respects people’s everyday needs and choices.
For example, in work that we do in Brazil, you may see older people who are not able to wash themselves, who have not been able to have a proper wash or a bath for months. Older people who experience incontinence and nobody to help them with those conditions. Older people who experience extreme pain, but don't have access to the relief that they need. Arguably, where these care needs are being neglected so severely represents one of the most severe forms of suffering, which can exist among humans on this planet. And so, the very degree of suffering, which can result from a neglect of people's care needs is a very powerful argument for framing this as a fundamental human right.
In addition, the right to care is not restricted to those who receive it, but also to those who provide it and to the capacity of each individual to take care of themselves. This three-dimensionality – being cared for, caring and self-caring – is the basis for understanding its scope and the need for public policies and legal frameworks that guarantee it in a universal and equitable way. We might also recognise the right not to receive care—such as in situations where a person’s carer has previously caused them harm or abuse. Similarly, there may be circumstances where a person should not be obliged to provide care to someone who has abused them. Both cases highlight the importance of dignity, autonomy, and protection within the right to care.
That’s why we propose to discuss this right as four dimensions: legal, ethical, social and practical.
A) Legal dimension of the right to care
The legal dimension of the right to care has gained increasing recognition in various legal systems, reflecting an evolution in the understanding of human and social rights.
In the international scenario, the Inter-American Court of Human Rights (IACHR Court) has stood out by recognising the autonomous existence of the human right to care. In recent decisions, the Inter-American Court of Human Rights has established that the right to care has the three dimensions already mentioned (being cared for, caring and self-care) and that its implementation depends on robust public policies and the guarantee of dignified conditions for those who provide care, whether paid or not [1]. This recognition by the Inter-American Court reinforces the universality of the right to care and the need for Member States to adopt measures for its full realisation.
In Brazil, the foundation of this right is rooted in the Federal Constitution of 1988, which, although it does not explicitly mention it, establishes principles and rights that serve as the basis for its interpretation and application. The principle of the dignity of the human person, for example, affirmed in Article 1, item III, of the FC/88, is one of the pillars that support the need to guarantee care as a fundamental right [2]. Human dignity implies the guarantee of minimum conditions for a full life, and care, in its various forms, is essential to ensure this fullness, especially for those in vulnerable situations.
In addition to constitutional principles, infra-constitutional legislation has advanced in regulating the right to care. A recent and significant milestone is Law No. 15.069/2024, which institutes the National Care Policy (PNC) [3]. This law aims to guarantee the right to care through the promotion of co-responsibility between the State, families, the private sector and society. The PNC recognizes care as a universal human right and divides it into three basic dimensions: the right to be cared for, the right to care, and the right to self-care. This three-dimensional approach is crucial for building a comprehensive and equitable care system, one that not only meets the needs of those in need of care but also values and supports those who provide it.
However, despite legislative and jurisprudential advances, the implementation and legal guarantee of the right to care still face significant challenges. The lack of resources, the scarcity of infrastructure and the persistence of social inequalities are obstacles that need to be overcome so that the right to care becomes a reality for all. The complexity of the issue requires an integrated approach, which combines the creation of legal frameworks with the implementation of effective public policies and society's awareness of the importance of care as a fundamental right.
B) Social Dimension of the Right to Care
The right to care depends on how societies organise and value care activities. Care encompasses practices that meet individuals' needs throughout life, such as during childhood, illness, or old age. Historically, care work—especially unpaid and domestic care provided mainly by women—has been undervalued and invisible, perpetuating gender inequalities. Access to quality care is crucial for development and social cohesion; its absence increases social and economic costs.
Disparities in care access reflect economic and social structures, with factors like gender, race, and class influencing who needs, who provides and who receives care. Women, especially those from low-income or minority backgrounds, disproportionately shoulder unpaid care work due to limited support services.
Addressing these inequalities requires shared responsibility among the state, family, market, and community. The state must ensure universal access to quality care through public policy and oversight, while families need support and resources. Markets should offer affordable care and promote work-life balance, and communities can provide mutual support. Importantly, care recipients must be central in discussions about care.
C) Ethical Dimension of the Right to Care
The ethical right to care elevates caregiving from a routine activity to a moral duty, offering an alternative or complement to traditional ethics focused on justice and universal rights.
Pioneers like Carol Gilligan and Joan Tronto emphasize the importance of relationships, interdependence, and mutual responsibility as key to moral life. Tronto identifies four ethical phases of care: attention, responsibility, competence, and receptivity, which collectively frame care as an essential practice that upholds dignity and well-being.
At its essence, care is rooted in solidarity and empathy, highlighting the value of human connection in a world that often prioritizes individualism. Yet, the ethics of care involves complex dilemmas, such as balancing autonomy with protection and addressing caregiver burdens. These challenges require ongoing dialogue and solutions that consider the well-being of all parties involved.
D) Practical Dimension of the Right to Care
The right to care is realised through practical actions, services, and infrastructure supporting daily needs. It spans basic personal assistance to specialised health, education, and social support, all crucial for an inclusive care system.
So, the transposition of these legal frameworks into practical reality still faces considerable challenges, requiring continuous investments and the overcoming of structural barriers:
- Socially, the right to care invites us to rethink the invisibility and devaluation of care work, historically attributed to women and often unpaid. The promotion of co-responsibility between the state, family, market and community is essential to relieve the individual and ensure that care is recognised as a public good. Overcoming inequalities in access to care, which disproportionately affect vulnerable groups, is a pressing challenge that demands inclusive public policies and the appreciation of all those involved in the care chain.
- In the ethical field, the ethics of care offers us a valuable lens to understand human relationships from the perspective of interdependence, attention, responsibility, and reciprocity. She reminds us that care is an expression of solidarity and empathy, and that the quality of our lives is intrinsically linked to how we care for each other. The ethical dilemmas inherent to care, such as the balance between autonomy and protection, and the burden of caregivers, require constant dialogue and the search for solutions that promote the wellbeing of all.
- Finally, the practical dimension of the right to care reveals the need for adequate infrastructure, qualified professionals and innovative technologies to ensure the provision of quality care services. Valuing care professionals, expanding accessible services, and promoting training and capacity building for care are crucial steps to turn the right into reality. Technology, while promising, must be used ethically and complementary to human interaction, ensuring that care remains person-centred.
In summary, the right to care is not only a social demand, but an ethical and legal imperative that requires an integrated and intersectoral approach. The full realisation of this right in Brazil and in the world will depend on the ability of governments, civil society, and the private sector to work together to build care systems that are universal, equitable, and centred on human dignity. Awareness of the importance of care and social engagement are key to driving the necessary changes and ensuring that the right to care becomes a reality for all, promoting a more just, supportive, and humane society.
References
[1] Inter-American Court of Human Rights. THE INTER-AMERICAN COURT RECOGNIZES THE AUTONOMOUS EXISTENCE OF THE HUMAN RIGHT TO CARE. https://www.corteidh.or.cr/docs/comunicados/cp_55_2025_POR.pdf
[2] Brazil. Constitution of the Federative Republic of Brazil of 1988. https://www.planalto.gov.br/ccivil_03/constituicao/constituicao.htm
[3] Brazil. Law No. 15,069, of December 23, 2024. Establishes the National Care Policy. https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2024/lei/L15069.htm
Dr Karla Giacomin
Cuidadosa/Brazilian Care Association, Brazil