Ancrée d’abord dans la charité, se métamorphosant dans la philanthropie libérale, dans la fraternité révolutionnaire, puis dans la solidarité républicaine, la fondamentalisation de l’accès aux soins des pauvres a finalement trouvé refuge dans les droits de l’Homme. Depuis la loi d’orientation relative à la lutte contre les exclusions du 29 juillet 1998, elle se traduit ainsi en France par l’affirmation d’un droit fondamental à la protection de la santé. Cette mutation est loin d’être anodine. L’action des pouvoirs publics et la responsabilité de la société dans la lutte contre l’exclusion sociale en santé s’en trouvent déportées du terrain économique et caritatif vers le terrain juridique. L’accès aux soins des pauvres ne relève plus seulement d’un devoir moral, mais aussi d’une obligation juridique en vertu du droit international des droits de l’Homme et des exigences constitutionnelles françaises. Mais quel est donc le contenu de cette obligation juridique ? Quelles sont la nature et la portée réelle de la notion juridique de droit fondamental à la protection de la santé, et de son emploi en lieu et place de celle de pauvreté ? Comment peut-elle s’inscrire dans un processus dynamique et pragmatique d’universalisation de l’accès aux soins ?C’est ainsi à une étude critique de la juridicisation contemporaine de l’accès aux soins des pauvres que la recherche s’attelle. Certes, la fondamentalisation de l’accès aux soins des pauvres se déploie désormais sur la base d’un droit fondamental à la protection de la santé. Mais le choix des moyens et des voies de réalisation de ce dernier ne fait pas consensus, et les juges hésitent toujours à sanctionner et contrôler pleinement le respect de son application. L’universalité de sa proclamation ne s’est pas encore muée en universalité de sa concrétisation. L’émergence d’un droit fondamental pour garantir l’accès aux soins des pauvres n’est en effet pas sans poser de difficultés. Ces dernières qui s’expriment de façon de plus en plus criante aujourd’hui tiennent à la tension irréductible entre son horizon d’universalité et sa pratique discriminatoire et ségrégative, mais aussi à son interactivité avec les autres droits jugés fondamentaux dans un monde où la santé est devenue un marché globalisé et la solidarité peut être assimilée à un délit.Malgré son inscription au sommet de la hiérarchie des normes, le droit à la santé reste en effet l’un des plus inégalement appliqués. S’il induit un principe d’égal accès aux soins, sa mise en œuvre catégorielle et différenciée pour les plus démunis entre en tension avec l’universalisme des droits de l’Homme. Aussi, l’effectivité des droits créances aux soins dépend fortement des finances publiques et donc des volontés politiques. Elle pose la question des devoirs de solidarité à imposer aux citoyens. Or, l’importance politique prise par l’économie dans le monde actuel vient particulièrement entraver les développements juridiques de la solidarité dans l’accès aux soins, en réduisant le rôle et les capacités de l’État providence. S’institue progressivement une forme de précarité sociale généralisée qui compromet l’accès aux soins de nombreuses personnes. En réintégrant les droits de l’Homme dans le débat, les nouvelles politiques de lutte contre la pauvreté tendent cependant à redonner sens au projet humaniste. L’éthique politique moderne en particulier, et la notion qui la traverse aujourd’hui, l’inclusion sociale, influencent les réflexions doctrinales, et avec elles les représentations du droit comme outils de la justice distributive. Désormais, les juristes se préoccupent des notions d’effectivité, de justiciabilité et d’exigibilité des droits sociaux aux soins. De nouvelles réponses sociales et juridiques émergent afin de donner aux personnes précaires et pauvres les capacités d’exercer pleinement leur droit fondamental à la protection de la santé. / Be in motivated by group or individual interest, the desire to help the poor appears as a constant around the world and throughout history. Originally anchored in charity, then reincarnated in liberal philanthropy, in the fraternity of the revolution, and in republican solidarity, the fundamentality of healthcare access for the poor finally found its home in Human Rights. Since the Framework Act on Measures to Combat Exclusion of 29 July 1998, the protection of health has been considered a fundamental right in France.This new incarnation is far from anodine. Government action and social responsibility in the fight against social exclusion in healthcare, have moved from an economic and charitable framework to a legal one. Healthcare access for the poor is no longer considered as just a moral duty, but also a legal obligation enshrined in international Human Rights law and the French Constitution. But what is the real content of this legal obligation? What is the nature and real application of the legal notion of a fundamental right to the protection of health, and how is this used to reduce poverty? How can we take poverty into account in the dynamic and pragmatic process of the universalisation of access to healthcare.This research thus attempts a critical study of contemporary legislation on healthcare access for the poor. Certainly, the fundamentality of healthcare access for the poor follows naturally from the fundamental right to the protection of health. But there is no consensus on the manner and means of its implementation, and the judiciary has hesitated to fully sanction and control its application. The universality of the proclamation has not yet been translated into universality of its realization. The emergence of a fundamental right guaranteeing access to healthcare for the poor is not without its difficulties. These difficulties, today more visible than ever, arise from the irreducible tension between the theoretical universality of this right and its discriminatory and segregative practice. Challenges also arise from the interaction of this and other rights considered fundamental in a world where health has become a globalized market and solidarity perhaps akin to a crime.Despite its place at the summit of the hierarchy of norms, the right to health remains one of the most unequally applied. If it demands a principle of equal access to healthcare, its discriminatory and segregational implementation among the poorest is at odds with the universalism of Human Rights. Moreover, the ability to claim the right to healthcare is highly dependent on public finances and political will. It requires that a duty of solidarity be imposed on citizens. However, the political importance given to the economy in the world today impedes on the legal development of solidarity in healthcare access, reducing the role and capacity of the welfare state. A generalized form of social precariousness is gradually being established, compromising access to healthcare for many people. By reintroducing Human Rights to the debate, new policies in the fight against poverty are beginning to bring meaning back to this humanist project. Modern political ethics in particular, and the current drive for social inclusion, are influencing doctrinal reflections, and with them the perception of the law as a tool for redistributive justice. Thus, lawyers now consider the notions of effectiveness, justiciability and accountability when addressing social rights to healthcare. New social and legal responses are emerging to empower people living in poverty or insecurity to fully exercise their fundamental right to the protection health.

The idea of universal applicability of human rights has been a symbol of hope that peace and justice in the world is possible, since the late 1940s. Although it is a fiction, and anthropology can proof this bringing countless evidence, strong general awareness of this idea still inspires many in their strive for freedom and dignity as well as opposition to violence. The aim of this thesis is to bring two controversial examples, illustrating how and why value-driven struggle for promotion of human rights fails. The aim is nevertheless not to compromise this noble idea but to contribute to its more thorough understanding as well as more effective implementation. A chapter on so called female genital circumcision (also known as female genital mutilation) offers critical analyses of the international campaign for eradication of this practice, led by international feminist movement since the late 1970s. The attention is drawn mainly to manipulation of facts and unfair argumentation, thanks to which the so called female genital circumcision was labelled cruel practice of backward societies serving degradation and control of women, making more structured understanding of reality impossible. A chapter dedicated to abortion tries to see political and cultural influences hidden under the surface of debate on...

The idea of universal applicability of human rights has been a symbol of hope that peace and justice in the world is possible, since the late 1940s. Although it is a fiction, and anthropology can proof this bringing countless evidence, strong general awareness of this idea still inspires many in their strive for freedom and dignity as well as opposition to violence. The aim of this thesis is to bring two controversial examples, illustrating how and why value-driven struggle for promotion of human rights fails. The aim is nevertheless not to compromise this noble idea but to contribute to its more thorough understanding as well as more effective implementation. A chapter on so called female genital circumcision (also known as female genital mutilation) offers critical analyses of the international campaign for eradication of this practice, led by international feminist movement since the late 1970s. The attention is drawn mainly to manipulation of facts and unfair argumentation, thanks to which the so called female genital circumcision was labelled cruel practice of backward societies serving degradation and control of women, making more structured understanding of reality impossible. A chapter dedicated to abortion tries to see political and cultural influences hidden under the surface of debate on...