Publications


ORIGINAL RESEARCH

Marcin Orzechowski, Marianne Nowak, Katarzyna Bielińska, Anna Chowaniec, Robert Doričić, Mojca Ramšak, Paweł Łuków, Amir Muzur, Zvonka Zupanič-Slavec and Florian Steger: Social diversity and access to healthcare in Europe: how does European Union’s legislation prevent from discrimination in healthcare? BMC Public Health (2020) 20:1399. https://doi.org/10.1186/s12889-020-09494-8

Background: Social diversity can affect healthcare outcomes in situations when access to healthcare is limited for specific groups. Although the principle of equality is one of the central topics on the agenda of the European Union (EU), its scope in the field of healthcare, however, is relatively unexplored. The aim of this study is to identify and systematically analyze primary and secondary legislation of the EU Institutions that concern the issue of access to healthcare for various minority groups. In our research, we have concentrated on three features of diversity: a) gender identity and sexual orientation, b) race and ethnicity, and c) religion or belief.

Method and materials: For the purpose of this analysis, we conducted a search of database Eur-Lex, the official website of European Union law and other public documents of the European Union, based on specific keywords accompanied by review of secondary literature. Relevant documents were examined with regard to the research topic. Our search covered documents that were in force between 13 December 2007 and 31 July 2019.

Results: Generally, the EU legal system prohibits discrimination on grounds of religion or belief, racial or ethnic origin, sex, and sexual orientation. However, with regard to the issue of non-discrimination in access to healthcare EU secondary law provides protection against discrimination only on the grounds of racial or ethnic origin and sex. The issue of discrimination in healthcare on the grounds of religion or belief, gender identity and sexual orientation is not specifically addressed under EU secondary law.

Discussion: The absence of regulations regarding non-discrimination in the EU secondary law in the area of healthcare may result from the division of competences between the European Union and the Member States. Reluctance of the Member States to adopt comprehensive antidiscrimination regulations leads to a situation, in which protection in access to healthcare primarily depends on national regulations. Conclusions: Our study shows that EU antidiscriminatory law with regard to access to healthcare is fragmentary. Prohibition of discrimination of the level of European binding law does not fully encompass all aspects of social diversity.

 


ORIGINAL RESEARCH

Moritz E Wigand, Marcin Orzechowski, Marianne Nowak, Thomas Becker, Florian Steger: Schizophrenia, human rights and access to health care: A systematic search and review of judgements by the European Court of Human Rights. International Journal of Social Psychiatry (2020). https://doi.org/10.1177%2F0020764020942797

Background: Persons with schizophrenia are vulnerable regarding human rights violations.

Aims: The aim of this research is to systematically analyse judgements by the European Court of Human Rights (ECtHR) involving persons with schizophrenia.

Methods: A systematic search of judgements by the ECtHR, using the search term ‘schizophrenia’. Descriptive statistics and a qualitative thematic analysis were performed.

Results: A total of n = 105 judgements were included, originating in n = 29 countries. Article 5 (Right to liberty and security) of the European Convention on Human Rights was ruled by the ECtHR to have been violated in 45.7% of judgements, Article 3 (Prohibition of torture) in 20.0% and Article 8 (Right to respect for private and family life) in 19.0%. Relevant themes were inadequate access to mental health care, especially in prisons and during police operations, involuntary confinement, detention and ill-treatment as a risk factor for psychosis, the right to family life versus the rights of others, extradition/expulsion and protection of other persons’ human rights against violent behaviour by persons with schizophrenia.

Discussion: Persons with schizophrenia often do not receive adequate treatment and are especially vulnerable in prisons, where ill-treatment can be an additional risk factor. They can have both offender and victim status. The judgements suggest that the ECtHR has a balanced view on involuntary confinement. National legislation and internal hospital guidelines should be written in a manner to help minimise human rights violations against persons with schizophrenia.

 


CONFERENCE REPORT

Robert Doričić, Marcin Orzechowski and Marianne Nowak: International Conference Healthcare as a Public Space: Social Integration and Social Diversity in the Context of Access to Healthcare in Europe. European Journal of Bioethics 11 (2020), pp. 283-286.

The conference report provides an overview of the various presentations, as well as insights and discussions that transpired during the First International Conference organized within the framework of the project.

The full text of the report can be accessed here.


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