Denial Of Medical Care Research Articles

“If I knew you were a travesti, I wouldn't have touched you”:Iatrogenic violence and trans necropolitics in Turkey

Since 2007, the number of HIV diagnoses in Turkey has increased more than 600% and the AIDS-related deaths have more than doubled. Despite trans community being severely impacted by the growing epidemic, there exists a conspicuous absence of epidemiological data regarding the HIV burden of trans people. This paper examines the medical experiences of HIV-positive trans women who engage in sex work and the harmful violence they encounter at the hands of health providers. The paper emphasizes the urgent need for comprehensive interventions to address the intersecting issues of HIV risk, structural violence, and discrimination faced by HIV-positive trans sex workers, one of the most marginalized communities worldwide. To interpret better how transphobia and HIVphobia become deeply entangled in Turkish medical settings, the paper draws from the concepts of iatrogenesis, necropolitics, and immunity. By bringing together these conceptual tools with long-term ethnographic data and in-depth interviews, this paper demonstrates that trans women are treated by healthcare providers as though they are always-already infectious. The paper contends that aggressive immunitarian boundaries, erected between healthcare personnel and individuals deemed "contagious others," are central to doctors' denial of medical care and reluctance to touch, examine, or even admit trans patients, particularly when they are HIV-positive.

Blacklisting Health Insurance Premium Defaulters: Is Denial of Medical Care Ethically Justifiable?

Rising health insurance costs and the cost of living crisis are likely leading to an increase in unpaid health insurance bills in many countries. In Switzerland, a particularly drastic measure to sanction defaulting insurance payers is employed. Since 2012, Swiss cantons – who have to cover most of the bills of defaulting payers - are allowed by federal law to blacklist them and to restrict their access to medical care to emergencies.In our paper, we briefly describe blacklisting in the context of the Swiss healthcare system before we examine the ethical issues involved in light of what is known about its social and health impacts. We found no evidence that blacklisting serves as an effective way of recovering unpaid health insurance contributions or of strengthening solidarity within the health insurance system. Furthermore, the ambiguous definitions of what constitutes an emergency treatment and the incompatibility of the denial of medical care with the obligation to provide professional assistance complicate the implementation of blacklists and expose care providers to enormous pressure.Therefore, we conclude that blacklists and the (partial) denial of medical care not only pose profound ethical problems but are also unsuitable for fulfilling the purpose for which they were introduced.

Denial of medical care: the example of blood transfusion refusal for religious reasons under the view of the cultural competence of health professionals

The relationship developing between Human Rights and health is dynamic, two-way, interdependent and in some cases conflicting. The challenges within health professionals in health care in a multicultural society are inevitable, as health users "carry" different cultures. The refusal of health users to perform medical procedures vital to their health, mainly for religious reasons, raises both legal and moral issues as well as practical ones. The refusal to transfuse blood for religious reasons must, on the one hand, follow the ethical principles governing health professionals and, on the other, the content of the relevant rights of health users, in order to avoid induced moral, legal and practical conflicts on both sides. To this end, based on the literature review, the application and enjoyment of the rights of the members involved under the cultural perspective of health professionals are considered of primary importance. The cultural competence training of health professionals will be a key element of individualization and holistic approach to managing the challenges, as well as removing the inequalities required by health care in a multicultural society.

Documentation of human rights abuses among Rohingya refugees from Myanmar

BackgroundDecades of persecution culminated in a statewide campaign of organized, systematic, and violent eviction of the Rohingya people by the Myanmar government beginning in August 2017. These attacks included the burning of homes and farms, beatings, shootings, sexual violence, summary executions, burying the dead in mass graves, and other atrocities. The Myanmar government has denied any responsibility. To document evidence of reported atrocities and identify patterns, we interviewed survivors, documented physical injuries, and assessed for consistency in their reports.MethodsWe use purposive and snowball sampling to identify survivors residing in refugee camps in Bangladesh. Interviews and examinations were conducted by trained investigators with the assistance of interpreters based on the Istanbul Protocol – the international standard to investigate and document instances of torture and other cruel, inhuman, and degrading treatment. The goal was to assess whether the clinical findings corroborate survivors’ narratives and to identify emblematic patterns.ResultsDuring four separate field visits between December 2017 and July 2018, we interviewed and where relevant, conducted physical examinations on a total of 114 refugees. The participants came from 36 villages in Northern Rakhine state; 36 (32%) were female, 26 (23%) were children. Testimonies described several patterns in the violence prior to their flight, including the organization of the attacks, the involvement of non-Rohingya civilians, the targeted and purposeful destruction of homes and eviction of Rohingya residents, and the denial of medical care. Physical findings included injuries from gunshots, blunt trauma, penetrating trauma such as slashings and mutilations, burns, and explosives and from sexual and gender-based violence.ConclusionsWhile each survivor’s experience was unique, similarities in the types and organization of attacks support allegations of a systematic, widespread, and premeditated campaign of forced displacement and violence. Physical findings were consistent with survivors’ narratives of violence and brutality. These findings warrant accountability for the Myanmar military per the Rome Statute of the International Criminal Court (ICC), which has jurisdiction to try individuals for serious international crimes, including crimes against humanity and genocide. Legal accountability for these crimes should be pursued along with medical and psychological care and rehabilitation to address the ongoing effects of violence, discrimination, and displacement.

Penolakan Pelayan Medis Oleh Rumah Sakit Terhadap Pasien Yang Membutuhkan Perawatan Darurat

Research on the denial of medical care by hospitals to patients who need emergency care, it is a normative research, including a study of the principles of law, the rules of law and systematic law. Primary legal materials derived from legislation, and secondary materials in the form of literature, documents, archives, legal expert opinion and research results to the researchers in the field of criminal law, in this case relating to the issues discussed in this study. In this case the purpose of the study was to determine whether the denial of hospital to patients who need of medical care is a criminal act, and to determine whether accountability to civil hospital for medical treatment refusal. Results from the study of criminal law, written by denial of medical care, including criminal acts, so it can be prosecuted under the criminal law in accordance with Article 304 and 531 Book Of The Criminal Justice Act . If the hospitals that perform denial of medical care to patients who need emergency care, giving rise to the violation of hospital leaders who are responsible for violations of the law, as stipulated in Article 190 paragraph (1) of Law No. 36 Year 2009 on Health. A patient who feels aggrieved over denial of medical care that the hospital, the patient can be sued in a civil suit and claim damages provided for in Article 58 paragraph (1) of Law No. 36 Year 2009 on Health, and in Article 32 letter q Law No. 44 of 2009 on Hospital. Denial of medical services to patients in need of emergency care including patient adverse action, it has been stipulated in Article 1365, 1366, 1367 Book Of The Civil Law.

Beliefs and perceptions that impair cleft care treatment in Madagascar: A qualitative study during humanitarian mission

Context: During humanitarian cleft care mission in developing countries, a considerable noncompliance of the patient remains evident despite the provided medical support. According to the literature, social background and beliefs are some of the factors that hamper cleft management in these areas. Aims: In this study, we investigated on these impairments for a better approach to cleft care in Madagascar. Settings and Design: This is a qualitative study conducted in Clinic Ave Maria, Antsirabe, Madagascar, which interviewed parents and patients. Subjects and Methods: One adult patient and nineteen parents of a patient with cleft lip and palate (CLP) were interviewed for a qualitative study. An open-ended, closed-ended semistructured interview was conducted. Results: Analysis of the interview result and a literature discussion were performed. The most believed cause of cleft lip was supernatural forces, diet, and a curse, leading to a strong self-blame and shame inside the community. Thus, CLP is thought to be a supernatural disease, which cannot be totally healed by injection and surgery. A belief leads to a delay, denial of medical care, and/or ignorance and rejection of new explanations. Conclusions: Social background and beliefs of our Malagasy community have a considerable impact on how the patients perceive cleft deformity. These perceptions strongly influence the patient's compliance to medical care. Considering education as a part of the treatment plan during a humanitarian mission can modify the patient's attitude and improve their motivation to a better treatment outcome.

Syria's humanitarian crisis.

The United Nations has called the conflict in Syria “the greatest humanitarian tragedy of our times.”1 What started as a peaceful protest in March 2011 has led to three years of an escalating conflict in which over 100,000 people have been killed2. Over 10 million Syrians—one-half of the country’s population—will need humanitarian aid in 20143. Over 5 million children are currently in need of aid, according to UNICEF (the United Nations International Children’s Emergency Fund)4. Innocent, noncombatant civilians are paying the largest price, and humanitarian workers—including orthopaedic surgeons—have been risking their lives to help them. Both government forces and extremist militias have committed atrocities and crimes against civilians and civilian infrastructures5. The decimation and starvation of civilian populations, the denial of medical care and humanitarian aid, the murder of doctors and nurses, and the destruction of schools, bakeries, and hospitals—all of these actions have been systematic and deliberate6. They have been conducted as a matter of policy and military strategy to achieve a tactical advantage. A collapsed health-care system further complicates the situation. Sixty percent of public hospitals and 78% of public ambulances are damaged or out of service7. Thousands of health-care personnel have fled the country for their safety, and hundreds have been arrested or kidnapped. As of July 2013, only 250 of 6000 physicians remained in Aleppo, Syria’s largest city, to serve a population of 2,500,0008. Over the past two years, sustained bombardments and intense fighting have transformed the civilian and residential neighborhoods of Aleppo into a battlefield. As a result, medical work in these areas has been driven underground where doctors and nurses operate in secret, makeshift, provisional facilities such as caves, farms, and apartment buildings. They do so under the threat …

Lesbian, Gay Bisexual, Transgender, and Questioning: Best Practices in Music Therapy

Over past several years, lesbian1, gay, bisexual, transgender, and questioning (LGBTQ) people and LGBTQ related issues have been visible in popular press (www.glaad.org). With marriage equality debate, increasing awareness of suicide rate of LGBTQ teens and young adults as a result of bullying, hate crimes victimizing LGBTQ individuals, legal challenges to Defense of Marriage Act, and Don't Ask, Don't Tell Policy reversal, lives and challenges of LGBTQ individuals have been open to public view, debate, and scrutiny (Carey, 2012; Webb, 2012). Because LGBTQ people are of all ages, cultures, and populations, and from all geographical areas, it is highly likely that therapists will find themselves working with LGBTQ clients, coworkers, students, and/or members, whether they know it or not. Given this reality, it is therefore essential for music therapists to seek out opportunities to learn about LGBTQ concerns and community resources as well as seek supervision about working with LGBTQ individuals.Historically, LGBTQ people have been marginalized and under served by mainstream culture2. According to Federal Bureau of Investigation, 1 7.8% of total number of reported hate crimes in 2010 was attributed to homophobia (U.S. Department of Justice, 2010). In a recent survey of 6000+ transgender individuals, discrimination was identified as a factor in workplace harassment (90%), loss of employment (26%), refusal of housing (19%), denial of medical care (19%), and homelessness (19%) (Grant et al., 2011). The effects of this discrimination are detrimental. Over past 20 years, long-term effects of nonacceptance, discrimination, and violence in lives of LGBTQ individuals have been studied. Researchers have noted lesbians, gay men, bisexuals, and transgender individuals have an increased risk for suicidal ideation (Clements-Nolle, Marx, & Katz, 2006; RotheramBorus, Hunter, & Rosario, 1994; Savin-Williams, 1994), high risk behavior (Heck, Flentje, & Cochran, 2011; SavinWilliams, 1994), mental health problems including substance abuse (Cochran, Sullivan & Mays, 2003; D'Augelli, 2002; DiPlacido, 1998; Heck et al., 2011; Lewis & Hugelshofer, 2004; Lewis et al., 2004; Meyer, 2003; Ross, 1990; SavinWilliams, 1994), and compromised physical health (DiPlacido, 1998; Lewis et al., 2004; Ryan, Huebner, Diaz, & Sanchez, 2007) due to heterosexism, transphobia, gender-role stereotyping, and lack of acceptance by and society.In a study of 245 lesbian, gay, bisexual, and transgender young adults, researchers found that the direct effect of adolescent gender nonconformity on young adult adjustment was fully mediated by experience of victimization (Toomey, Ryan, Diaz, Card, & Russell, 2010, p. 1587). Ryan et al. (2007) found family acceptance predicts greater selfesteem, social support, and general health status [while guarding against] depression, suicidal ideation, and behaviors (p. 205). Similarly, participation in Gay Straight Alliances while in school helped to created more favorable outcomes related to school experiences, alcohol use, and psychological distress (Heck et al., 2011, p. 161). Clearly, and societal acceptance and protections help to minimize detrimental psychological and physical effects of discrimination.Health and human services professions have historically marginalized LGBTQ individuals and diagnosed them as mentally ill. Until 1973, homosexuality3 was identified as a mental illness diagnosis in Diagnostic Statistical Manual (American Psychiatric Association, 1974). Many LGBTQ individuals were subject to a variety of treatments to cure their homosexuality, bisexual ity, gender expression, and/or gender identity.Psychological treatment models with intent to cure sexual orientation, known as conversion or reparative therapy, have experienced resurgence in recent years (Anton, 201 0). …

Infallible Apologies

Infallible Apologies James Warner Pope John Paul II issued nearly 100 apologies during his pontificate. He offered these statements on behalf of the Catholic Church for those who had sinned in its name, from the paedophilia of U.S. priests to the misdeeds of the church in its earliest days. Like the number of saints he canonized, this quantity of apologies was unprecedented and similarly drew on the supratemporal authority of the church to fortify its contemporary relevance. While most of these admissions of error attracted little attention, the 1992 lifting of the edict of Inquisition against Galileo Galilei and the sweeping Jubilee apology of 2000 attracted a great deal of publicity and revealed the contradictions of the papal mea culpa. In removing the edict against Galileo, the pope acted on the findings of an 11-year investigation that he had commissioned in 1981. Long preoccupied with the affair, the pope said at the time: From the beginning of the Age of Enlightenment down to our own day, the Galileo case has been a sort of "myth" . . . the symbol of the Church's supposed rejection of scientific progress, or of "dogmatic" obscurantism opposed to the free search for truth . . . in which the image fabricated out of the events was quite far removed from reality.1 John Paul II appears to have been motivated largely by a desire to clear the Church's name rather than to make amends with Galileo's memory. The pope's statement made no mention of the Inquisitors' treatment of the 69-year-old astronomer, which included a forced recantation under threat of torture and death and denial of medical care during his imprisonment. Instead, the pope had urged the commission to discover "the wrongs, from whatever side they may have come" and deemed the affair a "tragic mutual incomprehension" between Galileo and "theologians of that age," who could not reconcile heliocentrism and scripture. Since Galileo could deduce but not prove that the earth moved around the sun, the commission found that both parties had acted in good faith; to the pope, the investigation showed that a belief in the "fundamental opposition between science and faith . . . now belongs in the past." Strictly understood, it was less apology than apologia. Later, in 2000, the pope sought to "purify the memory" of the church in a grand public apology for all the sins committed in its name. Accompanied by five bishops and two cardinals, he asked forgiveness for sins "in the service of truth, against Christian unity, against the Jews, against respect for [End Page 67] love, peace and cultures; against the dignity of women and minorities, and against human rights," among others.2 A dramatic act without precedent, it was, as Leon Wieseltier wrote, also "an apology that [was] not apologetic,"3 and in that sense much like the Galileo rehabilitation—intended more to absolve the church according to its own standards than to right past wrongs. "Purifying the memory," after all, according to a Vatican document, means eliminating from personal and collective conscience all forms of resentment or violence left by the inheritance of the past . . . the remembrance of scandals of the past can become an obstacle to the Church's witness today, and the recognition of the past faults of the Church's sons and daughters of yesterday can foster renewal and reconciliation in the present.4 In modern parlance, "forgive and forget." Yet who was to be forgiven, and who was to do the forgiving? According to Catholic doctrine, the church itself can never sin, as it is a creation and the inheritance of Christ, but its servants can. The church's liability is limited to "assuming the weight of her children's faults in maternal solidarity."5 Moreover, the pope did not seek the forgiveness from those whom the church had wronged, but from God, who in the eyes of Catholicism is the only one with the power of pardon. Finally, the same document stated that "reciprocity—at times impossible because of the religious convictions of the dialogue partner—cannot be considered an indispensable condition, and that the gratuity of love often expresses itself in unilateral initiatives."6 In other words, this was...