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The Right to Accessible and Acceptable Healthcare Services. Negotiating Rules and Solutions With Members of Ethnocultural Minorities

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Abstract

The right to health implies, among other things, that individuals and communities must be allowed to have a voice in decisions concerning the definition of their well-being. The article argues for a more active participation of ethnocultural minorities in healthcare decisions and highlights the relevance of strategies aimed at creating a bottom-up engagement of people and groups, as well as of measures aimed at a broader organizational flexibility, in order to meet migrants’ and minorities’ needs. Finally, the article clarifies that these strategies are not simply the outcome of a welcoming attitude of the Western healthcare system but may be interpreted as a specific duty resulting from the notion of “particularly vulnerable groups,” as formulated by the ECtHR in its case law: when vulnerable groups are at stake, every decision about state actions and rules regarding healthcare should start from an a consideration of the specific conditions and needs of people belonging to vulnerable minority groups.

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References

  • Basu, A., and M. Dutta. 2007. Centralizing context and culture in the co-construction of health: Localizing and vocalizing health meanings in rural India. Health Communication 21(2): 187–196.

    Article  Google Scholar 

  • Bhopal, R.S. 2014. Migration, ethnicity, race, and health in multicultural societies. Oxford, Oxford University Press.

    Google Scholar 

  • Bishoff, A. 2006. Caring for migrants and minority patients in European hospitals. A review of effective interventions. SFM Studies.

    Google Scholar 

  • Blackhall, L.J., S. Murphy, G. Frank, V. Michel, and S. Azen. 1995. Ethnicity and attitudes toward patient autonomy. Journal of American Medical Association 274(10): 820–825.

    Article  CAS  Google Scholar 

  • Bonder, B., and L. Martin. 2013. Culture in clinical care: Strategies for competence. Slack Inc.

  • Bowen Matthew, D. 2008. Race, religion and informed consent: Lessons from social science. Journal of Law Medicine and Ethics 36(1): 150–173.

    Article  Google Scholar 

  • Brubaker, R. 2002. Ethnicity without groups. Archive Europenne de Sociologie 63(2): 163–189.

    Article  Google Scholar 

  • Campani, G. 2005. Minorities formation in Italy. In Institutional pre-requisites for cultural minorities in nation states, edited by J. Blaschke, 143–300. Berlin: Parabolis.

    Google Scholar 

  • Capotorti, F. 1977. The international protection of persons belonging to ethnic, religious and linguistic minorities since 1919. United Nations Economic and Social Council.

    Google Scholar 

  • ———. 1979. Study of the rights of the persons belonging to ethnic, religious and linguistic minorities. New York: United Nations, E/CN.4/Sub.2/384/Rev.1.

  • CESCR. 2000. UN Committee on Economic, Social and Cultural Rights. General Comment 14: The Right to the Highest Attainable Standard of Health. Geneva, Switzerland: United Nations: 2000. UN Document E/C.12/20e00/4. http://www.unhchr.ch/tbs/doc.nsf/(symbol)/E.C.12.2000.4.En?OpenDocument. Accessed August 15, 2018.

  • Charles, C., and S. De Maio. 1993. Lay participation in health care decision making: A conceptual framework. Journal of Health Politics, Policy and Law 18(4): 881–904.

    Article  CAS  Google Scholar 

  • Cioffi, R.N. 2003. Communicating with culturally and linguistically diverse patients in an acute care setting: Nurses’ experiences. International Journal of Nursing Studies 40(3): 299–306.

    Article  Google Scholar 

  • Davidson, E., and J.J. Liu, and A. Sheikh. 2010. The impact of ethnicity on asthma care. Primary Care Respiratory Journal 19(3): 202–208.

  • Degrie, L., C. Gastmans, L. Mahieu, B. Dierckx de Casterlé, and Y. Denier. 2017. How do ethnic minority patients experience the intercultural care encounter in hospitals? A systematic review of qualitative research. BMC Medical Ethics 18(1): 2.

    Article  Google Scholar 

  • Donders, Y.M. 2015. Exploring the cultural dimensions of the right to the highest attainable standard of health. PER: Potchefstroomse Elektroniese Regsblad 18(2): 180–222.

    Article  Google Scholar 

  • Dutta, M. 2008. Communicating health: A culture-centered approach. London: Polity Press.

    Google Scholar 

  • Eisenberg, A. 2009. Reasons of identity: A normative guide to the political and legal assessment of identity claims. New York: Oxford University Press.

    Book  Google Scholar 

  • Eisenberg, A., and J. Spinner-Halev. 2005. Introduction. In Minorities within minorities: Equality, rights and diversity, edited by A. Eisenberg and J. Spinner-Halev, 1–15. Cambridge: Cambridge University Press.

    Chapter  Google Scholar 

  • European Commission. 2009. Communication from the Commission to the European Parliament, the Council, the European Economic and Social Committee and the Committee of the Regions—Solidarity in health: Reducing health inequalities in the EU. https://eur-lex.europa.eu/legal-content/EN/TXT/?uri=CELEX:52009DC0567. Accessed January 14, 2019.

  • Faden, R.R. and T.L. Beauchamp. 1986. A history and theory of informed consent. New York: Oxford University Press.

    Google Scholar 

  • Fernando, S. 2003. Cultural diversity, mental health and psychiatry. The struggle against racism. Hove, England: Brunner-Routledge.

    Google Scholar 

  • Fineman, M.A. 2008. The vulnerable subject: Anchoring equality in the human condition. Yale Journal of Law & Feminism 20(1): 1–25.

    Google Scholar 

  • Florin, D., and J. Dixon. 2004. Public involvement in health ethics. British Medical Journal 328(7432): 159–161.

    Article  Google Scholar 

  • Gillon, R. 2003. Ethics needs principles—four can encompass the rest—and respect for autonomy should be first among equals. Journal of Medical Ethics 29(5): 307–312.

    Article  CAS  Google Scholar 

  • Green, G., H. Bradby, A. Chan, and M. Lee. 2006. We are not completely Westernised: Dual medical systems and pathways to health care among Chinese migrant women in England. Social Science & Medicine 62(6): 1498–1509.

    Article  Google Scholar 

  • Green, L. 1994. Internal minorities and their rights. In Group rights, edited by J. Baker, 257–272. Toronto, ON: University of Toronto Press.

    Google Scholar 

  • Griffiths, C., S. Ahmed, S. Ahmed, et al. 2000. Using health-related quality of life measures in minority ethnic groups: An approach to translating measures into Bengali (Sylheti). European Journal of General Practice 6(4): 130–134.

    Article  Google Scholar 

  • Jackson-Preece, J. 1998. National minorities and the European nation-states system. Oxford: Oxford University Press.

    Book  Google Scholar 

  • ———. 2014. Beyond the (non) definition of minority. European Centre for Minority Issues (ECMI) Brief # 30. http://www.ecmi.de/uploads/tx_lfpubdb/Brief_30.pdf. Accessed January 14, 2019.

  • Knifton, L. 2012. Understanding and addressing the stigma of mental illness with ethnic minority communities. Health Sociology Review 21(3): 287–298.

    Article  Google Scholar 

  • Lai, D., and N. Chappell. 2007. Use of Traditional Chinese Medicine by older Chinese immigrants in Canada. Family Practice 24(1): 56–64.

    Article  CAS  Google Scholar 

  • Lawn, J., J. Rohde, S. Rifkin, et al. 2008. Alma-Ata 30 years on: Revolutionary, relevant, and time to revitalise. Lancet 372(9642): 917–920.

    Article  Google Scholar 

  • Long, J., P. Byrne, M. Gabbay, L. Firth, and I. Fletcher. 2015. The dragon and the snake: Health practices among Chinese in the UK from an inter-disciplinary perspective. Ethnicity and Health 20(2): 18–22.

    Article  Google Scholar 

  • Lorant, V., and R. Bhopal. 2010. Comparing policies to tackle ethnic inequalities in health: Belgium 1 Scotland 4. The European Journal of Public Health 21(2): 235–240.

    Article  Google Scholar 

  • Macioce, F. 2017). Undocumented migrants, vulnerability and strategies of inclusion. A philosophical perspective. Constellations 25(1): 87–100.

    Article  Google Scholar 

  • Maclean, A. 2009. Autonomy, informed consent and medical law: A relational challenge, 1st ed. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • Malloy, T.H. 2014. National minorities between protection and empowerment: Towards a theory of empowerment. Journal on Ethnopolitics and Minority Issues in Europe 13(2): 11–29.

    Google Scholar 

  • Marshall, P., and B. Koenig. 2004. Accounting for culture in a globalized bioethics. Journal of Law, Medicine and Ethics 32(2): 252–266.

    Article  Google Scholar 

  • Meeuwesen, L., and J.A. Harmsen, R.M. Bernsen, and M.A. Bruijnzeels. 2006. Do Dutch doctors communicate differently with immigrant patients than with Dutch patients? Social Science and Medicine 63(9): 2407–2417.

  • Mladovsky, P. 2007. Migrant health in the EU. Eurohealth 13(9): 9–11.

    Google Scholar 

  • Montesi, L., M.T. Caletti, and G. Marchesini. 2016. Diabetes in migrants and ethnic minorities in a changing World. World Journal of Diabetes 7(3): 34–44.

    Article  Google Scholar 

  • Naish, J., J. Brown, and B. Denton. 1994. Intercultural consultations: Investigation of factors that deter non- English speaking women from attending their general practitioners for cervical screening. British Medical Journal 309(6962): 1126–1128.

    CAS  PubMed  Google Scholar 

  • Neveloff, D.N., and C.B. Liebman. 2011. Bioethics mediation: A guide to shaping shared solutions. Nashville: Vanderblit University Press.

  • Osipov, A. 2013. Non-territorial autonomy as a way to frame diversity policies: The case of Russia. In The challenge of non-territorial autonomy. Theory and practice, edited by E. Nimmi, A. Osipov, and D. Smith, 135–139. Peter Lang.

  • Peroni, L., and A. Timmer. 2013. Vulnerable groups: The promise of an emerging concept in European Human Rights Convention law. International Journal of Constitutional Law 11(4): 1056–1085.

    Article  Google Scholar 

  • Pieroni, A., and C.L. Quave. 2005. Traditional pharmacopoeias and medicines among Albanians and Italians in southern Italy: A comparison. Journal of Ethnopharmacology 101(1): 258–270.

    Article  Google Scholar 

  • Priebe, S., S. Sandhu, S. Dias, et al. 2011. Good practice in health care for migrants: Views and experiences of care professionals in 16 European countries. BMC Public Health 11(1): 187.

    Article  Google Scholar 

  • Rechel, B., P. Mladovsky, D. Ingleby, J.P. Mackenbach, and M. McKee. 2013. Migration and health in an increasingly diverse Europe. Lancet 381(9873): 1235–1245.

    Article  Google Scholar 

  • Rochelle, T.N., and D. Marks. 2011. Health behaviors and use of Traditional Chinese Medicine among the British Chinese. Journal of Cross-Cultural Psychology 42(3): 390–405.

    Article  Google Scholar 

  • Sadan, E. 2004. Empowerment and community planning: Theory and practice of people-focused social solutions. Tel Aviv: Hakibbutz Hameuchad Publishers.

    Google Scholar 

  • Salomonsen, L.J., L. Skovgaard, S. la Cour, L. Nyborg, L. Launsø, and V. Fønnebo. 2011. Use of complementary and alternative medicine at Norwegian and Danish hospitals. BMC Complementary and Alternative Medicine 11(1): 4.

    Article  Google Scholar 

  • Schouten B.C., and L. Meeuwesen. 2006. Cultural differences in medical communication: A review of the literature. Patient Education and Counseling 64(1–3): 21–34.

    Article  Google Scholar 

  • Secretary of State for Health (ed). 2008. High quality care for all: NHS next stage review final report. The Stationery Office, CM7432.

    Google Scholar 

  • Shachar, A. 2001. Multicultural jurisdictions. Cultural differences and women’s rights. Cambridge: Cambridge University Press.

    Book  Google Scholar 

  • ———. 2012. Demystifying culture. International Journal of Constitutional Law 10(2): 429–448.

    Article  Google Scholar 

  • Sproston, K., L. Pitson, G. Whitfield, and E. Walker. 2000. Health and lifestyles of the Chinese population in England. London, U.K.: Health Education Authority.

    Google Scholar 

  • Torbisco Casals, N. 2016. Multiculturalism, identity claims, and human rights: From politics to courts. The Law & Ethics of Human Rights 10(2): 367–404.

    Article  Google Scholar 

  • Viruell-Fuentes, E.A. 2007. Beyond acculturation: Immigration, discrimination, and health research among Mexicans in the United States. Social Science and Medicine 65(7): 1524–1535.

    Article  Google Scholar 

  • Weber, B., and B. Reilly. 1997. Enhancing mammography in the inner city: A randomised trial of intensive case management. Archives of Internal Medicine 157(20): 2345–2349.

    Article  CAS  Google Scholar 

  • Williamson, L. 2014. Patient and citizen participation in health: The need for improved ethical support. The American Journal of Bioethics 14(6): 4–16.

    Article  Google Scholar 

  • Woolley, S. 2005. Children of Jehovah’s witnesses and adolescent Jehovah’s witnesses: What are their rights? Archives of Disease in Childhood 90(7): 715–719.

    Article  CAS  Google Scholar 

  • Yamin, A.E. 2005. The right to health under international law and its relevance to the United States. American Journal of Public Health 95(7): 1156–1161.

    Article  Google Scholar 

  • Yehya, N.A., and M.J. Dutta. 2010. Health, religion, and meaning: A culture-centered study of Druze women. Qualitative Health Research 20(6): 845–858.

    Article  Google Scholar 

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  1. Lumsa University, Via Pompeo Magno, 22 – 00192, Rome, Italy

    Fabio Macioce

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Macioce, F. The Right to Accessible and Acceptable Healthcare Services. Negotiating Rules and Solutions With Members of Ethnocultural Minorities. Bioethical Inquiry 16, 227–236 (2019). https://doi.org/10.1007/s11673-019-09900-w

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