Justice and Discrimination in Health Ethics PDF

Justice and Discrimination in Health-Care Ethics Onur TURAN, PT, PhD(c), Lecturer Definition of Justice in Ethics Fairness in healthcare distribution, ensuring equality in access to resources and treatments. According to another definition, justice is a principle that states that no...

Justice and Discrimination in Health-Care Ethics Onur TURAN, PT, PhD(c), Lecturer Definition of Justice in Ethics Fairness in healthcare distribution, ensuring equality in access to resources and treatments. According to another definition, justice is a principle that states that no random discrimination can be made against anyone during the sharing of fundamental rights and duties, social benefits and burdens. Theoretical Foundations and Philosophical Underpinnings - Principles of Justice This principle concerns the fair allocation of resources and opportunities. Distributive In physical therapy, it ensures that patients Justice receive equitable access to rehabilitation services based on their clinical needs rather than economic status or other discriminatory factors. Theoretical Foundations and Philosophical Underpinnings - Principles of Justice Focuses on the fairness of processes and procedures involved in healthcare delivery. Procedural For instance, ensuring transparent and unbiased Justice decision-making in treatment plans, informed consent processes, and patient consultations. Theoretical Foundations and Philosophical Underpinnings - Principles of Justice Addresses disparities in health outcomes among different socio-economic groups. Social In physical therapy, this may involve advocating Justice for policies and practices that reduce barriers to rehabilitation services for marginalized communities. Application in 1 2 Physical Ensuring fair Prioritizing care in Therapy: treatment of all situations with patients, regardless limited resources of socioeconomic (e.g., during natural status. disasters or pandemics). Application in Physical Therapy: Equitable Distribution: Ensuring that all patients, regardless of socio-economic status or geographic location, have access to essential rehabilitation services. Access to Care Cultural Competence: Addressing cultural differences and linguistic barriers to ensure culturally sensitive care that respects patient diversity. Application in Physical Therapy: Resource Allocation Prioritization: Ethical frameworks guide decisions on allocating limited resources (e.g., therapy equipment, staff time) based on clinical need, potential benefit, and cost-effectiveness. Evidence-Based Practice: Utilizing evidence to guide treatment decisions promotes fair and effective care delivery, aligning with principles of justice by ensuring treatments are based on objective criteria. Application in Physical Therapy: Ethical Decision-Making Informed Consent: Respecting patient autonomy by providing comprehensive information about treatment options, risks, and benefits, allowing patients to make informed decisions. Confidentiality and Privacy: Safeguarding patient information to uphold trust and respect patient autonomy, maintaining confidentiality in accordance with legal and ethical standards. Challenges and Considerations Healthcare Disparities: Addressing inequalities in access to physical therapy services due to socio-economic factors, geographic barriers, or systemic discrimination. Global Health Equity: Advocating for global health justice by supporting initiatives that improve access to rehabilitation services in underserved regions or developing countries. Conclusion Justice in healthcare, particularly within the realm of physical therapy and rehabilitation, is a multifaceted concept that integrates ethical principles with practical applications. By adhering to principles of distributive justice, procedural fairness, and ethical theories like utilitarianism and deontology, physical therapists can navigate complex ethical dilemmas and promote equitable access to quality care for all patients. Discrimination «Treating individuals under the same conditions differently from others, based only on some of their characteristics, without any legal basis» «The deprivation of certain members of a state or society from certain rights and privileges accorded to other members» «All rights and freedoms are exercised equally by all, regardless of race, ethnic origin, color, sex, sexual orientation, age, language, religion, belief, national or social origin, property, disability, place of birth, political or other opinions. Treatments that prevent or restrict the enjoyment of Discrimination Positive discrimination Negative discrimination  Discriminatory behaviors, which are likely to be Discrimination encountered in different areas of life depending on their types, are also observed in health institutions. Characteristics that cause people to be treated negatively; race-ethnicity, religion-belief, gender, illness, disability, As education level may be political-political view, language, sect, age, physical appearance, income There may also be factors such as hometown. Discrimination Negative patient discrimination; Considering the characteristics such as gender, sexual orientation, color, ethnic origin, language, religion, race, age, disability, place of birth, political view, and illness of the individuals who come to the hospital, Deprivation of the rights that all patients should be able to access fairly by the health personnel or other personnel in the hospital, or It is expressed as restricting access to these rights. Discrimination Direct discrimination All kinds of exclusions, restrictions and the resulting different forms of discrimination for depriving a person or group of human rights and freedoms of another person or group under the same conditions based on reasons such as language, sexual orientation, race, disability are prohibited. are treatments. Discrimination Discrimination Theories Discrimination Theories  Stigma Homophobia Discriminatory Xenophobia Behaviors Prejudice Exclusion Discriminatory Behaviors; Stigma Stigma is to deem an individual as tainted, flawed, and discredited by others, based on a person's mental or physical disability, race, drug addiction, or any disease that is considered bad by society. This action causes stigmatized individuals to fear and isolate themselves from society. Stigma used to rule, marginalize, devalue or glorify subgroups; It causes the stigmatized person to be stereotyped as black, white, fat, or schizophrenic, and to be perceived as an "other" by everyone. Discriminatory Behaviors; Prejudice Prejudice; These are thoughts that an individual creates in his mind about a person or a group, depending on factors such as education, cultural background and family structure, and accepts them without needing to examine their accuracy. These thoughts often manifest themselves in a negative way. The individual, who has become addicted to his prejudices under the influence of intellectual and emotional elements, acts discriminately when evaluating the other person, and without complying with the principle of equality, treats individuals under the same conditions differently, when they should be treated in the same way. Discriminatory Behaviors; Phobias Prejudices developed against various groups will also bring about a phobia (fear) against those groups. While this phobia emerges as homophobia against those who prefer the same sex sexually, it emerges as Islamophobia against Muslims and xenophobia against foreigners. Discriminatory Behaviors; Homophobias Discriminatory Behaviors Homophobia Stigma Prejudice Xenophobia Exclusion Discrimination Other Types of Discrimination Discrimination Based African-American cardiac patients reported experiencing discrimination at the physician's office four times more than white patients. on Race-Ethnicity Religion-Belief-Based Educational obstacle due to dress code. Islamophobia after the September 11 attack. Discrimination Gender Based Discrimination based on gender Discrimination Discrimination Based Discrimination against LGBT individuals on Sexual Orientation Types of Discrimination Illness-Based Discrimination HIV/AIDS positive, Obesity, Cancer Disability-Based Discrimination Work and daily life Discrimination Based on Education Level Conversation according to the patient's knowledge level (normal birth / cesarean section) Discrimination on Other Reasons Discrimination decreases as income increases No insurance payments to those with genetic diseases Discriminatory Behaviors in Health Discriminatory Behaviors in Health Discriminatory behaviors against patients can result in various negative reactions in patients. This situation may cause psychological and physical disorders in the patient. Discriminatory Behaviors in Health The patients who feel People who do not experience discriminated against; They This situation causes the a healthy process in the exhibit behaviors such as patients condition to worsen treatment of their disease will refusing treatment, and prevents them from negatively affect the rest of the abandoning treatment, under- benefiting from their legal right society with negative reporting their symptoms, or to health. externalities. hiding their illness. Class Activity Minimizing of Discriminitation in Health-Care Settings 1. Managers should establish a good communication network with healthcare professionals and eliminate negative prejudices of healthcare professionals towards patients. 2. Communication of healthcare professionals with patients should be increased, 3. Interaction should be ensured between individuals who are/have the potential to be exposed to discrimination and healthcare personnel who are/have the potential to engage in discriminatory behavior, and thus prejudices regarding the perceived reasons for discrimination should be eliminated. Minimizing of Discriminitation in Health-Care Settings 4. Individuals should be made aware of patient rights. 5. Health personnel should be guided to treat every patient requesting service fairly (without discrimination), 6. Complaints of patients who think they have been exposed to discriminatory behavior should be evaluated within the institution and feedback should be given to the patient regarding the issue. Minimizing of Discriminitation in Health-Care Settings 7. While examining gender-based discrimination in studies in the literature, recruitment and task distribution in the workplace were mostly examined. Gender-based discrimination in the field of health should also be investigated and recommendations should be developed for its prevention. 8. Although disease-based discrimination has been extensively examined in studies abroad, it has remained a closed area for research in Turkey. The literature should be enriched by conducting a disease-based discrimination study with a qualitative research method. Minimizing of Discriminitation in Health-Care Settings 9. Field research should be conducted in which all types of discrimination are examined together, and the extent to which people are exposed to more discrimination should be determined and the necessary policies should be created. 10. Perceived discrimination in health services should be measured and addressed in order to improve the quality of services, and institutional regulations should be introduced. Thanks Questions?