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Women, people of foreign origin or those with disabilities are too often victims of discrimination in access to care

Women, people of foreign origin or those with disabilities are too often victims of discrimination in access to care

By The New Obs with AFP

Published on , updated on

Minimized pain, refusal of care, non-consensual acts... Women, people of foreign origin or those with disabilities are subject to discrimination in their access to care.

Minimized pain, refusal of care, non-consensual acts... Women, people of foreign origin or those with disabilities are subject to discrimination in their access to care. SYSPEO/SIPA

Minimized pain, refusal of care, non-consensual acts... Women, people of foreign origin or those with disabilities are subject to discrimination in their access to care and their medical journey, according to a report by human rights defender Claire Hédon , published this Tuesday, May 6.

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"While refusals of access to care remain the most well-known and obvious form, discrimination can occur at all stages of care and, in a less visible or conscious way, within the caregiver-patient relationship," believes the independent authority responsible for ensuring that rights are respected in France.

In 2022, 224 complaints were filed with professional bodies and health insurance and 31 claims were sent to the Defender of Rights, but the "scale of discrimination far exceeds" these figures, the report states.

“Mediterranean syndrome”, a racist prejudice with no medical basis”

In theory, healthcare professionals do not have the right to refuse a patient unless the request for care does not correspond to their area of ​​expertise, if they have too many patients, or if the patient in question has previously been violent or insulting towards them. But in practice and on the ground, this rule is subject to numerous breaches, whether in access to care or in the care pathway, notes the human rights defender.

In emergency services, the independent authority describes "an underestimation" of pain and "the severity of symptoms expressed by women, particularly when they are young, of foreign origin or perceived as such." "Depending on the case, the patient's pain is either minimized or questioned and attributed to supposed anxiety or hidden psychological suffering," it denounces.

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"The 'Mediterranean syndrome', a racist prejudice without medical basis according to which people of North African or black origin exaggerate their symptoms or pain" , has "the effect of minimizing the suffering expressed" by these patients "and/or a refusal of treatment, with sometimes fatal consequences" . "When a white man presents to the emergency room with heart failure, he is 50% more likely than a black woman to be considered in a life-threatening emergency" , Claire Hédon points out on Franceinfo.

Other victims of this discrimination are economically vulnerable people, such as patients living on the streets or drug users who, "because of their physical appearance, body odor or alcohol consumption," may be refused access to emergency services.

“Deleterious” impact

Beneficiaries of universal health coverage (CMU), complementary health solidarity (CSS) and state medical aid (AME) are having difficulty getting even an appointment, according to the report . As for people with disabilities, some are being refused for reasons ranging from "lack of time or training" to "inaccessible premises or unsuitable medical equipment."

Beyond access to care, the human rights defender is concerned about "frequent violations" of the patient's right to receive useful information to make an informed choice and to be able to give their consent. This is particularly the case for women during their gynecological follow-up with examinations (smear tests, endovaginal ultrasound, IUD insertion) "carried out without prior information and without their consent being sought."

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But the institution also says it has been alerted about "unconsensual acts of care on people with mental disabilities" , such as the forced administration of an injection to a patient who was nevertheless being treated under the voluntary hospitalization regime, or the increased and unjustified use of force, restraint or isolation.

These discriminations have "immediate and lasting harmful consequences on the care pathway of patients" who end up postponing or completely forgoing care, warns the institution, which urges the government to implement a national strategy to prevent and combat these practices. "We must train doctors, but also patients, on the avenues of recourse," it says on Franceinfo. It recommends in particular focusing efforts on preventing this discrimination, collecting and processing reports, and adapting the healthcare system to the specific needs of certain patients.

By The New Obs with AFP

Le Nouvel Observateur

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