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Patient Rights and AIDS Phobia

Patient Rights and AIDS Phobia. A Review of Existing Literature —Hans Moerkerk. Marginalized Groups. Men Who Have Sex with Men (MSM) Injecting Drug Users Transvestites Street Kids Hemophiliacs Poor of Haiti. Patient Rights Established by the World Health Organization.

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Patient Rights and AIDS Phobia

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  1. Patient Rights and AIDS Phobia A Review of Existing Literature —Hans Moerkerk

  2. Marginalized Groups • Men Who Have Sex with Men (MSM) • Injecting Drug Users • Transvestites • Street Kids • Hemophiliacs • Poor of Haiti

  3. Patient Rights Established by the World Health Organization • Right to Confidentiality • Right to Information • Right to Treatment

  4. Right to Confidentiality “Confidentiality covers all the information that has come to the knowledge of doctors (and other health workers, like nurses and laboratory personnel) i.e., not only information given to him or her on trust, but also anything he may have seen, heard, or understood.” — Geneva Declaration of 1948, Article 11

  5. Rights of the Individual vs. Rights of the Society • American College of Physicians, 1986 • U.S. Presidential Commission on the Human Immunodeficiency Virus Epidemic, 1988

  6. Right to Information • Consent is not seen as implicit, but is explicitly given by the person involved. • Patient’s informed consent is indispensable, especially in situations where treatment is possible.

  7. Right to Treatment “...doctors should respect their age-old tradition of treating patients infected with contagious diseases, a tradition that must be perpetuated in the case of the AIDS epidemic.” — World Medical Association, 39th Assembly, 1987

  8. AIDS Phobia “The Understanding and Responding to HIV/AIDS-related Stigma and Discrimination on the Health Sector,” Pan American Health Organization (PAHO), 2003.

  9. AIDS Phobia AIDS Phobia=A morbid fear or aversion for the individual or the social contamination of the disease. Stigma=A deeply discrediting attribute applied by society and borne or possessed by groups or individuals. (Ervin Goffman)

  10. AIDS Phobia Stigma Discrimination “HIV-related stigma may well be the greatest obstacle to action against the epidemic, for individuals and communities, as well as political, business and religious leaders.” — Peter Piot, UNAIDS, 2001

  11. HIV/AIDS-Related Stigma • Affects the rights of individuals and vulnerable groups • Creates barriers for effective prevention • Excludes people from treatment • Restricts the free movement of persons living with HIV/AIDS

  12. HIV/AIDS-Related Stigma • 1988—102 nations signed the “London Declaration on HIV/AIDS” • 1989—Ministerial Committee of the Council of Europe rejected stigma and discrimination of people living with HIV/AIDS • 1994—Paris Declaration • 1999—UN Commission on Human Rights

  13. HIV/AIDS-Related Stigma • American Convention on Human Rights • European Convention on Human Rights and Fundamental Freedoms • African Charter on Human and People’s Rights

  14. HIV/AIDS-Related Stigma United Nations Special Session on HIV/AIDS (UNGASS), June 2001, Paragraph 37: “. . .by 2003, nations should ensure the development and implementation of multisectorial national strategies and financing for combating HIV/AIDS that address the epidemic in forthright terms; confront stigma, silence, and denial; address gender- and age-based dimensions of the epidemic; and eliminate discrimination and marginalization;”

  15. HIV/AIDS-Related Stigma Paragraph 58: “. . .by 2003 nations should enact, strengthen, or enforce, as appropriate, legislation, regulations and other measures to eliminate all forms of discrimination against, and to ensure the full enjoyment of all human rights and fundamental freedoms by people living with HIV/AIDS and members of vulnerable groups. . . ”

  16. UNGASS Results in the Caribbean and Central America Good News— • Policy • Prevention Activities • Treatment • Attention to Human Rights

  17. UNGASS Results in the Caribbean and Central America • 2000—Partnership launched between all Caribbean countries and dependent territories • 2002—PANCAP, hosted by CARICOM • May 2002—Madrid Declaration • Regional Projects—PASCA, PASMO, NGOs

  18. UNGASS Results in the Caribbean and Central America • Dominican Republic • Cuba • Haiti

  19. HIV/AIDS-Related Stigma CAREC Workshop, 2002: “People living with HIV/AIDS reported that stigmatization and discrimination are widespread all over the different islands due to discriminatory attitudes among policymakers and health workers towards MSM and IDUs.”

  20. Recommendations • PANCAP should give more attention to the legal aspects concerning PLWHAs and vulnerable groups among its members. • PANCAP and other regional institutions should address political leaders and governments to fully implement the UNGASS conclusions and report about this initiative at the next PANCAP annual meeting.

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