Monday, February 23, 2009

Access to Healthcare

The human right to health is acknowledged in several international documents. Article 25.1 of the Universal Declaration of Human Rights assert: "Everyone has the right to a standard of living adequate for the health of himself and of his family, including food, clothing, housing and medical care and necessary social services".
That health is a fundamental human right is obviously incontestable. Yet, access to healthcare is an issue that is becoming highly controversial, particularly when it is becoming tied to the financial status of the person, not to personhood itself. Those who can pay or buy private insurance can afford treatment. Those who fare lower on the scale find themselves having to plead or to remain untreated. What is the morale of the story? That poor people are not allowed to get sick? Medical care is expensive and treatment is not always available and at times is poorly available. Should we “mind the gap” as if it were an anomaly or correct the malfunctioning in the system?

. تعترف مجموعة من الاتفاقات الدولية بحق الانسان بالرعاية الصحية.
فالمادة 25,1 من شرعة حقوق الانسان مثلا تنص على ان لكل انسان الحق بمستوى معيشي يضمن صحته وصحة عائلته بما يشمل الطعام والملبس والسكن والرعاية الطبية والخدمات الاجتماعية اللازمة
ما من شك ان الصحة من أسس حقوق الانسان , لكن الحصول على الرعاية الصحية اصبح امراً قابلاً للجدل وغير مضمون خاصة مع إرتباطه بالوضع المادي للمرء وليس بشخصه فحسب. فقط اذا كان باستطاعتك شراء بوليصة تأمين خاصة بالرعاية الطبية تحصل عليها. والاّ فإنك تُحرم المعالجة الطبية وتضطر الى التوسل في طلبها. هل المقصود هنا ان ليس للفقراء الحق بأن يمرضوا لأن الرعاية الطبية مكلفة وغير متوفرة للجميع ؟ وهل علينا مسؤوليته تصحيح الخلل في نظامنا ام ان نرضخ للواقع؟

Wednesday, February 4, 2009

Getting physicians to listen and talk to patients

Listening and talking to patients is one detail that physicians, residents, interns, nurses and everyone involved in health care should start taking to heart. Surveys all over have revealed patients’ lack of satisfaction with the interpersonal skills of healthcare practitioners. When the patient is a ‘chronic case’, a ‘juvenile diabetes’, a ‘muscular dystrophy in room 205’ instead of a person with a name, with a private history, with a personal narrative,
communication skills are not necessary. When the illness is added to the person instead of taking over the individual, then, communication skills become paramount. So? So perhaps it all boils down to a matter of perception. How do we perceive the patients with ‘juvenile diabetes’ or ‘muscular dystrophy in room 205’?
We were having dinner yesterday night, my friends and, very nice restaurant and very good food. But dinner was ruined by the stories of physicians who tarnished their professions by the lack of their communication or humane skills. Why would a doctor tell a man not to bother spending much money treating his mother because she is old and will inevitably die soon? This was a message delivered during a clinical encounter. His mother is not suffering from any terminal illness (which would not have justified the declaration either).
Then another one added: My doctor does not bother to greet me when I come in; his arrogance is one that leaves a lot to be desired. If I can g to another physician I would. But I am stuck. She hates having to see that physician who exemplifies the characteristics of condescension. Then came the closure: a unanimous agreement that physicians these days do not bother to spend more than a few minutes with the patient whom they treat as an illness to undo. Adieu the good old days!
In my opinion, something is wrong in the system. Medicine is a moral enterprise and the most humane of the sciences. Many physicians still live up to that ideal. If others are not, there must be something that can be done about it. Part of the responsibility lies on the patients themselves. They should know their rights and not allow healthcare workers to treat them as illnesses or numbers. Patients should demand explanations and time. Until this is done, there will always be physicians who will discredit the profession.
Painting above of Egyptian Physician by H.M Herget