Tietze Fabian-Alexander, Orzechowski Marcin, Nowak Marianne, Steger Florian
Institute of the History, Philosophy and Ethics of Medicine, Ulm University, Parkstraße 11, D-89073 Ulm, Germany.
Healthcare (Basel). 2021 Oct 13;9(10):1361. doi: 10.3390/healthcare9101361.
The right to non-discriminatory access to healthcare is anchored in the European Convention on Human Rights and other international treaties or guidelines. Since its ratification, the European Convention on Human Rights was made binding in all Member States of the Council of Europe and is interpreted by the European Court of Human Rights (ECtHR). Despite its legal recognition, discrimination in healthcare provision has repeatedly been an issue of medicoethical and political consideration. In this context, minors are particularly in danger of being deprived of this fundamental right. The aim of this study is to analyze the current state of the ECtHR jurisdiction on challenges in accessing healthcare for minor patients. We conducted a systematic search of judgments by the ECtHR using the keywords "healthcare" and "child". We performed descriptive statistics and qualitative thematic analysis. Our search resulted in = 66 judgments, which were all screened. Access to healthcare for minors played a role in = 21 judgments, which involved applications against = 13 countries. We formed five, partially overlapping categories, which represent recurring themes regarding the research topic. These themes are governance failure ( = 11), the status of refugee, asylum seeker or migrant ( = 5), parental home ( = 5), maternity and birth ( = 4) and others ( = 2). The normative framework of the ECtHR's jurisprudence illustrates intersections between social, legal and medicoethical aspects of minors' discrimination in the healthcare system. It emphasizes the particular vulnerability of children, who require exceptional protection. Inadequate access to healthcare manifests itself in specific situations, such as in the context of migration or staying in public institutions. Healthcare professionals need to be sensitized for such discrimination mechanisms, as they are often at the forefront of encountering structural discrimination in the healthcare system.
不受歧视地获得医疗保健的权利源自《欧洲人权公约》以及其他国际条约或准则。自批准以来，《欧洲人权公约》在欧洲理事会的所有成员国均具有约束力，并由欧洲人权法院（ECtHR）进行解释。尽管在法律上得到了承认，但医疗保健提供中的歧视问题一直是医学伦理和政治层面反复考量的议题。在此背景下，未成年人尤其面临被剥夺这项基本权利的风险。本研究的目的是分析欧洲人权法院在未成年患者获得医疗保健面临的挑战方面的管辖权现状。我们使用关键词“医疗保健”和“儿童”对欧洲人权法院的判决进行了系统检索。我们进行了描述性统计和定性主题分析。我们的检索结果为 = 66项判决，所有这些判决均经过筛选。未成年人获得医疗保健在 = 21项判决中起到了作用，这些判决涉及针对 = 13个国家的申请。我们形成了五个部分重叠的类别，它们代表了关于该研究主题反复出现的主题。这些主题是治理失败（ = 11）、难民、寻求庇护者或移民身份（ = 5）、父母家庭（ = 5）、孕产妇和分娩（ = 4）以及其他（ = 2）。欧洲人权法院判例法的规范框架说明了医疗保健系统中未成年人歧视的社会、法律和医学伦理方面的交叉点。它强调了儿童特别容易受到伤害，需要特殊保护。获得医疗保健不足在特定情况下表现出来，例如在移民背景下或居住在公共机构中。医疗保健专业人员需要对这种歧视机制保持敏感，因为他们往往处于医疗保健系统中遭遇结构性歧视的前沿。
