What is discrimination, and how might it be evident in health care?
People are discriminated against gender, race, age and even social and economic classes. It is a sad reality that even at this time of the century, discrimination in healthcare still cuts across the globe and is practiced through various forms. This is in contravention of the fundamental human rights. Among such rights, including the federal law that offers all-round protection to every individual from any forms of discrimination that could be experienced or witnessed in the provision of healthcare services.
Every patient deserves and has the full rights that allow him to have access to healthcare services from any healthcare facility (Brown, 2017). Unfortunately, this has remained more of ink on paper with numerous patients testifying against having received fair services from the various healthcare facilities they have visited. Discrimination defines any form of treatment given by a healthcare provider to a patient by who they are. In other words, discrimination is being in the context of healthcare refers to healthcare being biased in the delivery of healthcare services to his patients. This paper outlines discrimination and how it can be felt or seen being practices in healthcare settings.
Discrimination in the healthcare context: The Equality Act 2010 outlines that no individual should be discriminated against. Any discrimination that is a contravention of this act is considered unlawful, and thus its practice is not permitted. Discrimination in healthcare breaks these fundamental human rights and thereby affecting both patients and healthcare providers. The effect is on issues such as ethnicity, criminal record, dangerous gender stereotypes and asylum and migration status among other forms of prejudice (Nelson, 2011). Patients are discriminated by healthcare providers in the provision of healthcare services on the basis of:
- age
- gender
- pregnancy
- belief or religion
- sex
- disability
- sexual orientation
The Equity Act 2010 collectively calls these forms of discrimination as protected characteristics (Niles, 2016).
Discrimination runs parallel to the global commitments that are aimed at achieving universal health coverage besides the sustainable development goals. It does this by:
- diving people
- disempowering people
- hindering access to healthcare services
- taking away from people their basic dignity
- hindering investment in the healthcare sector and system
Discrimination as well has a negative impact on the social determinants of health. Most people find direct connections with the institutions of their states through healthcare systems. This means that through the healthcare systems, the lives and citizenships of most people are shaped. Discrimination in healthcare, therefore, serves to reinforce the widened gap between the citizens of a country and hence to lead to an enhanced societal exclusion (Journal, 2015).
Discrimination in the healthcare system can be evident in various ways. These ways demonstrate a person is receiving unfair treatment from a healthcare provider. Among the ways include:
- Refusal by a healthcare provider to provide healthcare services or take a person as a patient
- Cause a deliberate disadvantage or harm to a person when offering healthcare services-this is termed as detriment by the Equality Act
- Stopping without logical reasons the provision of healthcare services to a person
- Punishing a person because he has raised a complaint or concern regarding discrimination- This can as well be demonstrated in the case where a person is punished by a healthcare provider because he has helped another raise a concern or complain about discrimination. The Equality Law 2010 defines this as victimization(Editors, 2017)
- Deliberately offering services of worse quality or on worse terms of service in comparison to what they normally offer to a person
- The behavior of a healthcare provider in such a way that intimidates distresses or offends a healthcare receiver-this is defined ad harassment by the Equality Act 2010.
Discrimination in the healthcare context
Harassment to a patient: Harassment is evident in cases where the healthcare provider behaves in a way that is scary or adopts the use of an abusive or offending language. It can also be observed under circumstances when a healthcare provider behaves in a way that makes the patient, or the care receiver offended. Should any of these behaviors be related to protected characteristics, then it is termed unlawful discrimination of patients. A demonstration of such discrimination is when a security officer based in a hospital turns abusive on a patient because of his dislike to gay people. In such a case, the gay patients are being discriminated against their sexual orientation (Skochelak, 2016).
Terminating provision of healthcare services: A healthcare provider should not stop providing a patient with healthcare services in such a way that it can be linked directly or indirectly to reasons relating to protected characteristics (Erickson-Schroth, 2014). Should a healthcare provider decide to terminate the provision of healthcare services to a patient, it should be based on logic. An illustration of such form of discrimination would be the case where a local meals service terminates serving you meals but serves your colleagues with whom you are in the area. The basis of the halt of the services according to the wheels service is that the partner is transsexual. Such is an illustration of discrimination against reassignment of the gender of a patient.
Provision of worse quality service or worse service terms: It is professional and ethical that healthcare providers would provide the same quality of healthcare services to all patients and should not engage in acts that seem to be intending to worsen the services on a specific patient (Kaakinen, 2014). The healthcare provider should offer services to everyone as he does it normally without any bias. For a case where a patient has to pay more at a private healthcare facility because he is a Muslim is an illustration of worsening of the normal services on the basis of religious belief. The Muslim faithful is just like any other patients to the private healthcare facility, and this deserves similar services as the colleagues.
Causing damage or harm to a patient: It is unlawful for a healthcare provider to cause harm or disadvantage to a patient in the process of offering healthcare services. An illustration of this could be a situation where a GP makes it difficult and cumbersome for a patient to book surgery appointments because the patient is African. The discrimination, in this case, would be based on race, which is part of the protected rights (Williams, 2011).
Effects of discrimination on patients and healthcare providers
Punishing a patient for making a complaint or concern about discrimination: The Equality Act 2010 prohibits a healthcare provider from dispensing any form of punishment to a patient for raising a concern or a complaint on individual behalf or the behalf of another person (Buckley, 2015). This is a form of unlawful discrimination and amounts to victimization. An illustration of this form of discrimination is in the case when a person raises a complaint about the home care of a relative to the management of a healthcare facility, and the facility decides to increase the fee payable. This it does knowing very well that the complainant is one responsible for the fees.
Conclusion
Discrimination of various forms still engulfs most of the healthcare facilities around the globe with the provision of healthcare services limited and based on such factors as gender, age, race, sex, and sexual orientation among other factors. This has seen insignificant progress made as far as the aspirations of achieving universal health coverage is concerned. Despite the establishment of laws, among them Equality Act 2010, to reinforce fairness and just treatment, not so much can be pointed at as the achievements.
Combined efforts of the healthcare providers, patients and the various administrative organizations are required to push this dream close to reality. Discrimination does not occur in the vacuum neither is it only evident in the healthcare system alone. This calls upon the attention of every individual in any sectors to inject their support in eliminating discrimination. Enough attention should be given to the laws and the various stakeholders involved with the enforcement of these laws taking up to their tasks to ensure conformity to the human rights standards.
References
Brown, D. (2017). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems. New York: Elsevier Health Sciences.
Buckley, T. (2015). Mirrors – Manual on combating antigypsyism through human rights education. London: Council of Europe.
Editors, J. (2017). Journal of International Students 2017 Vol 7 Issue 3 (July/August). Journal of International Students 2017 Vol 7 Issue 3 (July/August), 518.
Erickson-Schroth, L. (2014). Trans Bodies, Trans Selves: A Resource for the Transgender Community. London: Oxford University Press.
Journal, Y. L. (2015). Yale Law Journal: Volume 124, Number 7 – May 2015. Yale Law Journal: Volume 124, Number 7 – May 2015, 483.
Kaakinen, J. R. (2014). Family Health Care Nursing: Theory, Practice, and Research. London: F.A. Davis.
Nelson, A. (2011). Body and Soul: The Black Panther Party and the Fight Against Medical Discrimination. Sydney: University of Minnesota Press.
Niles, N. J. (2016). Basics of the U.S. Health Care System. New York: Jones & Bartlett Learning.
Skochelak, S. E. (2016). Health Systems Science E-Book. Oxford: Elsevier Health Sciences.
Williams, R. A. (2011). Healthcare Disparities at the Crossroads with Healthcare Reform. New York: Springer Science & Business Media
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