Letters to the Editor

Toward a better response to human rights issues in health care

Tuesday, September 25, 2018

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Dear Editor,

The case of Jason and Charlotte Young, who were reportedly denied access to their child's medical records by staff members at the University Hospital of the West Indies (UHWI), brings the issue of human rights in Jamaica's health-care system into sharp perspective.

The ensuing court action, commendably supported by Jamaicans for Justice (JFJ), calls to attention the need to raise awareness among providers, patients, as well as civil society organisations of rights and responsibilities within the health-care system.

Since early 2017 the Partnership for the Promotion of Patients' Rights in Maternal, Neonatal and Infant Health (MNIH), through the European Union-funded Programme for the Reduction of Maternal and Child Mortality (PROMAC), has been holding discussions with stakeholders who interface with the health-care system, as well as health-care providers, around what they regard as important human rights in patients' care.

The MNIH project, implemented jointly by the Department of Community Health & Psychiatry at The University of the West Indies (UWI), Mona and the Women's Resource and Outreach Centre (WROC), is seeking to turn the spotlight on these rights. As the advocacy component of PROMAC, the MNIH project recognises both the rights and responsibilities of patients as users of the health-care system; and of health professionals as service providers in the system.

There have been many complaints of discrimination against youth (including young pregnant women), persons living with HIV/AIDS, and citizens who are deemed not able to represent themselves adequately, persons of different sexual orientations, etc.

Through citizens' reports of positive and, more often, negative encounters with various arms of Jamaica's health-care system runs a common thread, that is, the need for the following fundamental rights to be recognised and respected:

• the right to life;

• the right to information;

• the right to not be discriminated against on the basis of sexual orientation, class, age, occupation, or where one lives;

• the right to confidentiality, privacy and the maintenance of dignity;

• the right to competent and professional delivery of care;

• the right to be treated with respect, sensitivity, and empathy during the care process;

• the right to refuse treatment;

• the right to shared decision-making (ie, to be consulted and provided with understandable information to ensure truly informed consent for care);

• the right to view personal records;

• the right to clear, timely, frank and respectful communications;

• the right to an effective, robust complaints mechanism, which includes redress and an appeal process; and

• the right to due process.

It is the observance and acknowledgement of these rights that is at the heart of building confidence in the health-care system. We believe that a framework for an ongoing, sustainable dialogue to put more policies into action is vital in building the confidence of patients in the health-care sector. To this end, MNIH is developing a training programme on human rights in patients' health care. Specifically, it is partnering with civil society organisations with the aim of increasing their capacity to train, educate, and support the wider society in these efforts.

Through these partnerships, Jamaicans will be empowered to work more closely together towards the realisation of Targets 3.1, 3.2, and Goal 3, Target 3.7 of Jamaica's National Development Plan, Vision 2030: To reduce the maternal mortality rate; end preventable newborn, infant and under-five deaths; and ensure universal access to sexual and reproductive health-care services, including for family planning, information and education, and the integration of reproductive health into national strategies and programmes.

Ruth Howard

Women's Resource and Outreach Centre

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