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Index of documents > Reports and communications > Sicilia 2007



According to the “Health criteria”

 

The discrimination suffered by the elderlies was partially discussed in the Euromeeting held in Huelva in 2005 during the conferences given about the elderlies’ dependence. Then, we attested that in spite of all the efforts made by Worldwide, European or National Institutions, there is a long way to go until the elderlies’ social exclusion is eradicated; especially if we consider the fact that the population’s ageing is seen as a barrier, not to say an « economic disgrace »

 

The Worldwide institutions such as UNO and the European Union have already taken their positions; nevertheless, we can corroborate that the level of discrimination against the elderlies depends on the actions taken by each National Government.  In France, the fight against age discrimination is the main issue of several guideline texts, based at the same time, on Communitary texts and on the elderlies’ rights.

 

However, according to the Government, the demographic perspective creates individual challenges affecting the world at large, since the guideline systems used as a complement to Social Security are starting to feel a kind of pressure that will be increased with time.

 

 

This view is dangerous because give a perception of old age people as a part of society that can easily be exploited and useless in today’s society.  This situation can also lead to discrimination and remissness especially in what has to with sanitary care.

 

 

q DISCRIMINATION ON HEALTH AND AGE GROUNDS.

 

Despite the Fact that non- discrimination on age grounds is a fully extended right; this type of exclusion can be found in a developed country such as France.

 

The International agreement on economic, social and cultural rights (Sections 9, 11 and 12) establishes its aims in the following way: “Create, when necessary, health care systems and economic and social security nets for the old age population in order to eradicate all forms of violence and discrimination affecting them”.

 

The elderly has not to be seen as a useless portion of society just because the might need more care that those who are younger, since such clichés can entail inequality, slackness and even abuses. When this segregation affects the elderlies it is only applied in fields such as labour, training, incomes or loan concession. However, the sanitary discrimination is the one that affects the elderlies the most. 

 

The Human Rights’ Code states that the elderlies are entitled to be protected against health care discrimination. In France, this right has already been applied for some time in hospitals, health care centres, clinics and rest homes. For some time the Government and the Parliament has taken effective measures to stop nourishing discrimination when referring health care and disability.

 

The Government has prohibited any kind of selection based on sanitary risks even when the patients hold an Insurance covering all kind of illnesses that guarantees the holder free extra assistance and is also applied to elderly people.

 

In France, health discrimination against the elderly is no longer measurable. The French Government stated some time ago that this variety of social behaviour is unacceptable in the 21st Century. In addition public opinion would not accept this type of exclusion in a world where one of the greatest victories of science and medicine is the significant increase of life expectancy.

 

So, in review we could say that this kina of sectarism against the elderlies has been erradiceted from the ensamble of the French’s Society. We have just to point out our answers and admit the hidden existence of health discrimination that can be found among services and cares perceived.

             

qDIFFERENT EXPRESSIONS DEFINING HEALTH DISCRIMINATION.

 

µ Discrimination because of defferred assitance :   

 

What does it consist of

 

           In health care services, certain attitudes may affect the quality of the “sanitary provisions”  destined to the elderly. Sometimes, some members belonging to the medical system tend to standarize the elderlies’ health difficulties; in other words, they tend to consider or presume they are due to ageing and, therefore they don’t need to be treated as younger patients. For instance, for a IMR Scan, a younger person will get an appointment before an 80 year- old person.

 

          This is not a refusal to assist the patient, but an application of a priority principle related with the access- sometimes limited- to medical assistance.

                                                                                     

This way of direct discrimination, that could be defined as hypocritical, must be taken seriously.

 

And why hypocritical? Because this attitude doest not intend to provoke prejudices nor exclusion.

 

Hypocritical because it doesn’t blame those who inflict it since it is created by the lack of medical and logistical resources revealing the inherent financial considerations.

 

Those denying the equal right to medical assistance of every human being are wrong in their belief that the elderlies run down health resources, require more assistance time and efforts and, since there are no material, technical or human means, this priority must be given to younger patients,

 

µ Indirect discrimination: VIOLENCE AND MISTREATMENT

 

 

This is the most dubious discrimination variety, because it violates the right of elder people to be treated with humanity. This discrimination is usually created by the person’s poor health conditions. Those responsible for this kind of treatment take profit from old people vulnerability.

            The elderly, ill or disabled people are the easiest victims of this type of health-related discrimination. The elderly, mainly women, have to face very often physical and psychological negligence that may even develop into violence and mistreatment.

 

            Recent events spread by the media have thrown some light on the incomplete medical assistance that elder people are given sometimes.

           

Why mistreatment has to be considered as a way of discrimination?

            Because recent researches made by the Labour, Health and Politics Council show that in 80% of mistreatment cases elder people are involved. This type of violence can only be inflicted when the victim is a vulnerable person (with physical or psychological disabilities, senility, etc.) because, if the contrary situation was given, they would be more respected.

           

Which is the best way to explain it?

 

The elderlies’ mistreatment is probable an old reality, but today’s population is starting to be awared. While in France , in 1999, this problem was only found in the gerontologic scheme, it has now been converted into a raising phenomenon                                                                               with a rapid development since it has been defined as a part of the health discrmnatio towards the elderlies.

This consciouness makes us have a different view when looking at an elderly person because we re-evaluate the attitudes, behaviours and procedures related to their care.

It is necessary to highlight that, in most cases, mixed neglection can be found: physical psychological, medical or even related to financing. To this classification, the following one can be added:

 

-          Deliberate neglection.

-          Neglection caused by incompetent, ignorance or even the lack of individual possibilities. 

 

Lots of Sanitary and Medical institutions only consider valid, and therefore entitled to prosecution, health discrimination caused by neglection. Mistreatment due to psychological and “ordinary” negligences is part of the ordinary routine.

 

This idea that places mistreatment in the stage mentioned is shared by several health professionals who find hard to conceive the fact that their professional behaviour can be considered neglection or discrimination even if they don’t intend to cause harm.

 

 q WHAT TO DO? HOW TO ACT?

 

In a country like France where, as has been mentioned before, the European Charter against the elderlies’ health discrimination is respected and applied it may happen that:

  

 

 

 

ŚSome political and economic parameters to be taken into account by the Authorities.

 

      There is an important fact changing since “a few decades ago” the planet’s demography: age. Ageing is a social problem that will increase. Several countries, France among them, have put into practice systems in order to guarantee universal assistance. These Nations wonder about the future of the systems mentioned and the mechanisms needed to keep and maintain such protections affected by the raise of life expectancy.

 

            In Europe, the unavoidable raise of the demographical structure led by population’s ageing requires that some economic and social problems are solved immediately:

 

            - The raise and the geographical regulation on the implementation of detection techniques  (scan, MRI, etc)

-          The creation of enough specialised centres according to the existing demand could only follow an exponential rhythm.

 

Without an urgent and keen reaction coming from the authorities, the elderlies’ health discrimination could become a constant feature unacceptable for a developed country.

 

 

ŤStructure adaptation to specific needs

 

 

The sanitary and social offer will need to be adapted.

 

      Let’s take as an example a priority field: The training received by doctors and sanitary staff.

 

       For French doctors, gerontology and geriatrics became compulsory and theoretical subjects during the second cycle of the training programme only after the Government ordered enacted on the 4th of March 1997. Furthermore if we take a look at the index of Pars doctors, we can state that there are only 13 doctors inscribed under the section of Gerontology and geriatrics specialists.          

 

An adaptation of home-care assistance by means of doctors and sanitary staff is fundamental. As we have previously mentioned, the lack of resources, the fatigue of the relatives assisting the patients, the hostility of sanitary professionals against geriatrics and the ignorance about certain therapies may provoke health discrimination; no matter whether it is in a direct way, as in deferred assistance or indirectly like mistreatment.

 

The number of old and “very old” people will exceedingly increase in the next thirty years. The same thing will happen with chronic diseases and disabilities related to ageing, assistance and treatment necessities. The need for treatments and existing number of places offered in hospitals and specialised centres will be not be enough in order to face the challenges originated by illnesses associated to ageing.

 

 

The non-discrimination of the elderlies on health criteria requires the setting of enough establishments correctly located and provided with the adequate equipment and personnel.

 

qConclusions

 

 

We can only be happy to acknowledge that the population’s ageing is in the European Union’s sanitary political agenda.

 

But the action programme chosen when referring to sanitary discrimination because of age must go further that recognising the disabled and the elderlies’ fundamental rights. By means of several charters and agreements taking into account the elderlies’ rights. Our Governments have to be aware of the elderlies’ contributions to society and not just stay with the old-fashioned vision of their economical impact on the Labour Market.

 

Every joint strategy about the elderlies’ rights must erase all forms of age discrimination, including the one based on the unequal access to sanitary care.                   

 

            Even though in France the access to medical and sanitary subsidies for the elderlies is a reality, this issue deserves to be considered as a new challenge.

 

Jean Claude CHRETIEN

SCIACCA, April 2007