Editorial
Article Type: Editorial From: International Journal of Human Rights in Healthcare, Volume 8, Issue 2.
Welcome to the second issue of 2015. Despite of acknowledging the right to health as one of the basic human rights that all individuals should freely enjoy independently of their status, race, gender, sexual orientation and other protected characteristics,there is persistent discrimination and variation in its enjoyment and application worldwide. This is true even for the most progressive and rich countries. The reasons vary and they can be financial, political, social and sometimes conceptual. For example, variations in the definition of health, the lack of agreement as to which institutions are responsible for it as well as determinants of good and bad practice are all factors that contribute to the right’s misapplication and confusion.
One of the key objectives of the International Journal of Human Rights in Healthcare (IJHRH) is to address this international gap in knowledge with the ultimate aim of making the human right to health consistent in its interpretation and enjoyment by all. We aim to encourage an intellectual and evidence-based debate among researchers,academics, practitioners and policy makers internationally. This issue, for instance, provides new and ground-breaking evidence on key topics such as coercion in psychiatry, issues relating to HIV patients, different types of cancer and patterns in causes of death. It also looks at the relationship that patients and doctors want or need to have and how this compares with actual reality. As a truly international Journal, the geographical scope of the papers stretches from South Africa, the UK, France,India and Australia.
Looking at the first paper, “Oral health care experiences of people living with HIV in Kwazulu-Natal and Western Cape, South Africa”, it aims to explore the unmet needs of people living with HIV and who receive dental care. There is a persistent stigma associated with this illness and dental patients are most often at receiving end of it. The study considered the various factors that affect the accessibility and utilisation of dental services. Based on original research, the sample group was selected among HIV positive people attending selected CHC and regional hospital HIV clinics. The majority were black females. Almost a third of the participants reported a negative experience at the clinic and over half of them reported that staff knew about their HIV status. The study highlighted the barriers to care that exist within the current public health system. The paper concludes that the high prevalence of oral health problems with people living with HIV makes it imperative for the South African Government to make every attempt to take action ensuring secure equitable, affordable and accessible oral health care which is acceptable for people living with HIV and accountable to Indian society.
Coercion in psychiatry has long been debated. However, it is not often that we get to read scientific data as these are collected by users. The second article “Coercion and trust in psychiatry: the ultimate contradiction” provides an account from the perspective of a survivor and activist. This paper takes elements from and builds on three recent conference and seminar presentations presented in France and the UK in 2014. Additional research was carried out with the aim of generating a grounded perspective of how coercion is actually exerted and experienced through, a narrative approach. The paper is a contribution towards a more user and survivor-oriented discourse in this area.
We also know that doctor-patient communication is key in the provision of tailored and appropriate health care services. It is also a matter impacting on basic human rights including the right to be informed and be involved in decisions that affect you. There has been a long-standing attitude that patients do not need to be informed about the treatment that they receive,and that doctors do not have an obligation to inform or consult the patient. Focusing on ethnic Australian urological cancer patients, the third paper “Doctor-patient communication: a study of Australian ethnic urological cancer patients” used a sample of 50 Australian urological cancer patients of ethnic origin to make some progress in this important area. For example it concluded that patients from lower socioeconomic backgrounds for whom English is not their first language have low levels of medical literacy and therefore require additional written information about their illness and treatment such as informative brochures, educational booklets and educational videos.
Moving on to our paper from India, arguably there has been some significant progress in population health outcome indicators. However, very little is known on patterns in causes of death. The fourth paper “Health transition in India: does data on causes of death reveal trends, patterns and determinants?” aims to bridge this gap by drawing data from two sources namely, National Family Health Survey and published reports of Survey of Cause of Death. Three-years moving average causes-of-death estimates were calculated based on WHO classification of causes of death. The findings are revealing and ground breaking, as the epidemiologic transition in India has produced a shift in mortality from communicable, maternal, perinatal and nutritional conditions to non-communicable diseases, with little or no role played by injuries regardless of the level of all-cause mortality. Coupled with the effects of population age structures, other factors were also responsible for the bulk of the inter-regional disparities.
Finally, the fifth paper looks at cancer diagnosis, as this is believed to often serve as an impetus for making positive lifestyle changes. Titled “Positive lifestyle changes following urological cancer diagnoses: an Australian interview based study”, this ground-breaking study examines the positive life changes that patients report after cancer diagnosis. Most participants reported that they made positive lifestyle changes following a diagnosis of cancer including greater appreciation of health and life,improved diet, closer relationships with family and friends, more frequent visits and increased spirituality. I could not think of a more positive message to close this issue.
Theo Gavrielides
