Health in Haiti: when Haitian justice condones the impunity of health care providers for Non-assistance to people in danger
by Dr. Jean Ford G. Figaro
“It is not the doctors who we miss, but the medicine. “
Charles de Secondat, Baron of Montesquieu.
Boston, Wednesday, November 7, 2018 ((rezonodwees.com)) – Of premium on board, in front of the medico-legal spill of deaths recidivants for hospital care in Haiti, I call for the passage of a bill on the obligation of emergency health care in tribute and posthumous respect to Mrs. Sanette Dauphin, the mother of Roody Roodboy and all the victims of this grievous injustice: To help anyone whose life is in peril. I join the dismay of the whole society in denouncing and blaming the Haitian public health actors for their cynicism and concupiscence to the detriment of the population.
Haitian medicine today is developing a capitalist ethic who does not get along well with public health. Money has become the backbone of the system to such an extent that we are ready to let patients die if the required amount is not paid upon the patient's arrival. A situation denounced in almost all private health institutions in the country and sometimes in public centers where the patient must always have some tickets to buy first aid equipment. For millions of people across the country, coercion to pay for health care is an impassable financial barrier and one of the main causes of impoverishment. With this in mind, the Government of Haiti must support the implementation of several projects and strategies for the development and consolidation of social protection systems in health
I express my deepest sympathies to families and loved ones victims and my indignation to those who have the sacrosanct mission of care administration. Medicine is not an individual affair. It is part of a social, political and cultural dimension. According to the various UNDP Human Development Reports (2010-207), Haiti is a country with weak human development and a distribution of the latter which is highly unequal. Approximately 72% of the Haitian population lives on less than US $ 2 a day and the population has difficulty in accessing healthcare.
Biopolitics, a concept used by philosopher Michel Foucault to talk about a form of exercise power that is no longer about the territories but about the lives of individuals and populations. It is about the progressive taking into account, by the power, of the life of thousands of people. According to PAHO's latest five-year report, Haiti has invested less than 2 percent of its gross domestic product (GDP) in health care in the last five years, while the recommended minimum is 6 percent. Unfortunately, with only 4.3% of its budget allocated to health, Haiti is far from the PAHO / WHO recommendations that suggest that 15% of health spending should come from the national budget in low-income countries. This meager allocation shows that biopower is non-existent in Haiti. In addition, the Haitian constitution guarantees the right to health. A lie too much. The death of the singer's mother Roody Roodboy is due to this greedy situation of the private hospital system of our country. There are many similar cases that have been reported to the public. You have to pay first, otherwise you will die …
As many wise observers noted early on, Haiti remains a specialist in hard rules and soft applications. We adore laws and principles, provided they apply to others first. It seems to me very curious that public action has not been put in motion against any hospitals or individuals indexed for lack of assistance to people in distress. In a tweet, the former Minister of Public Health, Dr. Josette Bijou, wrote “For the construction of all, the Haitian law requires any health institution to provide emergency care to any patient with or without money the risk of punishment for failing to assist a person in danger “. If this is the case, no one has said a word about fatalities repeated daily in the country. In any system where life is valued, any situation resulting in the death of a man should be a subject of judicial investigation and a posteriori punished according to the law, if guilt is. The existence of such a law should intimidate the doctor or institution who would not assist a person in danger and would be prosecuted in the Haitian courts, would put his civil, criminal and ordinal liability at stake.
Even if the person is dying and help seems like a doomed exercise, it should not be denied. In countries such as the United States and Canada, there is a risk of criminal liability for anyone who would not interfere with another current with imminent danger. French law prefers to speak of voluntary abstention from assisting a person in danger. In order to encourage this practice, the Star Republic and some Canadian provinces have a law that mitigates the risk of prosecution in case of intervention, known as the Good Samaritan Law, inspired by a parabola used by Jesus to talk about the love of neighbor. Thus, it is necessary to prove the voluntary refusal to intervene. However, the only abstention may be simple negligence and therefore a source of civil and criminal liability. Beyond these offenses, it would be appropriate to speak also of Homicide and serious professional misconduct. Hence the need to strengthen the Haitian penal code and a code of ethics for the medical profession Haiti.
International bioethical literature has universal constants for health care providers, regardless of country customs, ideological beliefs, and spiritual beliefs. Autonomy, beneficence, non-maleficence and justice constitute the four methodological invariants and an ethical platform for the health professional, thematized by Beauchamp and Childress in 1979. These unfortunate events of a cyclical nature deserve urgent answers. . In the United States, after fatal accidents, measures and laws are passed quickly. This, to avoid new detrimental episodes and unfortunate mourning that could obviously be prevented.
The sad saga of Roody Roodboy's mother should be the trigger for a specific emergency law that would require any private institution or public, also to any individual, to assist people in dangerous situations. Hospital institutions will have to comply regardless of the ability of the sufferers to pay for services. Emergency care should not be denied to anyone and in the majority of cases, these are not really expensive or unaffordable procedures, they are almost in the majority of cases aimed at stabilizing a patient on the cardiovascular point and respiratory, likely to die without immediate intervention
This law would have nothing to do with free health services in general, but rather the obligation to treat all patients in an emergency situation all over the country. National territory. Impunity should not, under any circumstances, cover cases of killings by mercenaries and mercantilists in the health sector, disregarding the ethical principles and Hyppocrats' oath governing the medical corporation. Health is an integral part of the principle of social justice, which strives for equal rights without discrimination to enjoy the benefits of all kinds. Because in the end, the primary concern of any health system must remain the well-being and the safety of the patients, especially those in vital danger.
Dr. Jean Ford G. Figaro MD, MsC
] Specialist in Public Health Emergency Management.
Militant for the Rights to Health in Haiti.