Abstract:
BACKGROUND:France has long been a country of immigration and in some respects may be seen to have a generous policy with respect to asylum seekers and access to health care for migrants. The French state notably provides healthcare access for undocumented migrants, through state medical aid and since 1998 has had a humanitarian policy for granting temporary residence permits for medical reason (TRPMR) to migrants. Within a context of political debate, reform and tightening immigration control we will examine this latter policy focusing especially on the dilemmas that arise for physicians of migrant patients when they are requested to write medical certificates as part of a TRPMR application. In a 2017 reform the key role of making recommendations on the granting or not of permits was handed over to Ministry of the Interior health inspectors. Recommendations are made after perusal of medical certificates established by the migrant's physician and complementary evidence. MAIN BODY:The writing of medical certificates by a physician would seem straightforward. This is far from the case since it raises a number of ethical dilemmas. These occur within a physician-patient relationship embedded within a social contract between the State, the physician and the migrant patient. To clarify the ethical issues arising 3 vignettes based on practice within an infectious disease unit at a large Paris hospital have been developed. The vignettes highlight ethical dilemmas in the care for migrants with tuberculosis (dilemma in defining health and disease), chronic hepatitis (dilemma between beneficence and do not harm), and HIV / AIDS (issue of deservingness). We will go on to reflect on issues of social justice and responsibility for the health of migrants within a globalized world. CONCLUSIONS:Criteria for residence permit delivery appear less than clear-cut and are interpreted in a restrictive way. Neither are the consequences of refusing a residence permit taken into account. We call for an empirical transnational ethics study involving countries implementing similar TRPMR policies. We also call for inclusion of lobbying competences into the medical undergraduate curricula, in order to breed future generations of physicians skilled in defending social justice.
journal_name
BMC Med Ethicsjournal_title
BMC medical ethicsauthors
Cailhol J,Lebon MC,Sherlaw Wdoi
10.1186/s12910-020-00500-7subject
Has Abstractpub_date
2020-07-13 00:00:00pages
59issue
1issn
1472-6939pii
10.1186/s12910-020-00500-7journal_volume
21pub_type
杂志文章abstract:BACKGROUND:When a new intervention or drug is developed, this has to pass through various phases of clinical testing before it achieves market approval, which can take many years. This raises an issue for drugs which could benefit terminally ill patients. These patients might set their hopes on the experimental drug bu...
journal_title:BMC medical ethics
pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:BMC medical ethics
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pub_type: 杂志文章,评审
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journal_title:BMC medical ethics
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更新日期:2014-02-03 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 杂志文章
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journal_title:BMC medical ethics
pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.1186/1472-6939-8-7
更新日期:2007-06-19 00:00:00
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pub_type: 杂志文章
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journal_title:BMC medical ethics
pub_type: 杂志文章
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更新日期:2012-09-04 00:00:00
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journal_title:BMC medical ethics
pub_type: 杂志文章
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pub_type: 杂志文章
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