Post-traumatic stress disorder, human rights and access to healthcare: an analysis of judgments of the European Court of Human Rights from an ethical perspective

Abstract

Background: Human rights violations such as torture are associated with a high risk of posttraumatic stress disorder (PTSD). The judgements of the European Court of Human Rights (ECtHR) include a normative perspective on PTSD and address central ethical questions. Objective: To help bridge the gap between the psycho-medical and the legal discourse on human rights violations and to illustrate their medico-ethical implications by systematically assessing and categorizing all judgements by the ECtHR dealing with PTSD. Method: The ECtHR database was searched for 'post-traumatic stress disorder'. A descriptive statistic was performed on the Articles of the European Convention on Human Rights involved and violations to these articles. In a qualitative analysis, the judgements were thematically grouped. Results: The search yielded n = 103 judgements, of which n = 90 were included. There were mostly violations of Article 3 (prohibition of torture), Article 8 (Right to respect for private and family life) and Article 6 (Right to a fair trial). PTSD in these judgements is normatively discussed with regards to ethical, social and political themes such as inadequate access to healthcare, especially in prison, matters of asylum, expulsion and extradition, protection of minorities and minors, as well as rights and duties of traumatized witnesses. Conclusion: PTSD plays a central role in a large number of ECtHR judgements. Our results show that PTSD as a medical diagnosis also encompasses legal, ethical, social, and political dimensions. This knowledge is essential for healthcare professionals working with traumatized persons, but can also be relevant for political decision-makers.Trastorno por estrés postraumático, derechos humanos y acceso a la asistencia sanitaria: un análisis de las sentencias del Tribunal Europeo de Derechos Humanos desde una perspectiva ética Antecedentes: las violaciones de derechos humanos como la tortura están asociadas con un alto riesgo de trastorno de estrés postraumático (TEPT). Las sentencias del Tribunal Europeo de Derechos Humanos (TEDH) incluyen una perspectiva normativa sobre el trastorno de estrés postraumático y abordan cuestiones éticas fundamentales. Objetivo: ayudar a cerrar la brecha entre el discurso psico-médico y legal sobre las violaciones de los derechos humanos e ilustrar sus implicaciones médico-éticas evaluando y categorizando sistemáticamente todas las sentencias del TEDH relacionados con el trastorno de estrés postraumático. Método: Se buscó en la base de datos del TEDH para 'trastorno por estrés postraumático'. Se realizó una estadística descriptiva sobre los artículos del Convenio Europeo de Derechos Humanos involucrados y las violaciones a estos artículos. En un análisis cualitativo, las sentencias se agruparon temáticamente. Resultados: La búsqueda arrojó n = 103 sentencias, de las cuales se incluyeron n = 90. En su mayoría fueron violaciones del artículo 3 (prohibición de la tortura), artículo 8 (derecho al respeto de la vida privada y familiar) y artículo 6 (derecho a un ...

Access to healthcare for people living with HIV: an analysis of judgments of the European Court of Human Rights from an ethical perspective

“…In this context, they are regarded as a major barrier to health-related quality of life for PLHIV (14) and are a significant factor preventing the achievement of global goals to end the HIV epidemic (15). Limited or even delayed access to healthcare leads to increased mortality and morbidity of PLHIV (16), raised healthcare costs (17) and a surge of risk of infecting other people (18). It is therefore of high general interest that PLHIV experience the same access to healthcare as non-infected individuals.…”