CYIL vol. 13 (2022)

HELENA VAN BEERSEL KREJČÍKOVÁ CYIL 13 ȍ2022Ȏ the balance between the right of a healthcare worker to a conscientious objection and the patient’s right to access a treatment. 3.1 Roma Patients in the Czech Republic According to some research, Roma patients are considered to be problematic by Czech healthcare workers, as they allegedly do not really follow the recommended recovery regime, do not respect inner rules set by the healthcare provider (nor they respect authorities in general), are crowdy, loud, and inadequately demanding etc. 26 The Czech Republic (together with its ancestor, the former Czechoslovakia) has a shameful history of nonvoluntary sterilisation of Roma women since 1960s, out of eugenic reasons, also including the sterilisation of minors. One of the documented cases happened in 1977, when a then 16-year-old patient was sterilised after undergoing an abortion. The patient had been diagnosed with a mental impairment, that is why her parents had been appointed as her legal guardians. After the abortion, the parents were contacted by a social worker who suggested the sterilisation and made it clear that the parents would receive some financial benefits after their daughter’s sterilisation. The parents gave their informed consent and got the benefits. Neither them, nor the social worker nor the healthcare workers taking care of the patient informed the patient about the sterilisation. 27 Just to put things in context, the current Czech law only allows the sterilisation of minors due to health reasons, if the informed consent of the patient’s legal guardian is supported by a assent of an expert committee and a court approval; whilst the opinion of the patient concerned needs to be taken into consideration. 28 Only in 2021 was the mechanism to compensate the nonvoluntarily sterilised victims introduced through the Act on Compensation for Unlawful Sterilisation. 29 However, the Roma population seems to remain marginalised until today; the current access of Roma population to preventive healthcare still has been noticeably problematic as they suffer from discrimination 30 and more likely than the rest of the population will end up outside the public health insurance system. 31 26 See e.g., VEJSADA, P. Specifika ošetřovatelské péče o dětského romského pacienta. [The specifics of nursing care for a child Roma patient] Bachalor thesis. Jihočeská Univerzita v Českých Budějovicích, 2013. Online available from:https://theses.cz/id/m3l36g/4830922. 27 European Roma Rights Centre. Nucené a kruté: Zpráva Evropského Centra pro práva Romů. Sterilizace a její důsledky pro romské ženy v České republice [Forced and cruel: A report by the European Roma Rights Centre. Sterilization and its consequences for Roma women in the Czech Republic] (1966-2016), 2016, p. 41. 28 S. 13 of the Act No. 373/2011 Sb., on Specific Healthcare Services, together with S. 35 of the Act on Healthcare Services. 29 Act No. 297/2021 Sb. 30 Cf. with the findings of the Public Defender of Rights, in the report on discrimination, available from: https:// www.ochrance.cz/uploads-import/DISKRIMINACE/aktuality/DIS-zdravotni-pece.pdf, pp. 10 and 25. Similar conclusion are presented e.g., in: KARÁSKOVÁ, K., KAJANOVÁ, A. Romské obyvatelstvo a vybrané aspekty stomatologické péče. [Roma population and selected aspects of dental care] Č eská stomatologie/ Praktické zubní lékařství , ročník 117/ 2017, 1, p. 8–12. 31 See European Roma andTravellers Forum v. the Czech Republic, complaint No. 104/2014, available online from: https://www.coe.int/en/web/european-social-charter/czech-republic/-/asset_publisher/R6mZpZA1SdSG/ content/no-104-2014-european-roma-and-travellers-forum-ertf-v-czech-republic?inheritRedirect=false. However, this statement shows a misunderstanding regarding how the Czech health insurance system works: The participation in the insurance system is mandatory for Czech citizens (and selected categories of foreigners stated by law). Even if these persons fail to contribute (pay the insurance) into the health insurance fund they will not end up uninsured, they will “just” have a dept towards their health insurance company.

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