Ethical Dilemmas in the Doctor-Roma Patient Relationship, from the Perspective of Health Mediators
Ethical Dilemmas in the Doctor-Roma Patient Relationship, from the Perspective of Health Mediators

Summary/Abstract: Overall, the access of ethnic minority populations to the health care system is modest due to several factors: patient-physician communication barriers, strikingly different interpretation of diseases, different conceptions of illness and health care, etc. The Roma minority in Romania is a vulnerable, discriminated population, which, when faced with disease, behaves according to traditional values and principles regarding the meaning of the disease and treatment that often differ from the views of the general population. The profession of health mediator was introduced so as to facilitate the access of the Roma population to the health care system, to facilitate the communication between health professionals and Roma groups and not in the least to facilitate the implementation of public health programs in Roma communities. As part of a European project we conducted an extensive qualitative study centered on perceptions and attitudes about death, chronic diseases, terminal stages and dignity preservation among the Roma population, in the context of health services. This paper aims to present ethical medical issues raised by Roma health mediators during their daily activities. The method for data collection was the focus group. We conducted group interviews with 30 of the Roma health mediators working in communities from Iasi and Cluj. The main issues discussed which interfered with medical ethics were: stigma and discrimination in the provision of health services, barriers in doctor-patient communication, failure by doctors to patients' wishes regarding compliance to ethnic habits, maintaining the confidentiality of diagnosis compared to other Roma community, communicating a fatal diagnosis, the process of making medical decisions. These results pave the way towards achieving informative materials or organizing workshops in order to culturally adapt the medical approach of Roma patients.

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