WHY IN THE COUNTRIES THAT DO NOT LEGALLY EQUATE ASYLUM SEEKERS WITH ASYLEES, DOCTORS FROM THE NATIONAL SYSTEM CANNOT EFFICIENTLY GIVE HUMANITARIAN MEDICAL HELP ...(TO ASYLUM SEEKERS) – FIVE BASIC PRINCIPLES
Humanitarian medicine is by definition politically independent; it cannot be practiced by the government. When a certain government, therefore, wishes to practice humanitarian medicine (with the potentials of its national health care system), it, in fact, denies humanitarian medicine and its principles
Humanitarian medicine is otherwise called „international medicine. “ The principles the international medicine acts upon are not equal to those of the „national medicine. “ The doctors at the medical schools who have no special academic course on „international medicine“ are not trained for work in a multicultural ambiance of humanitarian medical help. This is not only the matter of their cultural incompetence which is otherwise an important aspect but of a whole set of professional and legal problems that the doctor from the national system has no information about; neither does he/she know its problems nor is he/she trained to act: starting from the problems of a complex international epidemiological questionnaire in anamnesis-taking, through various doctrinaire disparities about curative and preventive approaches, up to the psychological support to the patient and protection of the patient's rights that derive from medicine and are part of the professional doctor's responsibilities
It must be clearly said that the countries which do not equate asylum seekers with asylees are en masse violating the human rights of the asylum seekers. The asylum seekers are thus coerced to solve their health problems by humanitarian medical help. If the state refuses to give competent humanitarian medical help to asylum seekers, it deepens even more the violation of the human rights which, in this case, goes well beneath the level which is, in the humanitarian law, given to the prisoner of war. Practically, it is their indirect liquidation.
The doctor employed in the national health care system functions on the basis of the contract he has made with each individual patient. This contract is the legal base for the doctor's work. If the state requires the doctor from the national network to do medical examination without legal basis, it not only violates its own legal order – which is in itself problematic – but it also puts the doctor in the position to have two kinds of patients; one that he is legally bound to, and the other that he has no legal obligation to. This situation is professionally known as „Dual Loyalty“ which historically originated from the South African Republic in the epoch of apartheid when the law on health care treated patients in legally different ways. Due to the problems caused by the „Dual Loyalty“ of medical work, in the year of 2002 in Cape Town an international commission was formed of some fifty international experts who concluded that the state must not develop its medical practice on the principles of „Dual Loyalty“. In many cases such practice leads to criminalization of doctor's work.
Medicine in the conditions of restrictive legislature is reduced to Emergency Medical Service (EMS). The experiences of Slovenia have shown that the EMS narrows down the curative, preventive and legal framework for giving medical help which is a dangerous practice not only for patients but local population as well. The EMS personnel is not trained – neither is it meant to be – for diagnostics; nor is it trained for curing many diseases that the doctor of international medicine regularly comes upon in his practice (TBC is just one well known example for this situation). In this way local population is exposed to unnecessary risks while the doctors' work is compromised in the professional and legal sense.
Dimitar Anakiev, Doctor of Medicine, President
Doctors for Asylees
Slovenia
