Abstract

Key words:Medical field; Leprosy; Tuberculosis; Aids; Diabetes; Non-Stigmatization; Aiims; Diseases; Genetic characteristics

Introduction

Background

Worldwide the history of discrimination & stigmatization is available. It could be because of religion, race, regional, gender, rich-poor etc. The effects of such events on said identified group of people puts them on the judgmental area. They try to navigate to negotiate through it. There is reason to be concerned that genetic influences on such characteristics as intelligence, memory, shyness or sociability could be exaggerated and result in the stigmatization or discrimination of individuals or groups. A universal instrument on bioethics can impress upon the scientific community the eugenic implications of generalizations that are unfounded or premature. It can also warn people about the injustice that may result either from an exaggeration of group similarities or differences, or from the denial of such features when they have actually been established. A universal instrument on bioethics can encourage geneticists to confront the issues accurately, professionally and on the basis of the best available science (IBC, 2003). Even after such observations & measures conducted, we are well versed with the scenarios in which we come across few incidents which give us chill through the spine.

Events & Discussion

India is one of the most religiously and ethnically diverse nations in the world. While not divided by race, the country is deeply divided by caste, culture, language, regionalism, and sexism.2 Racial inequality in America has its parallel in caste inequality in India [1]. Students of certain castes and tribes face systematic denigration in medical institutions [1]. Though seemingly subtle, the impact can be tremendous on the lives of doctors from marginalized communities, at various stages of their careers. Early March 2012, Anil Kumar Meena, an MBBS student committed suicide at the All-India Institute of Medical Sciences [2]. He was a tribal, with a good academic record, but had difficulty in understanding English. The teachers allegedly humiliated him instead of helping him. His performance dropped. He ultimately took his life. This was the second suicide in AIIMS in two years, and protesters said that nothing was done to improve circumstances. The administration denied that Anil was discriminated against because he was a tribal. The situation is worse than it appears. In 2007, the Thorat Committee Report [3]. described extensive discrimination against SC/ST students in AIIMS, where 85% of the students reported that internal examiners wanted to know the caste of the students, and that they were blatantly discriminatory in awarding grades. The scenarios described above don’t exhaust the forms of discrimination that are encountered in India. I should also make it clear that I leave aside in this essay the large tract of discrimination that arises due to disease, as in leprosy, tuberculosis, AIDS and diabetes (for examples of such studies see [5-8]. I argue here that discrimination is pandemic across India. It is a cultural trait that expresses itself in an infinite variety of forms. This is an attempt to grasp how discrimination operates in India [4]. While underrepresentation of women among leadership positions in medicine is well documented, [9] the prejudice associated with gender stereotypes can be real. Female doctors are customarily expected to be less assertive and less competent than their male counterparts. Female residents are far more likely to be recognized as nurses than male residents. The implicit insult in the notion that a woman wearing a white coat couldn’t possibly have gone through the rigorous training required to become a doctor is offensive. Gender pays gap exists in nearly every profession, but as per a WHO report, the gap in healthcare is 25% greater than any other occupation [10]. Women form up to 70% of the workforce but occupy merely 25% of the leadership positions, implying that although women deliver the bulk of healthcare globally, men continue to lead it [10].

Regional discrimination is far less discussed & is felt by the students who move from one region to another region in India. Even they face challenge to understand the local language. The prejudice work place along with load of studies, duties at residency it takes toll on mental & physical health of the student.

Way towards Non-discrimination & Non-stigmatization

The steps taken by authorities to prevent such events are abundant. The first draft language of the non-discrimination and non-stigmatization article appeared in Article 9 of the third IBC draft of the Declaration (IBC, 2004c). It read as follows: In any decision or practice within the scope of this Declaration, no one shall be subjected to discrimination based on any grounds, including physical, mental or social conditions, diseases or genetic characteristics, nor shall such conditions or characteristics be used invoked] to stigmatize an individual, a family or a group. Timely improvements in such practices is observed.

Even in countries like France, United States they run research depending on feedback from the discriminated population. Practice like his will help us understand the severity & measure to be conducted for better future.

To conclude, structural discrimination has multiple faces, and though many a times unintentional, has potential to restrict the opportunities for those discriminated. Deep introspection of the inherent socio-cultural biases and prejudices towards people from different cultural identities, and compassion for our peers are the catalysts that will help nurture the thought of diversity, equity, and inclusion [1]. The scale of these problems may sometimes seem overwhelming, but social change can be accomplished through a series of minute steps made by individuals and institutions in pursuit of an improved world. These biases cannot be uprooted by any policy, agenda, norms, or planning. We, as a community, must come forward and unite against all forms of harassment and inequality.

References

1. H Mehta, A Bishnoi, K Vinay (2022) The multifaceted aspects of structural discrimination amongst medical community in India. Indian Dermatol Online J 13(2): 252-253.
2. Thorat Committee Report: Caste discrimination in AIIMS (2007) [Editorial]. Econ Pol Wkly 42: 22.
3. R Srivatsan (2015) Reflections on discrimination and health in India. Indian J Med Ethics 12(1):13-7.
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9. World Health Organization (2021) 10 key issues in ensuring gender equity in the global health.
10. Joshua G Rivenbark, Mathieu Ichou (2020) Discrimination in healthcare as a barrier to care: experiences of socially disadvantaged populations in France from a nationally representative survey. BMC Public Health 20(1): 31.