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Ombudsman Paunio issues reprimand to Hospital District of Helsinki and Uusimaa for discriminatory guideline

A handicap is not a ground for excluding a patient from resuscitation or intensive care

31.3.2009

A handicap is not a ground for excluding a patient from resuscitation or intensive care, stresses Ombudsman Riitta-Leena Paunio. A handicapped person has the same right to good medical and health care as everyone else. The Ombudsman has issued a reprimand to the Hospital District of Helsinki and Uusimaa for a guideline, issued by its Chief Medical Officer, in which it was stated that "severely handicapped persons are not generally included in the scope of intensive care." The guideline is in this respect contrary to the constitutional provision prohibiting discrimination.

The Ombudsman investigated a complaint in which the discriminatory guideline issued by the Chief Medical Officer was criticised. A further criticism in the complaint was that a decision had been made at the Helsinki University Central Hospital's children's clinic to limit the care given to handicapped children and refrain from resuscitating them contrary to their parents' wishes or even without their parents' knowledge.

The Ombudsman points out that patients are entitled to the good-quality health and medical care that their state of health requires, without discrimination. The prohibition on discrimination is a key question of fairness in treatment-related decisions. Doctors must assess the patient's need for treatment and weigh the advantages and disadvantages of treatment according to medical criteria. They must base their decision concerning the need for treatment on the patient's individual situation.

In the view of the Ombudsman, it is justified and necessary to draft general guidelines on the provision of treatment, because they ensure uniform treatment practices and increase equality. However, they can not limit or exclude the rights that are safeguarded in legislation; instead, they must only complement them. Guidelines that exclude from services, e.g., handicapped persons or categories of patients suffering from certain diseases are unlawful.

The Hospital District of Helsinki and Uusimaa has informed the Ombudsman that the sentence discriminating against handicapped persons is being removed from the guidelines. 

Additional information will be provided by Senior Legal Adviser Kaija Tanttinen-Laakkonen, tel. +358 (0)9 432 3377.