No. 1000-20

no. 07-00-444/2020-02 date: 12.10.2021.

 

OPINION

 

The opinion was issued in the procedure regarding the complaint of AA from B, against the Clinic for Oral Surgery of the Faculty of Dentistry in Belgrade, due to discrimination based on health condition. In the complaint and supplement to the complaint, he stated that on September 1, 2020, upon the referral by the Vračar Health Center, he came to the Clinic for Oral Surgery of the Faculty of Dentistry in Belgrade, in order to extract a tooth, because of which he suffered great pain for days. He states that he came during working hours, in the period between 6 and 7 p.m., however, after he informed the medical staff in the ambulance no. 3 of his HIV status, they refused to provide him with the service, explaining that they did not have the instruments and other necessary conditions, and recommended that he come the next morning. In its statement, the Clinic for Oral Surgery stated, among other things, that the Clinic provided the complainant with a dental health service in 2018, and that on September 1, 2020, а medical record for AA was opened, and he was sent for an X-ray, which was performed at 18:13, as well as that patients who come to this clinic in the period between 6 and 7 p.m., following the assessment of the on-duty clinician about a possible complicated intervention that has to be done in the operating room, which in the said period does not work due to sterilization of instruments, are advised to come on the following day, during the morning shift. When giving an opinion in this case, it is important to apply the provision of Article 45 of the Law on Prohibition of Discrimination, which refers to the rule on the burden of proof. Having in mind the stated rule, it is necessary to determine whether the Clinic for Oral Surgery provided evidence that there was no act of discrimination in this particular case, i.e., that there were objective and justified reasons for refusing to provide the service, and not reasons that are related to personal characteristics – health condition of the complainant. In this regard, the Commissioner asked the Clinic to submit an amendment to the statement, in particular, written statements of the on-duty clinician and other medical staff who attended the event from the complaint on the circumstances of refusing to intervene, evidence of working hours of this Clinic, that is, the outpatient unit/room where the intervention is performed due to sterilization of instruments, whether after the admission of the complainant other patients were admitted, as well as whether they were provided with health services. The clinic did not submit the required evidence until the day this opinion was issued. During the procedure, it was determined that the admission of the complainant at the Clinic for Oral Surgery was recorded on September 1, 2020, first in the outpatient unit for radiological diagnostics, and then in the outpatient unit for oral surgery no. 3, at 6:32 p.m. By examining the Questionnaire of the Faculty of Dentistry in Belgrade, it was determined that the complainant gave his consent for the proposed intervention to be carried out. I By examining the statement of the Clinic, it was determined that the complainant did not report his basic illness when handing over his helath card at the counter, and that this information was given to the doctor on specialization when taking the anamnesis, which was recorded by hand on the paper obtained from the counter. From the complaint, the statement and the submitted evidence, it is indisputable that the complainant was not provided with health dental services at this Clinic, after he declared his HIV status, but that he was suggested to come the following day. When giving his opinion, the Commissioner had in mind that the Faculty of Dentistry of the University of Belgrade is a reference institution in the field of dental health care, and that outpatient care is provided at the clinics of the Faculty of Dentistry in Belgrade in the field of health, which includes treatment of the most complicated pathology of the mouth and teeth, providing highly specialized services of secondary and tertiary level, providing services according to referrals from other health institutions and emergency dental services. Regarding the fact stated in the statement, which is indisputable after examination of the Questionnaire of the Faculty of Dentistry, that the HIV status was entered by hand in the upper right corner, the Commissioner points out that when entering data on the patient’s HIV status, it is necessary to take care of the manner of entering this data in the health records. In this regard, the Commissioner pointed out previously given recommendations of measures to health institutions, which recommended not to enter data on the HIV status of patients outside the section provided in the medical documentation for entering such data. If relevant for medical treatment, data on HIV status should be entered in the section in the medical documentation provided for the diagnosis, with letters of the same size and color as usually used for entering diagnoses and conditions relevant to the medical procedure, using the Latin name and disease codes according to the International Classification of Diseases, Injuries and Causes of Death. Having in mind all the above, the Commissioner issued the opinion that the Clinic for Oral Surgery of the Faculty of Dentistry in Belgrade, on September 1, 2020, violated the provisions of Article 6 in conjunction with Article 27 of the Law on Prohibition of Discrimination. The opinion was accompanied by a recommendation that the Clinic for Oral Surgery send a written apology to the complainant within 15 days from the date of receipt of the opinion, to the address of the complainant, or to his e-mail address, and that in the future, while performing tasks within the scope of its competence, does not violate anti-discrimination regulations.

COMMISSIONER FOR THE PROTECTION OF EQUALITY

Brankica Janković

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