Ethical and human rights considerations related to access to anemia diagnosis

• Published in: Annals of the New York Academy of Sciences Vol. 1450; no. 1; pp. 239 - 248
• Main Authors: Sinharoy, Sheela S., Fanzo, Jessica
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01.08.2019
• Subjects: Anemia; Anemia - diagnosis; Autonomy; Communities; Diagnosis; Diagnostic systems; equity; Ethics; Ethics, Medical; Etiology; Geography; Health; Health services; Health Services Accessibility - ethics; Healthcare Disparities - ethics; Human Rights; Humans; Longitude; Populations; Qualitative analysis; Socioeconomics; ethics; equity; anemia; human rights
• ISSN: 0077-8923; 1749-6632
• DOI: 10.1111/nyas.14125

Important disparities exist in anemia diagnosis globally. We examine individuals’ and populations’ access to anemia diagnosis, the accuracy of diagnostic tests, and the interpretation of test results through the lens of key ethical considerations. These include the human right to health and the Rawlsian concept of the social contract, as well as ethical principles, such as autonomy, self‐liberty, beneficence, and nonmaleficence. We discuss factors that influence individuals’ and communities’ access to high‐quality health services, including geography, gender, age, and socioeconomic status. Geographic and other differences exist in the types of diagnostic equipment and methods used to diagnose anemia, potentially leading to differential classification of anemia across individuals and populations. A diagnosis of anemia also requires follow‐up to understand etiology and appropriate treatment. However, this is not done consistently, in clinical care or in population‐based surveys. To better understand the problem and track countries’ progress, a need exists for disaggregated, longitudinal quantitative and qualitative data on disparities related to anemia. Moving forward, it will be important for countries to improve equitable access to high‐quality health services, particularly primary health care services, and to address barriers to the ability of individuals or communities to effectively enjoy the right to health.