Lack of Accessibility and Discrimination in Healthcare
Human Rights Watch and the Center for Human Rights in Iran documented multiple barriers impeding the ability of people with disabilities to access health care services on an equal basis with others. The lack of accommodations as well as discriminatory attitudes and a lack of awareness among doctors and medical staff are serious concerns. Further impediments to accessing medical and personal care include a lack of assistive services and equipment, a lack of financial means due to inadequate government support as well as inaccessible transportation and physical infrastructure, including in health care facilities.
Quality and specialized health care services are not provided in some provinces, particularly in remote and rural areas, and people must often travel long distances to reach a medical facility. Upon reaching a hospital or clinic, persons with disabilities often cannot access them because many do not have ramps or elevators. Blind people and those with low vision said that they do not go to health care facilities alone because the buildings are not accessible, and staff do not provide them with accommodations. Deaf and hard of hearing people interviewed said that they cannot use health care services independently due to the lack of sign language interpreters.
Many people with disabilities interviewed said that they faced discrimination from health care personnel, including denial of care. There is no publicly available information regarding any training doctors and other medical personnel receive regarding the rights of people with disabilities.
Access to sexual and reproductive health care and information is difficult for most of the population in Iran. Due to additional barriers, people with disabilities experience particular difficulties accessing these services and information. Women with physical disabilities told us that they rarely visit gynecologists or undergo sexual health preventative care due to financial and mobility restrictions, lack of professional assistance to facilitate doctors’ visits, or lack of information about the importance of this care.
We documented many cases in which doctors and other healthcare professionals did not seek or obtain the informed consent of their patients and did not provide them with comprehensive information about the treatment or potential side-effects in a fully understandable format, or often at all. For adults with disabilities, medicine and treatment should be delivered with the consent of the individual being treated. The CRPD requires health professionals to provide care of the same quality to people with disabilities as to others, including on the basis of free and informed consent.
For example, according to mental health professionals in Iran whom we interviewed, Electroconvulsive Therapy (ECT) is often carried out unnecessarily, or for conditions in which ECT is not likely to be helpful, and without the informed consent of the person receiving the treatment. ECT consists of passing electricity through the brain to induce a seizure and is used in mental hospitals in many countries to treat bipolar disorder and severe depression.
People with psychosocial disabilities interviewed said that they learned about ECT by experiencing it several times. For example, Jafar, a man with psychosocial disabilities, said, “The first time I had electroshock, a heart physician visited me the day before. Then, they took me for the shock and it was only then that I learned how it was. I forgot many things after that. They did it every other day. Now, I know how it is and what happens afterwards.”
