In the light of Medical Ethics of

Migrant Women’s Health

Prof. Dr. Nesrin ÇOBANOĞLU
Gazi University School of Medicine
Chair, Medical History and Ethics Department
• The phenomenon of global migration presents
significant challenges and opportunities within public
health systems. Migrant women, in particular
encounter unique healthcare barriers due to socio-
economic, cultural, and legal factors.
• In the context of medical ethics concerning migration and
women’s health, several ethical considerations need to be
addressed.
• These include ensuring equitable access to healthcare,
providing culturally competent services, respecting
patient autonomy, maintaining confidentiality, and
adopting a multidisciplinary approach to care.
• In the context of medical ethics concerning
migration and women’s health, several ethical
considerations need to be addressed.

• These include ensuring equitable access to

healthcare, providing culturally competent
services, respecting patient autonomy,
maintaining confidentiality, and adopting a
multidisciplinary approach to care.
• This comprehensive perspective is essential for
developing healthcare policies and practices that
effectively meet the unique needs of migrant women.
• Each of these elements plays a crucial role in fulfilling
the ethical obligations of healthcare providers to offer
compassionate, appropriate, and effective medical care
to this vulnerable population.
• In the context of medical ethics, the topic of migration
and women’s health involves examining the provision,
access, and patient rights in healthcare based on
fundamental ethical principles.
• Migrant women often face unique challenges
and disparities due to being both migrants and
women. This raises several significant ethical
issues:
• Access Justice: One of the core principles of medical ethics is fair
access to healthcare services. Migrant women may face
significant barriers to healthcare access due to language barriers,
legal, and economic constraints. Health policies and practices
should develop specific strategies to overcome these barriers and
ensure full access to healthcare for migrant women.
• Cultural Competence: It is an ethical imperative for healthcare
providers to gain cultural competence. Respecting the cultural,
religious, and social values of migrant women when providing
care can enhance their utilization of healthcare services and
adherence to treatments. This is especially critical in sensitive
areas such as reproductive health, childbirth, and mental health.
• Autonomy and Informed Consent: Medical ethics highly values
patient autonomy and informed consent. Migrant women’s
participation in health decisions should be supported by
healthcare workers who can speak their language and
understand their cultural values. This is crucial in ethical decision-
making processes.
• Privacy and Confidentiality: Migrant women, particularly those
who are undocumented or in illegal status, may have heightened
concerns about privacy. Healthcare providers are obligated to
maintain patient confidentiality and provide a safe environment.
• Multidisciplinary Approach: The health issues faced by migrant
women are often multifaceted, incorporating psychological,
social, and economic factors. Medical ethics should promote a
multidisciplinary approach to address these complex needs.
• These issues require a comprehensive understanding
and specific interventions to ethically provide and
improve healthcare services. Health policies
concerning migrant women should be developed in
compliance with medical ethics, sensitive to the
specific needs of these individuals.
• Existing research delineates numerous barriers to
healthcare for migrant women, including linguistic
hurdles, cultural discrepancies, and lack of legal
documentation. Studies have underscored disparities in
reproductive health services, mental health care, and
chronic disease management among this population.

• Furthermore, the literature suggests a frequent

misalignment between healthcare policies and the
ethical principles purportedly guiding them.
 Ethical Framework

• The ethical analysis of healthcare provision for migrant

women requires a robust framework that incorporates
principles of feminist ethics, which emphasize the need for
care and responsibility in understanding the layered impacts
of oppression. Key ethical principles include:
• Justice: Addressing equitable access to healthcare resources
and services.
• Autonomy: Respecting the decision-making capacities and
rights of migrant women.
• Beneficence and Non-maleficence: Ensuring that healthcare
practices benefit migrant women and do not inflict harm.
• Advocacy: Advocating for policy changes that enhance
health outcomes for migrant women.
Case Studies
 Picasso
“Girl in Front of
Mirror” 1932
Case Study 1

Challenges in Healthcare Access and Communication for a 35-Year-Old migrant

woman with Dyspareunia

Background: A 35-year-old female refugee presents to a local clinic with

symptoms of excessive bleeding and pain during sexual intercourse, diagnosed
as dyspareunia. Despite the urgency of her condition, significant barriers impede
her access to appropriate healthcare.

Clinical Presentation: The patient reports severe dyspareunia and excessive

menstrual bleeding. These symptoms cause considerable physical discomfort
and emotional distress, impacting her quality of life.
Communication Challenges: The patient faces substantial obstacles in communicating
her health issues due to language barriers. Unable to speak the local language, she relies
on her 10-year-old son to interpret medical discussions with healthcare providers. This
setup not only places an inappropriate burden on a young child but also risks inaccurate
translation of medical terms and nuances, potentially leading to misdiagnoses or
suboptimal care.

Cultural Barriers: Compounding the communication issues, cultural differences and

personal embarrassment about discussing reproductive health issues in the presence of
her son inhibit the patient’s ability to fully express her symptoms and concerns. This
reticence further complicates the diagnostic process, as crucial information may be
withheld during consultations.
Implications for Treatment: These communication and cultural barriers
delay timely access to necessary medical interventions, prolonging
suffering and potentially exacerbating medical conditions. The reliance
on a child interpreter raises ethical concerns regarding confidentiality,
informed consent, and the psychological well-being of the child.

Conclusion: This case exemplifies the critical need for healthcare

systems to implement more effective strategies to support non-native
speaking patients. Providing professional medical interpreters and
culturally sensitive care are imperative to ensure accurate diagnosis,
appropriate treatment, and equitable healthcare for refugees and other
vulnerable populations.
 Case Study:
Modern-Day Match Girl - A Glimpse into the Life of a Refugee in
Europe
Case Study 2

• Case Study: Modern-Day Match Girl - A Glimpse into

the Life of a Refugee in Europe

• Background: A 28-year-old refugee woman, residing in

a notorious camp known colloquially as “The Jungle” in
France, faces the daily struggle of maintaining basic
human necessities, one of which is the ability to
communicate with the outside world through her
phone.
• Scenario Description: Amid the harsh living conditions of the camp,
the young woman endures long hours in queues just for a fleeting
chance to charge her phone. This routine, though seemingly trivial,
underscores a desperate attempt to connect with her past life and
preserve her cultural identity.

• Interaction with Media: During one of these lengthy waits, a BBC

reporter notices her and a few others in the queue. The reporter,
intrigued by their persistence, approaches to inquire about their
reasons for charging their phones. When asked whom she intends
to call, the young woman reveals that she has no one to call but
merely wishes to look at photos of meals she had with her family
during happier times.
• Analysis: This interaction highlights the poignant
reality of many refugees who, displaced and
disconnected, cling to memories of better times
as a source of comfort and a reminder of their
identities. The simple act of viewing family
photos represents a temporary escape from the
grim realities of her current environment.
• Cultural and Psychological Implications: The case
emphasizes the psychological impact of
displacement on refugees — the loss, isolation,
and the cling to cultural rituals, like family
meals, that once brought joy and normalcy. Her
story also casts light on the broader issue of
societal indifference to the struggles of refugees,
mirrored in the brief and limited access to such
a basic utility as electricity for charging a phone.
• Conclusion: This modern-day account of the
match girl in a refugee camp illustrates not
only the struggle for survival but also the
struggle to maintain humanity in the face of
overwhelming adversity. It calls for a deeper
societal reflection on the support systems and
attitudes towards those displaced by conflict.
• Healthcare providers should receive training in
cultural competency and ethical decision-making.

• Policies must be reevaluated to ensure they do not

systematically disadvantage migrant women.

• Advocacy should be directed towards eliminating

healthcare disparities through comprehensive
policy reform.
• It recommends the implementation of targeted
policies and training programs that align more
closely with ethical principles. Future research
should focus on longitudinal studies to assess
the impact of such interventions on health
outcomes for migrant women.
Conclusion

This presentation reaffirms the critical need for an ethical overhaul in the
healthcare provision to migrant women. It recommends the
implementation of targeted policies and training programs that align more
closely with ethical principles. Future research should focus on
longitudinal studies to assess the impact of such interventions on health
outcomes for migrant women.

By adhering to an academic format, this paper seeks to contribute to the

scholarly discourse on migrant women’s health, advocating for a more
ethical and inclusive healthcare system that recognizes and addresses the
complex needs of this vulnerable population.
 Chagall,
I and the Village,
1911
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