Friday, March 29, 2013

UN report 2013 about torture in health care

On March 5, 2013 United Nationas launched a report about the torture and violation of human rights in healt care establishments. The United Nations Special Rapporteur on torture, Juan. E. Méndez called for an international debate on abuses in health-care settings that may cross a threshold of maltreatment equivalent to torture or cruel, inhuman or degrading treatment or punishment. The very welcomed UN report can be find here.

Thursday, March 28, 2013

2 Estonian prosecutors falsificate facts and evidence to close the cases

Autumn 2012/winter 2013. North Estonian prosecutor Endla Ülviste closed in autumn 2012 criminal case about the abuse, torture and violation of human rights at the biggest governmental PERH hospital in Tallinn in autumn 2009. EÜ signed the decision a day before Estonian doctor´s union leaderhip agreed to suspend the doctors strike, publicly launched as for pay increase. Several members of the union leadership had been personally involved helping to cover up the same case. Soon after in November 2012 EÜ´s colleague prosecutor Kristel Eliste closed the criminal case launched in 2011 upon the appeal of the Estonian Patient Advocacy Association about many lies and violations of several laws by state health surveillance inspector Peeter Mardna who has helped to cover up the case since autumn 2009. 

Mardna, the high rank health official in Estonia also during Soviet occupation when the country was run by KGB and communist party is paid extra money also by the hospitals whose council member he is despite being same time state health surveillance inspector. Lias of that man had been partly used by prosecutor Ülviste to close the hospital criminal case supervised by her since spring 2010. 

Closing the two criminal cases both Ülviste and Eliste falsificated several facts. Eliste has been also caught deliberately hiding the fact about existence of evidence in order to release the state health inspector from criminal proceedings for his legal violations and lies used partly by same the prosecutors.

"This is how the severe hospital abuse cases are slammed down in Estonia. It is far not seldom case but a style we have seen by authorities for nearly 20 years," Estonian Patient Advocacy Association summarised the another cover up, adding that only international assistance and pressure might bring a change one day.

The hospital and medical staff involved got also help from Marika Väli, Deputy director of Estonian Forensic Science Institute who had no problem to falsificate some facts in her "expertise" herself. Among other things Väli signed a lie that there "is no proof in medical records" that a patient in abuse case was chained to bed in hospital. However, there is the written evidence, written clearly by nursers whose records the hospital and authorities didnt manage all to falsificate.

Even the fact that the hospital had "treated" 12 days the young patient with brain suppressing substance instead of antibiotics he had urgently needed to cure two side bacterial pneumonia streptococcus that hospital had failed to detect 12 days because necessary tests were not done and one earlier test just ignored was not mentioned as medical mistake during that cover-up action. Not a single test was made during the "expertise" by Väli that simply echoed the lies of the hospital.

In order to save nurse who had left helpless young patient naked next to open window by morning in chilly Baltic October, another means were found - the nurse was simply not contacted at all neither bothered with any question by police or prosecutor. That didnt avoid prosecutor to declare that the acts of torture "were found groundless". All medicine and food taken off without any legal right? That cruelity -  first ignored for long - was decided to be covered up with simply ignoring the facts. Etc. etc. Long, long list of lies.

If you wonder what happens in Estonia when even prosecutors and high level state experts falsificate facts and evidence in hospital abuse cases and you might conclude that probably - as you read it here - nothing follows the answer is correct, as of the end of March 2013 long list of what and how was falsificated has simply been ignored.

The very long list of misconduct, lies, falsifications, ignorance of facts- all of what  can be proved with medical files and criminal file documents - filed by one of Tallinn wellknown law firm that went through  all the case related documents was just ignored as well. When prosecutors lie it takes only one judge and not a single court session to decide the investigation should not proceed.

Among the reasons why things like that can happen seems to be wide and strong backing from some top politicians. Estonian 2009-2012 Social Minister Hanno Pevkur, who decided not to punish health surveillance inspector for his lies and violations of several laws while covering up the case in state supervised hospital, is since autumn 2012 the Justice Minister.

Last, not least - almost all involved in helping to slam down hospital abuse cases got their medical or juridical education and seemingly also relevant  ethical standards during Soviet era.

The general attitude not only the medical staff involved but also authorities in Estonia seem to hail is that when a person is ill he or she has no similar human rights one might presume should be part of everyone´s rights as stated in UN conventions on human rights and torture.

June 2012 - no changes. Several new cases about patients abuse have been revealed in Estonian media in recent weeks, but there is still nothing but silence from parliament regarding our call for patients rights law. Estonian daily Postimees quoted a story this week about a patient who had just perished this week - after operation at Tallinn biggest hospital PERH the man was left bleeding from his operation wound in his hospital bed for full day and was discovered like that only after her daughther arrived to hospital! Just a week before another story from another Tallinn hospital about abusive treatment of patient was revealed in media and once again, was followed by complete denial of problem both by those involved and Social Ministry health officials. The Soviet era communist elite doctor Peeter Mardna, who will turn 80 in few years is still firmly in office there despite all his falsifications and lies in medical surveillance cases and the pending criminal investigation about is unlawful activities that the social minister Hanno Pevkur (since autumn 2012 Justice Minister) itself has helped to cover up. The way all the topic is handled in Estonia keeps reminding a lot the Soviet era - no man, no problem and when a problem is revealed the credo of responsible officials seems to be - target the victim, not the problem.

Estonian Prime Minister Andrus Ansip who is one of those on denial and even refused to answer last year to Patients union letter about brutal abuse of patients in some Estonian hospitals has repeatedly slammed on matter with claim that "Estonian health care is one of the best in world". Just recently OECD revealed a report on topic where the unsufficient level of medical treatment in Estonia was underlined with note that there really are problems with the shortages of quality of modern medical treatment in Estonia.

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Useful readings:

March 2012/2013, New criminal cases about killings of patients in Brazil and Uruguay reveal more mechanisms available and used at intensive care by the doctors and nursers putting themselves above the law. Reuters overview here and CNN here

September 2012 - Wall Street Journal/ US Johns Hopkins Surgeon Marty Makary: How to stop Hospitals from Killing Us. Brilliant article by surgeon Marty Makary about most necessary steps to decrease medical mistakes here.