Health inequalities and development plans in Iran: An analysis of the past three decades (1984–2010)

Introduction: Reducing inequalities in health care is one of the main challenges in all countries. In Iran as in other oil-exporting upper middle income countries, we expected to witness fewer inequalities especially in the health sector with the increase in governmental revenues. Methods: This study presents an inequalities assessment of health care expenditures in Iran. We used data from the Household Income and Expenditure Survey (HIES) in Iran from 1984–2010. The analysis included 308,735 urban and 342,532 rural households. Results: The results suggest heightened inequality in health care expenditures in Iran over the past three decades, including an increase in the gap between urban and rural areas. Furthermore, inflation has affected the poor more than the rich. The Kakwani progressivity index in all years is positive, averaging 0.436 in rural and 0.470 in urban areas during the time period of analysis. Compared to inequality in income distribution over the last 30 years, health expenditures continuously show more inequality and progressivity over the same period of time. Conclusions: According to the result of our study, during this period Iran introduced four National Development Plans (NDPs); however, the NDPs failed to provide sustainable strategies for reducing inequalities in health care expenditures. Policies that protect vulnerable groups should be prioritized

The Polish Parliament and the making of politics through abortion : nation, gender and democracy in the 1996 Liberalization Amendment Debate

The collapse of communism across East Central Europe was marked by a renewal of debates around reproduction, with abortion debates surfacing in Romania, Germany and Poland. Reproductive politics and more specifically abortion debates typically come to the forefront in times of crisis or societal transformation. Struggles over women's reproductive rights in Poland, as evidenced by continuing debate around the legal status of abortion, are in this postcommunist context intimately related to and bound up with ongoing symbolic and concrete re-definitions of Polish nationhood, identity and citizenship. Focusing on the connections between discourses of Polish nationhood, gender and democracy, this article offers a detailed and critical engagement with debate in the Sejm (the lower chamber of the Polish parliament) during the second reading of the 1996 liberalization of abortion amendment. Using a discourse analysis methodology, the article argues that abortion is a symbolic issue through which anxieties about postcommunist reform are raised, nationalist pasts and futures are imagined and through which political projects are articulated

Proposals to introduce a Tribunal for Assisted Suicide in the UK

It is time that Parliament took the brave and audacious move to publically debate legalising assisted suicide in the UK. Even though a Private Members Bill has recently been introduced in Parliament, it has little hope of success without Government backing. The continual underlying objection of the fear of the slippery slope and the effect of legalising assisted suicide would have on the elderly and the vulnerable is a justifiable one; however, the patient’s autonomy must be respected and it will be argued it is possible to legislate in favour of assisted suicide whilst protecting the vulnerable. It will be argued that the introduction of a Tribunal style system to speedily and sympathetically consider each and every patient’s plea to end their lives should be introduced. This would enable a panel, comprising representatives from both the judiciary and the medical profession an opportunity to assess each case on its merits. It would seek to confirm whether the patient has a terminal condition from which they will die within 9-12 months and each patient will be given a cooling off period to explore options of palliative care. Each case will be recorded and each death reported. The Panel will ensure that the patient is not being unduly pressurised and the person who will assist has nothing to gain. Each case will be closely monitored and each patient treated as an individual. Society should temper paternalism with respect for a patient’s autonomy in order to end the imbalance between the right of a patient to refuse medical treatment where they will surely die as a result and the lack of respect for the self determination of a patient who is clear they wish to end their lifeNon peer reviewe

Defending biomedical authority and regulating the womb as social space. Prenatal testing in the Polish press

The issue of abortion has been the topic of heated and frequent debate in post-Communist Poland. Parliamentary debate in 1998—9 centred around a legislative attempt to restrict prenatal testing, specifically amniocentesis, in order to further reduce the numbers of abortions carried out, as it was argued to inevitably result in the termination of pregnancy. Medical professionals are rarely visible as subjects of and authorities on the abortion debate in the Polish context. However, in this debate around prenatal testing, the medical community appear as key commentators and meaning-makers. This article asks the following questions: What role do the medical profession and biomedical knowledge play in the debate around prenatal testing, when abortion is highly politicized? Second, what social meanings and consequences are attributed to prenatal testing? How do these construct the relationship between foetus, pregnant woman and doctor, and what agency and 'rights' are attributed to women in the process of prenatal testing