Human rights in patient care: drug treatment and punishment in Russia

Abstract An inherent feature of drug control in many countries has been an excessive emphasis on punitive measures at the expense of public health. At its most extreme, this approach has reduced health services for people who use drugs to an extension of the drug control system. In these environments, health services are punitive rather than supportive for people who use drugs, especially those who are drug dependent. In Russia, the government’s official policy towards drug use is one of “social intolerance,” which seeks to legitimize and encourage societal ill treatment of people who use drugs. In practice, this policy has materialized as widespread and systematic human rights violations of people who use drugs, including by subjecting them to unscientific and ideologically driven methods of drug prevention and treatment and denying them access to essential medicines and services. While such human rights violations are well-documented, there have been no attempts to date to consider the consequences of this approach through the lens of human rights in patient care. This concept brings together the rights of both patients and providers and interrogates the role of the state on the relationship between two core groups: drug-dependent people and drug treatment doctors or “narcologists” in Russia. In this article, we apply the concept of human rights in patient care to consider the narcologist’s role in punitive drug policy and human rights violations against people who use drugs and to analyze how punitive drug policy manifests as human rights violations against narcologists themselves, who lose their professional independence and their ability to work according to professional standards and ethical norms. We conclude that both people who use drugs and narcologists suffer from punitive drug policy and should unite their efforts to ensure drug policy does not undermine patients’ health and human rights

Minimax-robust filtering of functionals from periodically correlated random fields

The problem of optimal estimation of linear functionals depending on unknown values of periodically correlated random field from observations of the field with noise is considered. Formulas for calculating mean square errors and spectral characteristics of optimal linear estimates of the functionals are derived in the case where spectral densities are exactly known. Formulas that determine least favourable spectral densities and minimax (robust) spectral characteristics are proposed in the case where spectral densities are not exactly known but a class of admissible spectral densities is given

Minimax-robust filtering of functionals from periodically correlated random fields PUBLIC INTEREST STATEMENT

Abstract: The problem of optimal estimation of linear functionals depending on unknown values of periodically correlated random field from observations of the field with noise is considered. Formulas for calculating mean square errors and spectral characteristics of optimal linear estimates of the functionals are derived in the case where spectral densities are exactly known. Formulas that determine least favourable spectral densities and minimax (robust) spectral characteristics are proposed in the case where spectral densities are not exactly known but a class of admissible spectral densities is given. PUBLIC INTEREST STATEMENT Cosmological Principle (first formulated by Einstein): the Universe is, in the large, homogeneous and isotropic. Last decades indicate growing interest to the spatio-temporal data measured on the surface of a sphere. These data include cosmic microwave background (CMB) anisotropies, medical imaging, global and land-based temperature data, gravitational and geomagnetic data, and climate model. Periodically correlated processes and fields are not homogeneous but have numerous properties similar to properties of stationary processes and fields. They describe appropriate models of numerous physical and man-made processes. In this article, we considered the problem of optimal estimation of functionals depending on unknown values of periodically correlated spatial temporal isotropic random fields from observations of the field with noise in the case of spectral certainty where spectral densities are known exactly as well as in the case of spectral uncertainty where spectral densities are not known exactly but a class of admissible spectral densities is given. Formulas that determine least favourable spectral densities and minimax (robust) spectral characteristics are derived

Study of human rights violations faced by women who use drugs in Estonia

Abstract Background Estonia continues to have the highest prevalence of HIV among people who inject drugs, and the highest overdose mortality, in the European Union. In August 2017, the Eurasian Harm Reduction Association (EHRA), the Canadian HIV/AIDS Legal Network (CHALN), and the Estonian Association of People Who Use Psychotropic Substances (LUNEST) conducted a study in Estonia to assess the situation regarding the human rights of women who use drugs and/or living with HIV. Methods The research methodology, developed by EHRA and CHALN, comprised in-depth interviews with 38 drug-dependent women conducted between August 8 and 14, 2017, in Tallinn and Ida-Viru county. The interviews were transcribed, and 37 were analyzed using thematic content analysis. Results The study has documented widespread violations of parental rights (removal of children because of their mother’s inability to cease drug use and barriers to regaining custody), violations of the right to health (the failure to provide quality drug and HIV treatment, and the disclosure of medical data, including HIV status and opioid substitution treatment (OST) records), the violation of labor rights due to drug use, arbitrary arrest, street drug testing, and violations of the right to a fair trial. A number of women have experienced repeated cases of gender-based violence but have had no access to psychosocial support, shelters, or other protection or rehabilitation measures. Conclusions Our findings suggest that punitive drug laws and their enforcement practices, the lack of gender-specific drug treatment facilities, combined with stigma related to drugs and HIV, are the main drivers of systematic and serious violations of the human rights of women who use drugs or who are drug dependent. Stigma and human rights violations undermine Estonia’s efforts in HIV prevention, care, and treatment, and its overall efforts to respect, protect, and fulfill the right to health of women who use drugs or who are drug dependent. For these reasons, the Government of Estonia should address a variety of issues related to the protection of human rights of this vulnerable population group