A medical practice in Germany sparked outrage last week after hanging a sign informing patients that they would only treat people speaking German or accompanied by a German interpreter.
The sign led to fierce online debates, with many accusing the practice of discrimination and wondering whether doctors can lawfully refuse to treat patients due to language difficulties.
The Medical Association in the Baden-Württemberg state, where the practice in question is located, later responded to criticism saying that doctors in Germany can discontinue the treatment of patients under various circumstances, including fundamental communication issues.
But as discussions continue over the fairness of the decision, what do Italian laws and health codes say about doctors treating foreign nationals?
Can Italian doctors refuse care due to language barriers?
Healthcare in Italy is a “fundamental individual right” enshrined in Article 32 of the Italian Constitution, and the national healthcare system must “support, maintain or restore the physical and mental health of the entire population without distinctions based on individual or social conditions”.
Further, Article 3 of Italy’s Doctors’ Code of Ethics (Codice Deontologico) says that a doctor’s duty is “to protect human life” without “distinctions of age, gender, ethnicity, religion, nationality, social status, or ideology”.
This means that doctors who deny treatment based on any of the above-mentioned traits face severe consequences, which can include them being permanently barred from the relevant medical association (ordine dei medici) and even facing a failure to assist (omissione di soccorso) criminal lawsuit in the most serious cases.
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That said, with respect to general practitioners (medici di base), there are some rare cases in which they can refuse to have a patient under their care, according to the national collective agreement for general medicine.
The agreement says that GPs can remove a patient from their practice list if the decision is justified "by exceptional and verified reasons of incompatibility".
For instance, the decision would be justified in the case of threats or deception attempts from the patient, or if conflicts over a treatment plan resulted in the bond of mutual trust between doctor and patient being broken beyond repair.
Dislike for a patient or any inconvenience experienced when assisting them are not considered sufficient reasons to refuse care.
Accessing English-speaking care in Italy
There’s no occupational requirement for Italian doctors to speak English (or any other second language), which means that many GPs and specialists, especially the older ones, have a poor command of English.
This can create major problems for foreign nationals looking to access even the most basic types of care.
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Problems are also exacerbated by the absence of interpreting services at clinics and hospitals around the country, as well as information centres at regional health offices.
That said, finding English-speaking doctors in Italy isn’t totally impossible.
A number of expat-friendly websites like Expat.com and Internations.org may offer forums where international residents share their recommendations for English-speaking doctors.
Your country’s embassy or consulate in Italy can also be a valuable resource as they often hold a list of English-speaking doctors and healthcare providers for each Italian region.
Finally, platforms like MedinAction and Doctors in Italy, which offer on-demand medical services from qualified English-speaking professionals, have become popular in recent years.
However, care may not always be available in all areas of the country, and does not come cheap (services are private and are operated outside of Italy’s national healthcare system).
Have you ever had problems with an Italian doctor because of language? Tell us in the comments section below.
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