On Monday 22nd of July 1013, the following
question was posed before the Greek Parliament by Ms Maria Yannakakis, MP (B
Pireaus) of the Democratic Left. It needs to be noted that Ms Yannakakis has
already posed two questions in the past (on March and April 1013) which to this
day remain unanswered by the respective Ministers they were addressed to.
To
The Esteemed Ministers for the Environment, Energy and
Climate Change
Health
Subject: Home birth and delivery of placenta material
to private enterprises
Recently, the private data concerning parents,
children, and health care practicioners participating in home births which took
place in the city of Thessaloniki during the year 2009, have fallen prey to the
discretion of sectors and services of (affiliated with) the Ministry of Health,
such the Midwife Association of Thessaloniki, the Medical Association of
Thessaloniki, the Ministry of Health and Social Solidarity (Department of
Public Health, Department of Sanitary Health & Sanitary Regulations for the
Environment, Minister's office, Vice Minister's Office, General Secretariat of
Health Office) …....... and the Inspector General of Public Governance, while
the Body of Inspectors of Health Services’ Providers – “SEYYP”(Regional Office
Thrace – Macedonia) conducted an investigation with all aforementioned private
data, in addition to further data collected (without notifying the subjects of
the investigation that they were being investigated) regarding the „“legality
of adherence to the prescribed management of genetic material produced during a
home delivery“
Following
this, all parents who opted for a home birth in the region of Thessaloniki
during the period covered by the investigation of the Ministry subsequently
found themselves accused for „ environmental pollution“ because, following the
birth, they failed to deliver the placenta to private companies specializing in
„waste management“ (companies which operate possibly without any tangible form
of outside control), but instead chose to handle the afterbirth material
themselves, with adequate respect to the bonding between mother and child.
Additionally, instances have been
observed when public sector officials have offered advice to those interested
in a home birth regarding the „legality of the process of home delivery“ and
all issues related to this decision, such as the delivery of after birth
material to private dangerous, toxic and medical waste management companies,
for a monetary price, if they do not wish to find themselves before the judge.
The SEYYP has taken the issue a
notch further, even suggesting that the invoice – proof of payment made to the
waste management company be a necessary prerequisite for the registration of
the newborn, if the child's birth took place outside medical facilities. The
suggestion was lodged even though its survey showed that only 21 home
deliveries had taken place outside the premises of accredited medical
facilities during the time of auditing, which makes the allegedly dangerous and
toxic medical waste in question virtually a non issue.
On the other hand it is certainly
doubtful that such accredited biological waste management companies are
subjected to adequate quality controls regarding the disposal of the placenta
material, a fact that seems insignificant enough in comparison to the arguably
bigger issues of the usual (bulky in quantity and potentially genuinely
dangerous) medical waste produced on average in the medical facilities, but
that acquires nonetheless significance if one is to consider that what is in this
case branded as „dangerous medical waste“ is in fact priceless on black market
terms and widely used both in the production of cosmetics and for unofficial
pioneering medical research. That fact alone places the issue on the core of
bioethics’ questions.
Women find themselves intimidated by
the potential law suits, the detailed emphasis placed upon the „lagality
conditions“ of a home birth and all additional actions that need to occur
surrounding this type of birth and express their need to protest being
essentially forced by law to surrender a part of their physical body (and to
have to pay for this) to privately owned companies. At the same time they need
to deal with the fear that they may somehow find themselves as defendants in
criminal proceedings for other “materials”, that may be considered medical
waste in the eyes of the law. The legislation itself does not specify with
regards to the quantity and the type of medical infectious waste. The law
clarifies that “any material which comes into contact with human blood and
human bodily fluids“ should obligatorily be surrendered to licensed enterprises
for it to be handled properly.
It should be dully noted that women
who choose a home delivery are closely monitored by specializing physicians
during their pregnancy, undergo all necessary prenatal care tests and are not
carriers of sexually transmitted or otherwise infectuous diseases.
Therefore, in the
light of the above, the competent Ministers are being asked:
1. What
types of internal and external control measures are enforced in order to ensure
that after birth material is in fact destroyed safely instead of being further
exploited in the black market against lucrative monetary incentives (cosmetics
industry/medical research)? In which precise manner are these private companies
being controlled in their everyday operations and which are the criteria for
their accreditation and the renewal of their licence?
2. Would
the Ministry be prepared to issue a Bulletin (“circular” giving direction for
the enforcement of the relative law), clarifying that women who so choose
should be allowed to handle their own placenta material according to their beliefs
and traditions, in conformity with Art. 9 and 3 of the ECHR, even if certain
restrictions are to apply?
3. Would
the Ministry be prepared to issue clarifications regarding the application of
the law on medical waste management produced daily and habitually in each and
every Greek household which comes into contact with bodily fluids and/or blood,
so that the average citizen may not run the risk of finding themselves before
the criminal courts?
4. What
monetary sanctions are there imposed by the Greek State
5. Has the
Ministry of Health (SEYYP) ever conducted a serious investigation regarding medical
waste management by the „major pollutors“ such as hospitals and private medical
clinics? What sanctions have been imposed against „major pollutors“ , sectors
and organs falling within the scope of the SEYYP's jurisdiction, which led the
country to convictions and the tax payers to contributions?
6. Could
SEYYP's controls extend to include other issues not directly relevant to
provision of health care per se to the public, such as adherence to urban
planning, environmental, tax/fiscal regulations etc. for the private sphere (as
a home birth can be considered) or are they strictly limited to issues
regarding the provision of health care to the public at large exclusively?
7. Given that in the relevant
Report of Controls by the SEYYP it is proposed that (page 12): „The Health
Directorate of the Prefectural Governance of Thessaloniki is to demand from the
Birth Registration Services to provide it permanently with the registration
details for every home birth within the Prefecture so that that compliance with
relevant legislation regarding biological/medical waste can be assured „ We are
therefore asking: has the Health Department of the Prefecture continued to
collect data regarding home birth participants and if that is the case have the
subjects of the database been informed about the process? If so, in what way?
Questions posed by Member of the
Parliament
Maria
Yannakakis
Special thanks to Faye Karavasili for the translation of the MP's Question in English.
Questions are one of the means for Parliamentary Control, according to the Greek Constitution and the Rules of the Parliament.
