Пълен протокол на разискванията

Понеделник, 13 февруари 2017 г. - Страсбург

15. Насърчаване на равенството между половете в рамките на изследванията в областта на психичното здраве и клиничните изследвания (кратко представяне)

  President. – The next item is the report by Beatriz Becerra Basterrechea on behalf of the Committee on Women’s Rights and Gender Equality, on promoting gender equality in mental health and clinical research [2016/2096(INI)] (A8-0380/2016).

  Beatriz Becerra Basterrechea, ponente. – Señora presidenta, querida comisaria Vestager, quiero expresar mi más sincero agradecimiento a los ponentes alternativos, a sus asistentes y asesores de los grupos políticos, porque han contribuido a llevar este informe mucho más allá de lo que en un primer momento planteaba. Ha sido un gran trabajo conjunto en favor de la igualdad de derechos.

Cuando hablamos de desigualdad de género, tendemos a pensar en la sonrojante brecha salarial, en la ridícula presencia de mujeres en puestos de decisión o en la gran lacra que nos avergüenza: la violencia de género, ya sea física o psicológica. Pero pocas veces pensamos en cómo esta desigualdad afecta a nuestra vida diaria, a nuestro bienestar, a nuestra salud y en especial a la salud mental.

¿Sabían ustedes que la investigación biomédica y los ensayos clínicos sobre medicamentos y tratamientos no tienen en cuenta que la mitad de la población somos mujeres? ¿Que no tienen en consideración las diferencias biológicas, fisiológicas y psicológicas entre hombres y mujeres, más allá de sus aparatos reproductores?

Tomé conciencia de este problema hace un tiempo cuando, en una visita a un hospital, una enfermera me contó su experiencia. El personal del hospital estaba preocupado porque no entendía por qué muchos pacientes que habían superado un ataque al corazón regresaban al hospital al cabo de un año y fallecían poco después. Las mismas condiciones higiénicas, los mismos mecanismos de seguimiento... Se habían tenido en cuenta historiales médicos, precedentes familiares y otros factores de riesgo.

Pero les llevó tiempo percatarse de que la mayoría de los enfermos que recaían y fallecían eran mujeres, porque las enfermedades cardiovasculares son más frecuentes en mujeres que en hombres y la investigación previa adolecía de ese enfoque.

En la salud mental se observa muy bien el problema. Existen diferencias de género considerables en los patrones de las enfermedades mentales, en especial las más comunes: la depresión y la ansiedad, por ejemplo, trastornos del ánimo que cualquiera de nosotros conoce de primera mano, tienen una prevalencia casi tres veces superior en mujeres que en hombres. Uno de cada diez trabajadores, por ejemplo, en la Unión Europea ha pedido una baja por depresión: eso cuesta unos 92 millones de euros al año.

La salud mental también está ligada al empleo y a la inversión.

El informe que hoy debatimos aborda sin temor estas cuestiones y otras igualmente relevantes, como los efectos devastadores y de por vida que la violencia de género tiene en la salud mental de las víctimas, como los prejuicios que aún existen sobre las personas LGBTI y que las condenan a una salud mental deteriorada o como la necesidad imperiosa de aplicar las directrices sobre protección y apoyo de la salud mental y bienestar psicosocial de los refugiados, solicitantes de asilo y migrantes en Europa.

Pero cuando hablamos de igualdad de género y salud, es imprescindible que hablemos sin ambages del aborto. La objeción de conciencia de los médicos no puede poner en riesgo la salud y la libertad de una mujer que solicita una interrupción voluntaria del embarazo. Es sencillamente inaceptable que en Italia, por ejemplo, más de un 70 % de los médicos se nieguen a practicarla hoy, a pesar de estar amparada por la ley.

Queremos asegurar que haya un número mínimo de profesionales de la salud disponibles para realizar estas intervenciones médicas, que garanticen el acceso a los servicios de salud sexual y reproductiva en todos los países de la Unión de acuerdo a los estándares legales en vigor.

La Unión Europea está obligada por sus Tratados a garantizar la protección de la salud humana como parte de todas sus políticas y a colaborar con los Estados miembros para mejorar la salud pública, prevenir las enfermedades y eliminar las fuentes de peligro para la salud física y mental.

En definitiva: es una responsabilidad jurídica y social de todos los responsables políticos integrar plenamente las necesidades específicas de las mujeres, la mitad de la población, a la hora de definir las políticas públicas de salud y de servicios del sector sanitario a escala europea y nacional.

Catch-the-eye procedure

  Michaela Šojdrová (PPE). – Paní předsedající, já bych se chtěla především paní kolegyni Basterrecheaové omluvit, protože bohužel tentokrát nemohu její zprávu podpořit. Mám za to, že je v ní více ideologie než odbornosti. My bychom měli k péči o duševní zdraví a klinický výzkum přistupovat z hlediska ryze lékařského a odborného a ne z hlediska genderové ideologie.

Navíc tato zpráva rozšiřuje to pojetí o další nerelevantní skupiny a především vyzývá k dostupnosti potratů a doporučuje členským státům, aby prosadily provádění potratů bez ohledu na právo lékařů a zdravotníků rozhodovat se podle svého svědomí. Bohužel tato zpráva je velmi nešťastná a doufám, že nebude přijata.

  Julie Ward (S&D). – Madam President, mental health and well—being are poorly understood in our societies and it is time for that to change. We actively need to break down the stigma and prejudice around mental well—being. Almost a third of Europeans will experience a mental health condition during their lifetime and we need to educate ourselves accordingly. It is clear that we need to take gender into account in mental health. Women are twice as likely to experience depression and anxiety as men as they face constant media objectification, as well as sexual violence and harassment. On the other hand, men and boys are also affected by gender stereotypes that often lead to repression of emotions. Men are three times more likely to commit suicide or develop alcohol and drug addictions.

This report is a strong call to the Commission and Member States to pursue an ambitious mental health and well—being strategy, which includes a psychosocial approach, taking into account the social, cultural and environmental factors that determine and affect mental health. It includes the impact of austerity policies, public service cuts, social inequalities, age and background. We need tailored policies to address the needs of the most vulnerable such as LGBTI women and women refugees.

  Branislav Škripek (ECR). – Madam President, mental health in Europe is a vital topic and worthy of clinical research. But the rapporteur has produced a very bad report on this topic here. A large part of this report is based on fake gender ideological claims. It certainly is not scientific research; for example, recital O, which says that ‘whereas transgender identities are not pathological, but are deplorably still considered mental health disorders’, and that this is a diagnosis that causes distress to those receiving it. True scientific research should be carried out which is examined by specialists and not used for political ends. Politics should not dictate what changes are made in medical text books.

Recital R refers to ‘gender-variant prepubescent children’. What are we doing confusing our children by encouraging them to choose their sex? This is a recipe for mental health problems. It is true that suicide is a huge problem among young men especially, but the cause is not the stereotyping of the two sexes. It is in fact the culture which confuses their God-given and natural capacities and nature.

  Florent Marcellesi (Verts/ALE). – Señora presidenta, el sábado pasado las acciones en torno al Día Internacional de la Mujer y la Niña en la Ciencia pusieron en evidencia una cosa real: la desigualdad de género en la investigación. Es decir, que el patrón universal para investigar es el varón blanco y joven. Por eso, los verdes consideramos este informe imprescindible para reducir la desigualdad de género.

Pero, como miembro, también, de la Comisión de Desarrollo, me gustaría recalcar que tenemos que ir más allá, desde una perspectiva norte-sur. Primero, hace falta invertir en investigación y desarrollo a escala mundial para alcanzar una cobertura sanitaria universal. Segundo, tenemos que exigir a las empresas farmacéuticas transnacionales que respeten los derechos humanos cuando realicen ensayos clínicos. Y, tercero, tenemos que reducir la pobreza, garantizar el acceso a la educación y la protección social para terminar de una vez con la brecha de género en la salud mental.

  Marijana Petir (PPE). – Gospođo predsjednice, žene kojima je narušeno mentalno zdravlje suočene su sa stigmatizacijom i potreban je holistički pristup kako bi im se pomoglo. Ovo izvješće daleko je izvan okvira kako same tematike tako i nadležnosti Europske unije, a pretjerano zadire i u samu struku. Zdravstvena skrb i zdravstvena politika u nadležnosti su država članica i to moramo poštivati.

To ne smijemo koristiti. I ovaj parlament također se ne bi smio koristiti za promicanje pojedine ideologije suprotne vrijednostima Europske unije. Izvješće koje promiče pobačaj kao društveno prihvatljiv i rodnu ideologiju kao ultimatum, za mene je apsolutno neprihvatljivo i neću ga podržati.

(End of catch-the-eye procedure)

  Margrethe Vestager, Member of the Commission. – Madam President, I have listened very carefully to the honourable Members’ views on this interesting report, promoting gender equality in mental health and clinical research. I hope that we share the very fundamental principle of equality between men and women, which was established in the treaties as one of our most important goals.

The Strategic Engagement for Gender Equality 2016-2019 is the Commission’s commitment to specific measures to promote gender equality. We are particularly grateful to this House for raising awareness of the differences between men and women in the prevalence and treatment of mental disorders and health in general. As you know, the health programme explicitly provides for the mainstreaming of gender equality in all actions promoted by the programme. Thus the Commission supported Member States’ cooperation on mental health with a Joint Action on Mental Health and Well-being under this programme. It resulted in a European Framework for Action on Mental Health and Well-being.

This framework addresses gender differences, highlighting for example the different prevalence of depression between men and women. A recent call under the health programme invited proposals for projects on improving access to mental health care and mental health literacy. The Commission is also organising, on behalf of the Parliament, a pilot project to improve the understanding of sex and gender differences in chronic diseases, using coronary heart disease as one example.

We fully agree with the resolution that mental health needs to be enshrined in a holistic patient-centred approach, for example addressing the impact of cancer and other major chronic diseases on patients’ mental health. In relation to research and innovation, we need to do more to address the gender dimension as reflected in Horizon 2020, the EU Research and Innovation Programme and, in particular, the work programme and the health—related calls for proposals.

Over several EU research programmes the Commission has founded many research projects, specifically addressing diseases affecting women, such as breast cancer, osteoporosis and endometriosis. The Commission also founded several research projects under the Seventh Framework Programme with over EUR 5 million devoted to supporting endometriosis research, to which the report specifically refers.

We must also continue our work to eradicate all forms of gender—based violence, including female genital mutilation.

In addition, the new Clinical Trial Regulation, which will become applicable in 2018, provides that subjects participating in a clinical trial should represent a population group likely to be treated with the medical product under investigation in the trial. This includes gender, age, and, where relevant, subjects with specific needs.

A further initiative that I would like to mention here is the Horizon 2020 Birth Day Prize that was launched in 2016. The Horizon Birth Day Prize will be awarded to a solution that best demonstrates a reduction in maternal or newborn morbidity and mortality or stillbirth during facility—based deliveries. Such a solution needs to be novel, safe and replicable because we need innovation here, as elsewhere.

Finally, a word on the under-representation of women in health research. I readily acknowledge the significance of this issue. I understand, however, that the situation is now rapidly improving and I sincerely hope that this upward trend will continue.

Thank you for giving me this opportunity to present the Commission’s approach to promoting gender equality, including regarding mental health and health issues in general.

(Applause)

  President. – The debate is closed.

The vote will take place on Tuesday, 14 February 2017.

Written statements (Rule 162)

  Miriam Dalli (S&D), in writing. – When we talk about gender equality, much of our focus is often directed at emancipating women in civil, political and economic society. And while much of the focus on the detrimental effects of patriarchal societies is targeted towards women, one serious issue targets men – the issue of suicide and mental health. If we raise our young men in societies where they are told that ‘boys don’t cry’, that they should be strong as opposed to weak, and stoic as opposed to emotive, then we will continue to perpetuate the stigmatisation of mental health. But while such ideals may be well intentioned, the phenomena has led to a major difference in suicide rates between men and women. In general, the rate for males is five times higher, and in some EU countries alone the differentiation between genders can lead to a figure of 52 males per 100 000 persons to 8 females per 100 000. This is a highly worrying phenomenon, and if even we as European leaders shy away from the topic, then we will continue to perpetuate the stigma within our own societies.