[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Medical ethics](https://durgical.com/en/medical-ethics/) › [The health system and the right to health](https://durgical.com/en/medical-ethics/areas/health-system/) › Fair opportunity and discrimination in health care # Fair opportunity and discrimination in health care - Topic Treating patients differently is fair only when the difference is clinical; origin, sex, ethnicity or money are not valid reasons. Updated Nov 13, 2026 ## Key points - Valid differences: need, risk and expected benefit. Invalid: traits unrelated to the clinical picture. - Direct discrimination (explicit rule) and indirect discrimination (neutral rule with an exclusionary effect). - Constitution, art. 13: equality, measures for discriminated groups and protection of those in manifest weakness. - Law 1751, art. 6, literal c: accessibility includes non-discrimination. - Law 1751, art. 11: persons under special protection, with no administrative or financial restrictions. ## What it is The formal rule of justice asks that like cases be treated alike. The hard part is deciding which differences count. In clinical care the valid reasons are clinical: need, risk and expected benefit. Discrimination is worse treatment of a person because of a trait unrelated to their need, such as sex, ethnicity, nationality, sexual orientation, disability or an HIV diagnosis. It can be direct (an explicit rule) or indirect (a neutral rule that in practice excludes a group). Fair equality of opportunity also asks that disadvantages a person is not responsible for be corrected. ## Key facts - Formal equality is not enough: the State must promote equality that is «real and effective» (Constitution, art. 13, paragraph 2). - Affirmative action means favourable treatment of a disadvantaged group; Law 1751 allows it for persons under special protection (art. 6, paragraph). - Law 1751, art. 11: children and adolescents, pregnant women, displaced persons, victims of violence and of the armed conflict, older adults, people with orphan diseases and people with disabilities. - Indirect discrimination includes opening hours, languages, paperwork or distances that, without intent, block a group's access. - Stigma (HIV, mental health, substance use) leads to worse care even when no rule requires it. ## In clinical practice - Deciding by prognosis is valid; deciding by age alone, nationality or social status is not. - Refusing to care for a person with HIV is prohibited and sanctionable (Decree 780 of 2016, art. 2.8.1.2.6). - Offering an interpreter, accessible information and reasonable accommodations to people with disabilities removes access barriers. - Check your own biases: the same symptom is weighed differently depending on who reports it, and that changes diagnoses. ## Legal framework in Colombia - Political Constitution, art. 13: equality before the law, without discrimination on grounds of sex, race, national or family origin, language, religion or opinion. - Statutory Law 1751 of 2015, art. 6: accessibility without discrimination (literal c) and equity for people with few resources and vulnerable groups (principle c); art. 11: persons under special protection. - Decree 780 of 2016, art. 2.8.1.5.10 (formerly Decree 1543 of 1997, art. 39): people with HIV and their families may not be discriminated against. - Official texts checked on 2026-11-13 at secretariasenado.gov.co and funcionpublica.gov.co. ## Test yourself Think of the answer, then tap the question to see it. ## Which differences justify treating patients differently? Clinical ones: need, risk and expected benefit. Unrelated traits such as ethnicity, nationality or ability to pay do not. ## What is indirect discrimination? A rule or practice that looks neutral but in practice blocks a group's access, such as a procedure that can only be done online. ## Which article of Law 1751 lists the persons under special protection? Article 11: their care may not be limited by any administrative or financial restriction. ## What does article 13 of the Constitution say about people in manifest weakness? That the State will protect them especially because of their economic, physical or mental condition, and will punish abuse or mistreatment against them. [Add to my cards (4)](https://durgical.app/estudiar/?add=/en/medical-ethics/fair-opportunity-and-discrimination-in-health-care/) ## Connections ## Related 5 - [Justice: fair distribution and equal treatment](https://durgical.com/en/medical-ethics/justice-fair-distribution-and-equal-treatment/) - [Theories of justice in health](https://durgical.com/en/medical-ethics/theories-of-justice-in-health/) - [HIV: testing, consent and confidentiality in Colombia](https://durgical.com/en/medical-ethics/hiv-testing-consent-and-confidentiality-in-colombia/) - [Health care for migrants in Colombia](https://durgical.com/en/medical-ethics/health-care-for-migrants-in-colombia/) - [Intercultural care and indigenous peoples](https://durgical.com/en/medical-ethics/intercultural-care-and-indigenous-peoples/) [← All of medical ethics](https://durgical.com/en/medical-ethics/) Educational content on ethics and health law; not legal advice. Laws and case law change: each page links the official text and says when it was last checked. For a real case, read the text in force and ask a lawyer or the medical ethics tribunal. Sources: [Discrimination](https://plato.stanford.edu/entries/discrimination/) (Stanford Encyclopedia of Philosophy, 2026); [Equality of Opportunity](https://plato.stanford.edu/entries/equal-opportunity/) (Stanford Encyclopedia of Philosophy, 2023); [Constitución Política de Colombia de 1991, art. 13](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=4125) (Función Pública, Gestor Normativo, 1991); [Ley Estatutaria 1751 de 2015, arts. 6 y 11](https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=60733) (Función Pública, Gestor Normativo, 2015). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/medical-ethics/fair-opportunity-and-discrimination-in-health-care/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/medical-ethics/fair-opportunity-and-discrimination-in-health-care/