1 Welcome to Unit 4 Health Law, Policy and Ethics and The Future of Population Health

2 Required Reading & The Components of Health Law, Policy and Ethics Required Readings: Chapter 5: Health Law, Policy and Ethics Chapter 13: The Future of Population Health Components: Health Care Public Health Bioethics

3 Components of Health Law, Policy and Ethics ComponentScopeExample of Uses Health careAccess to quality and cost of health care. Organizational and professional structures for delivery. Rules governing Medicare and Medicaid and private insurance. Hospital governance and professional licensure. Public HealthPopulation health and safety; service to entire populations and vulnerable groups Food and drug laws, EPA laws, and control for communicable diseases. BioethicsApplication of individuals and group values and morals to controversial areas. End of life care, stem cell research, abortion, protection of research subjects.

4 Helpful Terms to Know Police power Rights Negative rights Substantive due process Procedural due process Authoritative decision

5 Characteristics of Market Justice Views health care as an economic good Assumes free market conditions for health services delivery Production and distribution of health care determined by market-based demand Medical care distribution based on people’s ability to pay Access to medical care viewed as an economic reward for personal effort and achievement.

6 Implications of Market Justice Individual responsibility for health Benefits based on individual purchasing power Limited obligation to the collective good Emphasis on individual well-being Private solutions to social problems. Rationing based on the ability to pay

7 Characteristics of Social Justice Views health care as a social resource Requires active government involvement in health services and delivery Assumes that the government is more efficient in allocating health resources equitably Medical resource allocation determined by central planning Ability to pay inconsequential for receiving medical care Equal access to medical services viewed as a basic right

8 Implications of Social Justice Collective responsibility for health Everyone is entitled to basic packages of services Strong obligation to the collective good Community well-being supersedes that of the individual Public solutions to social problems Planned rationing of health care

9 Quarantine as a Public Health Authority Quarantine defined Right of the individual versus the right of society “Clear and convincing evidence” Comparable to involuntary psychiatric commitment

10 Nuremberg Trials and Tuskegee Syphilis Study Trials of German physicians Experiments on prisoners in Nazi concentration camps Tuskegee: Study 1930s to early 1970s Recruited disadvantaged, rural black men Results: The Ten Principles and the Belmont Report

11 The Ten Principles Contained in the Nuremberg Code 1.The voluntary consent of the human subject is absolutely essential 2.The experiment should be such as to yield fruitful results… 3.The experiment should be so designed and based on the results of animal experimentation and knowledge of the natural history of the disease or other problem under study that the anticipated results will justify the performance of the experiment. 4.The experiment should be so conducted as to avoid all unnecessary physical and mental suffering and injury.

12 The Ten Principles Continued 5.No experiment should be so conducted where there is a prior reason to believe that death or disabling injury will occur. 6.The degree of risk to be taken should never exceed that determined by the humanitarian importance of the problem to be solved by the experiment. 7.Proper preparations should be made and adequate facilities provided to protect the experimental subject against even remote possibilities of injury, disability, or death. 8.The experiment should be conducted only by scientifically qualified persons…

13 The Ten Principles Continued 9.During the course of the experiment the human subject should be at liberty to bring the experiment to an end if he/she has reached the physical or mental state where continuation of the experiment seems to him/her to be impossible. 10.During the course of the experiment the scientist in charge must be prepared to terminate the experiment at any stage, if he/she has probably cause to believe…

14 The Belmont Report Respect for Persons Beneficence Justice

15 Approaches to Public Health Interventions 1.Systems Thinking Approach 2.Reductionist Thinking Approach

16 Systems Thinking Approach Uses combined interventions simultaneously to deal with public health programs Use of dynamic models

17 Reductionist Approach Uses one intervention at a time to deal with public health problems Use static models

18 Course Project Outline: Unit 5 Written Assignment I.Introduction II.The historical public health figure you plan to write about A. Historic era this figure impacted B. Any interesting facts about this public health figure while growing up. III.The public health endeavor that his historical figure impacted A. Why he/she felt compelled to act (what called this person to action…unsanitary conditions leading to widespread illness or disease, widespread death, illness, etc…

19 Course Project Outline Continued B. The steps this public health figure took to achieve a positive change/impact 1. Research 2. Collaboration with other individual 3. Trial and error C.Results of efforts made A. Immediate impact B. Long-term impact

20 Course Project Outline Continued IV.Effects of the historical figure’s accomplishments today A. Effects in the United States B. Global effects C. Future outlook V.Conclusion VI.References

21 Course Project Outline Requirements APA format Cover page (header- upper right hand margin with page number beginning on cover page Cover page, outline…NO Reference page needed. No source citations required ALL doubled spaced Size 12 font, Times New Roman font style, 1” margins NO BOLD PRINT, PICTURES, or UNDERLINING Roman numerals for headings, Capital letters for subheadings.

22 Course Project Outline Continued Due to the Dropbox by 11:59 pm Tuesday (Unit 5). No late submissions will be accepted without proof of extenuating circumstances You may me a rough draft: No later than Midnight (EST) Sunday of Unit 5 Please contact me vial or phone call with any questions or concerns

23 Unit 4 To-Do-List Complete the discussion board original response by Saturday midnight and responses to 2 classmates’ posts by Sunday midnight. Begin working on your outlines if possible. Begin studying for your midterm exam (it is comprehensive and taken by the end of unit 5).