Chapter 5: Health Law, Policy, and Ethics

Introduction What Is the Scope of Health Law, Policy, and Ethics? What Legal Principles Underlie Public Health and Health Care? What Do We Mean by Health Policy? How do the Philosophies Toward the Role of Government Affect Health Policies?

Chapter 5 Health Law, Policy, and Ethics Is There a Right to Health Care? How Does Public Health Balance the Rights of Individuals and the Needs of Society? How can Bioethical Principles Be Applied to Protecting Individuals Who Participate in Research?

Introduction A new statute and subsequent administrative regulations give only a temporary license to newly licensed drivers prohibiting late night driving, limiting the number of passengers, and prohibiting use of cell phones. You wonder if older drivers are subject to these same regulations and are required to pass a driver’s test.

Introduction You decide not to enroll in the health plan offered by your employer because it seems so expensive and you are young and healthy. Not long after your car is struck by a hit and run driver and you find yourself on the way to the nearest hospital. After stabilizing you as required by law, they transfer you to the public hospital which is the only one in town that will take care of you without insurance. You complain that you have a right to health care but no one seems to respond.

Introduction You hear that a new drug has shown extremely promising results but will not be available for a least a couple of years. You wonder why you have to wait so long to take the newest prescription medicine while your e-mail fills up with promotions for the untested ways to enhance your energy, beauty, and sexual performance. You wonder why the Food and Drug Administration seems to have such differing standards.

Introduction You hear that a neighbor has TB and refuses treatment. Can’t they make him take his medicine or at least get him out of your neighborhood you wonder? What if he has the type of TB that can’t be cured with drugs, you ask yourself?

Introduction You hear an advertisement about participating in a new research study. It sounds like you’re eligible so you check into it. You’re surprised to find that even if you participate you may not receive the new drug and won’t even be told which treatment you are receiving. Despite your willingness to take your chances, you’re told that you are not eligible for the study due to conditions that put you at increased risk of developing side effects. Why can’t you participate if you’re willing to take the risks, you wonder.

Components of Health Law, Policy, and Ethics Scope Examples of issues Health care Access, quality, and cost of health care Organizational and Professional structures for the delivery of care Rules governing Medicare and Medicaid, as well as laws governing private insurance Hospital governance and professional licensure

Components of Health Law, Policy, and Ethics Scope Examples of issues Public health Population health and safety, including governmental efforts to provide services to entire populations, as well as vulnerable groups Food and drug laws and procedures, environmental laws regulations for control of Communicable diseases

Components of Health Law, Policy, and Ethics Scope Examples of issues Bioethics Application of individual and group values and morals to controversial areas End-of-life care, stem cell research, abortion, protection of research subjects

Characteristics of Market and Social Justice Market Justice Social Justice Views health care as an economic good Views health care as a social resource Assumes free market conditions for health services delivery Requires active government involvement in health services delivery Assumes that markets are more efficient in allocating resources equitably Assumes that the government is more efficient in allocating health resources equitably

Characteristics of Market and Social Justice Market Justice Social Justice Production and distribution of health care determined by market-based demand Medical resource allocation determined by central planning Medical care distribution based on people’s ability to pay Ability to pay inconsequential for receiving medical care Access to medical care viewed as an economic reward for personal effort and achievement Equal access to medical services viewed as a basic right

Implications of Market and Social Justice Market justice Social justice Individual responsibility for health Collective responsibility for health Benefits based on individual purchasing power Everyone is entitled to a basic package of services Limited obligation to the collective good Strong obligation to the collective good

Implications of Market and Social Justice Market justice Social justice Emphasis on individual well-being Community well-being supersedes that of the individual Private solutions to social problems Public solutions to Rationing based on ability to pay Planned rationing of health care