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Foundations of Public Health > Ch. 5: PH Health Law, Policy, and Ethics > Flashcards

Ch. 5: PH Health Law, Policy, and Ethics Flashcards

1
Q

Components of Health Law, Policy, and Ethics

A

Health Care
Public Health
Bioethics

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1
Q
  • Access, quality, and cost of health care
  • Organizational and professional structures for the delivery of care
A

Health Care

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2
Q

Example of Health Care

A
  • Rules governing Medicare and Medicaid
  • Laws governing private insurance
  • Hospital governance and professional licensure
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3
Q

Population health and safety, including governmental efforts to provide services to entire populations and vulnerable groups

A

Public Health

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4
Q

examples of Public Health

A
  • Food and drug laws and procedures
  • Environmental laws and procedures
  • Regulation for control of communicable diseases
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5
Q
  • Application of individual and group values and morals to controversial areas
  • Includes elements of health care and public health
A

Bioethics

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6
Q

examples of Bioethics

A
  • End-of-life care
  • Stem cell research
  • Use of new technology
  • Protection of research subjects
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7
Q

*** does not mention health

A

U.S. Constitution

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8
Q

are left primarily to the authority of the states

A

U.S. Constitution

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9
Q

Power of state governments to pass legislation and implement actions to protect the common good

A

Police Power

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10
Q
  • Regulation of healthcare professionals and facilities
  • Establishment of health and safety standards in retail and other occupational
    settings
  • Control of hazards: car restraint systems, vaccinations, restrictions on the sale of tobacco products
A

Police Power

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11
Q

Use of State Police Power is limited by protections afforded to individuals,

A

Individual Rights

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12
Q

are created through the U.S. Constitution, state constitutions, or laws passed at the federal and state levels

A

Rights

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13
Q

Types of rights

A

written
inferred

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14
Q

freedom of speech, religion, assembly, right to bear arms

A

written rights

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15
Q

right to creation, privacy, bodily integrity, and travel

A

inferred rights

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16
Q

** The U.S. Constitution allows, but does not require, the government to act to protect public health or to provide healthcare services

A

Negative Constitution

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17
Q

what is this an example of The Supreme Court has not found an obligation on the part of the states to act to prevent child or spousal abuse even when the state is fully aware of specific circumstances, or a court has issued a restraining order

A

Negative Constitution

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18
Q

Provides federal government with the authority to tax, spend, and regulate interstate commerce

A

Interstate Commerce Clause

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19
Q

Used to justify federal involvement in health care and public health

A

Interstate Commerce Clause

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20
Q

Often exerted through incentives to the states

A

Interstate Commerce Clause

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21
Q

States may be offered federal funding if they enact specific types of legislation, such as what

A

the rules governing Medicaid or definitions of blood- alcohol levels for driving under the influence

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22
Q

Declares that legitimate federal laws are the supreme laws of the land and overrule state laws that conflict with them

A

U.S. Constitution Supremacy Clause

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23
Q

what are examples of U.S. Constitution Supremacy Clause

A
  • Food and Drug Administration: quality controls on drugs
  • Environmental Protection Agency: levels of permissible exposures to toxic substance
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24
Q

A collaborative approach that integrates and articulates health considerations into policymaking across sectors to improve the health of all communities and people

A

Health in All Policies Approach

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25
Q

Private and public entities work toward common goals to achieve improved health for all while reducing health inequalities

A

Health in All Policies Approach

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26
Q

A public health policy decision goes beyond the individual sphere and effects the greater community

A

Health in All Policies Approach

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27
Q

Health in All Policies Approach Examples

A

Education polices
Employment policies
Housing policies

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28
Q

An overarching framework for integrating health issues into a broad range of social and economic issues

A

Health in All Policies Approach

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29
Q

that provide opportunities for women of childbearing age among all income-levels to attain a college education

A

Education polices

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30
Q

hat allow mothers to take maternity leave while maintaining their salary and health benefits

A

Employment policies

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31
Q

that require landlords to maintain safe structures free of hazards for young children, such as avoiding lead poisoning and asthma triggers

A

Housing policies

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32
Q
  • Imitative organized by the U.S. Department of Health and Human Services
  • Collaborative effort of a multitude or private and public organizations
  • Sets evidence-based objectives aimed at improved the nation’s health
A

Healthy People 2030

33
Q

The appropriate role of government is often what?

A

controversial

34
Q

Individual responsibility for health

A

Market Justice

35
Q

Benefits based on individual purchasing power

A

Market Justice

36
Q

Everyone is entitled to basic package of services

A

Social Justice

37
Q

Limited Obligation to the collective good

A

Market Justice

38
Q

Collective responsibility for health

A

Social Justice

39
Q

Strong obligation to the collective good

A

Social Justice

40
Q

Community Well-being supersedes that of the individual

A

Social Justice

41
Q

Emphasis on the individual well-being

A

Market Justice

42
Q

Private solution to social problem

A

Market Justice

43
Q

Public Solutions to social problems

A

Social Justice

44
Q

Planned rationing of healthcare

A

Social Justice

44
Q

Rationing based on the ability to pay

A

Market Justice

45
Q

Three Big Questions

A
  1. Is there a right to health care?
  2. How does public health attempt to balance the right of individuals and the needs of society?
  3. What bioethical principles are used to address public health issues?
46
Q

Is there a right to healthcare

A

*** In 1948, a right to health care was incorporated into the Universal Declaration of Human Rights and the World Health Organization’s Constitution

“Everyone has the right to a standard of living adequate for the health and well- being of himself and his family, including…medical care…and the right to security in the event of…sickness….”

47
Q

*** The standard of U.S. law that healthcare providers, either individuals or institutions, do not have an obligation to provide health services

A

No-Duty Principle

48
Q

This act establishes a right to health care for those seeking emergency services and establishes a duty on the part of hospital emergency departments to provide these services

A

1986 Treatment for Emergency Medical Conditions and Women in Labor Act

49
Q

** risk to an individual created through one’s own actions

A

Self-imposed risk

50
Q

what is this an example of

Exposure to environmental toxins from a local factory

A

Imposed risk

51
Q

*** risk to individuals and populations that is out of their direct control

A

Imposed risk

52
Q

what is this an example of

Choosing not to wear a motorcycle helmet while riding a motorcycle

A

Self-imposed risk

53
Q

separating those exposed to an illness from the population

A

Quarantine

54
Q

separating those with an illness from the population

A

Isolation

55
Q

Principles of Ethical Practice of Public Health

A
  1. Public health should address principally the fundamental causes of disease and requirements for health, aiming to prevent adverse health outcomes.
  2. Public health should achieve community health in a way that respects the rights of individuals in the community.
  3. Public health policies, programs, and priorities should be developed and evaluated through processes that ensure an opportunity for input from community members.
  4. Public health should advocate and work for the empowerment of disenfranchised community members, aiming to ensure that the basic resources and conditions necessary for health are accessible to all.
  5. Public health should seek the information needed to implement effective policies and programs that protect and promote health.
  6. Public health institutions should provide communities with the information they have that is needed for decisions on policies or programs and should obtain the community’s consent for their implementation.
  7. Public health institutions should act in a timely manner on the information they have within the resources and the mandate given to them by the public.
  8. Public health programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs, and cultures in the community.
  9. Public health programs and policies should be implemented in a manner that most enhances the physical and social environment.
  10. Public health institutions should protect the confidentiality of information that can bring harm to an individual or community if made public. Exceptions must be justified on the basis of the high likelihood of significant harm to the individual or others.
  11. Public health institutions should ensure the professional competence of their employees.
  12. Public health institutions and their employees should engage in collaborations and affiliations in ways that build the public’s trust and the institution’s effectiveness.
56
Q

requires more than a national response; it requires a global response

A

Pandemic disease

57
Q

have occurred since ancient times yet until the late 19th century there was little or no coordinated international response

A

Epidemic and widespread pandemics

58
Q

the first such international effort, focused attention on a subset of diseases primarily cholera, plague, and yellow fever and the quarantine regulations necessary to prevent the shipping trade from transporting these diseases across international borders

A

The International Sanitary Convention of 1892

59
Q

was established as a United Nations organization in 1948

A

The World Health Organization

60
Q

adopted the existing agreements as the International Health Regulations (IHR) which became binding on all WHO members

A

The World Health Organization

61
Q

Regulations were limited to cholera, plague, yellow fever, and smallpox (smallpox was removed after its eradication in the late 1970s)

A

The World Health Organization

62
Q

Embraced an all-hazards strategy, covering health threats irrespective of their origin or source as opposed to the previous disease specific coverage

A

International Health Regulation

63
Q

Includes biological, chemical, and nuclear events

A

International Health Regulation

64
Q

Requires nations to develop “core capacities” for rapid detection, assessment, reporting, and response to potential “public health emergencies of international concern”

A

International Health Regulation

65
Q

An extraordinary public health event which constitutes a public health risk to multiple countries through international spread of disease and potentially requires a coordinated response

A

Public Health Emergency of International Concern

66
Q

Includes infectious diseases, chemical agents, radioactive materials, and contaminated foods

A

Public Health Emergency of International Concern

67
Q

Any event irrespective of origin and source meeting 2 or more of the following criteria is considered a what

A

Public Health Emergency of International Concern

68
Q

what are the Public Health Emergency of International Concern criteria

A
  1. Unusual or unexpected event
  2. Resulting in serious public health impact
  3. With significant risk of international spread
  4. With significant risk of international travel or trade restriction
69
Q

Nuremberg Code

A
  1. The voluntary consent of the human subject is absolutely essential.
  2. The experiment should be such as to yield fruitful results for the good of society, unprocurable by other methods or means of study, and not random and unnecessary in nature.
  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.
  5. No experiment should be conducted where there is an a priori reason to believe that death or disabling injury will occur, except, perhaps, in those experiments where the experimental physicians also serve as subjects.
  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. The highest degree of skill and care should be required through all stages of the experiment of those who conduct or engage in the experiment.
  9. During the course of the experiment, the human subject should be at liberty to bring the experiment to an end if he has reached the physical or mental state where continuation of the experiment seems to him 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 has probable cause to believe, in the exercise of the good faith, superior skill, and careful judgment required of him, that a continuation of the experiment is likely to result in injury.
70
Q

*** Created by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research

A

The Belmont Report

71
Q

*** Focuses on key issues of defining informed consent and selecting participants for research

A

The Belmont Report

72
Q

Led to the development of the institutional review boards (IRBs); must approve most human research

A

The Belmont Report

73
Q

The Belmont Report

A

Respect for Persons
Beneficence
Justice

74
Q
  1. Individuals should be treated as autonomous agents
  2. Persons with diminished autonomy are entitled to protection
A

Respect for Persons

75
Q

Moral requirements of The Belmont Report

A
  1. The requirement to acknowledge autonomy
  2. The requirement to protect those with diminished autonomy.
76
Q

Persons are treated in an ethical manner not only by respecting their decisions and protecting them from harm, but also by making efforts to secure their well-being

A

Beneficence

77
Q

general rules of Beneficence

A
  1. Do no harm
  2. Maximize possible benefits and minimize possible harms
78
Q

Fairness in distribution of research benefits and burdens

A

Justice

79
Q

An injustice occurs when a benefit is denied without good reason or when some burden is imposed unduly

A

Justice

80
Q

In order to approve research, the IRB shall determine that all of the following requirements are satisfied:

A
  1. Risks to subjects are minimized.
  2. Risks to subjects are reasonable in relation to anticipated benefits.
  3. Selection of subjects is equitable.
  4. Informed consent will be sought from each prospective subject or the subject’s legally authorized representative.
  5. The research plan makes adequate provision for monitoring the data collected to ensure the safety of subjects.
  6. When appropriate, there are adequate provisions to protect the privacy of subjects and to maintain the confidentiality of data.
  7. When some or all of the subjects are likely to be vulnerable to coercion or undue influence, such as children, prisoners, pregnant women, mentally disabled persons, or economically or educationally disadvantaged persons, additional safeguards have been included in the study to protect the rights and welfare of these subjects.

Foundations of Public Health (9 decks)

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