Chapter 5

Question 1

Health care

Answer 1

Access, quality, and cost of health care
Organizational and professional structures for the delivery of care

Question 2

Health care - examples

Answer 2

Rules governing Medicare and Medicaid, as well as laws governing private insurance
Hospital governance and professional licensure

Question 3

Public health

Answer 3

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

Question 4

Public health - examples

Answer 4

Food and drug laws and procedures, environmental laws and procedures, regulations for control of communicable diseases

Question 5

Bioethics

Answer 5

Application of individual and group values and morals to controversial areas

Question 6

Bioethics - examples

Answer 6

End-of-life care, stem cell research, use of new technology , protection of research subjects

Question 7

authoritative decision

Answer 7

a decision made by an individual or group that has the power to implement the decision

Question 8

health in all policies approach

Answer 8

has begun to be used in which private and public entities work toward common goals to achieve improved health for all while reducing health inequities.

Question 9

social justice approach

Answer 9

views the equitable distribution of health as a social responsibility

Question 10

market justice approach

Answer 10

emphasizes individual, rather than collective, responsibility for health.

Question 11

no-duty principle

Answer 11

This principle holds that healthcare providers (whether they are individuals or institutions) do not have an obligation to provide health services. A right to health care can be created within a state via its constitution. It can also be created in the United States or within a state by legislative action

Question 12

Self-imposed risk

Answer 12

risk an individual knowingly and willingly takes on through his or her own actions, such as choosing not to wear a motorcycle helmet while riding a motorcycle

Question 13

Imposed risk

Answer 13

refers to risk to individuals and populations that is out of their direct control. An example of an imposed risk would be exposure to environmental toxins from a local factory.

Question 14

Bernheim and Childress12 have outlined a set of principles for guiding public health action as follows:

Answer 14

■ Producing benefits
■ Avoiding, preventing, and reducing harms
■ Producing the maximal balance of benefits over
harms and other costs
■ Distributing benefits and burdens fairly and ensuring public participation, including the participation of affected parties
■ Respecting autonomous choices and actions, including liberty of action
■ Protecting privacy and confidentiality
■ Keeping promises and commitments
■ Disclosing information as well as speaking hon-
estly and truthfully
■ Building and maintaining trust

Question 15

When considering whether action is justified, the following conditions should be met12:

Answer 15

■ Effectiveness: Is the action likely to accomplish the public health goal?
■ Necessity: Is the action necessary to override the conflicting ethical claims to achieve the public health goal?
■ Least infringement: Is the action the least restrictive and least intrusive?
■ Proportionality: Will the probable benefits of the action outweigh the infringed moral norms and any negative effects?
■ Impartiality: Are all potentially affected stakeholders treated impartially?
■ Public justification: Can public health officials offer public justification that citizens, and in particular those most affected, could find acceptable in principle?

Question 16

Belmont Report

Answer 16

The Belmont Report focused on the key issues of defining informed consent and the selection of participants and led to the development of institutional review boards (IRBs), which now must approve most human research.

Question 17

Respect for persons

Answer 17

Respect for persons incorporates at least two ethical convictions: first, individuals should be treated as autonomous agents, and second, that persons with diminished autonomy are entitled to protection. The principle of respect for persons thus divides into two separate moral requirements: the requirement to acknowledge autonomy and the requirement to protect those with diminished autonomy.

Question 18

Beneficence

Answer 18

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. Such treatment falls under the principle of beneficence. Two general rules have been formulated as complementary expressions of beneficent actions in this sense:

(1) do no harm and (2) maximize possible benefits and minimize possible harms.

Question 19

Justice

Answer 19

Who ought to receive the benefits of research and bear its burdens? This is a question of justice, in the sense of fairness in distribution or what is deserved. An injustice occurs when some benefit to which a person is entitled is denied without good reason or when some burden is imposed unduly. Another way of conceiving the principle of justice is that equals ought to be treated equally.

Question 20

public health emergency of international concern (PHEIC).

Answer 20

Declaration of a PHEIC allowed WHO to make unbind- ing disease control recommendations, provide assistance, and communicate with other nations regarding the health threat.