Chapter 5 Flashcards
How does the failure to respect human rights effect health?
- cause other people to be infected if the orignal person does not get treatment
- People don’t get the treatment they need
- less financing towards some issues
What ethical dilemmas are presented with human rights and health?
Is It okay to put of quarantines and restrict movement?
A universal declaration that place obligations on governments to respect, protect and fulfill rights and refrain from violating them
international Bill of Human rights
What is the international bill of human rights made up of?
International Covenant on Civil and Political Rights and the International Covenant on Economic, Social, and Cultural Rights
When was the universal declaration of human rights declared?
1948
What does article 25 of the UDHR declare that is realted to healthcare?
- Everyone has the right to adequate living conditions for good health
- Motherhood and childhood are entitled to special care and attention. All deserve the same attention and protection not matter their social status
A treaty about the rights of quality, liberty and security as well as freedom of movement, religion, expression and association.
International Covenant on Cilvil and Political Rights
a treaty that focuses on the well-being of individuals, including their right to work in safe conditions, receive fair wages, be free from hunger, get an education and enjoy the highest standard of health
International Covenant on Economic, Social and Cultural Rights
Rights that obligate the provision of benefits and services, such as by a government to the rights holder
positive rights
What the millennium development goals miss?
human rights considerations
The Treatment Action Campaign was created to sue to government of South Africa because it failed to insure that HIV-infacted mothers received treatments to prevent HIV from being passed to their children. this is an example of what?
a failure of article 25 of the UDHR
A convention that commits to promote equality between men and women
Convention of the Elimination of All from of discrimination against women
What was the first convention to focus on the human rights of children?
1989 Convention on the Rights of the Child
What does the Convention on the Rights of the Child state regarding health?
the right of the child to highest standard of health and health facilities.
An approach to global health that focuses on the fulfillment of people’s human rights as a way to improve health.
rights based approach
How does the rights based approach apply to global health?
- assess health policies, programs and practices in terms of their impact on human rights
- Analyze and address the health impacts resulting from violation of human rights
- protritize the fulfillment of human rights
Why is a rights based approach important to global health?
health is more then if you have an illness or not, but it also includes poverty, education, violence and discrimination
What are the limits of using a human rights based approach?
- sometimes you have to act for the public then for the individual
- suspension of human rights may need to occur to stop the spread of disease
Why is AIDs heavily stigmatized?
many people who have AIDs are homosexual, use drugs, have multiple sex partners or work in the sex industry
Individuals with AIDs might be fired, not allow to unroll in school or denied health care. This is an example of what?
Discrimination
Why is AIDs commonly used as an example for health ethics?
- People don’t have to inform others if they have AIDs, even if it puts others at harm
- Health care workers are often uninformed about the spread of HIV and AIDs which can lead to discrimination
- Many people cannot afford HIV drugs or are not given treatment
- Women can be rejected or harmed by family based on health status
New global health ethics state that treatments tested on individuals must be for those individuals. What prompted this to be included in discussions of human rights?
Nazi medical experiments, Tuskegee syphilis study, AZT trials
An AIDs treatment to prevent children of HIV positive mothers from getting HIV was only given to those in high-income countries. Later an inferior version was developed for low income countries.
AZT trials
Why were the AZT trials controversial?
- It would be unethical in high income countries to give an inferior or less effective drug
- They were giving some mothers a placebo
- These women had to partake in the trials because there was no other available treatments
What was the ethical guidelines created after the Nazi experiments?
nuremberg code
What are the 6 components of the declaration of Helsinki?
Scientific validity, fairness, risks and benefits, placebos, consent, and oversight and accountability
What are the four ethical principals of the Belmont report
respect for persons, beneficence, and justice
Clinical research must satisfy six conditions
- social value
- scientific validity
- fair subject selection
- acceptable risk benefit ratio
- informed consent
- respect for subjects
Research must be socially beneficial. A study can fail this requirement if the study is about something that we already know or the question is not that important.
social value
Research must be socially beneficial, but it can fail this if the methodology is inadequate to answer the question. The study must be ______
scientifically valid
The individuals enrolled in a study should not be from a vulnerable population just because they are more convenient and the individuals must be willing and capable of participating
fair subject selection
Participants should not be harmed by participating and the participants and society should benefit from the study
acceptable risk benefit ratio
The participants should understand what they are getting involved with or a designated care giver should enrol them on their behalf
informed consent
The researchers must protect subject confidentially and allow them to withdraw at any time
respect for enrolled subjects
Ethical issues that arise more commonly in low and middle income countries
- standard of care is less
- they can be influenced to participate based on perceived benefits
- Ancillary care after or during the trial may not exist
Why was the use of a placebo in the AZT trials contriversal?
the standard of care given to someone on the placebo is less than the standard for patients in high-income countries
What is the issue of testing drugs on populations that can’t regularly afford them?
after the trial is over, their treatment ends and health deteriates
medical care given to the participants that is not part of the design of the study
ancillary care
Ethical principals for resource dispersion
health maximization, equity, extra priority to the worse off, personal responsibility
Allotcation of health care researouses so the least amount of resources benefit the most amount of people
health maximization
issues with health maximization
sometimes giving money to those who are already well off because they already have the greatest potential to live longer.
Ensure that everyone has an equal chance at reviving a scarce resource or having access to healthcare
equity
making decisions about providing health care on the basis of who is already disadvantaged.
priority to the worse off
why is the priority to the worse off important?
because the most cost effective services do not always benefit the worse off
lower priority should be given to people whose health problems may be caused by their own behaviours.
personal responsibility
the proper processes for making health care investments should involve transparency, use appropriate data, and scientific and medical expertise.
fair process
what should a fair process include?
process that is institutionalized, explicit mention of principals and priorities, inclusive, and follow democratic procedures
Why can’t we use DALYs to distribute funds based on health maximization?
discriminate against disabled people
