Public Health Ethics, Equity, Policy, & Law Flashcards
What is Public Health Ethics
Values and means that inspire and informed public health and decision-making
What is research ethics?
The notion of scientific integrity, but is best known and most developed in relation to medical research involving human subjects
What is clinical ethics?
This addresses the ethical issues that arise in clinical practice. With the influence of bioethics, many healthcare providers now embrace a patient-centred model of care that emphasizes patient autonomy and informed consent. The patient-centred model conceives care as a contract between patient and provider.
What is bioethics?
Bioethics has a range of meanings, the first which applies to ethical issues brought about by advances in biomedicine and biotechnology. For example, ethical issues that arise from using life-sustaining technologies in end-of-life and beginning-of-life care.
Compare and contrast clinical medicine and public health. Give at least 10 different comparisons.
Mandate: in clinical medicine, the health of the patient is the mandate. In public health, the health of the community is the mandate.
Subject of intervention: In clinical medicine, individuals (and families) are the subject, in public health communities and populations are the subject.
Provider-patient relationship: Clinical medicine is direct and personal, whereas public health has no relationship between provider and patient in the traditional sense.
Autonomy: In clinical medicine, autonomy is often the primary consideration. In public health, the concept of autonomy from a population perspective is controversial.
Decision-maker: In clinical medicine, the decision-maker is the subject of the intervention, or legally-appointed substitute decision-maker. In public health, the decision maker is a public health or political figure, and is rarely the subject of the intervention.
Consent for intervention: In clinical medicine, consent is written or tacit, whereas in public health consent is rarely obtained.
Health status of intervention: In clinical medicine, the intervention usually targets the sick, whereas public health interventions usually target the healthy.
Initiation of relationship: In clinical medicine, the patient seeks the provider, whereas in public health, the provider seeks the patients.
Timing of intervention: In clinical medicine the intervention often comes after the disease, whereas public health focuses on disease prevention and health promotion
Modalities: Clinical medicine has a few modalities (medical/surgical), whereas public health has multiple diverse interventions
Sources of data: In clinical medicine, patients themselves, tests, records are sources of data. In public health, mandatory reporting, surveillance, epidemiologic studies are sources.
Harm/benefit: In clinical medicine, balance between harm and benefit must be considered for each individual patient. In public health, harms and benefits accrue to different individuals or groups.
Discuss public health ethics vs. biomedical ethics
Because public health issues are often community-level, biomedical ethics are suboptimal for assessing community-level public health.
Public health ethics focuses on the principles of solidarity, respect for community, reciprocity, and social justice. Biomedical ethics focus on nonmaleficence, beneficence, autonomy, and justice.
Public health focusses on community, social determinants, systems of practice, and distribution of resources. Biomedical ethics focuses on the individual person and individual agency, individual decision-making, and patient care.
