Unit 4 SeminarHealth Law, Policy and Ethics

Prof Tynan Weed

Reminders: Grading

• For full credit for Discussion Board posts, you want to post an initial response by Saturday, and post to no less than two other students by Tuesday

• For full credit for In My Backyard, you want to post an initial response by Saturday, and post to no less than two other students by Sunday

• If there are any questions about grading, feel free to send me an email and we can discuss it there.

Reminders: Grading

• If you click on the actual grade in the Gradebook, you can see the comments that I have made to you

• If you cannot attend seminar: Click Seminar tab for that unit, submit Option 2 assignment to Dropbox

• You all are doing a great job in the discussions!

Unit 4

• Chapter 5: Health Law, Policy and Ethics• Chapter 13: The Future of Population Health

Key Terms from Unit 4: Chapter 5 (starts on page 67)

• Bioethics• Police Power• Rights• Negative constitution• Substantive due process• Social Justice• Market Justice• No-duty principle• Belmont Report• Institutional Review Boards

Key Terms from Unit 4: Chapter 13

• All-hazards approach• Demographic transition• Epidemiologic transition• Nutritional transition• Leverage points• Reductionist approach• Static and Dynamic models• Syndemic orientation

Chapter 5: Health Law, Policy and Ethics

• Public Health– Population health and safety, governmental

efforts to provide services to entire population. Policies for large groups of people.

• Health Care:– Access, quality, and cost of health care;

organizational and professional structures for care delivery

Questions to ask ourselves-Chapter 5

• 1) Is it a basic human right to have access to health care?

• 2) How does public health balance the needs of individuals with the needs of society?

• 3) How can bioethical principles be applied to protecting those individuals who participate in research?

How does our view of the role of government affect health policy?

• Difference between Market and Social Justice (page 71)

• Market Justice: philosophy that market forces should be relied upon to organize the delivery of health care services

• Social Justice: philosophy that aims to provide fair treatment and a fair share of the reward of society to individuals and groups

Is there a right to healthcare?• 1948, Right to Health Care was incorporated into the

Declaration of Human Rights and the Constitution of the WHO (World Health Organization). Legal right to have health care.

• No-duty principle– Health care workers do not need to provide service in an

emergency situation (refused services to a pregnant woman and she and her baby died, the case Hurley v. Eddingfield)

• 1986 Treatment for Emergency Medical Care Conditions and Women in Labor Act– ER: you will be seen, regardless of ability to pay

How does public health balance the rights of individuals with the needs of

society?• Public Health looks at benefits for population

as a whole• Motor vehicle injuries– States can raise minimum driving age, restrict use

of cell phones• TB Sanatoriums, and the use of Quarantine– What is Quarantine?

How can bioethical principles be applied to protecting individuals who

participate in research?• Nuremberg Code

– As a result of Nazi experiments, Box 5-4 lists the 10 priniciples• Tuskegee Syphillis Study

– Untreated Syphillis in African American men in Tuskegee County, Georgia (over 40 years)

– Did not treat them, only pretended to treat so they could see what happened when Syphillis went untreated

– Penicillin cures Syphillis.• Belmont Report

– As a result of Tuskegee• informed consent!, also creation of IRBs

• Institutional Review Boards (IRBs)

Chapter 13: The Future of Public Health

• Outbreak Investigations– Toxic Shock Syndrome (TSS)• Traced back to the absorbancy of tampons causing

cardio-vascular shock

– HIV/AIDS• And the Band Played On

Terrorism/Bioterrorism

• 2001 Anthrax Attack (Box 13-2 Bioterrorism)– All-hazards approach: Public health uses the same

approach for many types of disasters, which includes surveillance systems, communications systems, evacuations, and an organized healthcare response

What can we learn from mistakes of the past?

• 1976 Guillain-Barre syndrome caused by the Swine Flu vaccination that was available at the time.– Realization: person-to-person spread needs to be

established, safety of intervention needs to be assessed

• Estrogen Therapy for menopause was found to increase risk of heart disease and breast cancer– Realization: interventions used on large numbers of

people need to be especially safe

Demographic, Epidemiological, and Nutritional Transition

• See Population Pyramids, pages 197-199• What is the pattern of the demographic

transition for Nigeria? Japan? United States?• What is the epidemiological transition?• What is the nutritional transition?• What can this information tell us?

Next Week-Unit 5

• Midterm Exam– 50 questions, multiple choice, 4 hours (a lot of time!),

questions are from textbook– Exam on all material covered in textbook through Unit

5– Due at end of Unit 5 (Tuesday 11:59pm EST)

• Project Outline is due, continuation of Final Course Project (see Final Course Project document in Doc Sharing, and/or Unit 5 Assignment section within course, for details)

Questions?

• Feel free to email me with questions at Tweed@kaplan.edu

• Have a good night!