Public Health Ethics Essay

Public Health Ethics Essay

Respond to the following in a minimum of 175 words:

What is the responsibility of the health care manager regarding public health ethics and social responsibility? Provide an example.

What is the biggest issue you believe you may face as a health care manager? Public Health Ethics Essay


In the last three decades HIV/ AIDS has become the one of the most notorious and widely spread diseases in the modern world. Its discovery in the late seventies prompted worldwide concern. The one thing that has become the most bothersome thing about the HIV/ AIDS epidemic is prevention. Prevention or stopping the transmission of the diseases is hindered by factors such as: denial or non-acceptance by infected persons, unsafe sex, and non-disclosure by infected persons to their at risk sexual partner(s). According to Alghazo, Upton, and Cioe (2011):

Human Immunodeficiency Virus (HIV) the precursor to Acquired Immune Deficiency Syndrome (AIDS) is prevalent in the United States. The October 2008 Center for Disease Control (CDC) Morbidity…show more content…
In medicine one of the things every patient is entitled to, no matter what, is their privacy. Since ancient times the privacy between a doctor and a patient has been somewhat of sacred thing. The patient has the right to release their health information to whomever they please. Even for doctors to access a patient’s medical history there has to be consent from the patient. In Mair’s article she reports about the case PD v Harvey in which PD upon asking for her future husband’s (FH) HIV test results was denied access because of lack of consent from FH. FH because of his right to confidentiality, despite having the disease, was able to lie and forge a pathology report which reported his HIV status as negative and in turn PD was lead to believe that FH actually received a negative result. If PD had been allowed the right to view the positive result or maybe even if the doctors would have taken into consideration her well-being PD could have avoided being infected (2009). Before testing a patient for HIV/AIDS a doctor should consult the patient in this consultation the patient should be educated about the disease, the testing process, and actions to be taken upon a positive result, including disclosure to sexual Public Health Ethics Essay

The public health ethics look at the moral basis of the health of human as a guiding support put in place to maximize welfare, and therefore health as a component of welfare [1,2]. This view frames the core moral challenge of public health as balancing individual liberties with the advancement of good health outcomes.

An alternative view of public health ethics characterizes the fundamental problematic of public health ethics differently: what lies at the moral foundation of public health is social justice [2]. While balancing individuals’ liberties with promoting social goods is one area of concern, it is embedded within a broader commitment to secure a sufficient level of health for all and to narrow unjust inequalities [2, 3]. Another important area of concern is the balancing of this commitment with the injunction to maximize good aggregate or collective health outcomes. Public health ethics has therefore a strong moral connection to broader questions of social justice, poverty, and systematic disadvantage Public Health Ethics Essay

1.1. Historical ethical perspective
Although there have been some manifested concerns about the vulnerability of human subjects implicated in clinical research for over a century, it was the scandals and tragedies of the Nazi doctors during the second World War that gave birth to the discipline of bioethics [4, 5]. Other recent concerns in bioethics are attempting to extend ethical debate beyond the one-to-one physician-patient relationship, to enter the domain of public health where focused is geared towards the health of the entire populations. In the Africa setting, these extended concerns are being driven in part by the persisting iniquities and disparities in the health status of the low income resource countries and the rich countries, the differences in access to health services, the differences in the effort put into solving health problems, whereby the larger health burdens of the South receive scarce research attention, and the fewer problems of the North receive most of the attention in what has been termed the 10/90 gap [6, 35]. More attempts made to redress these inequalities have led to greater research investment and North-South research collaboration with the aim of solving the major health problems affecting the population in the poor countries of the South  Public Health Ethics Essay

1.2. The Ethical fundamental principles
Four fundamental principles of ethics have been universally recognized namely; autonomy, beneficence, non-maleficence and justice. These principles universally deals with the respect for all other humans as moral equals, making sure that all our actions are intended to achieve results with less harm, and treating others with fairness and equity [8, 48].

1.2.1. Beneficence and non maleficence
The principle of beneficence and non-maleficence are best considered together as they are like mirror images of each other. Literally beneficence means doing good and non-maleficence means avoiding evil or harm [9, 38, 42]. Public Health Ethics Essay

1.2.2. The harm principle
It is likely that no classic philosophical work is cited more often in the public health ethics literature than John Stuart Mill’s essay “On Liberty” [10]. In that essay, Mill defends what has come to be called the harm principle, in which the only justification for interfering with the liberty of an individual, against her will, is to prevent harm to others. The harm principle is relied upon to justify various infectious disease control interventions including quarantine, isolation, and compulsory treatment. In liberal democracies, the harm principle is often viewed as the most compelling justification for public health policies that interfere with individual liberty [10, 19]. For example, a prominent view in the United States is that it was not until the public became persuaded of the harmful effects of “second hand smoke” that the first significant intrusion into smoking practices—the banning of smoking in public places—became politically possible. Perhaps because of the principle’s broad persuasiveness, it is not uncommon to see appeals made about harm to others in less than obvious contexts [11]. Defenders of compulsory motorcycle helmet laws, for example, argued that the serious head injuries sustained by unprotected cyclists diverted emergency room personnel and resources, thus harming other patients[12, 32]. The harm principle has been interpreted to include credible threat of significant economic harm to others as well as physical harm. Regarding smoking policy, various restrictions on the behavior of smokers have been justified by appeal to the financial burden on the health care system of caring for smoking-related illnesses [13]. Public Health Ethics Essay

As with all such principles, questions remain about its specification. How significant must the threat of harm be, with regard to both its likelihood and magnitude of effect? Are physical harms to the health of others to be weighted more than economic harms or other setbacks to interests? Whether interpreted narrowly or broadly, there are limits to the public health cases that can plausibly be placed in the harm principle box [14, 15]. Moreover, in the context of commitments to social justice and general welfare, and the other justifications described above, too exclusive a focus on the harm principle can undermine otherwise justifiable government mandates and regulation. It is undeniable that individuals have much broader and more multi-dimensional interests than narrowly self-directed physical ones, and in that sense, it is not unreasonable to have a fairly expansive understanding of “harm” in a public health context Public Health Ethics Essay

The concept of ethics in the healthcare industry has evolved over time and every stakeholder in the sector should strive on improving services delivery and attaining maximum patient satisfaction. Ethics in the healthcare industry involves making the good decisions and judgments that are universally acceptable. The code of ethics in the healthcare industry expresses the responsibilities and defines rules that every health care worker, physician, and nurse must follow while attending patients. These people undergo health education that makes them understand legal and ethical concerns, patient confidentiality and informed consent (Baum, Gollust, Goold & Jacobson, 2007). The following discussion analyzes ethics and public health in relation to two cases. The first case involves doctor’s war on common surgery while the second case patients complaining over heart procedures that have claimed lives of patients.

A description of ethical (bioethical) issues related to health care and health policy Public Health Ethics Essay
The first case concerns doctors speaking out about the pains and sufferings patients undergo because of the ignorance of some selfish physicians and health care workers. The case is about Hooman Noorchashm, a surgeon who tried to stop Morcellation procedure that was to be done on his wife because it can cause uterine cancer. Noorchashm was speaking from a witness’s point of view because he had experienced such cases and realized the risks associated with this procedure. Physicians termed the process safe and sound because majority of patients who had undergone the surgeon experienced small complications. The health care providers hold the responsibility of ensuring all procedures and operations done on patients are safe and cannot cause any health problem. The above case clearly shows that the public health policies and practices provided to healthcare practitioners ran counter to their professional principles. The case shows lack of emphases on fairness, efficiency of nursing practice, and in the use of public funds. In addition, the physicians demonstrated lack of respect for human life because they were more concerned about monetary gains because the procedure is very expensive to perform.
The second case is about heart patients challenging the type of procedures they undergo at Ky Hospital. There has been complains that heart patients undergo needless procedures that interfere with their health, while others die of pain. The above issue clearly shows some unethical operations practices by physicians that go centrally to health care ethics educations. Doctors and other health care workers in the hospital are seen defending themselves claiming they give patients the best services. The doctors’ code of ethics requires that each human look after each other irrespective of the race, religion, ethnicity or financial status. Positive relationship and positive collaboration is highly values in the health care sector, but physicians and doctors at Ky. Hospital failed to practice their ethical responsibilities. On the other hand, the hospital breaks the health care policy for failing to provide a close follow-up for their patients and administering wrong procedures to patients just to gain more money (Baum, Gollust, Goold & Jacobson, 2007). Public Health Ethics Essay


Health care workers and practitioners should express a strong commitment to ensuring and maintaining quality care to all populations. They have professional obligations that allow them to do what they perceive to be ‘right’ irrespective of the resources and available time. The two cases clearly show a breach of the code of ethics by practitioners who put the lives of individuals at stake. The role of public health in maintaining ethics has been really questioned following these cases. In the first case, physicians told Noorchashm that the operations scheduled for his wife was very safe. According to the public health code of ethics, every patient must be briefed on the positive and negative effects of any operation before it starts and sign an informed consent. These cases show that physicians never informed their patients on the dangers of such operations. In addition, public health has the responsibility of addressing the fundamental causes of disease and its health requirements to prevent adverse health outcomes (Bayer, Gostin, Jennings, 2007). Public Health Ethics Essay
On the other hand, equity is a paramount aspect of importance in the public health. Case 2 demonstrated total inequality among health care practitioners who perform heart surgeries depending on the financial status of the patient. Some patients receive poor quality services and end up losing their lives. In addition, the ignorance of physicians in their duties shows lack of ethics in their work. The public health’s ethical principle requires physicians to monitor the health status to identify community health problems. In the second case, the community provided the public health with relevant information, but they failed to act on this information breaking the healthcare ethical principle. Another ethical issue demonstrated on these cases was the lack of professional competence (Bayer, Gostin, Jennings, 2007). The health care practitioners shown on the cases lacked the required competence because they could not treat their patients effectively. In addition, the public health sector is ignorance of ensuring only competent health workers perform operations to patients to avoid incidences of unnecessary, painful and risky heart procedures. Public Health Ethics Essay

The philosophy of social justice is perceived by many practitioners as the foundation in public health. Upholding recommended ethics and principles in any organizations is a fundamental aspect that helps maintain a good relationship between stakeholders. The above two cases have demonstrated how health care workers, physicians, and practitioners ignore their responsibilities and perform operations without caring about the results. The ethical issues related to these cases form a vital ground for the future of the health care industry where physicians should uphold their dignity and do their duties caring about the lives of patients. Public Health Ethics Essay