5: Health Law, Policy, and Ethics
- Page ID
- 227626
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\(\newcommand{\avec}{\mathbf a}\) \(\newcommand{\bvec}{\mathbf b}\) \(\newcommand{\cvec}{\mathbf c}\) \(\newcommand{\dvec}{\mathbf d}\) \(\newcommand{\dtil}{\widetilde{\mathbf d}}\) \(\newcommand{\evec}{\mathbf e}\) \(\newcommand{\fvec}{\mathbf f}\) \(\newcommand{\nvec}{\mathbf n}\) \(\newcommand{\pvec}{\mathbf p}\) \(\newcommand{\qvec}{\mathbf q}\) \(\newcommand{\svec}{\mathbf s}\) \(\newcommand{\tvec}{\mathbf t}\) \(\newcommand{\uvec}{\mathbf u}\) \(\newcommand{\vvec}{\mathbf v}\) \(\newcommand{\wvec}{\mathbf w}\) \(\newcommand{\xvec}{\mathbf x}\) \(\newcommand{\yvec}{\mathbf y}\) \(\newcommand{\zvec}{\mathbf z}\) \(\newcommand{\rvec}{\mathbf r}\) \(\newcommand{\mvec}{\mathbf m}\) \(\newcommand{\zerovec}{\mathbf 0}\) \(\newcommand{\onevec}{\mathbf 1}\) \(\newcommand{\real}{\mathbb R}\) \(\newcommand{\twovec}[2]{\left[\begin{array}{r}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\ctwovec}[2]{\left[\begin{array}{c}#1 \\ #2 \end{array}\right]}\) \(\newcommand{\threevec}[3]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\cthreevec}[3]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \end{array}\right]}\) \(\newcommand{\fourvec}[4]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\cfourvec}[4]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \end{array}\right]}\) \(\newcommand{\fivevec}[5]{\left[\begin{array}{r}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\cfivevec}[5]{\left[\begin{array}{c}#1 \\ #2 \\ #3 \\ #4 \\ #5 \\ \end{array}\right]}\) \(\newcommand{\mattwo}[4]{\left[\begin{array}{rr}#1 \amp #2 \\ #3 \amp #4 \\ \end{array}\right]}\) \(\newcommand{\laspan}[1]{\text{Span}\{#1\}}\) \(\newcommand{\bcal}{\cal B}\) \(\newcommand{\ccal}{\cal C}\) \(\newcommand{\scal}{\cal S}\) \(\newcommand{\wcal}{\cal W}\) \(\newcommand{\ecal}{\cal E}\) \(\newcommand{\coords}[2]{\left\{#1\right\}_{#2}}\) \(\newcommand{\gray}[1]{\color{gray}{#1}}\) \(\newcommand{\lgray}[1]{\color{lightgray}{#1}}\) \(\newcommand{\rank}{\operatorname{rank}}\) \(\newcommand{\row}{\text{Row}}\) \(\newcommand{\col}{\text{Col}}\) \(\renewcommand{\row}{\text{Row}}\) \(\newcommand{\nul}{\text{Nul}}\) \(\newcommand{\var}{\text{Var}}\) \(\newcommand{\corr}{\text{corr}}\) \(\newcommand{\len}[1]{\left|#1\right|}\) \(\newcommand{\bbar}{\overline{\bvec}}\) \(\newcommand{\bhat}{\widehat{\bvec}}\) \(\newcommand{\bperp}{\bvec^\perp}\) \(\newcommand{\xhat}{\widehat{\xvec}}\) \(\newcommand{\vhat}{\widehat{\vvec}}\) \(\newcommand{\uhat}{\widehat{\uvec}}\) \(\newcommand{\what}{\widehat{\wvec}}\) \(\newcommand{\Sighat}{\widehat{\Sigma}}\) \(\newcommand{\lt}{<}\) \(\newcommand{\gt}{>}\) \(\newcommand{\amp}{&}\) \(\definecolor{fillinmathshade}{gray}{0.9}\)Health law and policy are the tools society uses to influence behavior. These laws and policies encourage or discourage certain actions by individuals, groups, or the entire population, and apply to public health centers and health care organizations (which will be covered in another chapter).
Health practitioners tend to be acquainted with the four principles of ethical evaluation: beneficence, nonmaleficence, respect for persons (autonomy), and justice in their interactions with patients. (U.S. National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research, 1978; Beauchamp and Childress, 2012). These principles apply to health and research and are also relevant to public health.
Bioethics arose in response to advances in biomedicine and biotechnology, medical paternalism, and the abuse of human subjects in medical research. Bioethics has championed informed consent, patient autonomy in doctor-patient relationships, and the safety of human subjects in research.
In the following pages, we will be covering how these topics relate to public health.
- 5.1: Bioethics
- This page discusses the integration of bioethics in health care and public health, emphasizing ethical principles in contentious issues like genetic modification. It traces its origins to historic research abuses, leading to regulations for human subject protection, such as informed consent and IRBs. New dilemmas, particularly gene editing, have emerged, especially highlighted by a controversial experiment in China that raised ethical concerns.
- 5.2: Police Power
- This page examines the foundational principles of the United States, focusing on the Declaration of Independence and the Constitution, particularly the Bill of Rights and Tenth Amendment, which delegates health responsibilities to states. It explores the balance between public health and individual rights through historical examples like Typhoid Mary and recent COVID-19 measures, highlighting ongoing tensions and raising questions about future governance and rights protections.
- 5.3: Health Policy
- This page discusses the importance of policymaking in public health, emphasizing the role of laws and regulations at different governmental levels. It highlights the interconnectedness of bureaucracies and introduces the Health in All Policies (HiAP) approach, which promotes incorporating health into all policy areas to improve community health and mitigate disparities.
- 5.4: Types of Law
- This page discusses the importance of public health policy and law as tools for safeguarding population health while honoring individual rights. It outlines four legal sources that shape public health policy: constitutional law, legislative law, administrative law, and judicial law. Additionally, it features exercises to illustrate these legal types in practice, emphasizing their role in public health governance.
- 5.5: Pandemic Response
- This page covers the establishment and development of the World Health Organization (WHO) since 1948, focusing on the International Health Regulations (IHR) and their role in global health security, especially during pandemics like COVID-19. It notes the WHO's power to declare public health emergencies and its "One Health" strategy connecting various health domains. The page also references the United States' withdrawal from the WHO and the uncertain implications of this action.
Reference:
Beauchamp, T.L., and J.F. Childress. 2012. Principles of biomedical ethics, 7th ed. New York: Oxford University Press.
National Commission for the Protection of Human Subjects of Biomedical and Behavioural Research. 1978. Belmont Report: Ethical principles and guidelines for the protection of human subjects of research. US Department of Health and Human Services. NIH www.hhs.gov