Ethics in Health Services and Policy ─ A Global Approach

This comprehensive textbook analyzes the ethical issues of health and health care in global perspective. Ideal for students of public health, medicine, nursing and allied health professions, public policy, and ethics, the book helps students in all these areas to develop important competencies in their chosen fields. Applying a comparative, or multicultural, approach, the book compares different perspectives on ethical issues in various countries and cultures, such as informed consent, withholding or withdrawing treatment, physician-assisted suicide, reproductive health issues, research with human subjects, the right to health care, rationing of limited resources, and health system reform. Applying a transnational, or cross-border, approach, the book analyzes ethical issues that arise from the movement of patients and health professionals across national borders, such as medical tourism and transplant tourism, ethical obligations to provide care for undocumented aliens, and the “brain drain” of health professionals from developing countries.

Comprehensive in scope, the book includes selected readings which provide diverse perspectives of people from different countries and cultures in their own words. Each chapter contains an introductory section centered on a specific topic and explores the different ways in which the topic is viewed around the globe.

Ethics in Health Services and Policy is designed to promote student participation and offers methods of activity-based learning, including factual scenarios for analysis and discussion of specific ethical issues.

Dean M. Harris, JD, is a clinical associate professor in the Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, and adjunct associate professor in the UNC School of Law. In addition, he serves as adjunct professor in the Health Economics and Management Institute (HEMI) in the Guanghua School of Management at Peking University. Companion web site: www.josseybass.com/go/deanharris

Introduction.

Acknowledgments.

The Author.

1 Ethical Theories and Bioethics in a Global Perspective.

Theories of Ethics.

Are Theories of Ethics Global?

Can Theories of Ethics Encourage People to Do the Right Thing?

2 Autonomy and Informed Consent in Global Perspective.

Ethical Principles and Practical Issues of Informed Consent.

Does Informed Consent Really Matter to Patients?

Is Informed Consent a Universal Principle or a Cultural Value?

3 Withholding or Withdrawing Treatment and Physician-Assisted Suicide.

Withholding or Withdrawing Treatment at the End of Life.

Assisting Patients in Committing Suicide.

4 Ethical Issues in Reproductive Health.

Ethics of Abortion in Different Times, Places, and Cultures.

Current Ethical Issues in Abortion.

Assisted Reproductive Technology and Stem Cell Research.

Emergency Contraception.

Ethics of Imposing Conditions on Funding.

5 Ethical Issues of Female Genital Mutilation.

The Facts About FGM.

FGM as a Challenge to Ethical Relativism.

Ethics of FGM for Adult Women.

6 Ethical Issues of Research with Human Subjects.

Background Information and the Belmont Report.

Autonomy and Voluntary Informed Consent.

Beneficence and Cost-Benefit Analysis.

Issues of Justice and Fairness for Human Subjects.

7 The Right to Health Care, and Ethical Obligations to Provide Care.

Is There an Ethical Right to Health Care?

Ethical Obligations of Health Care Professionals.

Ethical Obligations of for-Profit Health Care Providers.

8 Ethical Issues in Rationing and Allocation of Limited Resources.

Levels of Allocating Resources.

Methods of Rationing Health Resources.

Comparative Effectiveness Research and Cost-Effectiveness Analysis.

9 Ethical Issues of Health Insurance and Health System Reform.

Ethical Issues in Financing Health Services and Designing Insurance Systems.

Fundamental Values of Health Systems.

10 Ethical Issues in the Movement of Patients Across National Borders.

Ethical Duties to Provide Health Care to Undocumented Aliens.

Ethical Issues in Medical Tourism.

11 Ethical Issues in the Movement of Health Care Professionals Across National Borders.

Ethical Issues in the Migration of Health Professionals.

Proposed Solutions and Their Ethical Implications.

Fair Treatment of Health Care Workers from Other Countries.

12 Corruption and Informal Payments in Health Systems.

Payment of Informal Fees by Patients and Their Families.

Is Corruption Bad for Your (and Other People's) Health?

References.

Index.