Health Policy and Ethics

This book demonstrates the utility of healthcare law, policy and professional standards in analysing the ethical issues that arise in the provision of health services. Rejecting moral absolutes, its examination of health law, policy and professional standards and of how societies codify beliefs is pertinent to ethical analysis - and also offers the possibility of practical solutions to healthcare challenges across the globe. Comparing and contrasting ethical and policy issues from countries around the world (with a focus on Asia, Europe and the USA), this book addresses such issues as conflict of interest, the balance between healthcare quality and cost, and the effect of geography and demographics on access to healthcare. Critique and discussion are tempered with suggestions for the evaluation of policy and systems; its pragmatic approach suggests how theory can and should inform practice. Health Policy and Ethics offers refreshing reading for professionals and academics in healthcare, medical ethics and policy. Researchers and students with an interest in healthcare delivery, comparative healthcare policy analysis, and health and human rights will also find much of interest. 'This book offers an unusual and welcome perspective on the rights and wrongs of health policy, with comparisons across space and time, from China to Italy, from Malaysia to India, from pharmaceutical ethics to the overarching topic of rationing.' Theodore Marmor, Professor Emeritus, Yale University School of Management Ethical analysis in this domain is not easy, as things held sacred will at times conflict, and of course within a given society there will be variability in values and priorities between individuals and over time. The anticipated difficulties serve to further emphasize that the ongoing ethical analysis should include input from those with experience and skill at that task. This book successfully demonstrates that point. In addition, Health Policy and Ethics is a welcome bridge between these two fields, and a very worthwhile read for individuals whose primary interest lies in either one. - From the Foreword by Mark R. Mercurio

Roger Worthington, Robert Rohrbaugh

PART ONE Background; outline summaries. Why ethics and health policy. Rationale; law versus ethics; jurisprudence; justice and patient-centred care. Health policy and rationing: In search of reason. Frameworks; transparency; national versus regional or local; NICE roles; the influence of common law; alternative approaches to rationing; conclusion; a hypothetical example. Policy success and failure: Causes, remedies and methods of analysis. Patient care; policy contradictions; public versus private; transparency and democratic principles; human error and questions of probity; turning negatives into positives; summary; international comparative policy analysis. PART TWO Ancient origins and modern approaches to healthcare delivery in China. Medical ethics, policy and healthcare delivery in China. Accessing psychiatric treatment in China. Medicine, ethics and professionalism in modern India. Health and social policy trends in Malaysia. Pharmaceutical industry, medicine and questions of ethics. Industry and the physician-investigator in the USA. Postgraduate medical education in the USA. Geneva to Guantanamo and the ethics of military interrogation. Risk and shared decision-making: questions of medical practice and social policy in the UK. Italian policy and the ethics of ECT. PART THREE Comparative analysis and future healthcare decision-making. Changing healthcare systems; professional standards in a cross-cultural context; the legal and regulatory environment. conflicts of interest; integrating public opinion into risk assessment strategies; summary.