Question

Case Study: Global Healthcare Public Policy Imagine that in the near future, the global community has been wracked by successive crises including economic upheaval, severe food and water shortages, and attacks on human dignity. In response, nationwide grassroots movements of young people have elected members of congress and parliament who support restoring leadership throughout the world in the areas of health, freedom, and human rights. Groundswells invoking liberty and justice are sweeping Europe, Africa, South America, Oceania, and the United States. Prompted by this worldwide atmosphere of new hope, the United Nations is convening a World Congress of Present and Future Human Flourishing. Conference sessions will focus on the right to healthcare, health disparities/health inequities, emerging infectious diseases, food and water security, and mechanisms for global environmental and climate governance.

Ethical Analysis

1. Discuss the role of the principles of biomedical ethics in helping to establish a robust global healthcare community capable of providing services to all those in need.

2.Analyze the persistence of global undernutrition and poverty from the perspective of the biomedical ethical principles of autonomy and justice. Describe two global public policy solutions to meaningfully influence these social determinants of health.

3. Analyze the importance of helping to ensure optimal maternal and newborn health from the perspective of the biomedical ethical principles of autonomy and justice. Describe two global public policy solutions to meaningfully impact these social determinants of health.

Answer 1

1.

Nursing, as a profession

, has been, traditionally, a profession of the nurturing of, as well as the caring for, the patient. Until the latter part of the 20th century,

nursing was also, historically, a profession for women. It should come as no surprise, then, that an “ethics of care” approach to moral decision-making would be embraced by nurses, as well as by women in other health care professions, up to, and including, the profession of medical doctors. .

In the early 21st century, this approach to patient care in medical facilities, as well as in allied health care facilities, became almost mainstream in many societies across the globe, with accrediting agencies offering their respective “seals of approval” for those medical organizations that are successful in treating patients holistically..

. It should go without saying that many are the health care professionals who would choose to nurture, and to care for, their own patients in this same way, with or without the existence of any such accrediting agencies

3. Ethical Principles

In addition to the application of a variety of methods of moral decision-making to the practice of health care, ethical principles are also so applicable, but not procedurally in the same way as in the method of moral decision-making identified above as principlism.

As concerning normative ethical theories, in particular, regardless of the particular method of moral decision-making and its moral standard for action that one might choose to apply to moral decision-making situations, and even in the absence of any such theory or standard being applied in the day-to-day practice of professionals in the field of health care, ethical principles serve to guide one’s actions in moral decision-making situations by identifying those important and relevant considerations that must be taken into account in order for one to be able to think about such situations in a serious way.

In other words, ethical principles operate on a different level of moral decision-making than do normative ethical theories or other methods of moral decision-making; nonetheless, ethical principles, like normative ethical theories and these other methods of moral decision-making, are prescriptive, that is,

they offer recommendations for moral action. In theory, ethical principles can be used as one measure of how effective normative ethical theories are in their application to moral decision-making situations.

..For, any proposed normative ethical theory that is incapable of accommodating the requirements of the most fundamental ethical principles can be called into question on that very basis.

2.

Global action towards health in all policies

Following the WHO Commission on Social Determinants of Health, the Rio Political Declaration on Social Determinants of Health was adopted by 125 member states during the WHO World Conference on SDH on 21 October 2011.

The declaration expresses global political commitment for the implementation of a SDH approach to reduce health inequities and to achieve other global priorities.

The rationale was that it would help to build momentum within countries for the development of dedicated national action plans and strategies.8

In 2011, the United Nations (UN) General Assembly also adopted the Political Declaration on the Prevention and Control of Non-communicable Diseases9 calling for the development of multisectoral approaches to health at all government levels and to address the underlying determinants of health.I

May 2012, the 65thWorld Health Association then endorsed the Rio declaration and its recommendations.

It approved measures to support the five priority actions recommended in the declaration to address social determinants of health.T

he 2010 WHO Adelaide Statement on Health in All Policies (HiAP) paved the way for global recognition of the need for cross-sectoral action as well as considering health in wider policies in order to improve health outcomes and equity.

HiAP is a policy strategy, which targets the key social determinants of health through integrated policy response across relevant policy areas with the ultimate goal of supporting health equity.

HiAP is thus closely related to concepts such as ‘intersectoral action for health’, ‘healthy public policy’ and ‘whole-of-government approach’.

The HiAP approach is being advocated in several countries and in June 2013 the WHO eighth Global Conference on Health Promotion was dedicated to HiAP