Written from the perspective of philosophy of liberation, this essay holds that the reform of basic human relationships and their cultural instantiation(s) is central to all serious societal change. The essay analyzes naive, mythological, and critical consciousness. It examines how these modes of consciousness are embodied in the health delivery system and then describes areas where practitioners and patients of critical consciousness might work for greater humanization of health care.

Joseph Boyle; Catholic Health Care Institutions and the Modern Health Delivery System, Christian bioethics: Non-Ecumenical Studies in Medical Morality, Volume 5.

Livestock is one of the growth sectors in the rural economy. In the third world the provision of livestock services for smallholders has generally been in the hands of the governments, leading to erratic, insufficient, and unreliable delivery systems. Especially in cases where the benefits of services accrue to the owners of the animals, privatization of some of the animal services may improve the delivery system. In order to explore the impact of such a private system, a group (...) of sheep farmers in North Sumatra, Indonesia, were organized in an Animal Health Delivery Network (AHDN). The experience with AHDN indicates that the scope of private sector involvement is promising. Farmers were able to recognize the benefits and willing to pay for the drugs. However, they seem to be reluctant to apply the drugs themselves, thereby relying on the help of extension agents and traders. Selling drugs via poultry shops to farmers was not successful because drug wholesaler firms do not make their products available in small quantities. The study confirmed that the role of Government and private sector in the delivery of livestock services needs to be redefined. (shrink)

Animal health is key to successful livestock production in developing countries. The development and delivery of vaccines against major epidemic diseases is one component of improving animal health. This paper presents a case study from Kenya on the production and delivery of a vaccine against Contagious Caprine Pleuropneumonia (CCPP), a major disease of goats. The vaccine, while technically a viable preventative measure against CCPP, has not been well integrated into Kenya's animal health care system. From (...) February through November, 1992, the authors explored the organizational and policy constraints to vaccine production and distribution. Data were obtained through interviews, field visits, and available documents. Results suggest an animal health system that 1) does not have a well developed infrastructure to track, identify, and control animal diseases; 2) tends to place greater emphasis on cattle, rather than small ruminant health care; and 3) is not well linked in terms of research, development, and extension services. (shrink)

In this article, I will argue that the delivery of healthcare could be an act of resistance, that is, day‐to‐day, routine and perhaps mundane acts, undertaken in the course of the delivery of health services, which for many could also be considered otherwise routine care. I first consider how resistance has been conceptualised. How we understand resistance will determine if we believe healthcare could be conceptualised this way. I will show how resistance has been applied to day‐to‐day (...) struggles elsewhere and argue that it can clearly encompass open, collective dissent and more subtle, day‐to‐day action that does not necessarily make clear political demands. I go on to introduce some examples, where the delivery of health services could be conceptualised as resistance. While I advocate for a broad understanding of resistance, clearly not every act could be considered resistance; I will consider some points of tension and contention in utilising resistance to describe the delivery of health services, in particular discussing the issue of intent and opposition as they relate to resistance. Finally, while I hope that I make a convincing case, one final issue remains, namely, why turn to resistance at all, when many of the examples that I provide could be labelled using concepts that are more widely utilised. I will offer some general reflections on this point, speaking to the benefits and potential of resistance. (shrink)

Partially because of the high cost of developing and maintaining cold chains, systems needed to keep heat-labile vaccines under adequate refrigeration from their points of manufacture to their administration in the field, the Joint WHO/FAO Expert Committee on Zoonoses (i.e., the approximately four fifths of all described human infections that people share with other vertebrate animals) recommended in 1982 operation of common cold chains by health and veterinary services in rural areas. Following this recommendation, a 1984 pilot level initiative (...) in medical-veterinary intersectoral cooperation should be regarded as a practical way to deliver human primary health care to currently neglected African pastoralists, and as a potential core program for development efforts overall within arid and semiarid areas of the African continent. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the wealthy. After (...) exploring specific discrepancies in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)

The classic formulation of situation ethics in the 1960s was the result of the contention that the deductive application of general rules and principles in ethics was inherently flawed by the uniqueness of every situation. Quite often, ethical problems are problems precisely because existing rules do not apply four square to the singular situation at hand. There is a need, the argument ran, to assert the primacy of the special situation and to formulate a resolution of the unsettling circumstances appropriately (...) attuned to it. Situation ethics is, in a sense, a moral theory equivalent to case law in a legal system devoid of rule by law. (shrink)

Reason and Rationality in Health and Human Services Delivery is the first book to discuss the topic of decisionmaking and services from a multidisciplinary approach. It uses theory and social considerations, not just technology, as a basis for improved services. Health and human service students and professionals will learn how to form rational and reasonable decisions that take their clients'cultural backgrounds into consideration when identifying an illness or appropriating any kind of intervention. With a particular emphasis on (...) theories, models, organizational settings, technologies, and practitioner training methods that lead to culturally sensitive decisions, Reason and Rationality will help you deliver efficient and improved medical and social services to clients from all ethnic backgrounds. Recognizing reason as the centerpiece of most of Western philosophy, this text reveals how our idea of truth, fact, and order are wrongly thought to be universal; yet, Western principles are continually used in the decision-making process for health and social services. Focusing on the policy implications of decisionmaking in medical and social service settings, this text works to incorporate a broad range of factors into the reasoning process, such as cultural traditions and beliefs, that will result in better treatment for patients. Giving you suggestions and strategies for upgrading reasoning and decision-making processes and applying them to every area of service, Reason and Rationality discusses different themes that will help you improve services to patients, such as: the rationale currently used to justify decision-making strategies concerning medical and human services using computer technology to make clinical assessments revising administrative structure, management theories, and organizational strategies so that decision-making processes enhance the overall quality of service delivery how the practitioner/patient relationship is important in choosing the proper treatment soliciting community-based input to assess the public's health and human service needs in order to lessen political involvement in decision-making stages In addition, Reason and Rationality provides information and examples that show why you should consider the "life-world"--the values, beliefs, and commitments of a culture's history-- as the key to understanding the powers of reasoning that specify parameters of health and illness. (shrink)

With the promotion of the Internet of Things technology, more and more industries have begun to combine with the Internet of Things technology. After joining the WTO, China’s market economy has continued to deepen. During this period, the e-commerce industry has developed rapidly, which has promoted the rise of the express delivery industry. While the rise of the industry provides jobs for employees, it also brings enormous pressure to employees. Due to the occupational stress of various stressors in the (...) express delivery industry, a series of psychological problems have been caused. “Occupational stress” is also called occupational stress, which refers to the physiological and psychological stress caused by the imbalance between objective needs and personal adaptability in a certain occupational environment. The purpose of this paper is to conduct a correlation study on the psychological health of express delivery workers’ occupational stress in the information logistics environment. It is expected to explore the relationship between occupational stress and mental health of couriers in the context of informatization, so as to provide employees with a better working environment and reduce personal stress. Logistics informatization means that logistics enterprises use modern information technology to collect, classify, transmit, summarize, identify, track, and query all or part of the information generated in the logistics process, so as to realize the control of the flow of goods. This paper analyzed the inventory of express companies, and reasonably analyzed the profit composition of the inventory link, then used a more reasonable time series seasonal coefficient method to predict the amount of incoming shipments. This paper used a combination of theoretical and empirical methods to discuss the psychological health and occupational stress of express delivery workers and to explore the relationship between the two. The experiment results of this paper showed that in the interpersonal sensitivity analysis, the coefficient of occupational stress is 0.052, and the degree of occupational stress is proportional to interpersonal sensitivity. The higher the occupational stress, the higher the interpersonal sensitivity index. The coefficient of occupational stress is-0.31. Occupational stress is inversely proportional to age. The older the age, the lower the interpersonal sensitivity index. (shrink)

Many health care organizations made public commitments to become antiracist in the wake of George Floyd's murder. These actions raise questions about the appropriateness of health care's engagement in racial justice and social justice movements generally. We argue that health care organizations can be usefully thought of as having two roles: a functional role to care for the sick and a meta‐role as an organizational citizen. Fulfilling the role of citizen may require participating in the pursuit of (...) social justice, including efforts to achieve racial equity. The demands of these two roles will need to be balanced, but the role of organizational citizen has been largely ignored and merits serious attention. (shrink)

The unprecedented outbreak of the novel coronavirus has led to a great shift toward online retailing and accelerated the need for contactless delivery. This study investigates how technological and health belief factors influence consumer acceptance of autonomous delivery robots. Anchored in four behavioral theories [i.e., technology acceptance model, health belief model, perceived value theory and trust theory], a synthesized model is developed. A total of 500 valid responses were collected through an online questionnaire in Singapore, and (...) structural equation modeling was conducted to examine the responses. The results revealed that perceived ease of use, perceived usefulness, perceived susceptibility, perceived severity, self-efficacy and cues to action have a positive and significant influence on consumers’ perceptions of the value of ADRs. The total effect analysis also showed that perceived VAL strongly affects consumer acceptance of ADRs. Academically, this study introduces both technological and health belief factors to explain consumer acceptance of ADRs. It also provides recommendations for policymakers and autonomous delivery robot developers on policy formulation, public communication, product design and infrastructure development. (shrink)

Background The convergence of neuroscience, genomics, and data science holds promise to unveil the neurobiology of psychosis and to produce new ways of preventing, diagnosing, and treating psychotic illness. Yet, moral challenges arise in neurobiological research and in the clinical translation of research findings. This article investigates the views of relevant actors in mental health on the moral challenges of accessing neurobiological information in the context of psychosis. Methods Semi-structured individual interviews with two groups: researchers employed in the National (...) Health Service (NHS) or a university in England (n = 14), and mental health professionals employed in NHS mental health services (n = 14). This article compares results in the two groups (total n = 28). Results This article presents findings around three conceptual areas: (1) research ethics as mostly unproblematic, (2) psychosis, neurobiological information, and mental health care, and (3) identity, relationships, and the future. These areas are drawn from the themes and topics that emerged in the interviews across the two groups of participants. Researchers and health professionals provided similar accounts of the moral challenges of accessing—which includes acquisition, communication, and use of—neurobiological information in the context of psychosis. Acquiring neurobiological information was perceived as mostly unproblematic, provided ethical safeguards are put in place. Conversely, participants argued that substantive moral challenges arise from how neurobiological information is delivered—that is, communicated and used—in research and in clinical care. Neurobiological information was seen as a powerful tool in the process through which individuals define their identity and establish personal and clinical goals. The pervasiveness of this narrative tool may influence researchers and health professionals’ perception of ethical principles and moral obligations. Conclusions This study suggests that the moral challenges that arise from accessing neurobiological information in the context of psychosis go beyond traditional research and clinical ethics concerns. Reflecting on how accessing neurobiological information can influence individual self-narratives will be vital to ensure the ethical translation of neuroscience and genomics into mental health. Trial registration The study did not involve a health care intervention on human participants. It was retrospectively registered on 11 July 2018, registration number: researchregistry4255. (shrink)

Cochran has argued that Catholic health care occupies a “unique place on the border of public and private life”. Catholic health care is accountable to both its religious and sacramental traditions and its public responsibilities. It is inevitable that “border skirmishes” will arise. Yet there is no single formula for suggesting what public-private collaboration should comprise or how conflicts between values ought to be resolved. It may be, as Cochran suggests, that increasingly bitter conflicts over widely valued services (...) such as sterilization, combined with market pressures to conform to for-profit trends in health care, will make divestiture of faith-based hospitals in favor of other types of church-community partnerships the best course for the future. (shrink)

Controversy exists over how to ethically distribute health care resources and which factors should determine access to health care services. Although the US has traditionally used a market-based private insurance model that does not ensure universal coverage, the Patient Protection and Affordable Care Act in the United States aims to increase equitable access to health care by increasing the accessibility, affordability, and quality of health care services. This article evaluates the impact of the ACA on equitable (...) mental health care delivery according to access factors that can hinder or facilitate the delivery of mental health services based on need. The ACA has successfully expanded coverage to millions of Americans and promoted coordination and access to mental health care; however, financial and non-financial access barriers to mental health care and access disparities remain. Reform efforts should not undervalue the gains that the ACA has made but should attempt to balance considerations of cost and increasing free-market mechanisms with decreasing remaining health care disparities. (shrink)

Undisputedly, the United States’ health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty‐five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about (...) the balance of benefits and burdens associated with these advances. Every day on every shift, nurses at the bedside feel an intense array of ethical issues. At the same time, administrators, policy‐makers, and regulators struggle to balance commitments to patients, families, staff members, and governing boards. Ethical responsibilities and the fiduciary, regulatory, and community service goals of health care institutions are not mutually exclusive; they must go hand in hand. If they do not, our health care system will continue to lose valued professionals to moral distress, risk breaking the public's trust, and potentially undermine patient care. At this critical juncture in health care, we must look to new models, tools, and skills to confront contemporary ethical issues that impact clinical practice. The antidote to the current reality is to create a new health care paradigm grounded in compassion and sustained by a culture of ethical practice. (shrink)

Within a given culture – whether industrialized or more tradition oriented – essentially the same fundamental medical theories, practices, and pharmacopoeia tend to be applied to human and non-human sickness and patients. In modern industrialized societies, however, healthcare services are sharply divided between human and veterinary medicine. There is likewise a sharp division between practitioners in these two health sectors: medical doctors and veterinarians. Yet in non-Western, traditional or indigenous medical systems, the same practitioners often treat both humans and (...) animals. There is a growing body of literature that attests to the efficacy of traditional health practices and herbal medicines for the prevention and treatment of both human and livestock ailments.The authors argue for an intersectoral approach to human and veterinary health services in poor countries, especially those targeted to rural people with LIMITED access to modern health services. Extension of conventional medical and veterinary services is particularly difficult and costly in Third World countries where the necessary infrastructure (roads, clinics, labs, cold chains, etc.) is poorly developed and where much of the populace and their livestock reside in remote, rural areas, or where people may be nomadic or transhumant. Consideration should therefore be given to the joint delivery of human and livestock healthcare and related services, as well as to linking informal, ethnoveterinary practices and practitioners with more formalized systems of veterinary AND medical practice. Several advantages of such an approach are identified and explored. (shrink)

Task shifting is increasingly used to address human resource shortages impacting HIV service delivery in low- and middle-income countries. By shifting basic tasks from higher- to lower-trained cadres, such as Community Health Workers, task shifting can reduce overhead costs, improve community outreach, and provide efficient scale-up of essential treatments like antiretroviral therapies. Although there is rich evidence outlining positive outcomes that CHWs bring into HIV programs, important questions remain over their place in service delivery. These challenges often (...) reflect concerns over whether CHWs can mitigate HIV through a means that does not overlook the ethical and practical constraints that undergird their work. Ethical and practical guidance thus needs to become the cornerstone of CHW deployment. This paper analyzes such challenges through the lens of Ethical Principlism. We examined papers identifying substantive and ethical challenges impacting CHWs as they provide HIV services in low- and middle-income contexts. To do this, we analyzed papers written in English and published from year 2000 or later. These articles were identified using MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar databases. In total, 465 articles were identified, 78 of which met our inclusion criteria. Article reference lists and grey literature were also examined. CHWs experience specific challenges while carrying out their duties, such as conducting emotionally- and physically-demanding tasks with often inadequate training, supervision and compensation. CHWs have also been poorly integrated into health systems, which not only impacts quality of care, but can hinder their prospects for promotion and lead to CHW disempowerment. As we argue, these challenges can be addressed if a set of ethical principles is prioritized, which specifically entail the principles of respect for persons, justice, beneficence, proportionality and cultural humility. CHWs play a crucial role in HIV service delivery, yet the ethical challenges that can accompany their work cannot be overlooked. By prioritizing ethical principles, policymakers and program implementers can better ensure that CHWs are combatting HIV through a means that does not exploit or take their critical role within service delivery for granted. (shrink)

: Widespread collection and use of identifiable information can promote social goods while, at the same time, infringing on personal privacy. Information systems are developing within the context of a fundamental transformation in the organization, delivery, and financing of health care. Changes in the health care system include rapid development of employer-sponsored health coverage, managed care organizations, and integrated delivery systems. These complex, multifaceted arrangements for delivering and paying for health care require ever-more-sophisticated information (...) systems that facilitate extensive sharing of personal data. Systemic flows of sensitive health information occur both vertically and horizontally among employers, hospitals, insurers, laboratories, and suppliers. Beyond this complex web of vertical and horizontal sharing are the multiple demands for information management, quality assurance, research, governmental regulation, and public health. Theoretical problems exist with the law and ethics of informational privacy. The traditional method of exercising control over personal health information is through informed consent. Informed consent, however, within a modern health information infrastructure becomes highly complex. In this kind of environment, the doctrine of informed consent is flawed and does not provide sufficient control over personal information to assure adequate protection of privacy. (shrink)

Chloroquine-resistant plasmodium falciparum malaria is a serious public health threat that is spreading rapidly across Sub-Saharan Africa. It affects over three quarters (80%) of malarial endemic countries. Of the estimated 300-500 million cases of malaria reported annually, the vast majority of malarial-related morbidities occur among young children in Africa, especially those concentrated in the remote rural areas with inadequate access to appropriate health care services. In Liberia, in vivo studies conducted between 1993 and 2000 observed varying degrees of (...) plasmodium falciparum malaria infections that were resistant to chloroquine, including sulfadiazine-pyrimethamine. As the country emerges from a prolonged civil war, the health care delivery system may not be adequately prepared to implement an effective nation-wide malarial control strategy. As a result, the management of uncomplicated malaria in Liberia poses a significant public health challenge for the government-financed health care delivery system. Therefore, based on extensive literature review, we report the failure of chloroquine as an effective first-line drug for the treatment of uncomplicated plasmodium falciparum malaria in Liberia and recommend that national health efforts be directed at identifying alternative drug(s) to replace it. (shrink)

A considerable section of the population in India accesses the services of individual private medical practitioners (PMPs) for primary level care. In rural areas, these providers include MBBS doctors, practitioners of alternative systems of medicine, herbalists, indigenous and folk practitioners, compounders and others. This paper describes the profile, knowledge and some practices of the rural doctor in India and then discusses the reasons for lack of equity in health care access in rural areas and possible solutions to the problem.

My aims has been to approach the debate about health service priorities from the perspective of political philosophy, but to keep the discussion firmly anchored in comtemporary problems of health care provision. The chapters are designed to provide the groundwork for anyone interested in the ethical problems in modern health care. I have used examples of health care delivery in Britain, the USA, the USSR, and the People's Republic of China to illustrate different aspects of (...) the problem of priorities. The issues can be summarised under three broad headings: Distribution, effectiveness, and authority to make decisions. (shrink)

Diabetes is a chronic and systemic disease that has reached epidemic proportions. An estimated 17 million Americans have diabetes, and an additional 16 million individuals are considered to have pre-diabetes. Studies have shown that timely screening and referral are necessary to maintain healthy blood glucose levels and slow the progression of diabetes-related complications. Furthermore, lifestyle changes can prevent or delay the onset of Type 2 diabetes for high-risk individuals.The Division of Diabetes Translation at the Centers for Disease Control and Prevention (...) undertook an analysis of diabetes-related legislation across the nation. More specifically, state laws, rules and regulations mandating health insurance coverage for diabetes-related supplies and services were examined according to Sample Purchasing Specifications for Services Related to Diabetes—an evidence-based model of standards of care for persons with diabetes. (shrink)

A significant number of inmates with mental illness reside within the New York State Department of Corrections (NYSDOCS). New York State has taken the initiative to provide mentally ill inmates with necessary services through a collaboration of the New York State Department of Correctional Services and the New York State Office of Mental Health (NYSOMH). The collaboration results in a mental health delivery system that provides many essential services to mentally ill inmates. This paper focuses on the (...) organization of mental health services within NYSDOCS, best practices, past and current litigation, and staff responsibilities. As the population of mentally ill inmates continues to grow, implications for the Human Services professions of OMH and DOCS needs to continue to address and provide adequate mental health care and resources for this special population. (shrink)

Christians have considered the care of the sick to be a form of ministry ever since the time of Jesus. As Christians prepare to commemorate the second millenium of the birth of the founder of their religion, they cannot help but notice that health care is changing more than it ever has in the last 2,000 years. Nor can they help but notice that these changes threaten the notion that health care can be practiced as a genuine ministry (...) in the twenty-first century. (shrink)

This paper was first presented at the Annual Meeting of the American Society of Christian Ethics, Toronto School of Theology, Toronto, Ontario in January 1977. Robert Shelton aims to focus on the concept of 'right to health care,' its related principle, 'distributive justice' in an attempt to suggest 'where we are' at present and where we perhaps ought to be heading. The paper is divided into three parts, which in their turn explore the moral grounds, the US general public's (...) policy and the part justice and government are likely to play in the development and distribution of health care. He concludes by highlighting 'omissions', an intentional one of his own and the other a major gap in the literature. (shrink)

Health researchers working in low-resource settings routinely encounter serious unmet health needs for which research participants have, at best, limited treatment options through the local health system (Taylor, Merritt, and Mullany 2011). A recent case discussion features a study conducted in Bamako, Mali (Dickert and Wendler 2009). The study objective was to see whether children with severe malaria develop pulmonary hypertension in order to improve the general understanding of morbidity and mortality associated with malaria. In the study (...) team's interactions with participating children, they encountered not only malaria but also "eye infections, upper respiratory tract illnesses, rashes, pericardial effusions," .. (shrink)

Using data from the National Hospital Discharge Survey, this paper analyzes the effect of Medicaid eligibility expansions from 1985 to 1996 on the health insurance coverage of women giving birth. We find that the eligibility expansions reduced the proportion of pregnant women who were uninsured by approximately 10%, although the magnitude of this decrease is sensitive to specification. The decrease in the proportion of uninsured pregnant women came at the expense of a substantial reduction in private insurance coverage (crowd-out) (...) of at least 55%. Substantial crowd-out and the relatively small change in the proportion uninsured suggest that Medicaid eligibility expansions may have had small effects on infant and maternal health. (shrink)

Not all actions that are legal are necessarily morally correct. However, there are few protections for providers who are pressured to comply with actions and procedures that infringe on their religious beliefs regarding human dignity. The right of health care providers to freely act on religious convictions and refrain from cooperating with morally reprehensible tasks is often eschewed in favor of political correctness or is branded as discrimination. Adequate safeguards are urgently needed for health care workers at all (...) levels to ensure that they can continue to care for the sick and most vulnerable members of the community without violating the dictates of their conscience. This article examines the free exercise of religion as it pertains to medical provider conscience protections. The author argues for conscience protection legislation with a right of action. (shrink)

Background: Context: Digital health interventions have become essential instruments in contemporary medicine, providing viable means of improving patient outcomes and healthcare provision. The goal of this study is to examine the impact, difficulties, and potential future directions of digital health interventions across a range of healthcare situations by synthesizing results from 12 carefully chosen studies. Aim: This study's objective is to thoroughly examine and summarize the body of research on digital health interventions, with an emphasis on acceptance (...) and utilization as well as implementation and efficacy. Method: Twelve pertinent papers published between 2016 and 2024 were found after a thorough search of electronic databases. Numerous digital health interventions were covered by these research, such as remote monitoring systems, telemedicine, and mobile applications. In order to find common themes, sub-themes, and patterns among the chosen research, thematic analysis was used in the data synthesis process. Results: A number of important themes emerged from the thematic analysis, including interoperability problems, patient engagement, healthcare provider acceptability, regulatory concerns, and usability issues. The sub-themes that fell under these categories emphasized the variables that affect the uptake and efficacy of digital health interventions. Conclusion: The synthesis of data emphasizes how digital health initiatives can increase clinical results, improve patient care, and streamline the delivery of healthcare. But in order to fully reap the benefits, major obstacles like interoperability problems, regulatory difficulties, and usability impediments need to be solved. The recommendations put forth aim to promote innovation and evidence-based practice in digital health by stressing user-centered design, improving digital literacy among medical practitioners, and encouraging interdisciplinary collaboration. (shrink)

This paper aims to provide an argument for saying that a publicly funded health care system, available to all free at the point of delivery, is morally superior to a market system, and to provide a framework for deciding questions about which forms of health care should be included in such a public system. The argument presents health care as a ‘head’, in the sense of something to which human beings are morally entitled as a necessary (...) condition for a life worthy of human dignity. Alternative arguments for similar conclusions, proposed by Daniels and Buchanan, are critically examined and rejected. (shrink)

Ethics consultation has become an integral part of the fabric of U.S. health care delivery. This article summarizes the second edition of the Core Competencies for Health Care Ethics Consultation report of the American Society for Bioethics and Humanities. The core knowledge and skills competencies identified in the first edition of Core Competencies have been adopted by various ethics consultation services and education programs, providing evidence of their endorsement as health care ethics consultation (HCEC) standards. This (...) revised report was prompted by thinking in the field that has evolved since the original report. Patients, family members, and health care providers who encounter ethical questions or concerns that ethics consultants could help address deserve access to efficient, effective, and accountable HCEC services. All individuals providing such services should be held to the standards of competence and quality described in the revised report. (shrink)