1. Ethical Issues in Health

2. Ethical Issues in Resources
The ethical issues in developing resources involve health personnel, facilities, drugs and equipment, and knowledge

3. Ethical Issues in Resource Development
Personnel must be diverse enough to permit the consumer some choice of providers. Racial and ethnic diversity in both the training and practice of health professionals are emphasized.

4. Resources Continued
For facilities, the need for equitable access to quality institutions and for fair distribution of health facilities takes priority over individual personal or commercial interests. The financial crisis facing public hospitals throughout the nation poses an ethical problem of major proportions.

5. Resources Continued
With respect to knowledge, public health ethics focuses on the importance of research in assessing health system performance, including equity of access and medical outcomes.
The equity principles that should govern biomedical research involving human subjects are a high priority as well.

6. Economic Support
The ethical principle of justice makes it imperative that everyone in the population have equitable access to health services with dignity.

7. Economic Support Continued
Income inequality, together with limited access to health care, has serious consequences for the poor.
The 1983 President’s Commission for the Study of Ethical Problems in Medicine and Biomedical Research made a strong recommendation that society has an obligation to ensure equitable access to health care for all citizens

8. Organization of Services
Services should be organized and distributed in accordance with health needs and the ability to benefit the population.
In order to be fair and just, a health system must minimize geographic inequity in distributing care and must be culturally relevant to the populations it is designed to serve.

9. Managed Care & Ethics
The development of various forms of managed care raises another set of ethical questions
Conflicting goals of cost-containment and assurance of access to a full range of high quality services

10. Managed Care & Ethics
The question of who decides what is medically necessary
The question of whether individual patients can sue managed care plans and under what circumstances
The ethical dilemma between patient’s interests and profits

11. Ethical Issues in Management of Services
Health administration has ethical consequences that may be overlooked because they appear ethically neutral: organization, staffing, budgeting, supervision, consultation, procurement, logistics, records and reporting, coordination, and evaluation.

12. Ethical Issues in Management
Management of health services involves issues of allocating scarce resources, evaluating scientific evidence, measuring quality of life, and imposing mandates by legislation and regulations.

13. Mechanisms of resolving ethical issues
Ombudsmen
Institutional review boards
Ethics committees
Standards set by professional associations
Practice guidelines
Financing mechanisms
Courts of law