Bioethics in Healthcare bioethics course.pptx

Buoethics

1. TOPIC 10 HEALTHCARE RESOURCES Assoc. Prof . Dr Maizatul Akma Ibrahim Department of Plant Science, Kulliyyah of Science, IIUM.

2. “Bioethics is the interdisciplinary study of ethical issues arising in the life sciences, health care, and health and science policy .”

3. INTRODUCTION Examples of topic areas that have been the focus of bioethics for a long time are organ donation and transplantation, genetic research, death and dying, and environmental concerns. Bioethics in healthcare brings understanding and knowledge among healthcare professionals about medical practice. Stressing upon the ethical aspects of bioethics, medical professionals are capable of tagging along ethical codes while practicing especially while dealing with issues.

4. INTRODUCTION Because public health actions are often undertaken by governments and are directed at the population level, the principles and values which guide public health can differ from those which guide actions in biology and clinical medicine (bioethics and medical ethics) which are more patient or individual- centered . What is the purpose of ethics in healthcare? Health ethics promotes the consideration of values in the prioritization and justification of actions by health professionals, researchers and policymakers that may impact the health and well-being of patients, families, and communities.

5. The NHS "What it [the community] can and must do is to set aside an agreed proportion of the national revenues for the creation and maintenance of the service it has pledged itself to provide." Bevan A (1976) In place of fear.

6. Big moral considerations in bioethics often revolve around questions about: Whether one ought to act to maximize the best outcomes or ought to act to uphold important moral rules and duties?  Or how to do both? Are we required only not to harm others or must we also act in ways that benefit them or make their lives better? What should be done when we think policies or law are unethical because they don’t treat people fairly or equally? What does it mean to treat people fairly? How could we design access to a scarce resource such that all people have a fair or maybe an equal opportunity to obtain that scarce resource, e.g., organ allocation policies? How and when should we share information about a medical treatment to best permit others make informed and voluntary decisions about what is done or not done to their bodies?  What resources are needed to support people in making these decisions? When can minors make their own health care decisions? Who should decide if a minor child’s opinions about a medical treatment for them differs from that of his/her parent(s )?

7. Some issues about which bioethics concerns itself: Physician patient relationship Death and dying Resource Allocation Assisted reproductive techniques and their use Genetic testing and screening Sexuality and gender Environmental  ethics Clinical research ethics Disability issues Consent, vulnerability, and/or coercion Mental health illness, treatments, and care for patients Ethical treatment of research subjects in clinical trials Ethical treatment of animals

8. Issues in the health care costly denial of care wasteful inefficient - maldistribution overtreatment undertreatment fraud

9. 60.5 million 245 million Uninsured Insured US health insurance coverage : denial Health Insurance Coverage: Early Release of Estimates From the National Health Interview Survey, January— March 2011 by Robin A. Cohen, Ph.D., and Michael E. Martinez, M.P.H., M.H.S.A., Division of Health Interview Statistics, National Center for Health Statistics http://www.cdc.gov/nchs/data/nhis/health_insurance/NCHS_CPS_Comparison092015.pdf

10. Estimated sources of excess costs in US market system of health care 2009 (Total spending at 2009: $2.9 trillion on health care) Unnecessary services $210 billion Inefficiently delivered services $130 billion Excess administrative costs $190 billion Prices that are too high $105 billion Missed prevention opportunity $155 billion Total $790 billion (US Institute of Medicine report, 2012)

11. Insurer Marketing and Profit 11% Insurer Billing 8% Hospital Billing 4% Physician Billing 5% Medical Care Administration 8% Medical Care 64% Source: James G. Kahn et al, The Cost of Health Insurance Administration in California: Estimates for Insurers, Physicians, and Hospitals , Health Affairs, 2005 Allocation of spending for hospital and physician care paid through private insurers

12. Health care fraud in the US: $100 billion a year http://www.justice.gov/criminal- fraud/health- care- fraud- unit

13. US health care Large For profit provider corporations Pub l ic and private payers/ private health insurance User charges: copayments and deductables Known as Accountable Care Organisations (ACOs)

14. Across the world, countries are realising that a free market in healthcare, with people buying and selling medical services like other commodities, will never result in universal health coverage ( UHC ) . In such a system, only the rich will receive adequate coverage and the poor and vulnerable will be excluded. …… Margaret Chan Director General of WHO

15. WHO and the World Bank Group: joint statement 2015 Universal health care “is a critical component of the new Sustainable Development Goals (SDGs)” Target 3.8 “Achieve […] access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”.

16. Long Term Care From Public Health needs to Market