TABLE 15.6.
Individual and Community Rights and Responsibility in Health: Ethical/Legal Issues
| Ethical/Legal Issues | Individual Rights and Responsibilities | Community Rights and Responsibilities |
|---|---|---|
| Sanctity of human life | Right to health care; responsibility for self-care and risk reduction | Responsible for providing feasible basket of services, equitable access for all |
| Individual vs community rights | Immunization for individual protection | Immunization for herd immunity and community protection; education; community may mandate immunization |
| Right to health care | All are entitled to needed emergency, preventive, and curative care | Community right to care regardless of location, age, gender, ethnicity, medical condition, and economic status |
| Personal responsibility | Individual responsible for health behavior, diet, exercise, and non-smoking | Community education to health-promoting lifestyles; avoid “blame the victim” |
| Corporate responsibility | Management accountability to criminal and civil action | Producer, purveyor of health hazard accountable for individual and community damage |
| Provider responsibility | Professional, ethical care and communication with patient | Access to well-organized health care, accredited to accepted standards |
| Personal safety | Protection from individual, family, and community violence | Public safety, law enforcement, protection of women, children, and elderly; safety from terrorism |
| Freedom of choice | Choice of health provider; limitations of gatekeeper functions; control costs while function; right to second opinion; right of appeal | Confidentiality; informed consent; birth control ensuring individual rights; limitations of self-referrals to specialist |
| Euthanasia | Individual’s right to die; limitations by societal, ethical, and legal standards | Assure individual and community interests; prevention of abuse by family or others with conflict of interests |
| Confidentiality | Individual’s right to privacy, limitation of information | Mandatory reporting of specified diseases; data for epidemiological analysis |
| Informed consent | Right to know, risks vs benefits; agree or disagree to treatment or participation in experiment | Helsinki Committee approval of research; regulate fair practice in right to know; Patient’s Bill of Rights |
| Birth control | Right to information and access to birth control and fertility treatment; woman’s rights over her body | Political, religious promotion of fertility; alternatives to abortion; protection of women’s rights to choose |
| Access to health care | Universal access, prepayment; individual contribution through workplace or taxes | Solidarity principle and adequate funding; right to cost containment, limitations on service benefits |
| Regulation and incentives to promote preventive care | Social security for hospital delivery, attendance for prenatal care; primary care, ambulatory care; home care | Incentive grants to assist communities for programs of national interest; limit institutional facilities |
| Global health | Human rights and aspirations; economic development, health, education, and jobs | Transfer of health risks; occupational hazards and environmental damage |
| Rights of minorities | Equality in universal access | Special support for high-needs groups |
| Prisoners’ health | Human rights | Security and human rights; reduce inequalities in sentencing convicts, harsh dangerous conditions in prisons; prohibition of torture and execution |
| Allocation of resources | Lobbying, advocacy for equity and innovation | Equitable distribution of resources; targeting high-risk groups; cost containment |