Situations of Choice: Configuring the Empowered Consumer of Hearing Technologies
Abstract
Focusing on the largest and, arguably, the least visible disability group, the hearing impaired, this paper explores present-day views and understandings of hearing impairment and rehabilitation in a Danish context, with particular focus on working-age adults with late onset of hearing impairment. The paper shows how recent changes in perception of the hearing impaired patient relate to the introduction of a new health care reform that turns audiological rehabilitation into a consumer issue. Ethnographic and interview data from hearing clinics provides evidence that the hearing technologies tha...
Source: Health Care Analysis - August 20, 2015 Category: Health Management Source Type: research
Struggling Between Strength and Vulnerability, a Patients’ Counter Story
This article critically questions whether this is a realistic expectation. The paper presents the auto-ethnographic narrative of the first author, which spans a period of 27 years, from 1985 to 2012. In total nine episodes were extracted from various notes, conversations and discussions in an iterative process. Each of these episodes was condensed around a ‘critical moment’ as perceived by the “self”. The critical moments in the illness process vary between newly encountered problems with basic needs and mourning, to renewed strength and the desire to grow, embracing new situations. Being confronted with and livin...
Source: Health Care Analysis - August 20, 2015 Category: Health Management Source Type: research
Ethical Reflections on Genetic Enhancement with the Aim of Enlarging Altruism
Abstract
When it comes to caring about and helping those in need, our imaginations tend to be weak and our motivation tends to be parochial. This is a major moral problem in view of how much unmet need there is in the world and how much material capacity there is to address that need. With this problem in mind, the present paper will focus on genetic means to the enhancement of a moral capacity—a disposition to altruism—and of a cognitive capacity that facilitates use of the moral capacity: the ability to grasp vividly the needs of individuals who are unknown and not present. I will address two...
Source: Health Care Analysis - August 5, 2015 Category: Health Management Source Type: research
Interdependence, Human Rights and Global Health Law
Abstract
The connection between health and human rights continues to play a prominent role within global health law. In particular, a number of theorists rely on the claim that there is a relation of interdependence between health and human rights. The nature and extent of this relation, however, is rarely defined, developed or defended in a conceptually robust way. This paper seeks to explore the source, scope and strength of this putative relation and what role it might play in developing a global health law framework. (Source: Health Care Analysis)
Source: Health Care Analysis - August 3, 2015 Category: Health Management Source Type: research
A Troubled Past? Reassessing Ethics in the History of Tissue Culture
Abstract
Recent books, articles and plays about the ‘immortal’ HeLa cell line have prompted renewed interest in the history of tissue culture methods that were first employed in 1907 and became common experimental tools during the twentieth century. Many of these sources claim tissue cultures like HeLa had a “troubled past” because medical researchers did not seek informed consent before using tissues in research, contravening a long held desire for self-determination on the part of patients and the public. In this article, I argue these claims are unfair and misleading. No professional gui...
Source: Health Care Analysis - August 3, 2015 Category: Health Management Source Type: research
A Progressively Realizable Right to Health and Global Governance
Abstract
A moral right to health or health care is a special instance of a right to fair equality of opportunity. Nation-states generally have the capabilities to specify the entitlements of such a right and to raise the resources needed to satisfy those entitlements. Can these functions be replicated globally, as a global right to health or health care requires? The suggestion that “better global governance” is needed if such a global right is to be claimed requires that these two central capabilities be present. It is unlikely that nation-states would concede these two functions to a form of global ...
Source: Health Care Analysis - August 3, 2015 Category: Health Management Source Type: research
Speaking Out and Being Heard Residents’ Committees in Quebec’s Residential Long-Term Care Centre
Abstract
Residents’ councils in Quebec’s residential and long-term care centres have the mandate to promote the improvement of living conditions for residents, to assess their level of satisfaction, and to defend their rights. Based on two studies on the autonomy of councils, we examined how committees can express themselves on topics other than those the management is already aware of, to reveal various previously unknown aspects of the services, and to voice unexpressed concerns. We are especially interested in what makes management receptive, or not, to what the committee members say. The councils...
Source: Health Care Analysis - July 31, 2015 Category: Health Management Source Type: research
Global Health Justice and the Right to Health
Abstract
This paper reflects on Lawrence Gostin’s Global Health Law. In so doing seeks to contribute to the debate about how global health justice is best conceived and achieved. Gostin’s vision of global health is one which is communal and in which health is directly connected to other justice concerns. Hence the need for health-in-all policies, and the importance of focusing on basic and communal health goods rather than high-tech and individual ones. This paper asks whether this broadly communal vision of global health justice is best served by making the right to health central to the project. It ...
Source: Health Care Analysis - July 20, 2015 Category: Health Management Source Type: research
Ethical Frameworks in Public Health Decision-Making: Defending a Value-Based and Pluralist Approach
Abstract
A number of ethical frameworks have been proposed to support decision-making in public health and the evaluation of public health policy and practice. This is encouraging, since ethical considerations are of paramount importance in health policy. However, these frameworks have various deficiencies, in part because they incorporate substantial ethical positions. In this article, we discuss and criticise a framework developed by James Childress and Ruth Bernheim, which we consider to be the state of the art in the field. Their framework distinguishes aims, such as the promotion of public hea...
Source: Health Care Analysis - July 14, 2015 Category: Health Management Source Type: research
Governing for the Common Good
Abstract
The proper object of global health governance (GHG) should be the common good, ensuring that all people have the opportunity to flourish. A well-organized global society that promotes the common good is to everyone’s advantage. Enabling people to flourish includes enabling their ability to be healthy. Thus, we must assess health governance by its effectiveness in enhancing health capabilities. Current GHG fails to support human flourishing, diminishes health capabilities and thus does not serve the common good. The provincial globalism theory of health governance proposes a Global Health Consti...
Source: Health Care Analysis - June 29, 2015 Category: Health Management Source Type: research
In Search of Global Health Justice: A Need to Reinvigorate Institutions and Make International Law
Abstract
The recent outbreak of Ebola in West Africa has killed thousands of people, including healthcare workers. African responses have been varied and largely ineffective. The WHO and the international community’s belated responses have yet to quell the epidemic. The crisis is characteristic of a failure to properly comply with the International Health Regulations 2005. More generally, it stems from a failure of international health justice as articulated by a range of legal institutions and instruments, and it should prompt us to question the state and direction of approaches to the governance of gl...
Source: Health Care Analysis - June 26, 2015 Category: Health Management Source Type: research
The Principle-Based Method of Practical Ethics
Abstract
This paper is about the methodology of doing practical ethics. There is a variety of methods employed in ethics. One of them is the principle-based approach, which has an established place in ethical reasoning. In everyday life, we often judge the rightness and wrongness of actions by their conformity to principles, and the appeal to principles plays a significant role in practical ethics, too. In this paper, I try to provide a better understanding of the nature of principle-based reasoning. To accomplish this, I show in the first section that these principles can be applied to cases in a meaning...
Source: Health Care Analysis - June 3, 2015 Category: Health Management Source Type: research
Trust and Its Role in the Medical Encounter
We describe three attitudes, here called reliance, specific trust and general trust, each of which is characterised and illustrated. We argue that these attitudes are related, but not reducible, to one another. We suggest that the current impasse in the analysis of trust is in part due to the fact that some writers allude to these distinctions, but unclearly so, whilst others elide them altogether. The second research question focuses on doctor–patient interaction. Trust is often said to be central in medical encounters but this strikes us as too vague. The success of doctor–patient relations in part depends on adoptin...
Source: Health Care Analysis - May 18, 2015 Category: Health Management Source Type: research
Making Markets in Long-Term Care: Or How a Market Can Work by Being Invisible
Abstract
Many Western countries have introduced market principles in healthcare. The newly introduced financial instrument of “care-intensity packages” in the Dutch long-term care sector fit this development since they have some characteristics of a market device. However, policy makers and care providers positioned these instruments as explicitly not belonging to the general trend of marketisation in healthcare. Using a qualitative case study approach, we study the work that the two providers have done to fit these instruments to their organisations and how that enables and legitimatises market devel...
Source: Health Care Analysis - May 7, 2015 Category: Health Management Source Type: research
Evaluating Medico-Legal Decisional Competency Criteria
Abstract
In this paper I get clearer on the considerations that ought to inform the evaluation and development of medico-legal competency criteria—where this is taken to be a question regarding the abilities that ought to be needed for a patient to be found competent in medico-legal contexts. In the “Decisional Competency in Medico-Legal Contexts” section I explore how the question regarding the abilities that ought to be needed for decisional competence is to be interpreted. I begin by considering an interpretation that takes the question to be asking about the abilities needed to satisfy an idea...
Source: Health Care Analysis - April 21, 2015 Category: Health Management Source Type: research
