Biobank research and the right to privacy

What is privacy? What does privacy mean in relation to biobanking, in what way do the participants have an interest in privacy, (why) is there a right to privacy, and how should the privacy issue be regulated when it comes to biobank research? A relational view of privacy is argued for in this article, which takes as its basis a general discussion of several concepts of privacy and attempts at grounding privacy rights. In promoting and protecting the rights that participants in biobank research might have to privacy, it is argued that their interests should be related to the specific context of the provision and reception of health care that participation in biobank research is connected with. Rather than just granting participants an exclusive right to or ownership of their health information, which must be waived in order to make biobank research possible, the privacy aspect of health information should be viewed in light of the moral rights and duties that accompany any involvement in a research based system of health services.     

Health (care) and human rights: a fundamental conditions approach

Many international declarations state that human beings have a human right to health care. However, is there a human right to health care? What grounds this right, and who has the corresponding duties to promote this right? Elsewhere, I have argued that human beings have human rights to the fundamental conditions for pursuing a good life. Drawing on this fundamental conditions approach of human rights, I offer a novel way of grounding a human right to health care.     

A Code of Ethics for Health Care Ethics Consultants: Journey to the Present and Implications for the Field

For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.     

Inpatient Standards of Care and the Suicidal Patient Part II: An Integration with Clinical Risk Management

The authors elaborate on the standards of care for the assessment, management, and treatment of hospitalized suicidal patients. The authors attempt to synthesize the concepts of the minimal standard of care with clinical risk management and clinical judgment. They point out the areas of overlap and where optimum care diverges from legal standards of care. Case examples are provided to illustrate major areas of concern. Alleged failures of omission and commission are discussed. Tables are provided that differentiate duties and responsibilities between and among clinicians, hospital staff, and hospital administration.     

Common future and personal responsibilities: A comparison between Italian and Burundian students

The political, social, and cultural history of a nation modulates the representations of rights and duties. The aim of this research is to compare students from two countries (Italy and Burundi) in terms of how they define their rights and duties. In the two countries, there are differences both in the legal protection of fundamental rights and in regard to material conditions, which in turn ensure the effectiveness of rights. Focus groups structured around nine questions were conducted in Burundi and in Italy. The discussions with Italian and Burundian students showed some clear differences. Although both groups speak of rights as something to be safeguarded and something that everyone is born with, Italian students do not recognize the complementarity of rights and duties and consider the latter simply as a limit and an obstacle to individual enhancement. On the contrary, Burundian adolescents seem more aware of their personal responsibilities and their role in protecting human rights.     

The Religious and Social Principles of Patients’ Rights in Holy Books (Avesta, Torah, Bible, and Quran) and in Traditional Medicine

Health protection and promotion in healthy people and restoring patients’ health have been the most important themes in medicine and health throughout our history. Therefore, discussion of different aspects of patients’ rights includes implementation of these objectives by the medical community, including physicians, nurses, pharmacists, etc., and the people in charge of health affairs. The principal objective of our research is the study of medical ideology and the approaches of our ancestors in relation to different aspects of patients’ rights. To study the different ideologies of traditional medicine in relation to patients’ rights, appropriate data were extracted from the original resources of traditional medicine and from religious books. By means of library research we studied these resources in addition to electronic versions of the Alhavi book (by Rhazes), the Kamel-al-Sanaah (by Ahvazi), the Canon of Medicine (by Avicenna), the Zakhireye Khawrazmshahi (by Jorjani), the Avesta, the Torah, the Bible, the Quran, and many other resources, and, finally, after searching, gathering, and encoding the findings, analyzed them qualitatively for thematic content. The holy Avesta book clearly insists on the competence of physicians and setting the appointment fee in accordance with peoples’ income. The Old Testament (holy Torah) warned government officials who did not observe patients’ rights. In the four gospels (holy Bible) the importance of treatment and taking care of the patient is stressed. After the emergence of Islam, medical students, before beginning the principal courses, had to study Islamic jurisprudence, ethics, logic sciences, natural sciences, geometry, astrology, calculus, and similar courses so that after purifying their soul they could enter the saintly profession of physicians. The holy Quran refers to saving the life of a human irrespective of social class, race, and religion, and insists on exemption of patients from physical activity, including the physical aspects of prayer. In these resources, some warnings are offered in relation to fake drugs, the lack of awareness of some physicians, the need for complete preparedness of medical society, and the need to manufacture appropriate drugs and offer a suitable medical service. This information is to familiarize medical and health authorities and persons receiving health services. According to the evidence available about traditional medicine, there was no specific difference between public and professional ethics, public and professional rights, or rights and ethics—ethics were no different from rights nor rights from ethics. So ethics are similar to the soul in the body of rights, and rights are similar to the litter of ethics, and they have developed in parallel with each other. Traditional medicine is community-based and preservation of the health of healthy people is given priority over the treatment of patients; there is insistence that “health rights” has wider scope than “patients’ rights”. It can be stated that health rights in Iran both before and after the emergence of Islam have been based on guidance from divine religions, observation of humanist ethics, passing suitable courses in the basic sciences, and an introduction to the practical piety of our ancestors, in addition to the syllabus of medical and health education.     

The doctor-proxy relationship: the neglected connection

Advance directives have been lauded by scholars and supported by professional organizations, Congress, and the United States Supreme Court. Despite this encouragement, only a small number of capable patients execute living wills or appoint health care agents. When patients do empower proxies, doctors may be uncertain about the scope of their duties and obligations to these persons who, in theory, stand in the shoes of the patient. This article argues for a conscious focus on the ethical duties, emotional supports, and guidance owed by physicians to health care agents.     

family responsibilities discrimination: what employment counselors need to know

Family responsibilities discrimination—bias against workers based on their responsibilities to care for family members—is rapidly becoming a 21st‐century workplace concern. Employers who harass, pass over for promotion, or terminate workers because such workers care for children, spouses, elderly parents, or family members with disabilities have been sued with more frequency and have been incurring increasing litigation costs. Recently, the U.S. Equal Employment Opportunity Commission took an important step toward ending this discrimination by issuing enforcement guidance that addresses family responsibilities discrimination and caregivers' rights and responsibilities. This article addresses the guidance and its importance for employment counselors.     

A right to health care? Participatory politics,progressive policy,and the price of loose language

This article begins by clarifying and noting various limitations on the universal reach of the human right to health care under positive international law. It then argues that irrespective of the human right to health care established by positive international law, any system of positive international law capable of generating legal duties with prima facie moral force necessarily presupposes a universal moral human right to health care. But the language used in contemporary human rights documents or human rights advocacy is not a good guide to the content of this rather more modest universal moral human right to health care. The conclusion reached is that when addressing issues of justice as they inevitably arise with respect to health policy and health care, both within and between states, there is typically little to gain and much to risk by framing deliberation in terms of the human right to health care.     

Bonhoeffer and Universal Health Care as a Human Right

Bonhoeffer gave a theocentric basis for human rights, as God is the ground of ethics. In our earthly world, the “ultimate” must be prepared by what is “penultimate.” That includes humanity’s natural life and bodily wholeness, leading to human duties crafted by human reason. Nowadays, biblical texts should not be used as partisan weapons attacking government provision of health care, since all Scripture (even the Law) is seen as a Christ-centered focus on human redemption. Thus, Bonhoeffer implies a right to universal health care, but leaves entirely open which practical structures may best provide it.     

The ethics of the pharmaceutical industry and the need for a dual market system

In an era of increasing medical costs and cries for health care reform in the United States, the pharmaceutical industry has come under intense scrutiny. Ethical issues are inherent in the pharmaceutical marketplace, and there is a need to address the moral rights and responsibilities of drug manufacturers consumers, health care professionals, and governmental agents in the production, distribution, regulation, and use of these products. A dual market system protecting individual rights to access and autonomy without placing an undue strain on societal resources would provide an adequate and equitable framework for an ethical pharmaceutical industry.     

POVERTY AND RIGHTS

I defend economic and social rights as human rights, and as a feasible approach to addressing world poverty. I propose a modest conception of economic and social rights that includes rights to subsistence, basic health care and basic education. The second part of the paper defends these three rights. I begin by sketching a pluralistic justificatory framework that starts with abstract norms pertaining to life, leading a life, avoiding severely cruel treatment, and avoiding severe unfairness. I argue that economic and social rights are not excessively burdensome on their addressees and that they are feasible worldwide in the appropriate sense. Severe poverty violates economic and social rights, and accordingly generates high-priority duties of many parties to work towards its elimination.     

Employment and Roles of Counselors in Mental Health Agencies

The authors studied the employment of counselors with master's degrees in multiservice mental health agencies. The study focused on the types of clients seen, the direct care services provided, and the administrative duties performed. Results suggested that the employment of counselors does not differ significantly from the employment of individuals with master's degrees in psychology and social work. Also, the data indicated that counselors are delivering direct care services that traditionally have been offered in mental health centers, that clients seen by counselors demonstrate a range of mental disorders, and that counselors are responsible for fulfilling various administrative duties.     

Health Promotion in International Documents: Strengths and Weaknesses from the Perspective of Community Empowerment

Informed by a community psychology perspective, which takes an integrated and systemic, or holistic view of health and health promotion, this study presents quali‐quantitative analysis of health documents, produced by the World Health Organization (WHO) over the last 30 years. Textual analysis facilitated the identification of the typical specificities of international WHO health promotion documents, highlighting the lexical contexts of health promotion, particularly in relation to responsibilities for health and the concept of community health. Further, this textual analysis demonstrated how these understandings of health and health promotion have evolved over the last 30 years. Drawing on theory from within the field of community psychology, the changes proposed throughout international WHO documentation in conceptualizations of health and health promotion and in defining strategies to achieve the stated goals of health promotion are discussed critically. Copyright © 2011 John Wiley & Sons, Ltd.     

The corporate social responsibility of the pharmaceutical industry: idealism without illusion and realism without resignation

In recent years society has come to expect more from the "socially-responsible" company and the global HIV/AIDS pandemic in particular has resulted in some critics saying that the "Big Pharma" companies have not been living up to their social responsibilities. Corporate social responsibility can be understood as the socio-economic product of the organizational division of labor in complex modern society. Global poverty and poor health conditions are in the main the responsibilities of the world's national governments and international governmental organizations, which possess society's mandate and appropriate organizational capabilities. Private enterprises have neither the societal mandate nor the organizational capabilities to feed the poor or provide health care to the sick in their home countries or in the developing world. Nevertheless, private enterprises do have responsibilities to society that can be categorized as what they must do, what they ought do, and what they can do.     

论权利与义务的关系

权利与义务的关系可以归结为两种相关性。一种是一个人的权利与他人的义务的关系:一个人的权利,必然是他人的义务;反之亦然。这是一个人的权利与他人的义务的必然的、客观的、事实如何的关系,亦即所谓“权利与义务的逻辑相关性”。另一种则是基于这种逻辑相关性的“权利义务道德相关性”,亦即一个人的权利应该是对他自己的义务的交换:一个人所享有的权利应该等于他所负有的义务;而他所行使的权利则应该至多等于他所履行的义务。     

Ethics and Changing Mental Health Care: Concerns and Recommendations for Practice

Recent developments in health care delivery in the United States have left many professionals baffled by the continuing changes in practice sparked by the relatively new managed care environment. Psychologists who practice in medical settings are struggling to balance the seemingly competing needs to deliver quality care to clients and patients, while meeting the demands of third-party payers and trying to remain true to their ethical responsibilities. Critical elements of managed care, which many suggest compromise the ethical provision of quality care, include utilization review, financial incentives, and threats to confidentiality. Recommendations are proposed so that mental health professionals may be proactive in protecting their ethical responsibilities in this changing environment.     

The Duty to Aid Nonhuman Animals in Dire Need

abstract   Most moral philosophers accept that we have obligations to provide at least some aid and assistance to distant strangers in dire need. Philosophers who extend rights and obligations to nonhuman animals, however, have been less than explicit about whether we have any positive duties to free-roaming or 'wild' animals. I argue our obligations to free-roaming nonhuman animals in dire need are essentially no different to those we have to severely cognitively impaired distant strangers. I address three objections to the view that we have positive duties to free-roaming nonhuman animals, and respond to the predation objection to animal rights.