LibGuides: PMA08-4 Medical Law and Ethics: Ethical Resources

Bioethics

Bioethics Legislation in Selected Countries
This report is from the Law Library of Congress website.
Report Summary: "Countries around the world are facing questions about how to balance developments in various areas of biotechnology with concerns about ethics, human health and safety, and the environment. This report examines bioethics-related international instruments and bioethics legislation in ten countries: the United Kingdom, Germany, Japan, China, Israel, India, Kenya, New Zealand, Brazil and Russia." (Quote is from the Law Library of Congress website.)
Hastings Center
"The Hastings Center is an independent, nonpartisan, and nonprofit bioethics research institute founded in 1969." (Quote is from the website itself.)
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To access the full text of some of the documents, you will need to create a free account when prompted.
Markkula Center for Applied Ethics at Santa Clara University
The Markkula Center for Applied Ethics offers programs and resources on ethical issues in end-of-life care, vulnerable patient populations, medically ineffective interventions (futility), culturally competent care, biotechnology, pandemics, and other areas of bioethics.
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This link is for the bioethics section of this website. Santa Clara is a Jesuit/Catholic University.
Presidential Commission for the Study of Bioethical Issues
This Commission "is an advisory panel of the nation’s leaders in medicine, science, ethics, religion, law and engineering. The Commission advises the President on bioethical issues arising from advances in biomedicine and related areas of science and technology." (Quote is from the website itself.)
UNESCO: Bioethics
The scientific arm of the United Nations has combined its resources in one place, with links to the advisory bodies, the International Bioethics Committee (IBC) and the Intergovernmental Bioethics Committee (IGBC).

Pros and Cons of Health and Medicine Issues

The links below are all on the Pros and Cons of Controversial Issues website. This website was chosen by the American Library Association as one of the "Top 25 Free Reference Websites of 2011."

The researchers at ProCon.org "research issues that are controversial and important, and ... present them in a balanced, comprehensive, straightforward, transparent, and primarily pro-con format at no charge" with the purpose of providing "resources for critical thinking and to educate without bias." (Quotes are from the website itself.)

Abortion The debate over whether abortion should be a legal option continues to divide Americans long after the US Supreme Court’s 7-2 decision on Roe v. Wade declared the procedure a fundamental right on Jan. 22, 1973. Proponents, identifying themselves as pro-choice, contend that choosing abortion is a woman’s right that should not be limited by governmental or religious authority, and which outweighs any right claimed for an embryo or fetus. They say that pregnant women will resort to unsafe illegal abortions if there is no legal option. Opponents, identifying themselves as pro-life, contend that individual human life begins at fertilization, and therefore abortion is the immoral killing of an innocent human being. They say abortion inflicts suffering on the unborn child, and that it is unfair to allow abortion when couples who cannot biologically conceive are waiting to adopt.
Euthanasia Proponents of euthanasia and physician-assisted suicide (PAS) contend that terminally ill people should have the right to end their suffering with a quick, dignified, and compassionate death. They argue that the right to die is protected by the same constitutional safeguards that guarantee such rights as marriage, procreation, and the refusal or termination of life-saving medical treatment. Opponents of euthanasia and physician-assisted suicide contend that doctors have a moral responsibility to keep their patients alive as reflected by the Hippocratic Oath. They argue there may be a slippery slope from euthanasia to murder, and that legalizing euthanasia will unfairly target the poor and disabled and create incentives for insurance companies to terminate lives in order to save money.
Medical Marijuana In 1970, the US Congress placed marijuana in Schedule I of the Controlled Substances Act because they considered it to have “no accepted medical use.” Since then, 33 of 50 US states and DC have legalized the medical use of marijuana. Proponents of medical marijuana argue that it can be a safe and effective treatment for the symptoms of cancer, AIDS, multiple sclerosis, pain, glaucoma, epilepsy, and other conditions. They cite dozens of peer-reviewed studies, prominent medical organizations, major government reports, and the use of marijuana as medicine throughout world history. Opponents of medical marijuana argue that it is too dangerous to use, lacks FDA-approval, and that various legal drugs make marijuana use unnecessary. They say marijuana is addictive, leads to harder drug use, interferes with fertility, impairs driving ability, and injures the lungs, immune system, and brain. They say that medical marijuana is a front for drug legalization and recreational use.
Obamacare/Health Care Laws In Mar. 2010, the US Congress passed HR 3590, the Patient Protection and Affordable Care Act (PPACA), and HR 4872, the Health Care and Education Reconciliation Act of 2010. President Barack Obama signed both into law in late Mar. 2010. The PPACA included an individual mandate that imposed tax penalties on people who chose not to buy health insurance. On June 28, 2012, the US Supreme Court upheld the constitutionality of the PPACA in a 5-4 ruling. Proponents of the health care legislation, frequently referred to as Obamacare, have called it a historic political achievement and landmark legislation that reformed the US health care system by lowering health care costs, making health care more affordable, and protecting consumers. They cited the Congressional Budget Office estimates that it would reduce the nation’s deficit by about $210 billion. Opponents have called it a socialist and unconstitutional government takeover of the health care system that would increase the cost of health care, decrease the quality, and entrench a new entitlement. They said the law will increase the nation’s deficit $340-$700 billion over the next decade. In 2011 and 2012 the House of Representatives voted 36 different times to repeal or replace Obamacare.
Obesity (Is Obesity a Disease?) The United States is the second most obese industrialized country in the world. 39.6% of American adults in 2016 were obese, compared to 14% in the mid-1970s. Obesity accounts for 19.8% of deaths and 21% of healthcare spending in the United States. Proponents contend that obesity is a disease because it meets the definition of disease; it decreases life expectancy and impairs the normal functioning of the body; and it can be caused by genetic factors. Opponents contend that obesity is not a disease because it is a preventable risk factor for other diseases; is the result of eating too much; and is caused by exercising too little. Read more background…
Prescription Drug Ads to Consumers The US pharmaceutical industry spent $6.1 billion on advertising prescription drugs directly to consumers in 2017. Since 1962 these ads have been regulated by the Food and Drug Administration (FDA) to ensure that they are not false or misleading. The United States and New Zealand are the only two countries where direct-to-consumer (DTC) advertising of prescription drugs is legal. Proponents of DTC prescription drug ads contend that the ads inform patients about diseases and possible treatments, encourage people to seek medical advice, help remove stigma associated with medical conditions, and provide needed sales revenue to fund costly research and development (R&D) of new drugs. Opponents contend that DTC drug ads misinform patients, promote drugs before long-term safety-profiles can be known, medicalize and stigmatize normal conditions and bodily functions like wrinkles and low testosterone, waste valuable medical appointment time, and have led to our society’s overuse of prescription drugs. Read more background…
Pros and Cons of Controversial Issues “To promote civility, critical thinking, education, and informed citizenship by presenting the pro and con arguments to debatable issues in a straightforward, nonpartisan, freely accessible way.”
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Through our website, ProCon.org, we serve as a non-biased information source for our users. We present sourced pros and cons of debatable issues, as well as a host of reference information relevant to those issues, thoroughly researched and compiled by our research staff and editors. We use the pro and con format because it achieves four objectives:

First, by exposing readers to both sides of an issue in a side-by-side format, we make it easier for them to see the difference in the facts and arguments offered by each side.
Second, our pro and con format creates what we call “beneficial confusion,” causing readers to struggle with well-presented opposing positions, and, therefore, to engage in evaluative thinking to formulate their own views. Readers who have a pre-existing view of an issue may feel more confident in their view, or they may change their view. In either case, many will recognize that the process of acquiring and critically evaluating information has a beneficial and satisfying effect on their decision-making.
Third, the format makes readers more confident and comfortable in discussing and debating their views with others, knowing what the “other side” may think.
Fourth, challenging readers to examine both sides of an issue tends to reduce the likelihood that they will resort to the “demonization” of those who hold opposing views.
Right to Health Care 27.5 million people in the United States (8.5% of the US population) do not have health insurance. Among the 91.5% who do have health insurance, 67.3% have private insurance while 34.4% have government-provided coverage through programs such as Medicaid or Medicare. Employer-based health insurance is the most common type of coverage, applying to 55.1% of the US population. The United States is the only nation among the 37 OECD (Organization for Economic Co-operation and Development) nations that does not have universal health care either in practice or by constitutional right.
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Proponents of the right to health care say that no one in one of the richest nations on earth should go without health care. They argue that a right to health care would stop medical bankruptcies, improve public health, reduce overall health care spending, help small businesses, and that health care should be an essential government service.

Opponents argue that a right to health care amounts to socialism and that it should be an individual’s responsibility, not the government’s role, to secure health care. They say that government provision of health care would decrease the quality and availability of health care, and would lead to larger government debt and deficits. Read more background…
Vaccines for Kids Vaccines have been in the news over the past year due to the COVID-19 pandemic. To date the COVID-19 vaccine has not been approved for children younger than 12 years old and no state has yet added it to their required vaccinations roster. However, the Centers for Disease Control (CDC) recommends getting 29 doses of 9 other vaccines (plus a yearly flu shot after six months old) for kids aged 0 to six. No US federal laws mandate vaccination, but all 50 states require certain vaccinations for children entering public schools. Most states offer medical and religious exemptions; and some states allow philosophical exemptions.
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Proponents say that vaccination is safe and one of the greatest health developments of the 20th century. They point out that illnesses, including rubella, diphtheria, smallpox, polio, and whooping cough, are now prevented by vaccination and millions of children’s lives are saved. They contend adverse reactions to vaccines are extremely rare.

Opponents say that children’s immune systems can deal with most infections naturally, and that injecting questionable vaccine ingredients into a child may cause side effects, including seizures, paralysis, and death. They contend that numerous studies prove that vaccines may trigger problems like ADHD and diabetes. Read more background…

Ethics

Health Issues Tracked by the Business & Human Rights Resource Centre The American Library Association chose the website of the Business & Human Rights Resource Centre as one of the best free sites of 2009. According to the Centre's website, "Business & Human Rights Resource Centre is the only non-profit organization drawing attention to the human rights impacts (positive & negative) of over 5100 companies, operating in over 180 countries."
Internet Encyclopedia of Philosophy (IEP)
This is a peer-reviewed source that was chosen by the American Library Association as one of the best free sites of 2008.
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Of particular interest may be the essays on "Care Ethics," "Medicine, Philosophy of" (with a section on ethics), and "Bioethics."
LegalEthics.com This is "a web site focused on the ethical issues associated with the use of technology by legal professionals." "All posts are coded by one or more topics. Select a topic to the right to read relevant posts. Select the “States” topic to see an expanded view of individual topics devoted to each state." (Quotes are from the website itself.)
Medscape Ethics Center "Medscape from WebMD offers ... health professionals the Web's most robust and integrated medical information and educational tools. After a simple, 1-time, free registration, Medscape from WebMD automatically delivers to you a personalized specialty site that best fits your registration profile." (Quote is from the website itself.)
Stanford Encyclopedia of Philosophy This is a peer-reviewed source that was chosen by the American Library Association as one of the best free sites of 2011.

Health Information Privacy

Privacy, Security, and Confidentiality Section of the American Health Information Management Association (AHIMA)
"AHIMA has a myriad of resources addressing privacy, security and confidentiality. Find the information you need to be compliant." (Quote is from the website itself.)
"Health Information Privacy" Section of the Website of the U.S. Department of Health & Human Services
The texts of the HIPAA Privacy Rule and the PSQIA Statute and Rule along with information about both documents are included here.
"Health Privacy" Section of the Center for Democracy & Technology (CDT) Website
Issues covered here include privacy framework, consent, de-identified data, HIPAA, privacy enforcement, personal health records, HITECH/ARRA implementation, and state privacy protections.
Health Information Privacy, Security, and Your EHR
From the "Providers and Professionals" section of the website of the Office of the National Coordinator for Health Information Technology (ONC), a part of the U.S. Department of Health and Human Services (HHS).
Guide to Privacy & Security of Electronic Health Information
From the "Policy Researchers and Implementers" section of the website of the Office of the National Coordinator for Health Information Technology (ONC), a part of the U.S. Department of Health and Human Services (HHS).
Privacy/Security and Research with Electronic Health Records
Provided through the NIH National Library of Medicine website, this contains information on HIPAA and links to appropriate resources.

Codes of Ethics and Related Resources

Below are three links to the code of ethics and related documents for members of the American College of Healthcare Executives (ACHE), "an international professional society of more than 40,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations." (Quote is from the website itself.)

The fourth and final link is to a website with codes of ethics for individual medical professions arranged alphabetically by the names of their professional associations.

Healthcare Executives - Code of Ethics
The ACHE Code of Ethics itself along with links to relevant resources.
Healthcare Executives - Ethical Policy Statements
"The Ethical Policy Statements present ACHE’s position on various ethical issues in healthcare and suggest a standard of behavior for healthcare executives facing these challenges." (Quote is from the website itself.)
Healthcare Executives - Ethics Toolkit
Helpful resources from the ACHE website, including an article that lists the steps to take when making an ethical decision, information on how to use the ACHE Code of Ethics and Ethical Policy Statements, and links to other resources.
Codes of Ethics for Professions in Health Care and Medicine
From the website of the Center for the Study of Ethics in the Professions at the Illinois Institute of Technology.

In addition to the links for the individual codes of ethics, there are links near the top to other helpful information, such as "Using Codes of Ethics" and "Authoring a Code."
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It can be helpful to click on the "Visit Source Page" or "Visit Organization Page" link near the top of each code of ethics to see if a more recent edition has been approved and posted on the specific professional association website.

Evaluation of Internet Sites

Remember to evaluate the information you find when searching the Internet. Not all Internet sites are trustworthy or appropriate to use as research sources. If you have any concerns about the credibility of an Internet site, consult your instructor or a librarian for evaluation assistance.