Disability Issues in Health Care Ethics and Law in the Public Health Curriculum

Abstract

The term “health care ethics” (sometimes called “bioethics” or “medical ethics”) was the name given to an area of study and practice that arose after World War II with revelations about abuse of vulnerable people by medical researchers – abuse which, two decades later, was documented to be all too common in American clinical research (Beecher, 1966). Although originally focused on clinical and research encounters, today the scope of health care ethics has expanded to include resource allocation, health systems assessment, disease control, health promotion and ill-health prevention, risk reduction and other familiar public health issues. Recently, the Institute of Medicine has argued that it is essential for schools of public health to teach health ethics (Gebbie, Rosenstock & Hernandez, 2002), and the American Public Health Association has adopted a public health code of ethics that incorporates basic values and principles from health care ethics (APHA, 2002). Some writers carefully distinguish health care ethics from public health ethics (e.g., Gostin, 2002; Callahan & Jennings, 2002); but increasingly health care ethicists have recognized that these boundaries are vague at best and there is a need to extend the limits of health care ethics to encompass more traditional public health issues.

Dr. Jerome Bickenbach is a lawyer by training and a long time Professor of Philosophy at Queen’s University in Canada. He has consulted with the World Health Organization for the past 15 years on disability policy and has contributed substantially to the literature on disability rights. He is currently the head of the Disability Policy Unit at Swiss Paraplegic Research in Nottwil, Switzerland.