Introduction
Healthcare disparities can be explained as the differences or the inequalities that exist in the provision of medical care to various groups of people. These differences disproportionately affect the people in terms of morbidity and mortality based on an individual’s sex, gender, social class, economic position, culture, ethnicity, and race, among other factors.
Bioethical theories
The bioethical theories are a number of theories that have evolved over time in the medical care practice. These theories therefore, are described as an interdisciplinary field of the health care system which in the modern medicine deals with ethical issues surrounding science and technology; they seek to provide sophisticated care systems. The healthcare providers face a dilemma when it comes to the right to decide, informed consent, alternative treatment options, right of life and death, among other issues. Technological challenges include cost being due to prolonged life by use of technology and sickness that eventually causes death is said to be chronic.
The most significant theories in the US have been the theory of principlism and that of moral rules.
Principlism
This theory is divided into four major principles namely, Nomaleficence, beneficence, justice, and autonomy. The medical practitioners are expected to apply these principles whenever they are faced with moral dilemmas, the bioethical issues. Professionals should respect the autonomy of the patients; they should also avoid causing harm (nonmaleficence); the care provided should balance between cost and benefits (beneficence); and finally justice where risks and benefits in groups are distributed in a fair manner (Beauchamp &Childress, 2001, p. 12). There are certain instances where the principles can apply singly or work over another principle and no one principle has a prima facie authority on the rest. The specific only determines the principle to be used at that instance. For instance in vaccination of children the beneficence can outweigh the autonomy of the child. Therefore, principlism just offers a guide to the health practitioners to use when working. The programs like Medicare and Medicaid often apply this theory when dealing with the older people (Beauchamp &Childress, 2001, p. 12).
The Moral Rules
The rules or morality are very important in the practice of medicine. Gert, Clouser and Culver have posited ten rules that act as a guide and justify the bioethical decision made by practitioners. The ten rules are based on the common morality concept (Gert, Culver & Clouser, 2006, p.3). The first five rules address prohibition of harm to the beneficiaries. The second set from rule six to ten can lead to causation of immediate harm. The rules include do not kill, do not cause pain intentionally, do not cause permanent injury (disable), do not take away people’s freedom and do not deprive people of pleasure (Gert et al., 2006, p. 4). The second says do not lie or cheat; honor promises; do not trick or deceive, follow the law and do your duty as a professional. The US faces a lot of cases on neglect, cheating, permanent injuries and some failing to honor promises and so on.
Solutions
Regardless of the high quality of healthcare provision in the US, many citizens still do not have access to adequate care and the government has not had a formal dedication to universal access for some time. With new reforms in place, Medicaid and Medicare will be able to care for every citizen especially the poor families.
Proper Ethical principles
Even though it is still not possible to define the absolute meaning of adequate healthcare, the application of proper principles of morality van help in the proper determination of the adequate care (Gert et al., 2006, p. 4). The society’s resources should be distributed well for maximum impact. Issues to note include:
- Duration of benefit (Hengameh 2010, p. 123)
- Degree of benefit
- Likelihood of benefit
- Number of beneficiaries
- The cost of care
Other measure should include democratic decision making and defining the role of the physician in the allocation of resources and making decisions. These professional have a great deal to offer (Hengameh 2010, p. 123). Adequate degree of care should be provides and there needs to be respect for all the people despite their backgrounds. These means there should not be discrimination of any form. Finally, there should be broad acceptance of the care.
Reference List
Beauchamp, T. L., & Childress, J. F. (2001). Principles of Biomedical Ethics. New York, NY: Oxford University Press
Gert, B., Culver, M., & Clouser, K.D. (2006). Bioethics: A Systematic Approach. Oxford: Oxford University Press
Hengameh, H. (2010). Strategies to contain the high and rising costs of health: Will they increase existing health care disparities and are they ethical? Humanomics, 26(2), 112 – 123