Open any standard bioethics textbook, and therein can be found a host of subjects ranging from the abortion rights controversy to the morality of xenographic tissue transplantation. Just as there is a wide scope to the subject matter of bioethics, its practitioners come from a multitude of disciplines, including law, medicine, nursing, theology, philosophy, sociology, and anthropology. And yet, despite a rich variety of investigators and methods, bioethicists overlook numerous subjects that deserve to be addressed. In particular, they neglect issues (...) of public health, preventive medicine, and social medicine. Although topics such as physician-assisted suicide, prenatal genetic testing, and the ethics of new reproductive technologies constitute the contemporary canon of bioethics and deserve sustained analysis, these subjects are not so significant that they should eclipse other issues. For example, gun control policies, the regulation of food additives. immunization programs, prenatal care, leave programs enabling employees to care for dying relatives, the provision of nutrition and medical care to the homeless, and the use of emergency rooms by the most impoverished citizens are all topics neglected by bioethicists. (shrink)

A wide variety of forms of domination hasresulted in a highly heterogeneous health riskcategory, ``the vulnerable.'''' The study of healthinequities sheds light on forces thatgenerate, sustain, and alter vulnerabilities toillness, injury, suffering and death. Thispaper analyzes the case of a high-risk teenfrom a Boston ghetto that illuminatesintersections between ``race'''' and class in theconstruction of vulnerability in the US.Exploration of his ``wounds'''' helps specify howlarge-scale social and cultural forces becomeembodied as individual experience of disparatehealth risk. The case demonstrates that healthinequities would (...) not occur if resources –employment, income, wealth, education, housing,profiling in the legal system, and health care– were more justly managed in keeping withstandards outlined in the Universal Declarationof Human Rights. Professional responses to the``wounds of vulnerability'''' may reveal importantaspects of who we are and what our work asscholars, practitioners, and advocates mustbecome. (shrink)

As during other eras of American history, both the current debate and attempts to reform the health care system are fraught with vested interests and conflict among policy makers, consumers, the health and medical complex, insurers, and the business community. The process reflects both the strengths and the limitations of our democratic system, and demonstrates the factional battles that must be waged to attain fundamental social change in American society.Although racial justice is not the dominant issue, the parallels between the (...) present congressional deliberations and polemics and the passage of civil rights legislation in the 1960s are inescapable. For one, a major goal is to codify the basic human right of health care for all, regardless of medical or socioeconomic condition—that is, universal health insurance. Second, although a general feeling exists among the public that considerable change is needed in our health care system, elected representatives cannot agree on an appropriate course of action. (shrink)

As during other eras of American history, both the current debate and attempts to reform the health care system are fraught with vested interests and conflict among policy makers, consumers, the health and medical complex, insurers, and the business community. The process reflects both the strengths and the limitations of our democratic system, and demonstrates the factional battles that must be waged to attain fundamental social change in American society.Although racial justice is not the dominant issue, the parallels between the (...) present congressional deliberations and polemics and the passage of civil rights legislation in the 1960s are inescapable. For one, a major goal is to codify the basic human right of health care for all, regardless of medical or socioeconomic condition—that is, universal health insurance. Second, although a general feeling exists among the public that considerable change is needed in our health care system, elected representatives cannot agree on an appropriate course of action. (shrink)

The ethical theories employed in health care today assume, in the main, a modern Western philosophical framework. Yet the diversity of cultural and religious assumptions regarding human nature, health and illness, life and death, and the status of the individual suggest that a cross-cultural study of health care ethics is needed. A Cross-Cultural Dialogue on Health Care Ethics provides this study. It shows that ethical questions can be resolved by examining the ethical principles present in each culture, critically assessing each (...) value, and identifying common values found within all traditions, It encourages the development of global awareness and sensitivity to and respect for the diversity of peoples and their values and will advance understanding as well as help to foster a greater balance and a fuller truth in consideration of the human condition and what makes for health and wholeness. (shrink)

would like for them to know that I am in pain or this part of my body hurts or the other part hurts — that I am not lying about it. To examine me and to cut down on the pain….And help me out.Patient with Sickle Cell Disease, Focus Group ParticipantPain in the United States is widely recognized to be undertreated; however, the capacity to treat pain has never been greater. The causes of this undertreatment are varied. As we focus (...) on pain and why it is too often ineffectively treated, we also discover that this undertreatment afflicts some more than others. What divides the some from the others isn't limited to one factor, but one particularly disturbing factor is race and ethnicity. Racial and ethnic minority populations are at higher risk for oligoanalgesia, or the ineffective treatment of pain. Only through further study of the differences in pain treatment based on race and ethnicity can we develop strategies to reduce the disparities in care. (shrink)