A Case Study Reflecting Ethical Dilemmas in Health Care Policy in the Alaska Native Population

1. A Case Study Reflecting Ethical Dilemmas inHealth Care Policy in the Alaska Native Population

2. The development and application of ethical principles in case study reflects how determinates of health care coverage can affect vulnerable populations

3. Ethical issues are: • Lack of patient access to medical care • Distributive Justice • Stigmatization of individuals or populations • Appropriate priority setting • Use of limited resources • Notions of professional integrity • Issues of resource allocation • ActuarialFairness • Mutual Aid

4. A social minimum = bundle of resources which suffices in the circumstances of a given society to enable someone to lead a minimally decent life. • A social minimum policy regime = set of policies and institutions that serve to secure • reasonable access to this social minimum for all members of the society. • (Shanawani & Lowe, 2005, p. 3)

5. The dilemma of ethical practice: • Patient’s advocate with limited resources • Doing the best one can with what one has to work with

6. CELIBATE • C for clinical situation • E for ethical issues • L for legal issues • I for information • B for brainstorming action steps • A for analyzing action steps • T for taking the action • E for evaluating the results. (Kornblau and Starling 1999)

7. Analytical decision process seen from formal ethical constructs give dimension, perspective, and construct to complex ethical dilemmas.

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