health care policies week 3

Chapter 6:

Individual Rights in Health

Care and Public Health

Chapter Overview

• Describes the meaning and importance of the

“no-duty-to-treat” principle

• Explains generally how the U.S. approach to health

rights differs from that of other high-income

countries

• Describes the types and limitations of individual legal

rights associated with health care

• Describes the balancing approach taken when

weighing individual rights against the public’s health

Background

• “No-duty-to-treat” principle: Generally

speaking, individuals have no legal right to

health care services or to public health

insurance and, correspondingly, there exists on

the part of health care providers no general

legal duty to provide care.

Individual Rights and Health Care: A

Global Perspective

• U.S. is one of the only high-income nations that does

not guarantee health care as a fundamental right.

• Some two-thirds of constitutions world-wide address

health or health care.

• Yet including language respecting health rights in a

constitution does not guarantee that the right will be

recognized or enforced.

Individual Rights and the Health Care

System

• Categorize health care rights in 3 ways:

1. Rights related to receiving services explicitly

provided under health care, health financing,

or health insurance laws.

° For example, rights under EMTALA,

Medicaid, or the Affordable Care Act.

Individual Rights and the Health Care

System

2. Rights concerning freedom of choice and

freedom from government interference when

making health care decisions.

° One of the most important health care rights

is the right of individual patients to make

informed decisions about the scope and

course of their own care. This includes the

right to refuse treatment.

Individual Rights and the Health Care

System

3. The right to be free from unlawful

discrimination when accessing or receiving

health care.

° Discrimination in health care can occur on

the basis of race/ethnicity, socioeconomic

status, disability, age, and gender.

Individual Rights in a Public Health

Context

• One simple way to think about individual

rights in a public health context is to use a

balancing approach—what might the

appropriate legal trade-offs be between private

rights and public health and welfare?

Individual Rights in a Public Health

Context

• Police powers: Represent government

authority to require individual conformance

with established standards of conduct;

standards are designed to promote and protect

the public’s health, safety, and welfare, and to

permit government control of personal,

corporate, and other private interests.

Individual Rights in a Public Health

Context

• Prevailing view is that the Constitution empowers

government to act in the name of public health but

does not require it to do so.

• This interpretation refers to what is known as the

“negative constitution”—the idea that the

Constitution does not require government to provide

any services, public health or otherwise.

• This approach to constitutional law derives from the

fact that the Constitution is phrased mainly in

negative terms