Ethics, justice and women's health

Abstract

The ethical obligations that physicians owe their patients have a long history of study, and have inspired the modern discipline called bioethics. Physician-patient relations tell only one half of the story of ethics, however. The other half concerns public health and the allocation of scarce resources to a population’s health needs. The former ethics are often described as ‘microethics’, and the latter as ‘macroethics’. Laws, such as on patients’ consent to treatment and rights to confidentiality serve microethical goals, and are part of what is often called private law. Laws supporting macroethics are part of domestic constitutional law and international human rights law. This body of law is currently grappling with the problem of defining the right to the highest attainable standard of health, expressed in the International Covenant on Economic, Social and Cultural w x Rights 1 . Ethical approaches to resource allocation raise the problem of whether scarce resources are better concentrated on achieving effective results, such as by prioritizing treatment of patients with the greatest prospects of rehabilitation to good health rather than patients closest to death, or on serving the goal of social fairness or equity. This