Globalization and Healthcare Ethics - Coursework Example

Globalization and Healthcare Ethics Teacher               Globalization and Healthcare Ethics Definition of Globalization The key issues surrounding the idea of globalization is whether it is “good” or “bad” for human life in general, and particularly for human health. The exposure of the world to the Internet and to social networking sites has somehow led people to believe in the greatness of the impact of globalization in the lives of people in this world. However, the question that this paper seeks to discuss is whether the effects of globalization on healthcare are positive or negative, and how globalization may affect healthcare ethics. Healthcare is crucial in every sense of the word as it determines the general health, the survival and mortality rate of people in a specific area or in general. Nevertheless, before the possible positive and negative effects can be discussed, the definition of globalization should be looked into. Although it is a highly misused, overused and abused word, “globalization” is technically defined based on the changes it brings about. Firstly, globalization brings about spatial changes or the human perception of physical or territorial space, especially the fact that national borders are now considered irrelevant. The world has become a smaller place – a “global village” – and communication among individuals and groups of people all over the world has become not only easier but also faster (Lee, 2014). Another functional definition of globalization is that it has caused temporal changes, or the idea of living a life that has sped up due to technological advances in communication, transportation and social interaction. The third functional definition of globalization is that it leads to cognitive changes, or the idea that the needs, values and beliefs of people are being changed by those of more widespread advertising and exposure to various cultures and ideologies. Negative effects and Issues The next question is how globalization and the changes it brings affect or have affected healthcare. According to Lee (2014), spatial change brought about by globalization has caused epidemic infections like AIDS and tuberculosis to spread around the world fast. Cognitive changes have also been the factor behind the spread of so-called lifestyle diseases such as obesity and the tobacco pandemic spread by the tobacco industry. Intensive advertising of high-calorie foods and cigarettes have also negatively affected the health of consumers worldwide at lightning speed. These changes have greatly affected the healthcare system too. Challenges to the healthcare system brought about by globalization mainly include those that deal with healthcare ethics. Firstly, there is a greater emphasis on professionalism while underscoring ethical conduct, thus leading to the increase in the frequency of moral issues and dilemmas (Syna, 2011). In terms of health and healthcare, the primary goal is the efficiency of medical care and professionalism. Sometimes, there is simply just no room for respect for human dignity as well as the Aristotelian virtues that are supposed to characterize all forms of human services, including healthcare. Furthermore, as stated by Syna (2011), the attainment of a global view of healthcare is only made possible through the integration of the social, economic, environmental, religious, and professional aspects of healthcare while taking into account all possible subdivisions of such aspects. This means that doctors of some countries may actually deliver professional healthcare services but may actually not respect human dignity at all. For example, while TB is treated in some hospitals, but regardless of one’s nationality, many hospitals in the US resort to coercive confinement of patients who refuse to take their medication. There is also the problem of who will be confined because everyone has the right not to take their medication or even not to purchase it if they cannot afford the costs (Selgelid, 2008). Furthermore, misunderstanding may also arise between doctors in some countries that are known to value obedience to authority and the patients in other countries who cannot possibly obey doctors’ advice and buy the prescribed medicine simply because of a financial lack. There are also moral issues regarding confidentiality of healthcare records and information. Selgelid (2008) further states that third party notification of people who are apt to be infected by AIDS will also somehow breach the trust that the AIDS patient has towards the healthcare institution. This is clearly a moral dilemma that cannot be resolved immediately. Furthermore, as globalization has caused more people of different nationalities to meet together as doctors and patients, there may therefore be some conflict regarding the differences in how each particular nationality values professionalism, concern for others, and trust and secrecy. Thus, because of globalization, everything becomes more complicated. There are also various managerial issues in healthcare that somehow violate ethical considerations. For example, in European settings men and women in junior managerial posts are considered and treated differently by their superiors and colleagues. Women are reported to assume only secondary roles because of their perceived lack of skills in management. On the other hand, men are given top management positions and more privileges because of the positive perception towards the male gender in general when it comes to management skills (Syna, 2011). As globalization opens the entire healthcare system to foreigners, this problem is further aggravated by the fact that certain nationalities would tolerate gender discrimination like Indians, while some nationalities of healthcare workers like Americans would not be able to tolerate such settings because of the degree of equality that they have been accustomed to in their own countries. Another ethical issue concerning healthcare and one that is mostly brought about by globalization is the idea that extensive commercialization of healthcare may compromise the common goal of all healthcare systems: “population health and the provision of care for all according to need” (Commercialization, 2007). The issue here is that commercialized healthcare means “the provision of health care through market relationships [only] to those able to pay” and it remains a fact for low-income countries to “face the most poverty-inducing form of health finance: out-of-pocket payment” (Commercialization, 2007). This means that the more healthcare is available to low-income countries like those in Africa and South America, the worse their poverty may get. This is because the money that they are supposed to invest in food and livelihood becomes the money that they have to use to buy medicine. Thus, the commercialization of medical services and drugs may actually in fact be a major contributor to a country’s state of poverty. Another issue related to the commercialization of the healthcare sector is that the response of globalized commercial supply industries to public health priorities is dependent on regulatory changes (Commercialization, 2007). This means that the healthcare sector will most likely not serve the ailing population or extend services unless the owners of medical companies and institutions are sure that they are free of any legal impediments, or unless they will gain more in such a situation. Furthermore, this is the realization of the selfishness of people in general especially when they ask, “What’s in it for me?” Truly, whether healthcare institutions are only protecting their own interests or they are indeed unscrupulous, the main basis of most of their decisions are geared towards self-interest and never to the greater good of relieving patients of their illnesses. Moreover, as many healthcare institutions are only short-term profit makers, they may even take advantage of the ignorance or helplessness of poor patients. Another issue in healthcare ethics that is brought about by globalization is the differences of the goals of certain healthcare companies and institutions. If such companies and institutions are geared towards profit, then they will definitely not honor employees who are there for rather unselfish reasons like serving the poor and giving medical assistance to the sick. Thus, there will be punishments for such employees, and no matter how much the company or medical institution emphasizes balance, this is something that would be extremely hard to comprehend. Therefore, if the company rewards ethically objectionable behavior like not accepting patients who cannot pay a particular amount even in emergency cases, then the employees will have to live by the company rules sooner or later and will just be as harsh in the long run. Otherwise, their own career will be endangered (Zekos, 2004). Moreover, the fact that globalization has taken precedence over the matter of providing healthcare services, this previously mentioned situation would turn out to be worse because of the fact that people of certain countries like the United States would have institutions care for them without much work on the patient’s part. If such patients, therefore, find themselves in rather stricter and more conservative medical institutions, then conflicts may arise. Still, another challenge that the healthcare sector faces in the midst of globalization is the fact that the law may not be fair, especially to the less fortunate. In fact, Zekos (2004) emphasized that “in countries where the market system is not deeply rooted, laws not enforced, and state intervention is invasive, bribes and payoffs may…enhance the market system and raise overall welfare.” This means that in many countries where corruption exists, there may not only be unequal healthcare opportunities but also a bias against those who have no money for bribes and payoffs. The problem is that in the context of globalization, such practices may spread to other countries and the immoral practice itself may be graciously tolerated. According to Turner (2007), although there are several advantages in tourists finding more affordable healthcare outside their own countries, such as searching for cheaper surgery in Asian countries like Indonesia, the Philippines, Thailand, India and Malaysia, these practices actually “increase regional economic inequalities and undermine health equity.” Although this practice may free someone from possible accumulation of debt or from bankruptcy and other financial issues, the practice may actually lead to people seeking medical services not because of their quality but because of their low cost. This may also lead to certain countries monopolizing medical services, which somehow leads to economic inequalities. Macer (2006) also states another possible ethical challenge concerning globalization. According to Macer, the increasing devotion of people towards genetics and other methods might make people deviate from the true purpose of healthcare which is the love and preservation of life. Some new technological methods may now be detrimental to life and human dignity, such as human experiments and anything concerning cloning and genetics. Such medical methods may therefore undermine the core of all healthcare philosophy and purpose. Eventually, it may not all be worth it. Bennett and Tomossy (2006) also underlines a very important problem concerning healthcare ethics vis-à-vis globalization. According to the authors, the globalization of healthcare is based on the context of global social justice, which is actually very confusing, because no one exactly knows on which principles public health should be based. For example, in the recent outbreak of Ebola in Africa, there is no clear understanding whether the commands should be coming from the African countries, from the UN, or from the CDC. According to Cohen (2013), the United States heavily depends on foreign-trained doctors that work for their healthcare system. There is also an empowerment of many NGOs all over the world in order to improve healthcare system in as many places as possible. However, the problem with this is that there are countries which are not that financially stable and cannot possibly send trainees in other countries or cannot possibly host such trainings. These countries will eventually become poorer. Giordano (2013) underlined another crucial problem with healthcare systems in a globalized world. According to Giordano, it is ethical relativism that fully describes the globalized world, and this means that eventually there will be conflict of interests as to whether it is healthcare or economics that should be prioritized. There is also a growing conflict of interest when it comes to what should be prioritized when it comes to dealing with a particular disease – whether it is the prevention of it or the immediate cure, or perhaps the laws that govern it or the economic and political issues behind it. Conclusion Ethical considerations in healthcare institutions and systems are a major issue in the context of globalization. From political issues to inequalities to respect for human dignity and global social justice, there are numerous concerns regarding the evolution of healthcare into one of a globalized version. Nevertheless, the solution to all these may be simpler than what one thinks. Examples include the intervention of the United Nations, the cooperation of national governments in eliminating bribery, inequalities and other subversive factors in the healthcare systems, and most of all, education of all those involved in healthcare. The process is, however, not only gradual and slow but also tedious and difficult, not to mention costly. Globalization may impact healthcare negatively now but perhaps more positively in the near future. References Bennett, B. & Tomossy, G. (2006). Globalization and Health: Challenges for health law and bioethics. Springer, 27, 1-202. Cohen, G. (2013). “Introduction and Front Matter: The Globalization of Health Care: Legal and Ethical Issues.” The Globalization of Health Care: Legal and Ethical Issues. Eds. I. Glenn Cohen. Oxford: Oxford University Press. Abstract. Retrieved from Social Science Research Network: http://papers.ssrn.com/sol3/papers.cfm?abstract_id=2210508 Commercialization and Globalization of Health Care: Lessons from UNRISD Research. (2007). UNRISD Research and Policy Brief 7. Retrieved from the Conselho Nacional de Saude: http://conselho.saude.gov.br/cm/artigos/7_RPB7e.pdf Giordano, J. (2013). Ethical considerations in the globalization of medicine – an interview with James Giordano. BMC Medicine, 11(69), doi:10.1186/1741-7015-11-69. Retrieved from Bio Med Central: http://www.biomedcentral.com/1741-7015/11/69 Lee, K. (2004). Globalisation: what is it and how does it affect health? The Medical Journal ofAustralia:1914-2014, 180(4), 156-158. Macer, D. (2006). The globalization of ethics and balancing cultural diversity with universal bioethics. Retrieved from Eubios Ethics Institute: http://www.eubios.info/Papers/DMAPPEND2006.pdf Selgelid, M. J. (2008). Ethics, Tuberculosis and Globalization. Public Health Ethics, 1(1), 10-20. Syna, H. D. (2011). Gender, globalization and ethics in public healthcare system: the challenges of nurses-managers in engaging moral dilemmas. Global Management Journal, 3(2). Turner, L. (2007). First World Health Care at Third World Prices: Globalization, Bioethics and Medical Tourism. Biosocieties, 2, 303-325. Zekos, G. I. (2004). Ethics versus corruption in globalization. Journal of Management Development, 23(7), 631-647. Read More