ipe_370_final_review[1] - I PE 370 Final Review Paternalism...

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IPE 370 Final Review Paternalism- overriding the patients autonomy and making the decision for them, not fully disclosing all the options Why was Paul Farmer not described as paternalistic? Gave the patient all the relevant information and choices and let them make their own decisions. Solitary was one of Farmer’s principles. In Haiti, medicine is not well known. Farmer was asked questions and he answered with the best of his ability. This is not paternalistic. Farmer listens to his patients and really hears what they say. Turned public health upside down, public health is paternalistic. Public health has lost the individual patient. He takes back the individual and listens to what they need/want. Ex: Joe, doesn’t have TB, sits on bed w/ patient and talked, asked what he wanted, wanted to be on the inside/safe, be in a place where he can have a beer, can’t take meds unless in controlled environment where you can take drugs consistently – sent people to houses to make sure patients are taking meds 1. Distributive justice 2. Microallocation decisions- dealing with only people around you Macroallocation decisions- dealing with whole society (policy decisions) Fairness- each person gets their fair share- dealing with equality (balance) Equity- looking at groups – socioeconomic issues- why is this group so much worse than the rest? – need more than the other group bc they are already this far below- need more to get up to a certain level- understanding everyone is not on the same playing field 3. Social Justice is defined as taking responsibility for the good of others and applying knowledge and skills helping the most vulnerable. Difference between justice and social justice. Explain the difference between the role of social justice and charity in health care according to Farmer (also the role of human rights and O for P) Justice- treat equals equally- balance system
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Social justice- making others issues part of your own (compares with equity/vulnerability)- people are owed this, due this bc they are human (due basic needs (food,water,and education, health care)) Charity- one time gift – don’t owe anybody anything O for P- option for the poor- find a way to provide for those who can’t provide for themselves- poor owed this option- most vulnerable 4.”Structural Violence” refers to socioeconomics Structural violence- system as it stands will cause a stance- system isn’t perfect- human agency is involved the way society made up and decisions made can put people at great risk Example: Haiti/Farmer – the Damn – uprooted everybody and destroyed way of living – done for industry (agency) USA- government response to Hurricane Katrina- more quicker aid to foreign countries than our own 5. “The only noncompliant people are physicians. If the patient doesn’t get better, it’s your own fault, fix it.” What does Farmer mean, what was he talking about? Physicians don’t observe the patients- Farmer checks on patients with meds,
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ipe_370_final_review[1] - I PE 370 Final Review Paternalism...

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