Chapter 15 Health Technology, Quality, Law, and Ethics

Tulchinsky, Theodore H.; Varavikova, Elena A.

Abstract Technology assessment capability is vital in determining health policy and priorities because science and technology changes occur rapidly and are essential for progress. Quality is promoted by high professional education and practice standards, accreditation by state and non governmental authorities for health provider institutions, public health departments as well as educational program for public health, health policy and health management. Quality is an ongoing challenge in health care and public health. New innovations and therapies change the nature of care and prevention, with important epidemic and epidemiologic effects. Adoption of new evidence based methods of prevention, diagnosis and therapy have and will continue to improve quality of life and longevity. Translation of scientific and technological advances into applied practice requires education of public health policy makers, and practitioners to be well trained to evaluate new evidence and keep up with rapidly changing capacity to address old and new challenges in public health. The context of public health is set in legal frameworks and ethical standards developed over many millennia, centuries and decades which need continuous revision in keeping with societal changes and norms. Law and ethics in public health reflect the societal values in the context of social, economic, demographic, epidemiologic and political changes, while facing new health challenges and new technologies. Health ethics needed to be reexamined in the light of medical participation in 20th century genocides in the name of racial purity and industrialized murder of millions in World War II. The Nuremberg Trials redefined ethics of health research and bioethics. Public health works to protect the population from illness and premature death, often with restrictions such as in cigarette advertisement and smoking. Failure to act in protection of public health can be unethical by denying best practices in health protection and health promotion.