The New Public Health (Fourth Edition), Chapter 15 - Health technology, quality, law, and ethics

Elsevier, The New Public Health (Fourth Edition) 2023, Pages 1037-1095
Theodore H. Tulchinsky MD, MPH, Elena A. Varavikova MD, MPH, PhD, Matan J. Cohen MD, MPH, PhD

Technology assessment capability is vital in determining health policy and priorities because changes in science and technology occur rapidly and are essential for progress. Quality is promoted by strong professional education and practice standards, accreditation by state and nongovernmental authorities for health provider institutions, and public health departments, and educational programs 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. Adopting new evidence-based methods of prevention, diagnosis, and therapy has improved and will continue to improve quality of life and longevity. Translation of scientific and technological advances into applied practice requires the education of public health policymakers and that practitioners are 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 that need continuous revision in keeping with societal changes and norms. Law and ethics in public health reflect societal values within social, economic, demographic, epidemiologic, and political changes while facing new health challenges and technologies. Health ethics required reexamination in light of medical participation in 20th-century genocides in the name of racial purity and the industrialized murder of millions in World War II. The Nuremberg Trials redefined health research ethics and bioethics. Public health works to protect the population from illness and premature death, often with restrictions, such as in cigarette advertisements and smoking. Failure to act to protect public health can be unethical because it can deny the best practices in health protection and health promotion.