Health Equity in the U.S. Constitution: Amendments, Ethics, and Nursing Impact
Introduction
Health equality is often described as the absence of socially unjust or unfair health inequalities. It specifically emphasizes the allocation of resources and other mechanisms that contribute to a certain kind of health disparity. Health equality and equity are crucial because health is essential to the basic aspects of human existence. Attaining comprehensive health equality is an abstract concept; nevertheless, in practice, many countries and governance systems contain varying degrees of success in reaching it.
For instance, the United States exhibits significant differences in health and access to healthcare. Health equality in the United States requires eradicating disparities in the availability of healthcare services based on factors such as race, ethnicity, sex, gender identity, comorbidities, or ability (Schweikart, 2021). To achieve health equity, governments can use a range of instruments, including civil rights laws and constitutional principles. The U.S. Constitution and its amendments promote health equality by establishing the groundwork for civil rights and anti-discrimination measures.
Significance of the Topic
The role of the U.S. Constitution and its amendments in advancing health equity is important at the local, national, and international levels. Fair and equal access to healthcare is inherently connected to the entire operation and well-being of a society. Health equality guarantees that every person, regardless of race, income, or gender, has equal access to high-quality healthcare and the opportunity to lead a healthy life (World Health Organization, 2020). It is essential to establish this as a basis for attaining social justice and serves as a measure of a just and cultured society. Health equality at the community level may lead to improved public health outcomes and greater economic stability, as communities gain greater control over the spread of infectious diseases and the management of chronic health conditions.
An improved state of health among individuals leads to better educational achievement, lower poverty rates, and a stronger, more productive labor force. At the national level, it is crucial to have constitutional safeguards that guarantee equal rights, including the implied right to health, to tackle systemic health inequities effectively. Health equality is both a question of justice and an aim of public policy (World Health Organization, 2020). It may increase social unity and ensure the country’s stability by showcasing the appreciation and assistance given to all individuals. On a global scale, when a country such as the U.S. prioritizes equitable access to healthcare, guided by its constitutional ideals, it establishes a benchmark that may inspire other countries to do the same.
Ethical Principles Involved
The promotion of health equity is guided by several ethical principles that embody the ideals and standards necessary to establish a fair and just healthcare system. The principles cover autonomy, which supports people’s entitlement to make well-informed choices about their own medical treatment (World Health Organization, 2020). Facilitating individuals’ access to the necessary knowledge and tools to make informed choices is a crucial component of achieving health equality. Beneficence encompasses the need to prioritize patients’ best interests and raise their well-being, which is fundamental to achieving health equality (Varkey, 2021). Ensuring the delivery of high-quality healthcare services that improve patient well-being and welfare is a moral obligation.
Nonmaleficence requires healthcare practitioners and systems to take measures to prevent harm to patients. The aim of addressing health inequalities is to mitigate damage that might disproportionately affect certain populations. Justice is the principle of treating individuals fairly and equally (Varkey, 2). In healthcare, it ensures access to medical services, resources, and therapies regardless of an individual’s socioeconomic status, ethnic background, gender, or other personal attributes.
Equality, closely linked to justice, requires considering the distinct needs and circumstances of people or communities to ensure impartial treatment. It entails offering further assistance to those who encounter more significant barriers to achieving good health. The concept of ‘Respect for Persons’ acknowledges the inherent dignity of every person and emphasizes the need to honor their rights and autonomy (Subramani & Biller-Andorno, 2022). Within the realm of health equity, the principle of respect for people entails providing fair and impartial attention and care to all individuals seeking medical treatment. They involve interconnected principles that provide a moral structure for examining and resolving health disparities.
Issues to Consider in Resolving the Ethical Question
Regarding the promotion of health equity, the U.S. Constitution and its amendments address ethical questions. It involves interpreting the equal protection clause and due process in relation to healthcare access, understanding how constitutional rights apply to healthcare services. It also means recognizing the limitations of constitutional protections in addressing the social factors that contribute to health disparities.
Moreover, the Fifth and Fourteenth amendments specifically restrict discrimination by the federal and state governments (Civil Rights Division, n.d.a). Although these rules have the potential to decrease health inequities, their full effectiveness has not been realized due to the judicial branch’s interpretation and enforcement of these laws. The manner in which courts resolve health-related matters, particularly those involving civil or other human rights laws, is crucial to advancing legislative and legal strategies effectively.
Legislative Efforts
There have been many legislative endeavors in the United States, at both the federal and state levels, with the explicit aim of advancing health equity. However, regarding human rights, the United States does not have an officially established right to health, nor does it participate in any human rights convention that explicitly mentions such a right. An exemplary instance of such an agreement is the International Covenant on Economic, Social, and Cultural Rights (ICESCR).
It develops a distinct, but contested as “ambiguous” and “impractical,” right to health. The United States has ratified the ICESCR without signing it, meaning the pact is morally obligatory on the US but not legally binding (UNHCR, n.d.). One instance of regulation of the issue was the Affordable Care Act, implemented in 2010, which aims to reduce the number of uninsured individuals in the United States and lower healthcare costs (Isola & Reddivari, 2022). The policy included subsidies to help people purchase insurance, expanded Medicaid, and prohibited insurers from refusing coverage on the grounds of pre-existing conditions. The purpose of these efforts was to enhance healthcare access for historically marginalized communities and help mitigate health inequities.
Title VI of the Civil Rights Act of 1964 prohibits discrimination based on race, color, or national origin in any program or activity that receives federal financial assistance. Even though it is not centered on the health sector, its effects extend to ensuring fair opportunities and treatment in this industry as well (Civil Rights Division, n.d. b). Proper insurance coverage plays a significant role in reducing health issues.
Importance of the Topic to the Nursing Profession
The issue of health equity and its impact on the American Constitution is of great significance to the nursing profession and nursing services. Nurses often serve as the first line of patient care and play a crucial role in ensuring fair and impartial healthcare. They, as a highly trusted and significant part of the healthcare profession, directly observe and address the impact of health inequalities on individuals’ and communities’ health. The U.S. Constitution plays a distinctive role, enabling nurses to champion marginalized groups, deliver care sensitive to diverse cultures, and work to remove barriers to healthcare access. These actions are in accordance with the nursing profession’s dedication to social justice and ethical principles of practice.
Conclusion
The pursuit of health equity is complex and burdensome; however, the nursing profession makes significant contributions to accelerate progress towards this goal. Owing to their direct patient interaction, community outreach, and contributions to developing the national health policy, nurses are well-placed to identify and address the root causes of health disparities. By operating on a foundation of cultural competence, nurses may eventually lead in the creation of a national health system that serves each person equitably. The future of nursing is closely connected to the goal of achieving health fairness, which is possible through amendments to the Constitution that address the needs of the healthcare industry.
References
Civil Rights Division. (n.d. a). Section V – defining title VI. Justice.
Civil Rights Division. (n.d. b). Title VI of the Civil Rights act of 1964. Justice.
Isola, S., & Reddivari, A. K. R. (2022). Affordable Care Act (ACA). StatPearls Publishing.
Schweikart, S. (2021). How to apply the Fourteenth amendment to the constitution and the Civil Rights Act to promote health equity in the US. AMA Journal of Ethics, 23(3), E235-239.
Subramani, S., & Biller-Andorno, N. (2022). Revisiting respect for persons: Conceptual analysis and implications for clinical practice. Medicine, Health Care and Philosophy, 25(3).
UNHCR. (n.d.). International covenant on economic, social and cultural rights, international covenant on civil and political rights and optional protocol to the international covenant on civil and political rights. Refworld.
Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17–28.
World Health Organization. (2020). Health equity — global. Who.int.
