We all know that every country in the world is unique in its culture, language, and lifestyle. But have you ever considered how provision of healthcare and treatment varies from region to region globally? It’s obvious that third world countries might not have the resources available to provide treatment equivalent to a public hospital in the United States. However, it is expected that a patient be provided the best treatment that is possible based on the funding and resources available in their home country. Ensuring each citizen of a country is given the same form of care is considered a form of justice, a perspective I had never thought of before. Often times, you will find there are nationally standardized guidelines about treatment options for the use of local doctors; this ensures a one patient does not get “better” medical care than his/her neighbor. All of these aspects fall under the jurisdiction of “standard of care” within a country, a link between law and medicine that I had previously never considered.
Standard of care is a common topic in medical discussion, though it is not clearly defined in the field. The most concrete definition of standard of care is a legal one, which defines the term as “the caution that a reasonable person in similar circumstances would exercise in providing care to a patient.” To uphold to the standard of care is a legal obligation of doctors. If they were to deviate from it, the practitioner could be held liable for medical malpractice or negligence. Standard of care often comes up when discussing global health politics, especially when physicians from one country are attempting to provide relief or treatment to citizens of another country. Clinical trials or research conducted outside the United States, for example, are expected to adhere to the local standard of care.
Here is an example where standard of care might be taken into consideration: say researchers were planning on testing a cure for an STI in South Africa. The doctors can only afford to administer the drug to a portion of the infected population due to the expenses of manufacturing the drug. After treatment, however, researchers find the drug worked on participants! But now, only a fraction of the population benefited from this new magical drug, and the rest of the country remains infected. This brings about an ethical issue because a portion of the population received a higher standard of care than other members of the community. It is possible, in this scenario, that the researchers violated a legal standard.
Ideally it seems like a simple concept to provide equal treatment opportunities to all citizens under a system of government. But in application, it can be a difficult task to accomplish. Medicine is not a science that can be executed identically for every procedure; there can be multiple solutions, each situation is unique, and every doctor might provide treatment differently. As a result, the guidelines for standard of care are always changing with time, location, and experience, as is the case for the field of medicine and law. So if you’re planning on embarking to a novel location for research or public health, remember to consider the country’s standard of care! You might be surprised to know that sometimes providing American standard of care in an impoverished country might not always be beneficial to the target population or the most ethical course of action!