Public Health Ethics: Mapping the Terrain
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Mill, 1976, On Liberty
Beauchamp, 2001, Principles of Biomedical Ethics
3. We recognize that there are different views about the ultimate moral justification for the social institution of public health. For example, some communitarians appear to support public health as an instrumental goal to achieve community. Others may take the view that the state has a duty to ensure the public's health as a matter of social justice. Although these different interpretations and others are very important for some purposes, they do not seriously affect the conception of public health ethics that we are developing, as long as public health agents identify and inform others of their various goals.
13. See Faden, Geller, Powers, , supra note 11 Gostin, , supra note 4, at 199–201.
Kawachi, 2000, Income Inequality and Health, vol. 1 of The Society and Population Health Reader
Stern, 1996, Understanding Risk: Informing Decisions in a Democratic Society
14. In rare cases, it may be ethically justifiable to limit the disclosure of some information for a period of time (for example, when there are serious concerns about national security, about the interpretation, certainty, or reliability of public health data; or about the potential negative effects of disclosing the information, such as with suicide clusters).
2. Committee for the Study of the Future of Public Health, Division of Health Care Services, Institute of Medicine, The Future of Public Health (Washington, D.C.: National Academy Press, 1988): at 1.
23. See Gostin, , supra note 4, at 21.
1. Our definition builds on the definition of health systems offered by the World Health Organization: Health systems include “all the activities whose primary purpose is to promote, restore, or maintain health.” See World Health Report 2000 Health Systems: Improving Performance (Geneva: World Health Organization, 2000): at 5.
Gostin, 2000, Public Health Law: Power, Duty, Restraint
9. This justificatory condition is probably the most controversial. Some of the authors of this paper believe that the language of “necessity” is too strong. Whatever language is used, the point is to avoid a purely utilitarian strategy that accepts only the first two conditions of effectiveness and proportionality and to ensure that the non-utilitarian general moral considerations set some prima facie limits and constraints and establish moral priorities, ceteris paribus.
Nieburg, Law in Public Health Practice
Mann, 1997, “Medicine and Public Health, Ethics and Human Rights,”, The Hastings Center Report, 27, 6, 10.2307/3528660
Nagel, 1995, Society's Choices: Social and Ethical Decision Making in Biomedicine, 201
7. We do not explore here the overlaps among public health ethics, medical ethics, research ethics, and public policy ethics, although some areas of overlap and difference will be evident throughout the discussion. Further work is needed to address some public health activities that fall within overlapping areas — for instance, surveillance, outbreak investigations, and community-based interventions may sometimes raise issues in the ethics of research involving human subjects.
17. Id. at 16–17, 156.
22. Mann, , supra note 21, at 10. Mann thought that the language of ethics could guide individual behavior, while the language of human rights could best guide societal-level analysis and response. See Mann, , supra note 21, at 8; Marks, supra note 21, at 131–38. We disagree with this separation and instead note the overlap of ethics and human rights, but we endorse the essence of Mann's position on human rights.
Daniels, 1997, “Limits to Health Care: Fair Procedures, Democratic Deliberation, and the Legitimacy Problem for Insurers,”, Philosophy and Public Affairs, 26, 303, 10.1111/j.1088-4963.1997.tb00082.x
8. Recognizing universalizability by attending to past precedents and possible future precedents does not preclude a variety of experiments, for instance, to determine the best ways to protect the public's health. Thus, it is not inappropriate for different states, in our federalist system, to try different approaches, as long as each of them is morally acceptable.