Ethics, Prevention, and Public Health (Issues in Biomedical Ethics)

Cover......Page 1
Contents......Page 6
Notes on Contributors......Page 8
Preface......Page 12
1.1. Aims of this Collection......Page 14
1.2. Some Central Themes of this Book......Page 15
1.3. The Emerging Field of Public Health Ethics......Page 19
1.4. Overview of this Book......Page 21
2.1. Introduction......Page 26
2.2. Definitions of ‘Public Health’......Page 27
2.3. Two Senses of ‘Public’ in Public Health......Page 34
2.4. The Health of the Public......Page 35
2.5. Collective Interventions......Page 38
2.6. Demarcating the Area of Public Health?......Page 40
2.7. Conclusion......Page 42
3.1. Introduction......Page 43
3.2. The Limits of Liberalism for Public Health Ethics......Page 45
3.3. A Sketch of Civic Republicanism......Page 51
3.4. Civic Virtue......Page 57
3.5. The Concept of the Public......Page 61
3.6. Health and the Common Good......Page 68
4. Health of the People: The Highest Law?......Page 72
4.1. The Problem of Public Health: From Personal Rights to Societal Obligations......Page 74
4.2. Public Health and the Law: A Theory and a Definition......Page 75
4.3. Public Health’s Vision: Why Population Health should be a Salient Public Value......Page 79
4.4. Law as a Tool to Protect the Public’s Health: Models of Public Health Intervention......Page 81
4.5. Conclusion......Page 89
5.1. What is Distinctive in a Population Focus? A Bird’s Eye Perspective in Bioethics......Page 91
5.2. Society’s Responsibility for Health......Page 92
5.3. Individual Responsibility for Health......Page 93
5.4. Health and Human Rights: What Relation to Population-Level Bioethics?......Page 94
5.6. Cost-Effectiveness Analysis (CEA)......Page 95
5.7. Health Measurement......Page 96
5.8. Health and Economic Development......Page 97
5.10. Risks and the People Who Bear Them......Page 98
5.11. Environmental Equity......Page 99
5.13. Protecting Health, Endangering Civil Liberties......Page 100
5.14. Global Aging......Page 101
5.16. Inequalities in Health Within Countries......Page 102
5.17. Social Determinants of Population Health......Page 103
5.18. Practice Implications of a Population Perspective......Page 104
5.20. Health System Reform......Page 105
5.21. Conclusion......Page 106
6. Parental Choice and Expert Knowledge in the Debate about MMR and Autism......Page 108
6.1. MMR Vaccination after the Wakefield Paper......Page 109
6.2. Respect for Parents and Patients......Page 110
6.3. Parental Choice, Realism and Deference to Experts......Page 114
6.4. Expert Knowledge and Democracy......Page 119
7.1. Introduction......Page 124
7.2. Ethical and Value Assumptions in CEA......Page 126
7.3. Ethical Issues in the Use of CEA......Page 131
7.4. Conclusion......Page 140
8.1. Introduction......Page 142
8.2. Limits to Demands on Agents......Page 144
8.3. Influenza Vaccination in Nursing Homes......Page 148
8.4. Demandingness and Reasonable Morality......Page 153
8.5. Relevance to Public Health Debates......Page 156
9. Vertical Transmission of Infectious Diseases and Genetic Disorder: Are the Medical and Public Responses Consistent?......Page 158
9.1. Syphilis......Page 161
9.2. Cystic Fibrosis......Page 162
9.3. Strategies for Testing for these Two Vertically Transmitted Diseases......Page 163
9.4. Syphilis and Cystic Fibrosis Compared......Page 166
9.5. What would Explain these Differences?......Page 167
9.6. Inconsistencies in Policy Approaches to Vertically Transmitted Diseases......Page 171
10. Herd Protection as a Public Good: Vaccination and our Obligations to Others......Page 173
10.1. The Nature of Contagious Diseases and Vaccinations......Page 174
10.2. Harm to Others......Page 179
10.3. The Harm to Others Argument and Vaccinations......Page 181
10.4. The Existence of Herd Protection and the No Additional Benefit Argument......Page 184
10.5. NAB as a Free-Rider Argument......Page 186
10.6. Conclusions......Page 190
11.1. Introduction......Page 192
11.2. Tobacco Discouragement: Changing People’s Preferences......Page 194
11.3. Harm to Others......Page 196
11.4. Economic Costs and Consequentialist Perspectives on Public Health......Page 200
11.5. Tobacco Discouragement as a Public Good......Page 204
11.6. Conclusion......Page 209
12. Informed Consent and the Expansion of Newborn Screening......Page 211
12.1. The Expansion of Newborn Screening......Page 213
12.2. The Informed Consent Imperative......Page 215
12.3. Full Informed Consent......Page 217
12.4. Problems for the ICI......Page 221
12.5. Concluding Remarks......Page 224
References......Page 226
Index......Page 246