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Public health is fundamentally concerned with promoting the health of populations through the prevention of disease and injury. It is, at its core, a moral endeavor, because the end it seeks is the advancement of human well-being.
Vexing ethics issues are inherent in all aspects of public health practice and policy. This chapter provides a concise overview of the topics and issues examined in the Oxford Handbook of Public Health Ethics.
Keywords: public health ethics , population health , individual rights , justice. Natural disasters and cholera outbreaks. Ebola, SARS, and concerns over pandemic flu. Threats of bioterrorism. Contamination of compounded drugs. Vaccination refusals and outbreaks of preventable diseases. These are just some of the headlines from the last thirty-plus years highlighting the essential roles and responsibilities of public health, all of which come with ethical issues and the responsibilities they create.
Public health has achieved extraordinary successes. Life-threatening diseases that were once scourges—smallpox and diphtheria, for example—are either non-existent or far less prevalent CDC, , particularly in wealthier countries, and infant mortality rates are vastly lower in most parts of the world. Motor vehicles, workplaces, and the food supply are all considerably safer than they once were Berkeley Wellness, And yet these successes also bring with them ethical tension.
Not all public health successes are equally distributed in the population, and extraordinary health disparities between rich and poor still exist. The most successful public health programs sometimes rely on policies that, while improving public health conditions, also limit individual rights.
Moreover, the work of public health is always challenged by inadequate resources, raising the question of how best to allocate limited resources. Resources, financial and otherwise, may only be available to support programs that benefit a particular population or neighborhood, or that reflect a higher public health priority. Which community should receive an asthma prevention program? How should we weigh the interests of programs targeted to children against those targeted for older persons?
Should public resources be dedicated to bioterrorism preparedness or obesity prevention programs? How should vaccines, antivirals, and other life-saving resources be allocated during a global pandemic? Public health practitioners and policymakers face these and other questions of ethics routinely in their work, and they must navigate their sometimes competing responsibilities to the health of the public with other important societal values, such as privacy, autonomy, and prevailing cultural norms.
While overarching ethical commitments of public health are similar to those of medicine, the emphasis is quite different. Public health focuses its attention primarily on population and community health, often engaging in collective action or targeting societal conditions that contribute to better or worse health. This shift in emphasis inevitably leads public health to give moral priority to utility and to equity in ways that medical ethics need not.
A number of years ago, we realized that while there are volumes in the Oxford Handbook series devoted to a range of areas in bioethics, including the Handbooks of Bioethics, Clinical Research Ethics, Reproductive Ethics, Psychiatric Ethics, and Animal Ethics, none are devoted to public health ethics. The time has come.
The 15 sections of the volume begin with 2 sections that discuss the conceptual foundations, ethical tensions, and ethical frameworks of and for public health and how public health does its work. The following 13 sections examine the application of public health ethics considerations and approaches across a broad scope of public health topics.
While chapters are arranged into topical sections, each chapter is designed to serve as a stand-alone contribution. This approach makes the book, its sections, and individual chapters useful in a range of applications as part of course materials, or as a reference for students, scholars, and public health professionals. For this volume, we recruited 11 section editors, primarily from among our talented colleagues at the Johns Hopkins Berman Institute of Bioethics. Together, we identified the most important and pressing topics to be covered in a comprehensive handbook and potential authors who could contribute their expertise to this effort, including leading scholars working in public health ethics and authorities working in relevant areas of public health.
The section editors then recruited and worked with chapter authors to identify central issues and ethical challenges within distinct areas in our field. Authors were given substantial freedom in approach and were expected to share their perspectives on their assigned topics.
The resulting volume includes 73 chapters covering many topics from varying perspectives. We recognize that there may be some omitted areas—an acknowledgment of the breadth of activities and areas that define public health in the United States and globally, and the important diversity of ethics issues that occur within them.
Indeed, we encourage others to contribute to what this project has begun. Berkeley Wellness. Find this resource:. Childress, J. Kass, N. Anna C. Her scholarly work examines the intersection of law, bioethics, and public health policy.
Before joining the university, she was a practicing attorney and subsequently worked in a number of legal and governmental policy positions. She is an elected Fellow of the American Association for the Advancement of Science, recognized for her contributions to health policy, law, and bioethics. His research interests include the ethics of research, ethics and public health, and ethics and emerging biomedical technologies.
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Mastroianni Anna C. Jeffrey P. Kass Nancy E. All rights reserved. Sign in to annotate. Delete Cancel Save. Cancel Save.
The humanitarian sector has been strengthening its focus on and commitment to community-centred responses in recent years. This guide aims to provide field staff with clear, accessible guidance on the principles and practice of community engagement in WASH programmes. The content has been field tested in a variety of contexts. The principles and approaches described here are relevant in other programmes and sectors too, but the target audience for this guide is WASH staff in humanitarian programmes — especially those responsible for designing, implementing and monitoring public health promotion activities. It will also be relevant for managers, public health engineers and decision makers interested in promoting good quality outcomes in WASH programmes by ensuring that communities affected by crisis are at the centre of the response. Breadcrumb Home. Cover page image.
The technology necessary for effective, innovative application of information technology to public health practice is available today at very reasonable costs. The barrier to the widespread application of such technology is that few public health professionals have received any formal training in informatics, and most lack even a basic understanding of the nature and purpose of informatics as a discipline. Although the discipline of public health informatics has much in common with other informatics specialty areas, it differs from them in several ways. These include 1 a focus on applications of information science and technology that promote the health of populations, rather than of individuals; 2 a focus on disease prevention, rather than treatment; 3 a focus on preventive intervention at all vulnerable points in the causal chains leading to disease, injury, or disability; and 4 operation within a governmental, rather than a private, context. Drivers of change forcing public health professionals to be conversant with the development, use, and strategic importance of computerized health information systems include public health reform, the growth in managed care, and the information technology revolution. Unable to display preview.
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Public health is fundamentally concerned with promoting the health of populations through the prevention of disease and injury. It is, at its core, a moral endeavor, because the end it seeks is the advancement of human well-being. Vexing ethics issues are inherent in all aspects of public health practice and policy. This chapter provides a concise overview of the topics and issues examined in the Oxford Handbook of Public Health Ethics.
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