Public Health Ethics

ISSN: 1754-9973

35 found

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  1.  1
    Informed Decision-Making and Capabilities in Population-based Cancer Screening.Ineke L. L. E. Bolt, Maartje H. N. Schermer, Hanna Bomhof-Roordink & Danielle R. M. Timmermans - 2022 - Public Health Ethics 15 (3):289-300.
    Informed decision-making (IDM) is considered an important ethical and legal requirement for population-based screening. Governments offering such screening have a duty to enable invitees to make informed decisions regarding participation. Various views exist on how to define and measure IDM in different screening programmes. In this paper we first address the question which components should be part of IDM in the context of cancer screening. Departing from two diverging interpretations of the value of autonomy—as a right and as an ideal—we (...)
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  2.  6
    COVID-19 Vaccines and the Virtues.Konrad V. Boyneburgk & Francesca Bellazzi - 2022 - Public Health Ethics 15 (3):209-219.
    From a moral point of view, what arguments are there for and against seeking COVID-19 vaccination? Can it be morally permissible to require (parts of) a population to receive a vaccine? The present paper adopts a perspective of virtue ethics and argues both that it is morally right for an individual virtuous moral agent to seek COVID-19 vaccination and for a virtuous ruler to impose mandatory vaccinations on her population.We begin by first presenting virtue ethics and the current vaccine controversy. (...)
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  3. Inequalities in the Challenges Affecting Children and their Families during COVID-19 with School Closures and Reopenings: A Qualitative Study.Ilaria Galasso & Gemma Watts - 2022 - Public Health Ethics 15 (3):240-255.
    School closure is one of the most debated measures undertaken to contain the spread of the Coronavirus disease (COVID-19) pandemic. The pandemic has devastating health and socio-economic effects and must be contained, but schools play a vital role in present and future well-being, capabilities and health of children. We examine the detrimental consequences of both the closure and reopening of schools, by focusing on inequalities in the challenges affecting children and their families. This paper is grounded on Irish and Italian (...)
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  4.  3
    Firearm Violence in the United States: An Issue of the Highest Moral Order.Chisom N. Iwundu, Mary E. Homan, Ami R. Moore, Pierce Randall, Sajeevika S. Daundasekara & Daphne C. Hernandez - 2022 - Public Health Ethics 15 (3):301-315.
    Firearm violence in the United States produces over 36,000 deaths and 74,000 sustained firearm-related injuries yearly. The paper describes the burden of firearm violence with emphasis on the disproportionate burden on children, racial/ethnic minorities, women and the healthcare system. Second, this paper identifies factors that could mitigate the burden of firearm violence by applying a blend of key ethical theories to support population level interventions and recommendations that may restrict individual rights. Such recommendations can further support targeted research to inform (...)
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  5.  9
    Realizing Ubuntu in Global Health: An African Approach to Global Health Justice.Nancy S. Jecker, Caesar A. Atuire & Nora Kenworthy - 2022 - Public Health Ethics 15 (3):256-267.
    The COVID-19 pandemic has highlighted the question, ‘What do we owe each other as members of a global community during a global health crisis?’ In tandem, it has raised underlying concerns about how we should prepare for the next infectious disease outbreak and what we owe to people in other countries during normal times. While the prevailing bioethics literature addresses these questions drawing on values and concepts prominent in the global north, this paper articulates responses prominent in sub-Saharan Africa. The (...)
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  6.  3
    Maternal Referral Delays and a Culture of Downstream Blaming Among Healthcare Providers: Causes and Solutions.Monali Mohan, Rakhi Ghoshal & Nobhojit Roy - 2022 - Public Health Ethics 15 (3):268-276.
    Patient referral management is an integral part of clinical practice. However, in low-resource settings, referrals are often delayed. The World Health Organization categorizes three types of referral delays; delay in seeking care, in reaching care and in receiving care. Using two case studies of maternal referrals (from a low-resource state in India), this article shows how a culture of downstream blaming permeates referral practice in India. With no referral guidelines to follow, providers in higher-facilities evaluate the clinical decision-making of their (...)
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  7.  6
    Commercial mHealth Apps and Unjust Value Trade-offs: A Public Health Perspective.Leon W. S. Rossmaier - 2022 - Public Health Ethics 15 (3):277-288.
    Mobile health (mHealth) apps for self-monitoring increasingly gain relevance for public health. As a mobile technology, they promote individual participation in health monitoring with the aim of disease prevention and the mitigation of health risks. In this paper, I argue that users of mHealth apps must engage in value trade-offs concerning their fundamental dimensions of well-being when using mobile health apps for the self-monitoring of health parameters. I particularly focus on trade-offs regarding the user’s self-determination as well as their capacity (...)
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  8.  3
    How Mandatory Can We Make Vaccination?Ben Saunders - 2022 - Public Health Ethics 15 (3):220-232.
    The novel coronavirus (SARS-CoV-2) pandemic has refocused attention on the issue of mandatory vaccination. Some have suggested that vaccines ought to be mandatory, while others propose more moderate alternatives, such as incentives. This piece surveys a range of possible interventions, ranging from mandates through to education. All may have their place, depending on circumstances. However, it is worth clarifying the options available to policymakers, since there is sometimes confusion over whether a particular policy constitutes a mandate or not. Further, I (...)
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  9.  1
    (Un)fairness of Vaccination Freeriding.Marcel Verweij - 2022 - Public Health Ethics 15 (3):233-239.
    For contagious diseases like measles a successful immunization program can result in herd protection. Small outbreaks may still occur but fade out soon, because the possibilities for the pathogen to spread in the ‘herd’ are very small. This implies that people who refuse to participate in such a program will still benefit from the protection it offers, but they don’t do their part in maintaining protection. Isn’t that a case of freeriding—and isn’t that unfair towards all the people who do (...)
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  10.  8
    Democratic Ethical Consumption and Social Justice.Andreas Albertsen - 2022 - Public Health Ethics 15 (2):130-137.
    Hassoun argues that the poor in the world have a right to health and that the Global Health Impact Index provides consumers in well-off countries with the opportunity to ensure that more people have access to essential medicines. Because of this, these consumers would be ethically obliged to purchase Global Health Impact Index-labeled products in the face of existing global inequalities. In presenting her argument, Hassoun rejects the so-called democratic account of ethical consumption in favor of the positive change account. (...)
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  11.  4
    Metric Used in the Global Health Impact Project: Implicit Values and Unanswered Questions.Yukiko Asada - 2022 - Public Health Ethics 15 (2):124-129.
    The core aims of the Global Health Impact Project include incentivizing pharmaceutical companies for socially conscious production and promoting socially conscious consumption among consumers. Its backbone is a metric that computes the amount of illness burden alleviated by a pharmaceutical drug. This essay aims to assess the connection between values and numbers in the Global Health Impact Project. Specifically, I concentrate on two issues, the anonymity of illness burden and the distribution of health benefits. The former issue asks whether we (...)
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  12.  6
    Personal Responsibility for Health: Exploring Together with Lay Persons.Yukiko Asada, Marion Brown, Mary McNally, Andrea Murphy, Robin Urquhart & Grace Warner - 2022 - Public Health Ethics 15 (2):160-174.
    Emerging parallel to long-standing, academic and policy inquiries on personal responsibility for health is the empirical assessment of lay persons’ views. Yet, previous studies rarely explored personal responsibility for health among lay persons as dynamic societal values. We sought to explore lay persons’ views on personal responsibility for health using the Fairness Dialogues, a method for lay persons to deliberate equity issues in health and health care through a small group dialogue using a hypothetical scenario. We conducted two 2-h Fairness (...)
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  13.  4
    DALYs and the Minimally Good Life.Tim Campbell - 2022 - Public Health Ethics 15 (2):119-123.
    Nicole Hassoun’s book Global Health Impact: Extending Access to Essential Medicines has three parts. Part 1 is about the right to health, Part 2 offers a concrete proposal for how to promote the ability of people in the developing world to live minimally good lives and Part 3 is concerned with consumer responsibility as it relates to global health. I argue that there is a philosophical tension between the respective projects of Parts 1 and 2. The project of Part 1 (...)
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  14. Better Mechanisms Are Needed to Oversee HREC Reviews.Lisa Eckstein, Rebekah McWhirter & Cameron Stewart - 2022 - Public Health Ethics 15 (2):200-203.
    Hawe et al. raise concerns about Human Research Ethics Committees (HRECs) taking a risk-averse and litigation-sensitive approach to ethical review of research proposals. HRECs are tasked with reviewing proposals for compliance with the National Statement on Ethical Conduct in Human Research for the purpose of promoting the welfare of participants. While these guidelines intentionally include a significant degree of discretion in HREC decision making, there is also evidence that HRECs sometimes request changes that go beyond the guidance provided by the (...)
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  15.  2
    Holly Wardlow. Fencing in AIDS: Gender, Vulnerability and Care in Papua New Guinea.Katherine Furman - 2022 - Public Health Ethics 15 (2):204-205.
    This book provides a detailed ethnography of the lives of those with HIV, mostly women, in the Tari region of Papua New Guinea. The author, Holly Wardlow, is Professor of Anthropology at the University of Toronto, with extensive experience in Papua New Guinea and an academic focus on medical anthropology and intimate relationships. Her research for Fencing in AIDS: Gender, Vulnerability and Care in Papua New Guinea takes place over most of a decade: starting in 2004 and ending in 2013. (...)
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  16.  2
    Enhancing Global Health Impact—Beyond the Basic Minimum, Metrics and Ethical Consumption.Nicole Hassoun - 2022 - Public Health Ethics 15 (2):138-146.
    How should we measure medicines’ global health impact to set targets, monitor performance and improve health around the world? Can such a metric provide a philosophically well-grounded basis for an ethical consumption campaign that will create incentives for pharmaceutical companies and other agents to expand (equitable) access to essential medicines? And if such metrics exist, how should we think about our individual obligations to support ethical consumption campaigns on this basis? This paper reflects on these questions in light of Tim (...)
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  17.  2
    Risk Management Practices of Health Research Ethics Committees May Undermine Citizen Science to Address Basic Human Rights.Penelope Hawe, Samantha Rowbotham, Leah Marks & Jonathan Casson - 2022 - Public Health Ethics 15 (2):194-199.
    Lack of supportive workplaces may be depriving babies and mothers of the health advantages of breastfeeding. This citizen science pilot project set out to engage women in photographing and sharing information on the available facilities for breastfeeding and expressing and storing breastmilk in Australian workplaces. While some useful insights were gained, the project failed in the sense that 234 people ‘liked’ the project Facebook page set up to recruit participants, but only nine photographs were submitted. The heaviest loss of participation (...)
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  18.  1
    Global Health Impact.Anders Herlitz - 2022 - Public Health Ethics 15 (2):117-118.
    Why should we care about global health? What obligations do we have to improve global health? How can we work towards establishing a health industry that is better equipped to deal with the most significant global health challenges? In her impressive and ambitious book, Global Health Impact: Extending Access to Essential Medicine (Hassoun, 2020), Nicole Hassoun attempts to answer these questions, by drawing on contemporary research in political philosophy, global justice, health economics and business ethics. In this symposium, Timothy Campbell, (...)
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  19. Building an Opt-Out Model for Service-Level Consent in the Context of New Data Regulations.A. R. Howarth, C. S. Estcourt, R. E. Ashcroft & J. A. Cassell - 2022 - Public Health Ethics 15 (2):175-180.
    The General Data Protection Regulation (GDPR) was introduced in 2018 to harmonize data privacy and security laws across the European Union (EU). It applies to any organization collecting personal data in the EU. To date, service-level consent has been used as a proportionate approach for clinical trials, which implement low-risk, routine, service-wide interventions for which individual consent is considered inappropriate. In the context of public health research, GDPR now requires that individuals have the option to choose whether their data may (...)
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  20.  3
    Empirical Research and Recommendations for Moral Action: A Plea for the Transparent Reporting of Bridge Principles in Public Health Research.Katja Kuehlmeyer, Marcel Mertz, Joschka Haltaufderheide, Alexander Kremling, Sebastian Schleidgen & Julia Inthorn - 2022 - Public Health Ethics 15 (2):147-159.
    Academic publications of empirical public health research often entail recommendations for moral action that address practitioners and policy makers. These recommendations are regularly based on implicit moral judgments with the underlying reasons not explicitly stated. In this paper, we elaborate on the moral relevance of such judgments and the need to explain them in order to account for academic argumentation. We argue for an explicit reporting of bridge principles to increase the transparency of the reporting of public health research. The (...)
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  21.  1
    Language of Incarceration and of Persons Subject to Incarceration.Lynette Reid - 2022 - Public Health Ethics 15 (2):191-193.
    Reflecting on Smith (2021) in this issue, this commentary extends our consideration of issues in carceral health and questions the dehumanizing language we sometimes use—including in public health and public health ethics—to talk about persons held in incarceration. Even the language we use for the carceral system itself (such as ‘criminal justice system’) is fraught: it casts a laudatory light on the system and papers over its role in compounding racial health inequities and in sustaining colonialism. A host of issues (...)
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  22.  2
    James Wilson. Philosophy for Public Health & Policy: Beyond the Neglectful State.Diego S. Silva - 2022 - Public Health Ethics 15 (2):206-208.
    Complexity abounds in public health, yet public health ethics—as currently practiced—often struggles to accept this state-of-affairs; this results in moral debates that overemphasize the potential overreach of states in the pursuit of public health, while underemphasizing its morally troubling underreach. James Wilson’s Philosophy for Public Health and Public Policy: Beyond the Neglectful State (2021) represents a culmination of over a decade of his work where he tries addressing directly the challenge of complexity of reasoning about values in applied political philosophy. (...)
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  23.  2
    Ethical Implications of Preventive Medicine within Correctional Healthcare.Molly Smith - 2022 - Public Health Ethics 15 (2):186-190.
    Incarcerated offenders are categorically high-risk patients who are disproportionately more likely to suffer from chronic illnesses than members of the general population. The conditions of confinement (e.g., overcrowding, poor nutrition, risky sexual practices) furthermore make them increasingly susceptible to acquiring an infectious disease. Past research has linked preventive care, including the early detection and treatment of such diseases, with better long-term health outcomes; however, such care is not universally provided to this population. The benefits and current availability of preventive care (...)
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  24.  1
    Data Medicine: ‘Broad’ or ‘Dynamic’ Consent?Henri-Corto Stoeklé, Elisabeth Hulier-Ammar & Christian Hervé - 2022 - Public Health Ethics 15 (2):181-185.
    The General Data Protection Regulation imposes, at European level, a need to seek express or explicit consent for the processing of health data. In the framework of biomedical research, some favor the use of express ‘broad’ consent, whereas other maintain, or wish to maintain the use of presumed or implicit consent, often referred to as ‘non-opposition’ in conditions in which such consent is still authorized. In our view, broad consent and presumed consent are likely to prove to be easy solutions (...)
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  25. Pandemic Ethics and Status Quo Risk.Richard Yetter Chappell - 2022 - Public Health Ethics 15 (1):64-73.
    Conservative assumptions in medical ethics risk immense harms during a pandemic. Public health institutions and public discourse alike have repeatedly privileged inaction over aggressive medical interventions to address the pandemic, perversely increasing population-wide risks while claiming to be guided by ‘caution’. This puzzling disconnect between rhetoric and reality is suggestive of an underlying philosophical confusion. In this paper, I argue that we have been misled by status quo bias—exaggerating the moral significance of the risks inherent in medical interventions, while systematically (...)
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  26.  17
    We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources.Roberto Fumagalli - 2022 - Public Health Ethics 15 (1):87-103.
    In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures to allocate scarce life-saving resources. In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims (...)
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  27.  20
    Public Health Virtue Ethics.Kathryn MacKay - 2022 - Public Health Ethics 15 (1):1-10.
    This paper proposes that public health is the sort of institution that has a role in producing structures of virtue in society. This proposal builds upon work that describes how virtues are structured by the practices of institutions, at the collective or whole-of-society level. This work seeks to fill a gap in public health ethics when it comes to virtues. Mainstay moral theories tend to incorporate some role for virtues, but within public health ethics this role has not been fully (...)
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  28.  6
    Response: Collective Moral Agents and Their Collective-Level Virtues.Kathryn MacKay - 2022 - Public Health Ethics 15 (1):23-26.
    In this short piece, I attempt to respond to some of the challenges raised by Jessica Nihlén Fahlquist and Karen Meagher in their commentaries on my paper, ‘Public Health Virtue Ethics’. While these authors have made many insightful and challenging remarks, I mostly focus on two questions here: first, about the nature of collectives as moral agents, in response to Nihlén Fahlquist, and second, about the concept of a collective-level virtue, in response to Meagher.
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  29.  6
    The Ethics of COVID-19 Vaccine Allocation: Don't Forget the Trade-Offs!Julian W. März, Anett Molnar, Søren Holm & Michael Schlander - 2022 - Public Health Ethics 15 (1):41-50.
    The issue of COVID-19 vaccine allocation is still highly controversial on the international as well as on the national level, and policy-makers worldwide struggle in striking a fair balance between different ethical principles of vaccine allocation, in particular maximum benefit, reciprocity, social justice and equal respect. Any political decision that implements these principles comes at a cost in terms of loss of lives and of loss of life years that could potentially have been prevented by a different vaccination strategy. This (...)
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  30.  3
    Excellent Traits in Public Health: Virtuous Structures and the Structure of Virtue.Karen M. Meagher - 2022 - Public Health Ethics 15 (1):16-22.
    MacKay’s Public Health Virtue Ethics offers a distinctive approach to public health ethics, with social structures at the forefront. MacKay’s helpful overview of the recent literature considers three distinct referents for ascribing virtues in public health ethics: (i) individuals, such as public health practitioners, (ii) social structures, such as public health institutions and policies and (iii) the communities affected by public health policy. While MacKay is interested in virtuous structures, I am interested in the structure of virtue as a precursor (...)
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  31.  7
    Public Reason and Public Health: Can Anti-smoking Policies Be Justified According to a Public Reason Account of Justification?Morten Ebbe Juul Nielsen - 2022 - Public Health Ethics 15 (1):104-116.
    Public reason demands that policies are justified to all reasonable citizens. Public health aims at protecting or improving aggregated health outcomes. Since health is not an uncontroversial value, an insurmountable chasm between public reason and public health seems to preclude any viable synthesis between the two outlooks. For any given public health policy, some reasonable citizen seems to have a reason to support ‘no policy’ over ‘some policy’, meaning that the policy cannot be justified to all. The paper first spells (...)
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  32.  1
    Individual Virtues and Structures of Virtue in Public Health.Jessica Nihlén Fahlquist - 2022 - Public Health Ethics 15 (1):11-15.
    Public health ethics is commonly analyzed within a consequentialist or rights-based perspective, but recent approaches explore public health from a virtue ethical perspective. Rozier focuses on the virtues of individual members of the public and I discuss public health professionals. MacKay emphasizes the role of the collective level, the practice and social structure of public health. The structure can be important in two ways. First, it potentially affects the cultivation of the virtues of individuals. Second, the structure itself could have (...)
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  33.  14
    COVID-19 Vaccination Passports: Are They a Threat to Equality?Kristin Voigt - 2022 - Public Health Ethics 15 (1):51-63.
    In several countries, governments have implemented so-called ‘COVID passport’ schemes, which restrict access to venues such as bars or sports events to those who are vaccinated against COVID-19 and/or exempt vaccinated individuals from public health measures such as curfews or quarantine requirements. These schemes have been the subject of a heated debate. Concerns about inequality have played an important role in the opposition to such schemes. This article highlights that determining how COVID passports affect equality requires a much more nuanced (...)
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  34.  30
    In Defense of Vaccine Mandates: An Argument from Consent Rights.Daniel A. Wilkenfeld & Christa M. Johnson - 2022 - Public Health Ethics 15 (1):27-40.
    This article will focus on the ethical issues of vaccine mandates and stake claim to the relatively extreme position that outright requirements for people to receive the vaccine are ethically correct at both the governmental and institutional levels. One novel strategy employed here will be to argue that deontological considerations pertaining to consent rights cut as much in favor of mandating vaccines as against them. The presumption seems to be that arguments from consent speak semi-definitively against forcing people to inject (...)
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  35.  27
    The Ethics of Selective Mandatory Vaccination for COVID-19.Bridget M. Williams - 2022 - Public Health Ethics 15 (1):74-86.
    With evidence of vaccine hesitancy in several jurisdictions, the option of making COVID-19 vaccination mandatory requires consideration. In this paper I argue that it would be ethical to make the COVID-19 vaccination mandatory for older people who are at highest risk of severe disease, but if this were to occur, and while there is limited knowledge of the disease and vaccines, there are not likely to be sufficient grounds to mandate vaccination for those at lower risk. Mandating vaccination for those (...)
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