Abstract
Intuitively we feel that we ought (to attempt) to save the lives, or ameliorate the suffering, of identifiable individuals where we can. But this comes at a price. It means that there may not be any resources to save the lives of others in similar situations in the future. Or worse, there may not be enough resources left to prevent others from ending up in similar situations in the future. This chapter asks whether this is justifiable or whether we would be better served focusing on public health in the form of preventative medicine. It looks briefly at the supposed difference between benefiting individuals and benefiting populations by considering the difference between interventions aimed at ‘rescue’ and those which are preventative. It then considers the rule of rescue in the health care setting, and looks at some of the reasons stemming from this that we might have for allocating resources to rescue interventions. If these reasons do not provide adequate justification for preferring these types of interventions, then the implication is that our current mode of resource allocation may need to be revised in favour of a more public health-oriented model.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bayer, R. and Fairchild, A.L. 2004. “The Genesis of Public Health Ethics.” Bioethics 18(6): 473–492.
Brazier, M. and Harris, J. 1996. “Public Health and Private Lives.” Medical Law Review 4(2): 171–192.
Broome, J. 1994. “Discounting the Future.” Philosophy & Public Affairs 23(2): 128–156.
Boylan, M. 2004. “What is Public Health?” Public Health Policy and Ethics, ed. M. Boylan. Dordrecht: Kluwer, pp. ix–xiii.
Chan, S. and Harris, J. “Free Riders and Pious Sons–Why Science Research Remains Obligatory.” Bioethics Online Early Articles Published: 25-Apr-2008.
Charlton, B.G. 1993. “Public Health Medicine–a Different Kind of Ethics.” Journal of the Royal Society of Medicine 86: 194–195.
Childress, J.F., Faden, R.R., Gaare, R.D., Gostin, L.O., Kahn, J., Bonnie, R.J., Kass, N.E., Mastroianni, A.C., Moreno, J.D., Nieburg, P. 2002. “Public Health Ethics: Mapping the Terrain.” Journal of Law, Medicine & Ethics 30: 170–178.
De Jong, M.D., Tran, T.T., Truong, H.K., Vo, M.H., Smith, G.J., Nguyen, V.C., Bach, V.C., Phan, T.Q., Do, Q.H., Guan, Y., Peiris, J.S., Tran, T.H., Farrar, J. 2005. “Oseltamivir Resistance During Treatment of Influenza A (H5N1) Infection.” New England Journal of Medicine 353: 2667–2672.
Diehr, P., Derleth. A., Cai, L., and Newman A.B. 2007. “The Effect of Different Public Health Interventions on Longevity, Morbidity, and Years of Healthy Life.” BMC Public Health 7: 52.
Harris, J. 1980. Violence and Responsibility. London, Boston and Henley: Routledge and Kegan Paul.
Harris, J. 1994. “Does Justice Require That We Be Ageist?” Bioethics 8(1): 74–84.
Harris, J. 1996. “What Is the Good of Health Care?” Bioethics 10(4): 269–292.
Harris, J. 1997. “What the Principal Objective of the NHS Should Really Be.” British Medical Journal 314(7081): 669–672.
Harris, J. 2002. “Identity, Prudential Concern and Extended Lives: A Response to Walter Glannon.” Bioethics 16(3): 284–291.
Harris, J. 2003. “Consent and End of Life Decisions.” Journal of Medical Ethics 29(1): 10–16.
Harris, J. 2005. “The Age-Indifference Principle and Equality.” Cambridge Quarterly of Healthcare Ethics 14(1): 93–99.
Harris, J. 2007. Enhancing Evolution. Princeton and Oxford: Princeton University Press.
Harris, J. and Sulston, J. 2004. “Genetic Equity.” Nature Reviews Genetics 5: 796–800.
Hope, T. 2001. “Rationing and Life-Saving Treatments: Should Identifiable Patients have Higher Priority?” Journal of Medical Ethics 27: 179–185.
Institute of Medicine, Committee for the Study of the Future of Public Health. 1988 The Future of Public Health. Washington DC: National Academy Press.
Jenni, K.E. and Lowenstein, G. 1997. “Explaining the Identifiable Victim Effect.” Journal of Risk and Uncertainty 14: 235–257.
Jonsen, A.R. 1986. “Bentham in a Box: Technology Assessment and Health Care Allocation.” Law, Medicine & Health Care 14: 172–174.
Kamm, F.M. 2000. “Does Distance Matter Morally to the Duty of Rescue?” Law and Philosophy 19: 655–681.
Lindgren, P., Fahlstadius, P., Hellenius, M.L., Jönsson, B., and De Faire, U. 2003. “Cost-effectiveness of Primary Prevention of Coronary Heart Disease Through Risk Factor Intervention in 60-Year-Old Men from the County of Stockholm–a Stochastic Model of Exercise and Dietary Advice.” Preventative Medicine 36(4): 403–409.
McKie, J. and Richardson, J. 2003. “The Rule of Rescue.” Social Science & Medicine 56: 2407–2419.
Mill, J. S. (1962). Utilitarianism, ed. M. Warnock. London: Collins/Fontana.
Miller, A. (1961). All My Sons. Harmondsworth: Penguin.
Pamuk, E.R., Wagener, D.K., and Molla, M.T. 2004. “Achieving National Health Objectives: The Impact on Life Expectancy and on Healthy Life Expectancy.” American Journal of Public Health 94(3): 378–383.
Parfit, D. 1984. Reasons and Persons. Oxford: Clarendon Press, pp. 356ff.
Parfit, D. (1978) “Innumerate Ethics.” Philosophy & Public Affairs 7(4): 285–301.
Schwappach, D.L.B., Boluarte, T.A., and Suhrcke, M. 2007. “The Economics of Primary Prevention of Cardiovascular Disease–a Systematic Review of Economic Evaluations.” Cost Effectiveness and Resource Allocation 5: 5.
Segal, L., Dalton, A.C., and Richardson J. 1998. “Cost-Effectiveness of the Primary Prevention of Non-insulin Dependent Diabetes Mellitus.” Health Promotion International 13(3): 197–209.
Taurek, J. 1977. “Should the Numbers Count?” Philosophy & Public Affairs 6: 293–316.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2008 Springer Science + Business Media B.V
About this chapter
Cite this chapter
Quigley, M., Harris, J. (2008). Personal or Public Health?. In: Boylan, M. (eds) International Public Health Policy and Ethics. International Library of Ethics, Law, and the New Medicine, vol 42. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-8617-5_2
Download citation
DOI: https://doi.org/10.1007/978-1-4020-8617-5_2
Publisher Name: Springer, Dordrecht
Print ISBN: 978-1-4020-8616-8
Online ISBN: 978-1-4020-8617-5
eBook Packages: MedicineMedicine (R0)