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  1.  16
    Public Health, Public Goods, and Market Failure.L. Chad Horne - 2019 - Public Health Ethics 12 (3):287-292.
    This discussion revises and extends Jonny Anomaly's ‘public goods’ account of public health ethics in light of recent criticism from Richard Dees. Public goods are goods that are both non-rival and non-excludable. What is significant about such goods is that they are not always provided efficiently by the market. Indeed, the state can sometimes realize efficiency gains either by supplying such goods directly or by compelling private purchase. But public goods are not the only goods that the market may fail (...)
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  2.  1
    Justifying the Expansion of Neonatal Screening: Two Cases.Niklas Juth - 2019 - Public Health Ethics 12 (3):250-260.
    During the last two decades, neonatal screening in Europe and North America has expanded substantially. This article examines two recent suggestions for expanding neonatal screening: severe combined immunodeficiency and X-linked adrenoleukodystrophy. With reference to well-established risk-benefit based rationales for screening, it is argued that the case for introducing SCID in neonatal screening is considerably stronger than for introducing X-ALD. For instance, the majority of those screened for X-ALD most likely have a negative risk-benefit ratio of screening: they develop milder symptoms (...)
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  3.  6
    Adding Lithium to Drinking Water for Suicide Prevention—The Ethics.Jared Ng, Manne Sjöstrand & Nir Eyal - 2019 - Public Health Ethics 12 (3):274-286.
    Recent observations associate naturally occurring trace levels of Lithium in ground water with significantly lower suicide rates. It has been suggested that adding trace Lithium to drinking water could be a safe and effective way to reduce suicide. This article discusses the many ethical implications of such population-wide Lithium medication. It compares this policy to more targeted solutions that introduce trace amounts of Lithium to groups at higher risk of suicide or lower risk of adverse effects. The question of mass (...)
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  4.  18
    Public Health and the Virtues of Responsibility, Compassion and Humility.Jessica Nihlén Fahlquist - 2019 - Public Health Ethics 12 (3):213-224.
    In contrast to medical care, which is focused on the individual patient, public health is focused on collective health. This article argues that, in order to better protect the individual, discussions of public health would benefit from incorporating the insights of virtue ethics. There are three reasons to for this. First, the collective focus may cause neglect of the effects of public health policy on the interests and rights of individuals and minorities. Second, whereas the one-on-one encounters in medical care (...)
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  5.  7
    A Solidaristic Approach to Workers’ Compensation Reform in Taiwan.Ming-Jui Yeh - 2019 - Public Health Ethics 12 (3):261-273.
    The workers’ compensation system in Taiwan cannot provide sufficient coverage for all workers. This essay adopts a solidaristic approach to address this issue by analyzing the reasons why workers’ compensation is underdeveloped in Taiwan and what could be done to persuade more key actors to support the reform for a more just policy arrangement. First, through comparison with the healthcare system, it is argued that the lack of solidarity and the perception of relevant similarities could explain the underdevelopment of workers’ (...)
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  6.  2
    Corrigendum: A Solidaristic Approach to Workers’ Compensation Reform in Taiwan.Ming-Jui Yeh - 2019 - Public Health Ethics 12 (3):293-293.
    The published version of this article one reference was originally given with an incorrect author name. This has now been corrected online.
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  7.  8
    Equality, Liberty and the Limits of Person-Centred Care’s Principle of Co-Production.Gabriele Badano - 2019 - Public Health Ethics 12 (2):176-187.
    The idea that healthcare should become more person-centred is extremely influential. By using recent English policy developments as a case study, this article aims to critically analyse an important element of person-centred care, namely, the belief that to treat patients as persons is to think that care should be ‘co-produced’ by formal healthcare providers and patients together with unpaid carers and voluntary organizations. I draw on insights from political philosophy to highlight overlooked tensions between co-production and values like equality and (...)
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  8.  31
    Against Moral Responsibilisation of Health: Prudential Responsibility and Health Promotion.Rebecca C. H. Brown, Hannah Maslen & Julian Savulescu - 2019 - Public Health Ethics 12 (2):114-129.
    In this article, we outline a novel approach to understanding the role of responsibility in health promotion. Efforts to tackle chronic disease have led to an emphasis on personal responsibility and the identification of ways in which people can ‘take responsibility’ for their health by avoiding risk factors such as smoking and over-eating. We argue that the extent to which agents can be considered responsible for their health-related behaviour is limited, and as such, state health promotion which assumes certain forms (...)
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  9.  29
    Solidarity and Responsibility in Health Care.Ben Davies & Julian Savulescu - 2019 - Public Health Ethics 12 (2):133-144.
    Some healthcare systems are said to be grounded in solidarity because healthcare is funded as a form of mutual support. This article argues that health care systems that are grounded in solidarity have the right to penalise some users who are responsible for their poor health. This derives from the fact that solidary systems involve both rights and obligations and, in some cases, those who avoidably incur health burdens violate obligations of solidarity. Penalties warranted include direct patient contribution to costs, (...)
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  10.  13
    The Shadows of Sunlight: Why Disclosure Should Not Be a Priority in Addressing Conflicts of Interest.Daniel S. Goldberg - 2019 - Public Health Ethics 12 (2):202-212.
    This article argues that positioning disclosure as a primary remedy in addressing the ethical problems posed by conflicts of interest in medicine and health is an error. Instead, bioethical resources should be devoted to the problems associated with sequestration, defined as the elimination of relationships between commercial industries and health professionals in all cases where it is remotely feasible. The argument begins by arguing that adopting Andrew Stark’s conceptual framework for COIs leads to advantages in understanding COIs and in ordering (...)
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  11.  31
    Taking Responsibility for Responsibility.Neil Levy - 2019 - Public Health Ethics 12 (2):103-113.
    Governments, physicians, media and academics have all called for individuals to bear responsibility for their own health. In this article, I argue that requiring those with adverse health outcomes to bear responsibility for these outcomes is a bad basis for policy. The available evidence strongly suggests that the capacities for responsible choice, and the circumstances in which these capacities are exercised, are distributed alongside the kinds of goods we usually talk about in discussing distributive justice, and this distribution significantly explains (...)
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  12.  14
    Government Policy Experiments and Informed Consent.Douglas MacKay & Averi Chakrabarti - 2019 - Public Health Ethics 12 (2):188-201.
    Governments are increasingly making use of field experiments to evaluate policy interventions in the spheres of education, public health and welfare. However, the research ethics literature is largely focused on the clinical context, leaving investigators, institutional review boards and government agencies with few resources to draw on to address the ethical questions they face regarding such experiments. In this article, we aim to help address this problem, investigating the conditions under which informed consent is required for ethical policy research conducted (...)
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  13.  3
    Reflections on Responsibility and the Prospect of a Long Life.Kathryn MacKay - 2019 - Public Health Ethics 12 (2):130-132.
    In this commentary on Brown and colleagues’ paper, entitled ‘Against Moral Responsibilisation of Health: Prudential Responsibility and Health Promotion’, I highlight the tension between individual responsibility—even when this is prudential and not moral—and systemic factors that impact people's health. Brown and colleagues and I agree that individuals are frequently held inappropriately responsible for health-related behaviours or diseases that have become associated with the so-called ‘lifestyle’ diseases. We further agree that health is an instrumental value to people, allowing them to achieve (...)
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  14.  14
    What is in a Name? Parent, Professional and Policy-Maker Conceptions of Consent-Related Language in the Context of Newborn Screening.Stuart G. Nicholls, Holly Etchegary, Laure Tessier, Charlene Simmonds, Beth K. Potter, Jamie C. Brehaut, Daryl Pullman, Robin Z. Hayeems, Sari Zelenietz, Monica Lamoureux, Jennifer Milburn, Lesley Turner, Pranesh Chakraborty & Brenda J. Wilson - 2019 - Public Health Ethics 12 (2):158-175.
    Newborn bloodspot screening programs are some of the longest running population screening programs internationally. Debate continues regarding the need for parents to give consent to having their child screened. Little attention has been paid to how meanings of consent-related terminology vary among stakeholders and the implications of this for practice. We undertook semi-structured interviews with parents, healthcare professionals and policy decision makers in two Canadian provinces. Conceptions of consent-related terms revolved around seven factors within two broad domains, decision-making and information (...)
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  15.  15
    Being Healthy, Being Sick, Being Responsible: Attitudes Towards Responsibility for Health in a Public Healthcare System.Gloria Traina, Pål E. Martinussen & Eli Feiring - 2019 - Public Health Ethics 12 (2):145-157.
    Lifestyle-induced diseases are becoming a burden on healthcare, actualizing the discussion on health responsibilities. Using data from the National Association for Heart and Lung Diseases ’s 2015 Health Survey, this study examined the public’s attitudes towards personal and social health responsibility in a Norwegian population. The questionnaires covered self-reported health and lifestyle, attitudes towards personal responsibility and the authorities’ responsibility for promoting health, resource-prioritisation and socio-demographic characteristics. Block-wise multiple linear regression assessed the association between attitudes towards health responsibilities and individual (...)
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  16.  7
    Sharing Responsibility: Responsibility for Health Is Not a Zero-Sum Game.Marcel Verweij & Angus Dawson - 2019 - Public Health Ethics 12 (2):99-102.
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  17.  21
    The Precautionary Principle for Shift-Work Research and Decision-Making.Charleen D. Adams, Erika Blacksher & Wylie Burke - 2019 - Public Health Ethics 12 (1):44-53.
    Shift work is a fixture of our 24-hour economy, with approximately 18 per cent of workers in the USA engaging in shift work, many overnight. Since shift work has been linked to an increased risk for an array of serious maladies, including cardiometabolic disorders and cancer, and is done disproportionately by the poor and by minorities, shift work is a highly prevalent economic and occupational health disparity. Here we draw primarily on the state of science around shift work and breast (...)
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  18.  11
    Do Sugary Drinks Undermine the Core Purpose of SNAP?Anne Barnhill - 2019 - Public Health Ethics 12 (1):82-88.
    Ross and MacKay argue that excluding sugar-sweetened beverages from the Supplemental Nutrition Assistance Program is ‘in principle morally permissible’ because it does not violate the central obligation that SNAP is meant to discharge—the obligation to ensure that citizens have secure access to food adequate to meet their nutritional needs. I query this argument, and suggest two other ways of understanding the core purpose of SNAP. According to the first, the core purpose of SNAP includes promoting good nutritional outcomes; thus, one (...)
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  19.  11
    Towards an Integration of PrEP Into a Safe Sex Ethics Framework for Men Who Have Sex with Men.Julien Brisson, Vardit Ravitsky & Bryn Williams-Jones - 2019 - Public Health Ethics 12 (1):54-63.
    The ethics of safe sex in the gay community has, for many years, been focused on debates surrounding the responsibility regarding the use of condoms to prevent HIV transmission, once the only tool available. With the development of Truvada as a pre-exposure prophylaxis for HIV, for the first time in the history of the HIV/AIDS epidemic there is the potential to significantly reduce the risk of HIV transmission during sex without the use of condoms. The introduction of PrEP necessitates a (...)
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  20.  52
    The Case Against Forced Methadone Detox in the US Prisons.Daniel D’Hotman, Jonathan Pugh & Thomas Douglas - 2019 - Public Health Ethics 12 (1):89-93.
    Methadone maintenance therapy is a cost-effective, evidence-based treatment for heroin dependence. In the USA, a majority of heroin-dependent offenders are forced to detox from methadone when incarcerated. Recent research published in The Lancet has demonstrated the negative health and economic outcomes associated with such policies. Methadone Continuation Versus Forced Withdrawal on Incarceration in a Combined US Prison and Jail: A Randomised, Open Label Trial. The Lancet, 386, 350–359). This novel evidence raises questions as to the justification for current policies of (...)
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  21.  25
    Circumcision, Autonomy and Public Health.Brian D. Earp & Robert Darby - 2019 - Public Health Ethics 12 (1):64-81.
    Male circumcision—partial or total removal of the penile prepuce—has been proposed as a public health measure in Sub-Saharan Africa, based on the results of three randomized control trials showing a relative risk reduction of approximately 60 per cent for voluntary, adult male circumcision against female-to-male human immunodeficiency virus transmission in that context. More recently, long-time advocates of infant male circumcision have argued that these findings justify involuntary circumcision of babies and children in dissimilar public health environments, such as the USA, (...)
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  22.  14
    Can Healthcare Workers Reasonably Question the Duty to Care Whilst Healthcare Institutions Take a Reactive Approach to Infectious Disease Risks?Michael Millar & Desmond T. S. Hsu - 2019 - Public Health Ethics 12 (1):94-98.
    Healthcare workers carry a substantial risk of harm from infectious disease, particularly, but not exclusively, during outbreaks. More can be done by healthcare institutions to identify risks, quantify the current burden of preventable infectious disease amongst HCWs and identify opportunities for prevention. We suggest that institutional obligations should be clarified with respect to the mitigation of infectious disease risks to staff, and question the duty of HCWs to care while healthcare institutions persist with a reactive rather than proactive attitude to (...)
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  23.  4
    Disruptive Solidarity or Solidarity Disrupted? A Dialogical Narrative Analysis of Economically Vulnerable Older Adults' Efforts to Age in Place with Pets.Ann M. Toohey & Melanie J. Rock - 2019 - Public Health Ethics 12 (1):15-29.
    Over one-third of older adults in many countries have a companion animal, and pets may harbor health-promoting potential. Few studies have considered pet-ownership in relation to economic vulnerability, and pet-ownership has not been often considered within policy efforts to promote ageing-in-place. We conducted a mixed methods case study to understand perspectives of both community agencies that support ageing-in-place and older adults themselves. A shortage of affordable, appropriate pet-friendly housing emerged as a challenge, even when framed as a legitimate choice and (...)
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  24.  98
    Should the Homeless Be Forcibly Helped?Bart van Leeuwen & Michael S. Merry - 2019 - Public Health Ethics 12 (1):30-43.
    When are we morally obligated as a society to help the homeless, and is coercive interference justified when help is not asked for, even refused? To answer this question, we propose a comprehensive taxonomy of different types of homelessness and argue that different levels of autonomy allow for interventions with varying degrees of pressure to accept help. There are only two categories, however, where paternalism proper is allowed, be it heavily qualified. The first case is the homeless person with severely (...)
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  25.  11
    Exploring Users’ Perceptions and Senses of Solidarity in Taiwan’s National Health Insurance.Ming-Jui Yeh - 2019 - Public Health Ethics 12 (1):1-14.
    Under the influence of concerns about sustainability, health system reforms have targeted institutional designs and have overlooked the role of socio-political factors like solidarity—a concept that is generally assumed to underpin the redistributive health system. The purpose of this research is to investigate users’ perceptions of the National Health Insurance as a system, their senses of solidarity and their views on the sustainability of the system in Taiwan. Using the descriptive ethics approach, qualitative in-depth interviews were conducted with typical case (...)
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