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Public Health Ethics

Public Health Ethics

Utilitarianism is a principle that states that actions that benefit the community and promote contentedness and happiness are right. An action that creates complaints and unhappiness is wrong. Utilitarianism evaluates actions based on their consequences. The main focus is the impact of the consequences on the well-being of society (Marseille & Kahn, 2019). Therefore, utilitarianism requires that people should always act impartially to ensure that their actions generate maximum benefit.

Utilitarianism can be applied in public health under different circumstances. The main focus of public health is the health of the community. Public health advocates for a healthy population. This can be considered a right, as provided by the principle of utilitarianism. Furthermore, the fulfillment of the goal of public health can be evaluated. An example of a tool of measurement used is the Quality Adjusted Life Years index (Marseille & Kahn, 2019). Public health, just like utilitarianism, focuses on the evaluation of the efficiency of their interventions. Furthermore, public health emphasizes on consequences of actions and upholds impartiality in all activities. An example of a consequence is shutting down a restaurant with subpar hygienic levels. The restaurant is likely to expose its customers to diseases such as cholera. Its shutdown is a consequence of non-compliance with the set hygienic levels.

Distributive justice is a principle that advocates for fairness when resources are being allocated to the community. Distributive justice focuses on various aspects. Focus is shifted to those in dire need, reducing inequalities witnessed in resource distribution, and ensuring that community members meet a set threshold (Galiatsatos et al., 2020). It is applied to the distribution of services provided by public health. Public health applies distributive justice in ensuring that health care services are availed to all members of society.

Public health can apply distributive justice when evaluating different countries’ quality of life or life expectancies. Countries whose citizens have a poor quality of life may be having difficulties accessing various resources (Galiatsatos et al., 2020). Examples include clean water, vaccinations, toilets and latrines, and medical supplies. Public health uses the principles of distributive justice to ensure that these countries can access the resources. Countries in dire need of these resources are given priority when distributing them. This helps to minimize the existing inequalities in resource allocation.

The aspect of distributive justice that requires all members to meet a set threshold is applied in public health. An example is a provision that maternal and infant mortalities should be below a specific threshold during deliveries. Public health focuses on countries or regions that do not fulfill this threshold. Appropriate interventions such as advocating antenatal care, constructing new maternity homes, and equipping hospitals with medication and personnel can solve the problem.

Paternalism occurs when a person’s decision-making authority is denied to ensure the well-being of that person. The critics of paternalism argue that it denies people their autonomy and presents them as being unable to make moral decisions (Todt & Luján, 2021). Paternalism is applied in public health under various circumstances. It can be adopted when the health of society is threatened. An example is in the phase of the COVID-19 pandemic; the public health provided different measures. The measures include mandatory quarantine for those infected with the virus, wearing of facemasks, regular washing of hands, and social distancing. These measures may infringe on the decision-making capability of people, but they are aimed at controlling the spread of the disease. Quarantine limits the interaction of infected persons with the public and stops the disease from spreading. Observing the social distancing rule prevents the spread of the disease by limiting the possibility of contact with sputum or salivary droplets. Regular handwashing techniques and sanitization are important to eliminate the virus with contact with the skin. Given the opportunity, society would make contrary decisions which would have led to an increase in the number of infections and mortality rates.

Paternalism can also be applied in public health if an imminent infection can cause significant harm to society. A directive requiring the public to get mandatory immunization can be issued. Public health officials can also issue mandatory testing, quarantine, and treatment (Todt & Luján, 2021). This decision may not be plausible, but it will ensure the well-being of society. However, paternalism should only be used if the interventions are sufficient to mitigate the looming risk.

Selgelid (2009) championed the recognition that utilitarianism, equality, and liberty are important values, and none should supersede the other. The existing thresholds where equality supersedes utility and liberty should not exist (Selgelid, 2009). Public health officials should make decisions that ensure that the three ethical principles are applied equally. In public health practice, distributive justice should always accompany utilitarianism to ensure that decisions are made fairly (Giubilini et al., 2018). Distributive justice should also accompany paternalism to ensure that the decisions made are implemented equally across society. Therefore, the ethical principles are all important, and none should supersede the other.

Utilitarianism, distributive justice, and paternalism are ethical principles that are applied to public health. Utilitarianism is a principle that states that actions that benefit the community and promote contentedness and happiness are right. Distributive justice is a principle that advocates for fairness when resources are being allocated to the community. Paternalism occurs when a person’s decision-making authority is denied to ensure the well-being of the person. Selgelid (2009) proposed an approach that ensured that none of the public health principles supersedes the other.

References

Galiatsatos, P., Kachalia, A., Belcher, H. M. E., Hughes, M. T., Kahn, J., Rushton, C. H., Suarez, J. I., Biddison, L. D., & Golden, S. H. (2020). Health equity and distributive justice considerations in critical care resource allocation. Journal of Cleaner Production, 8(August), 758–760. https://doi.org/10.1016/S2213-2600(20)30277-0

Giubilini, A., Douglas, T., & Savulescu, J. (2018). The moral obligation to be vaccinated: utilitarianism, contractualism, and collective easy rescue. Medicine, Health Care and Philosophy, 21(4), 547–560. https://doi.org/10.1007/s11019-018-9829-y

Marseille, E., & Kahn, J. G. (2019). Utilitarianism and the ethical foundations of cost-effectiveness analysis in resource allocation for global health. Philosophy, Ethics, and Humanities in Medicine, 14(1), 1–7. https://doi.org/10.1186/s13010-019-0074-7

Selgelid, M. J. (2009). A moderate pluralist approach to public health policy and ethics. Public Health Ethics, 2(2), 195–205. https://doi.org/10.1093/phe/php018

Todt, O., & Luján, J. L. (2021). Health Claim Regulation and Public Health : Individual Choice or Libertarian Paternalism ? XL, 199–213.

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Question 


Public Health Ethics

Case Assignment
For this Case Assignment, write a 3- to 4-page essay in which you address the following:

Discuss the application of the following ethical theories/principles to public health. Provide recent examples within the field of public health which are consistent or inconsistent with these principles:

  • Utilitarianism

    Public Health Ethics

    Public Health Ethics

  • Distributive Justice
  • Paternalism

Selgelid (2009) wrote:

  • While public health ethicists often claim that the least restrictive alternative should be used to achieve the public health goal in question, I argue that a plausible but under-recognized idea is that the least restrictive alternative might sometimes involve improvement of global health via redistributive taxation—i.e., rather than coercive social distancing measures.

What did he mean by this? Provide arguments for and against his position.Assignment Expectations

  • Length: Assignment should be from 3 pages (750 words) in length.

Required Reading

Read Chapter 7 of the following text:
Wing, K. R., & Gilbert, B. (2007). The law and the public’s health. Chicago, IL: Health Administration Press.

Ethical Theories and Principles. (2011).

Baum, N., Gollust, S., Goold, S., & Jacobson, P. (2007). Looking ahead: Addressing ethical challenges in public health practice:1. The Journal of Law, Medicine & Ethics, 35(4), 657-667.

Burris, S., Wagenaar, A. C., Swanson, J., Ibrahim, J. K., Wood, J., & Mello, M. M. (2010). Making the case for laws that improve health: A framework for public health law research. The Milbank Quarterly 88(2) 169–210.

Cassatly, M. G. (2012). The four critical drivers of healthcare reform. The Journal of Medical Practice Management: MPM, 28(3), 162-3.

Clemans-Cope, L., Kenney, G. M., Buettgens, M., Carroll, C., & Blavin, F. (2012). The Affordable Care Act’s coverage expansions will reduce differences in uninsurance rates by race and ethnicity. Health Affairs, 31(5), 920-30.

Selgelid, M. J. (2009). A moderate pluralist approach to public health policy and ethics. Public Health Ethics, 2(2), 195-205. Available via EBSCO.