Topic 11: public health ethics

Question 1

Define public health

Answer 1

• Science of preventing disease = prolong life
• Promote health via organized efforts

Question 2

Define social determinants of health

Answer 2

• Poverty + lack of education + living in deprived areas
• Lead to health disparities

Question 3

What is the difference between public health + clinical ethics

Answer 3

• Public = ethical issues related to policies + strategies targeting population
• Clinical = ethical issues in doctor/patient interaction

Question 4

Define health maximization

Answer 4

• Need > resources
• Use scarce resources efficiently
• Produce health benefit for greater number of people

Question 5

Describe justice in public health

Answer 5

• Fair distribution of health benefits
• Equity > equality
• Improve health outcomes for everyone + special effort for most in need
• Disproportionately distribute resources to in need

Question 6

Describe autonomy in pubic health

Answer 6

• Balance = improve health outcome via behavior change + respect individual freedom
• Only justification to interfering with someone’s will = prevent harm to others
• E.g. public health + vaccines
• Respect for individual + community interests

Question 7

Give the 3-step approach to public health decision making

Answer 7

1) Analyze ethical dimension of public health issue + context
2) Formulate alternative course of action + evaluate ethical dimension
3) Provide justification of pubic health decision

Question 8

Explain step 1 of the decision making

Answer 8

QUESTIONS:
- Risks/harms
- Public health goals
- Laws that apply
- Precedent legal/ethical cases
- Features of socio-cultural context applying
- Relevant codes of ethics

Question 9

Explain step 2 of decision making

Answer 9

• Utility = does action produce best balance of benefit vs harms/cost
• Equity/justice = is distribution of benefit/burden fair
• Respect = does action respect human rights + community values

Question 10

Explain step 3 of decision making

Answer 10

• Effectiveness = will action likely be effective
• Proportionality = will benefit of action outweigh violated moral considerations
• Necessity = is action necessary
• Least infringement = is action least restrictive available
• Public justification = do public + stakeholders + effected people find it acceptable

Question 11

Compare public health vs clinical ethics

Answer 11

PUBLIC HEALTH:
- Focus = population
- Aim = prevention
- Government
- Utilitarian
- Consent not alwasy feasible
- Coercion acceptable
- 1st duty = general public
CLINICAL:
- Focus = individual
- Aim = treatment
- Health care professionals
- Rights
- Consent
- Coercion unacceptable