Abstract
This paper suggests that public health, due to its community orientation, may be ignoring certain ethical principles--namely the rights of individuals and communities to self-determination. The expectation of individual rights as a member of a community is reviewed and the additional right of a community for self-determination is proposed. The influences on ethical evaluations by the legal and economic environments are suggested, using US examples. The conclusion argues that as the focus of health-care delivery changes, it will become more important to consider these questions of group ethics.
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Selected References
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- Callahan D. Minimalist ethics. Hastings Cent Rep. 1981 Oct;11(5):19–25. [PubMed] [Google Scholar]
- Danis M., Churchill L. R. Autonomy and the common weal. Hastings Cent Rep. 1991 Jan-Feb;21(1):25–31. [PubMed] [Google Scholar]
- Dworkin G. Voluntary health risks and public policy. 1. Taking risks, assessing responsibility. Hastings Cent Rep. 1981 Oct;11(5):26–31. [PubMed] [Google Scholar]
- Emanuel E. J. A communal vision of care for incompetent patients. Hastings Cent Rep. 1987 Oct-Nov;17(5):15–20. [PubMed] [Google Scholar]
- Hastings L. E. Dentistry in Shandong province: China. Ont Dent. 1990 Oct;67(8):14-6, 18, 20-1 passim. [PubMed] [Google Scholar]
- Loewy E. H. Communities, self-causation and the natural lottery. Soc Sci Med. 1988;26(11):1133–1139. doi: 10.1016/0277-9536(88)90189-x. [DOI] [PubMed] [Google Scholar]
- Ransohoff D. F., Lang C. A. Screening for colorectal cancer. N Engl J Med. 1991 Jul 4;325(1):37–41. doi: 10.1056/NEJM199107043250107. [DOI] [PubMed] [Google Scholar]
- Skrabanek P. Why is preventive medicine exempted from ethical constraints? J Med Ethics. 1990 Dec;16(4):187–190. doi: 10.1136/jme.16.4.187. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stason W. B., Weinstein M. C. Public-health rounds at the Harvard School of Public Health. Allocation of resources to manage hypertension. N Engl J Med. 1977 Mar 31;296(13):732–739. doi: 10.1056/NEJM197703312961307. [DOI] [PubMed] [Google Scholar]
- Vilnius D., Dandoy S. A priority rating system for public health programs. Public Health Rep. 1990 Sep-Oct;105(5):463–470. [PMC free article] [PubMed] [Google Scholar]
- Weinstein M. C., Stason W. B. Allocating resources: the case of hypertension. Hastings Cent Rep. 1977 Oct;7(5):24–29. [PubMed] [Google Scholar]
- Weinstein M. C., Stason W. B. Foundations of cost-effectiveness analysis for health and medical practices. N Engl J Med. 1977 Mar 31;296(13):716–721. doi: 10.1056/NEJM197703312961304. [DOI] [PubMed] [Google Scholar]