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Public Health Ethics And Autonomy
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Public Health Ethics And Autonomy
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Question:
To what extent should governments interfere with human behaviour towards health outcomes?
Answer:
Introduction
Public health ethics and autonomy had been a surge these years. Although medications focus on individual health, health of the population is mainly alarmed with the health of the entire population which is different from the responsibility in catering to individual patients. Public health is more concerned with the societal accountability to care for the health of the entire populace. And this is where paternalism and breaching of public autonomy comes in to being. This report focuses on how government interferes in the lives of individual towards the good of a society, the concept of paternalism, autonomy and justice. It also discusses about the limits of paternalism, a clarification on the principles of justice. It also provides information of the public health ethics and the harm principles.
Paternalism
Law and the public attitude identify the protection of health as a core function of the government. Public health actions are sometimes featured as invasive. Today many public health measures were accepted cordially which were once thought as intrusive, controversial and misguided (Buchanan 2008). The initiatives for public health includes the efforts to encourage an open information for facilitating informed decision making, save the persons from being harmed by the other persons of the group (Kelly 2013).
Information which is free and unbolt enables individuals to make informed choices and reduce the likelihood of the misinformation. Considering the growing field of public health ethics, significant time has already been given to identify the ethical justifications of the paternalistic interventions that collide with the person’s autonomy from preventing the individuals from adopting harmful behavior (Kelly 2013). On ethical and empirical grounds public health should seek instead of expanding the individual autonomy for improving the public health. Public health is concerned to protect and promote the health of the population (Buchanan 2008). Collective interventions can often require government initiatives. For example the CDC and the FDA are in part or in whole public agencies related to health.
One of the views of the public health ethics regarding the ethical foundation of the public health is an embargo to the maximum welfare. Paternalism in public health is mainly found in issues like seatbelts and motorcycle helmet laws, policies to restrict certain substances, excise taxes and advertising bans on unhealthy products, propose tax breaks for the ones having low blood pressure, body mass index (Mullin 2014). So the justification for the paternalistic interventions of the government is quite justified here as it is for the health and the well being of the population,, that is for the greater good (Kelly 2013). The ethics of concern here is that prevention of harm to others for the purpose of infectious disease control is ethically defensible. Thwarting the choice of a person for their own good in preventing chronic diseases is quite acceptable. Hence there are few initiatives that government take up are against the choice of the public. Many public health professionals put forward the argument behavioral interventions are acceptable as persons provide their informed consent for treatments such as smoking cessation classes. Such interventions do not pose harm in case of an individual but becomes a problem when the same law is applied for the masses, where the chance of gaining individual consent is nearly impossible (Lee 2012).
Clarifying principles of justice
It is important to differentiate between the term autonomy and positive freedom. One can remain restricted still autonomous. The critical point lies in the position of deciding the acceptable reasons behind the consent (Carter et al. 2012). Public may think that individuals may do what they want to survive and should be responsible for any decisions they make. It may act as unfair to burden those individuals who actually make healthy choices and yet they have to pay high health care taxes supporting those who take up imprudent choices.
Harm principle and ethics in public health
Opposed to this perception, health professionals can argue that it is the responsibility of the society to bear the responsibility of the unhealthy behaviors. Marmot and Wilkinson have pointed out the powerful linkage between the health status and social position. Ross Upshur introduced four public health principles such as the harm principle, the principle of least restraining means, the reciprocity principle and the transparency principle. These principles conduct the decisions when public health policies are justified (Lee 2012). The harm principle states that a government can impose restriction over a person if there is a chance for other getting harmed. The least restrictive principles may help one to choose which of the actions are really justified. For achieving the public health goals, least restrictive means should be employed. If the least restrictive means fail to achieve the public health goal then public heath would move to a more coercive level (Lombardi et al. 2016). This is how the government moves from education to facilitation and discussion and then to restriction.
Conclusion
In the end it can be said that public health requires engaging the public directly in creating a society in which every citizen will feel supported characterized by integrity, dignity and mutual responsibility. The goal of the public health professionals is to check that people have adequate opportunities for achieving good health. Furthermore, other things being equal, the society in which individuals choose to behave responsibly, than being forced against their will, paying of taxes is justified. The main aim is to improve the quality of life of the people.
References
Buchanan, D.R., 2008. Autonomy, paternalism, and justice: ethical priorities in public health. American Journal of Public Health, 98(1), pp.15-21.
Carter, S.M., Kerridge, I., Sainsbury, P. and Letts, J.K., 2012. Public health ethics: informing better public health practice. New South Wales public health bulletin, 23(6), pp.101-106.
Kelly, J., 2013. Libertarian paternalism, utilitarianism, and justice.
Lee, L.M., 2012. Public health ethics theory: review and path to convergence. The Journal of Law, Medicine & Ethics, 40(1), pp.85-98.
Lombardi, M., Miyagishima, K. and Veneziani, R., 2016. Liberal egalitarianism and the Harm Principle. The Economic Journal, 126(597), pp.2173-2196.
Mullin, A., 2014. Children, paternalism and the development of autonomy. Ethical Theory and Moral Practice, 17(3), pp.413-426
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