Utilitarian Jeremy Bentham said ethics is "the greatest good for the greatest number of people". According to the Institute of Medicine, “the mission of public health is fulfilling society’s interest in assuring the conditions in which people can be healthy”. It seems that ethics and public health really follow a common trend. Why then does it seem that everything we do (what we eat, breathe and even how we die) creates a battle between these two entities, which are ultimately both trying to provide us with better lives?
In 1796, Edward Jenner, a British physician, infected an eight-year-old boy with cowpox, subsequently protecting him against smallpox. Jenner pioneered vaccine development providing the gateway for prophylactic medicine. Modern ethics greatly restricts experimentation on humans and even animals, contradicting the goal of the greater good for a population though a few individuals are put at risk. Presently, we struggle with this ethical dilemma and add to it the substantial economic profits pharmaceutical companies and private health providers earn from vaccinations and other medication.
The development of public health policies faces ethical conflict when the well-being of society intrudes on privacy, individual choice, and liberty. Public health laws tend to attract attention from the media as they affect us daily and tailor our lives; yet, they are also the most close to us, the ones we take most personally, because they expose our harmful actions and sanction us for them.
Some public health interventions enforced via legislations include:
· Immunization programs
· Isolation and quarantine of infected individuals in order to prevent potential outbreaks (as with SARS in 2002)
· Regulation of common goods (potable water, environment, food quality)
· Limitation of hazardous substances (alcohol, cigarettes)
It seems an arduous task to ensure that Public Health policies follow ethical guidelines within countries that have been working on the issue for some time. We must also face the further task of working toward that goal at an international level. Developing countries offer another challenge in that each community may have different needs and sensitive cultural practices which must be taken into consideration when developing public health legislation and programs. To ensure health ethics world wide, equity and justice must be maintained via a transparent participatory and democratic process.
Further readings on this topic:
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