An ethical framework for public health

1
An ethical framework for public health

• Professor Tom Baldwin Professor of Philosophy,
  University of York

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The state and the citizen ethical theories

• Libertarian Perspective
• Intermediate positions (Liberal State)
• Collectivist Perspective
• (Utilitarian and Social Contract approaches)

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• How to resolve the conflict between promotion of
  public health and protection of individual
  freedoms?
• The harm principle
• That the only purpose for which power can be
  rightfully exercised over any member of a
  civilised community, against his will, is to
  prevent harm to others. His own good, either
  physical or moral, is not a sufficient warrant

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An initial framework

• Goals for public health 
• reduce health risks from environment and actions
  of others
• provide information and advice, with special
  attention to children
• Constraints 
• avoid coercive attempts to make people lead
  healthy lives and minimise interventions in
  important areas of personal life

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Further issues important in public health

• Individual consent
• Health inequalities
• Changing habits
• Community

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Also consider

• Paternalism
• The nanny' state
• The Stewardship Model

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The revised framework

• Goals
• reduce the risks of ill health people impose on
  each other
• environmental conditions to sustain good health
• special attention to the vulnerable
• access to medical care
• reduce inequalities
• Constraints
• minimise intrusion / coerciveness
• consent / alternative procedures

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Role of third parties

• Medical institutions, schools, charities
• Businesses food, drink, tobacco and
  pharmaceutical companies, shops, pubs and
  restaurants
• Corporate social responsibility function
• But, intervention by the state to protect
  important goods is acceptable