| 1. |
- Juth, N
(författare)
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Justifying the Expansion of Neonatal Screening: Two Cases
- 2019
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Ingår i: PUBLIC HEALTH ETHICS. - : Oxford University Press (OUP). - 1754-9973 .- 1754-9981. ; 12:3, s. 250-260
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- During the last two decades, neonatal screening in Europe and North America has expanded substantially. This article examines two recent suggestions for expanding neonatal screening: severe combined immunodeficiency (SCID) and X-linked adrenoleukodystrophy (X-ALD). With reference to well-established risk-benefit based rationales for screening, it is argued that the case for introducing SCID in neonatal screening is considerably stronger than for introducing X-ALD. For instance, the majority of those screened for X-ALD most likely have a negative risk-benefit ratio of screening: they develop milder symptoms or perhaps no symptoms at all, while still being monitored for a long time. This argument is used as a vehicle for making some general points regarding justified expansions of neonatal screening. First, when considering the expansion of neonatal screening, we should look at a condition specific case-by-case basis. Moreover, future expansions of neonatal screening should stick to the well-established rationales for screening while avoiding risk-benefit slippage. Otherwise, more strict procedures of informed consent are warranted in neonatal screening, procedures that, in the end, risk undermining the benefits of current neonatal screening programmes.
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| 2. |
- Ng, J, et al.
(författare)
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Adding Lithium to Drinking Water for Suicide Prevention-The Ethics
- 2019
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Ingår i: PUBLIC HEALTH ETHICS. - : Oxford University Press (OUP). - 1754-9973 .- 1754-9981. ; 12:3, s. 274-286
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Recent observations associate naturally occurring trace levels of Lithium in ground water with significantly lower suicide rates. It has been suggested that adding trace Lithium to drinking water could be a safe and effective way to reduce suicide. This article discusses the many ethical implications of such population-wide Lithium medication. It compares this policy to more targeted solutions that introduce trace amounts of Lithium to groups at higher risk of suicide or lower risk of adverse effects. The question of mass treatment with Lithium recalls other choices in public health between population-wide and more targeted interventions. The framework we propose could be relevant to some of these other dilemmas.
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| 3. |
- Nihlén Fahlquist, Jessica, 1976-
(författare)
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Public Health and the Virtues of Responsibility, Compassion and Humility
- 2019
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Ingår i: Public Health Ethics. - : OXFORD UNIV PRESS. - 1754-9973 .- 1754-9981. ; 12:3, s. 213-224
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Tidskriftsartikel (refereegranskat)abstract
- In contrast to medical care, which is focused on the individual patient, public health is focused on collective health. This article argues that, in order to better protect the individual, discussions of public health would benefit from incorporating the insights of virtue ethics. There are three reasons to for this. First, the collective focus may cause neglect of the effects of public health policy on the interests and rights of individuals and minorities. Second, whereas the one-on-one encounters in medical care facilitate a compassionate and caring attitude, public health involves a distance between professionals and the public. Therefore, public health professionals must use imagination and care to evaluate the effects of policies on individuals. Third, the relationship between public health professionals and the people who are affected by the policies they design is characterized by power asymmetry, demanding a high level of responsibility from those who wield them. Against this background, it is argued that public health professionals should develop the virtues of responsibility, compassion and humility. The examples provided, i.e. breastfeeding information and vaccination policy, illustrate the importance of these virtues, which needed for normative as well as instrumental reasons, i.e. as a way to restore trust.
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| 4. |
- Yuksekdag, Yusuf, 1988-
(författare)
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Individual Responsibilities in Partial Compliance : Skilled Health Worker Emigration from Under-Served Regions
- 2019
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Ingår i: Public Health Ethics. - Oxford : Oxford University Press. - 1754-9973 .- 1754-9981. ; , s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- One of the ways to address the effects of skilled worker emigration is to restrict the movement of skilled workers. However, even if skilled workers have responsibilities to assist their compatriots, what if other parties, such as affluent countries or source country governments, do not fulfil their fair share of responsibilities? This discussion raises an interesting problem about how to think of individual responsibilities under partial compliance where other agents (including affluent countries, developing states, or other individuals) do not fulfil their fair share of responsibilities. What is fair to expect from them? Taking health worker emigration as a case in point, I discuss whether the individual health workers’ fair share of responsibilities to address basic health care needs decreases or increases when the other parties do not fulfil their share. First, I review the responsibilities that different stakeholders may hold. Second, I argue that there are strong reasons against increasing or decreasing health workers’ fair share of responsibilities in a situation of partial compliance. I also argue that it is unfair for non-complier states to enforce health workers to fulfil their fair share or take up the slack.
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