Ethical Theories in Public Health - Book Report/Review Example

Ethical Theories in Public Health There are several ethical theories that determine the formulation of different public health ethical policies. Moreover, these ethical theories influence the action taken by medical practitioners in their practice. Ethical theories and principles are also critical guidelines for communities and families when making decisions regarding certain forms of treatment or behavioral aspects that either promote or diminish the health of the people. In the recent past, the application of these ethical theories developed by varying moral philosophers has caused a measure of tension1. The moral philosophies exhibit different rationalities in determining actions that receive justification as morally right2. Evidently, authors with interest in public health have focused on describing the application of these moral principles in public health. Although these moral, philosophical theories were not developed solely for application in public health, they have served as invaluable guidelines in the formulation of health policies. There are salient criticisms surrounding these theories and their relevance, as some appear more rational in public health3. Consequentialism-Utilitarianism In Holland’s book titled ‘public health ethics’, he offers an extensive description of consequentialism ethical principle and highlighted the different facets of its application in public health. Evidently, consequentialism perform a check on the consequences of a certain act in a bid to ascertain whether the cat receives any form of justification depending on the measure of moral value deduced from the consequences. Utilitarianism is one of the theories that fall under consequentialism. Utilitarianism endeavors to promote maximal benefits to a greater number of people. In its application in public health, utilitarianism focuses on weighing out whether a certain public health policy, treatment, health promotion concept and the determination of health priorities present a high moral value to a greater population of people4. In this case, a medical practitioner would justify his action towards a patient if it presents good for the family or the community at large5. Utilitarianism seeks to ensure that the consequences of any decision in public health are assessed thoroughly before the finalization of the decision. Evidently, Stephen Holland highlights that a naïve view of consequentialism has been adopted in the justification of many actions and policies in public health. He poses an argument that the naïve view focuses on the immediate consequences of an action. Evidently, this is a flawed application of the principle, as it is obvious that actions exhibit both short-term and long-term effects. His argument introduces an ardent need for the consideration of immediate and long-term consequences of actions, policies, and health promotion programs before justifying them. However, many of the applicants of consequentialism in public health have relied on this naïve view of utilitarianism in public health. Moreover, Holland is keen to highlight that the benefits considered in the justification of a certain act should not be limited to the health realm6. It is critical to consider other diverse consequences, both in their short and long-term sense before any action receives justification. After such analysis, Holland offers a rational view of utilitarianism that can be applied in public health as a good guideline to replace the naïve view. Evidently, the attention accorded to utilitarianism as an ethical theory in public health only serves to highlight its criticality in the field. Non- consequentialism On the other hand, Holland offers theories that exhibit a non-consequentialist view in his book7. Under this, he explores deontology, Kantianism, and principlism. Deontology is one of the ethical principles that has been applied in public health in the recent past. This theory does not focus on the consequences presented by an action, but rather focuses on analyzing the moral value in the nature of the act itself. Irrespective of whether it presents multiple benefits in the short and long-term sense, an act may prove morally wrong in its nature8. A clear illustration of this ethical theory application is in the case of blood transfusion and Jehovah’s witnesses. Although acceptance of blood transfusion may present multiple benefits to the individual and family, the nature of the act in the view of a Jehovah’s Witness is wrong because of his religious beliefs. As it is evident in this example, certain actions or forms of treatment, or policies may be wrong morally. This is not necessarily because they are not beneficial, but because of their very nature. Holland also advances to describe Kantianism, which focuses on the moral obligations that serve as binding agents, compelling us to act in certain ways. The most critical aspect of this principle is that Kant argued that a person lacks justification to use another as merely a means towards a certain end. Moreover, Kant highlighted that the moral maxims defined as principles to guide the life of a person should be subject to universalization. In cases where those maxims cannot be universalized to apply to different people, then morally they lack any form of justification. Other non-consequentialist ethical theories include principlism, which is emerging under the guidelines of four basic ethics for application in biomedicine. These principles include respect for autonomy, non-maleficence, beneficence, and justice. These principles translate to the fact that individuals should exercise the right to make health-related decisions, while health specialists should have no intention to harm, but rather focus on offering help to the individual. In all cases, the upholding of justice should occur9. Holland also focuses on virtual ethics in public health, which depend on the personality of an individual10. The character of an individual may include certain virtues that may prompt a health practitioner to assist patients. Virtue ethics may motivate an individual to promote the health of others in different ways11. Paternalism Paternalism is an ethical philosophy that justifies certain actions as long as they occur with the intention of offering help in a similar case as a parent does to children. Therefore, its application in public health justifies the interference of peoples’ lives with noble intentions of offering help12. Therefore, the family, medical practitioners and other interested persons may offer health related help with the intention of restoring health or preventing health-related problems13. In the medical context, application of the paternalism may arise when medical practitioners face the compulsion of making certain health related decisions when the patient is unconscious or unstable. In other cases, the government, state, or agency may intervene in a bid to improve the health of people by defining high medical standards and advocating for better health practices14. Liberalism This political philosophy has found its application in public health. Liberalism is a school of thinking exhibited by a wing of politicians who believe in freedom. It is of critical emphasis that freedom has both positive and negative connotations. The negative connotation points out to the idea of lacking any form of constraints15. However, the positive connotation translates to the fact that individuals should have a measure of freedom to exercise autonomy. In public health, liberalism only implies that the views of the individual are of critical importance. The role of the liberal state and its efforts to promote health are of critical consideration in the context of application of liberalism in public health16. Communitarian This ethical theory seeks to divert the increasing emphasis placed on the individual, and introduce the concept of the community. Communitarian ethics serves to introduce levels and bases of mutual responsibility contrary to the focus on the rights of an individual. In the communitarian sense, communal benefits are of critical consideration, with communities defining goals that they can focus17. In the public health context, it is evident that communitarian efforts can motivate communities to define strategic goals of promoting health. With less focus on individualism, communities can cooperate and define health-related priorities that present communal benefits. This ethical theory also helps in the determination of the justified way of allocating resources, and determining health rights with a target to improve the health of the entire community18. Best Ethical Theory in Public Health Factors Defining the Best Theory With multiple ethical theories described above, and with each of them proving applicable in public health, it is challenging to determine the best of these theories. However, certain factors can help in the determination of the best ethical theory. Evidently, public health emerged to address the multiple diseases that affect people19. Over time, the definition of health has only widened with public health efforts and activities diversifying to cover prevention, cure, and cater for other health related aspects in any community20. Therefore, the best ethical principle should not stagnate the efforts of public health in achieving these goals. Although the issue of individual choice has received emphasis as the globe adopts individualism and liberalism, it remains evident that there is a surging need to view issues in the larger context, that of communities. In the recent past, public health efforts have included promotion of healthy habits and practices as well as provision of standard health care in hospitals21. It proves challenging when highly contagious diseases are the focus of the public health sector. This only serves to highlight that the focus on the individual in moral philosophy may not prove to be the best option in public health22. Utilitarianism as Best Theory Utilitarianism can prove to be the best ethical principle in public health if viewed in a mature perspective as Stephen Holland described in his book23. Evidently, consequentialism is a critical aspect in public health because the short and long-term effects of public health policies, treatment interventions, and preventive interventions need proper analysis before adoption. This is the reason behind every thorough assessment and testing of any intervention in public health. Public health policies need to prove to be reliable and effective, and a close analysis of the potential consequences upon adoption is usually a main concern to experts designated for this role24. In the case of preventive strategies, understanding all the potential consequences on both individuals and communities can prove to be a reliable way of determining their efficiency. A similar perspective is adopted for treatment strategies25. It is almost impossible then for experts for experts not to rely on consequential ethics when analyzing these three aspects. In all these cases, it is of critical significance to consider the potential consequences of any action in public health. It serves as a guideline for defining different strategies. Caution is important in this case that the consideration of consequences takes into account any ramification of the action that may occur in the future. This serves to avoid the naïve view of only the immediate consequences, as many have been misguided to apply the utilitarian ethical theory26. Moreover, utilitarianism is an appropriate principle because its application has a basis in the rationality defined by other ethical theories. Consideration of the consequences ensures that the adopted strategies present health benefits to the community, bringing communitarian ethics into the picture27. According consideration to the consequences of certain policies can help in the determination of whether public health policies conform to the community’s health needs and priorities28. Moreover, utilitarianism also conforms to the principles of paternalism concerning the state, government and agency, as intervention by these institutions depends on the perceived benefits of the action. In many cases, health practitioners and policy makers face the compulsion of making decisions that present more benefits. Utilitarianism has received attention from different authors who have either explained its context in multiple health situations. This has helped in enlightening the public health sector on its application. Without doubt, criticism has ensued as well. However, it is evident that this ethical principle has been and will be an invaluable guideline in public health29. Although utilitarianism viewed in the mature perspective remains a reliable, ethical guideline in public health, tension still surrounds the need to promote public health while at the same time, according consideration to the rights bestowed upon each individual to exercise autonomy when making health-related choices. Despite the efforts made by the public health sector have the best intention in health promotion, there are cases when some people have expressed the overreaching of individual rights. However, mature application of the utilitarianism theory can form a better platform of making health-related decisions30. Bibliography Holland, Stephen. 2007. Public health ethics. Cambridge, UK: Polity. Nuffield Council on Bioethics. 2007. Public Health ethical issues, http://www.nuffieldbioethics.org/sites/default/files/Public%20health%20-%20ethical%20issues.pdf Peckham, Stephen, and Alison,Hann. 2010. Public health ethics and practice. The Polity Press, Bristol, UK. Read More