Since public health seeks to protect the health of populations, it inevitably confronts a range of ethical challenges having to do primarily with the friction between individual freedoms and what might be perceived as governmental paternalism. This volume brings together twenty-five articles by leading thinkers in the field, writing on topics that concern both classic and novel problems. They open up new terrain in each area, including tobacco and drug control, infectious disease, environmental and occupational health, the effect of new genetics on the publics health, and the impact of social inequalities on patterns of morbidity and mortality. The volume editors offer a context for discussion with introductory essays for each of the books five sections.
Reviewer:Griffin Trotter, MD, PhD(Saint Louis University)
Description:This edited book draws together essays on core topics in public health ethics.
Purpose:It seeks to provide an introduction to theories of public health ethics, and to provide helpful introductory essays on a number of central issues. Though these objectives are worthwhile, the current paucity of scholarship in public health ethics hampers the depth and completeness of the treatment of some topics.
Audience:The book is written for anyone with a scholarly or professional interest in public health ethics. It should be helpful for public health students, policy makers, bioethicists, and others with an interest in public health practices. The editors are well qualified, and many of the essays are written by well known scholars.
Features:The book is divided topically into sections, with each section containing essays that address the topic from a variety of perspectives. General topics include the overall perspective of public health, the tension between autonomy and paternalism, justice and health, coercion in the response to infectious disease, environmental and occupational health, and genetics. Many of the essays investigate particular issues within a general topic area (for instance, there are two essays about tobacco in the section on autonomy and paternalism). These more focused essays provide helpful illustrations of issues examined in the more general essays. For the most part, the focused, practical essays seem more helpful than the general, theoretical ones, as many of the theoretical discussions are truncated, occasionally to the point of being misleading (for instance, the comments about libertarianism on page 20 and about utilitarianism on page 22).
Assessment:This is a useful addition to previously available anthologies on public health ethics such as New Ethics for the Public's Health, Beauchamp and Steinbock (Oxford University Press, 1999), and Promoting Healthy Behavior; How Much Freedom? Whose Responsibility?, Callahan (Georgetown University Press, 2000). None of these anthologies clearly is better than the others, and each exhibits theoretical weaknesses such as the failure to adequately address the multitude of competing concepts of justice.