The Ethical Implications of the Social Determinants of Health: A Global Renaissance for Bioethics

Illingworth, Patricia; Parmet, Wendy E.

doi:10.1111/j.1467-8519.2008.00719.x

Cited by 6 publications

(5 citation statements)

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“…34 After being enshrined into the new German Constitution in 1949, 35 the reference to ‘human dignity’ nowadays allows for a much more stringent application of prevention policy. However, it has taken quite a while for public health to get the attention of academic bioethics, 3 , 36 , 37 resulting in the newly emerging field of PHE. PHE has barely been engaged with the notion and worth of human dignity and its potential usefulness to inform the foundation of ethical judgments in the public context.…”

Section: Resultsmentioning

confidence: 99%

“…2 Thus, public health issues and social determinants of health in Europe and at the global level have only recently appeared to become the focus of bioethical consideration. 3 Given the financial constraints of states in economic crises and associated weaknesses in their social systems, states are increasingly aiming at sustainable policies for prevention and health promotion while striving to achieve more efficient overall health performance. 4…”

Section: Introductionmentioning

confidence: 99%

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Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions

Winter

2017

Int J Health Policy Manag

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Background: There is ample evidence that since the turn of the millennium German health policy made a considerable step towards prevention and health promotion, putting the strategies of ‘personal empowerment’ and ‘settings based approach’ high on the federal government’s agenda. This phenomenon has challenged the role of ethics in health policy. Concurrently, increasing relevance of the Concept of Human Dignity for health and human rights has been discussed. However, a direct relationship between Human Dignity and Public Health Ethics (PHE) has surprisingly not yet been established. Methods: We here conduct a systematic ethical analysis of eminent German health prevention policy case-examples between the years 2000–2016. Specifically, our analysis seeks to adapt and apply the principalism (autonomy, beneficence, justice)-based Concept of Human Dignity of Italian philosopher Corrado Viafora, contextualizing it with the emerging field of PHE. To further inform this health policy analysis, index databases (PubMed, Google Scholar) were searched to include relevant published and grey literature. Results: We observe a systematic approach of post-millennial health policy decisions on prevention and on defined health targets in Germany, exemplified by (1) the fostering of the preparedness against pandemic infectious diseases, (2) the development and implementation of the first cancer vaccination, (3) major legal provisions on non-smokers protection in the public domain, (4) acts to strengthen long term care (LTC) as well as (5) the new German E-Health legislation. The ethical analysis of these health prevention decisions exhibits their profound ongoing impact on social justice, probing their ability to meet the underlying Concept of Human Dignity in order to fulfill the requirements of the principle of non-maleficence. Conclusion: The observed health policy focus on prevention and health promotion has sparked new public debates about the formation of/compliance with emerging standards of PHE in Germany. We believe that the overall impact of this novel policy orientation will gradually show over mid- and long-term periods, both in terms of improvements in health system performance and concurrently in diagnostics, therapies and health outcome on individual patient level. The Concept of Human Dignity may soon play an even greater role in European PHE debates to come.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions

Winter

2017

Int J Health Policy Manag

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“…Global concerns about health and well-being demonstrate the interdependence of people in the world (ten Have, 2011 ), however traditional western approaches to bioethics and health decision making demonstrates a narrow mind-set that privileges autonomy and independent decision making. The World Health Organization (WHO) states that health inequities arise because of the circumstances in which people grow, live, work and age ( 2009 ), and efforts are being made to reduce those inequities and improve social development (e.g. the Millennium Development Goals [MDGs]) (Jacob, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Exploring values among three cultures from a global bioethics perspective

2021

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The United Nations Educational, Scientific and Cultural Organisation’s (UNESCO) Declaration on Bioethics and Human Rights refers to the importance of cultural diversity and pluralism in ethical discourse and care of humanity. The aim of this meta-narrative review is to identify indigenous ethical values pertaining to the Ojibway (Canada), Xhosa (South Africa), and Mayan (Mexico and Central American) cultures from peer-reviewed sources and cultural review, and to ascertain if there are shared commonalities. Three main themes were identified, namely illness, healing, and health care choices. Illness was described with a more complex and dynamic picture than from the western view, as illness is not considered to be one dimensional. Healing needs to take place on various levels in order to restore a state of equilibrium between the different spheres. Health care choices were also considered from a multi-level perspective. In all three of the indigenous cultures explored, good decision-making is seen to have occurred when choices are informed by commitments to one’s moral and ethical responsibilities towards the community, nature, and the spirit world.

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“…To begin to address these critiques, some-again, both within and outside bioethics-have suggested that the discipline could productively engage the social sciences, including sociology, ethnography, and STS (Farmer 2004;Daniels 2006;De Vries et al 2007;Azétsop and Rennie 2010;Petersen 2013). Specifically, arguments have been forwarded that institutionalized ethics should pay more attention to power and to structural determinants of health and to understand health as more socially situated and less the product of medical and technological intervention (Powers and Faden 2006;Illingworth and Parmet 2009;Brock 2010). Some have argued that ethics could also benefit greatly from contributions from the Global South and the medically marginalized (Farmer 2004;Rennie and Mupenda 2008).…”

Section: Ethics and Its Critiques In Establishment And Community-base...mentioning

confidence: 99%

Community Bioethics: Provocations for Institutionalized Ethics from Community-Based Biology

Murray¹,

Santos

2022

Citizen Science: Theory and Practice

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In the United States, institutions of scientific and medical ethics developed out of histories that continue to shape their principles and scope of concerns. Many have identified that the movement of practitioners identifying as community-based biologists (or any of several overlapping labels) presents challenges for institutionalized ethics. Community-based biology has been the subject of ethical controversies, but it has also taken proactive measures to establish ethics of its own. We argue that the challenges that community-based biology poses for establishment, institutionalized ethics are just as significant as their challenges to establishment science more generally, and that the two are inextricable. We also assert that these challenges are more profound than either existing literature suggests or that efforts to establish ethics within community-based biology so far are equipped to address. Drawing on our experiences as social scientists working with the Open Insulin Project and community-based biology more broadly, we demonstrate several ways that community-based biology efforts problematize established approaches to institutionalized research ethics. We describe how, at the same time, efforts to institutionalize ethics in community-based biology risk reproducing features of institutionalized ethics seemingly at odds with the critiques community-based biology itself embodies. Through a series of three empirically grounded provocations, we argue that community-based biology should evolve in tandem with a community bioethics that more consciously engages critiques of institutionalized ethics and embraces the diversity and pluralism of community-based biology.

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The Ethical Implications of the Social Determinants of Health: A Global Renaissance for Bioethics

Cited by 6 publications

References 0 publications

Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions

Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions

Exploring values among three cultures from a global bioethics perspective

Community Bioethics: Provocations for Institutionalized Ethics from Community-Based Biology

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