Paternalism and Public Health

Author(s):  
Jessica Flanigan

Since medical paternalism is wrong in the clinical context, it should be rejected in public policy as well. But even if paternalistic public health policies were permissible, it is not clear that prohibitive pharmaceutical regulations are necessary to promote public health. Prohibitions could undermine health in some cases, for example, if prescription requirements make patients more deferential to physicians and tolerant of medical risks. Premarket testing requirements cause people to suffer and die waiting for new drugs to get approved, and they discourage new drug development. This is not to say that regulation serves no purpose. Pharmaceutical regulators provide a valuable pubic good by overseeing testing for new drugs and by certifying drugs that they deem generally safe and effective. But the benefits of regulation do not require that the regulations be prohibitive, and prohibitive regulations not only violate patients’ rights, they may also cost lives.

2021 ◽  
pp. 89-109
Author(s):  
James Wilson

Public health policies are often accused of being paternalistic, or to show the ‘Nanny State’ in action. This chapter argues that complaints about paternalism in public health policy are, for a variety of reasons, much less convincing than is often thought. First, for conceptual reasons, it is difficult to specify what it would be for a policy to be paternalistic. Second, two of the elements that make paternalism problematic at an individual level—interference with liberty and lack of individual consent—are endemic to public policy contexts in general and so cannot be used to support the claim that paternalism in particular is wrong. The chapter concludes that instead of debating whether a given policy is paternalistic, it would be better to ask whether the infringements of liberty it contains are justifiable, without placing any weight on whether or not those infringements of liberty are paternalistic.


Percurso ◽  
2019 ◽  
Vol 3 (30) ◽  
pp. 57 ◽  
Author(s):  
Lourenço De Miranda Freire NETO ◽  
Priscila Luciene Santos LIMA

RESUMOA garantia do acesso à saúde no Brasil é tema recorrente nas discussões sobre os problemas enfrentados pelos cidadãos usuários dos serviços públicos de saúde, razão pela qual é necessário estudar e diagnosticar problemas e as possíveis soluções para os mesmos, no contexto do nosso Sistema Único de Saúde. Um destes problemas tem ganhado grande destaque, a saber, a presença física dos médicos, notadamente as desigualdades de distribuição dos mesmos, com tentativa de solução adotada pelo Programa Mais Médicos, razão pela qual é mister analisar se tal política pública soluciona a contento a questão, bem como, de forma geral, quais as estratégias complementares ou alternativas a serem implementadas de forma a obter, no maior grau possível, a efetivação da garantia constitucional. Palavras-chave: Acesso à saúde. Políticas públicas em saúde. Programa Mais Médicos. PALAVRAS-CHAVE: Acesso à Saúde; Mais Médicos; SUS.ABSTRACTThe guarantee of access to health in Brazil is a recurring theme in the discussions about the problems faced by citizens who use public health services, which is why it is necessary to study and diagnose problems and possible solutions for them, in the context of our “Sistema Único de Saúde" of these problems has gained prominence, namely the physical presence of physicians, especially the inequalities of their distribution, with an attempt to find a solution adopted by the "Mais Médicos" Program, which is why it is necessary to analyze if such public policy solves to the satisfaction of the question, as well as, in a general way, what complementary or alternative strategies to be implemented in order to obtain, to the greatest possible degree, the realization of the constitutional guarantee. Keywords: Access to health. Public health policies. "Mais Médicos" Program. Keyword: Health Access; More Doctors; SUS.


JAMIA Open ◽  
2021 ◽  
Author(s):  
Bo Peng ◽  
Rowland W Pettit ◽  
Christopher I Amos

Abstract Objectives We developed COVID-19 Outbreak Simulator (https://ictr.github.io/covid19-outbreak-simulator/) to quantitatively estimate the effectiveness of preventative and interventive measures to prevent and battle COVID-19 outbreaks for specific populations. Materials and methods Our simulator simulates the entire course of infection and transmission of the virus among individuals in heterogeneous populations, subject to operations and influences, such as quarantine, testing, social distancing, and community infection. It provides command-line and Jupyter notebook interfaces and a plugin system for user-defined operations. Results The simulator provides quantitative estimates for COVID-19 outbreaks in a variety of scenarios and assists the development of public health policies, risk-reduction operations, and emergency response plans. Discussion Our simulator is powerful, flexible, and customizable, although successful applications require realistic estimation and robustness analysis of population-specific parameters. Conclusion Risk assessment and continuity planning for COVID-19 outbreaks are crucial for the continued operation of many organizations. Our simulator will be continuously expanded to meet this need.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R S Caló ◽  
B S N Souza ◽  
N D Galvão ◽  
R A G Souza ◽  
J C S Oliveira ◽  
...  

Abstract Background Colorectal cancer has been one of the cancers that most contributed to mortality, in both sexes in the world. In Brazil, cancer is among the top five causes of death and colorectal cancer is ranked on the fifth position. Of the Federative Units belonging to the Legal Amazon, Mato Grosso stands out for the higher adjusted incidence of colorectal cancer for both sexes. Thus, the objective is to characterize deaths from colorectal cancer, according to sociodemographic variables in Mato Grosso from 2000 to 2016. Methods A descriptive study was carried out, using data from the Mortality Information System, made available by the Department of Health of the Mato Grosso State. Deaths of all ages were selected, whose basic cause was identified by the codes from the International Classification of Diseases: (C.18) colon cancer, (C.19) rectosigmoid junction cancer, (C.20) rectal cancer or (C.21) anus cancer. Results Between 2000 and 2016, 31,607 deaths from cancer were registered. Of these, 1,750 (5.6%) were due to colorectal cancer. An increased number of deaths was observed at the end of the period, with a variation from 46 deaths in 2000 from 173 in 2016. Highest frequency was verified in men (51.3%), people aged 60 years or older (59.7%), black (54.6%), married (52.3%) and those with primary education (55.2%). According to Brazilian occupation classification options or those answers filled out on the death certificate, highest frequency were for “Retired” (26.2%), “Housewife” (23.1%), Agricultural/Forestry and Fisheries” (11.3%) and “Production of Industrial Goods and Services” (10.3%). Conclusions This study evidenced the increased number of deaths due to colorectal cancer in Mato Grosso State, and identified priority groups for interventions through public health policies which should include screening and early diagnosis to cope with the disease. Key messages Evidenced the increased number of deaths due to colorectal cancer in Mato Grosso State. Identified priority groups for interventions through public health policies.


2021 ◽  
Vol 17 (2) ◽  
pp. 186-203
Author(s):  
Nathan Genicot

AbstractThe COVID-19 pandemic has given rise to the massive development and use of health indicators. Drawing on the history of international public health and of the management of infectious disease, this paper attempts to show that the normative power acquired by metrics during the pandemic can be understood in light of two rationales: epidemiological surveillance and performance assessment. On the one hand, indicators are established to evaluate and rank countries’ responses to the outbreak; on the other, the evolution of indicators has a direct influence on the content of public health policies. Although quantitative data are an absolute necessity for coping with such disasters, it is critical to bear in mind the inherent partiality and precarity of the information provided by health indicators. Given the growing importance of normative quantitative devices during the pandemic, and assuming that their influence is unlikely to decrease in the future, they call for close scrutiny.


The Lancet ◽  
2017 ◽  
Vol 390 ◽  
pp. S12 ◽  
Author(s):  
Katie Thomson ◽  
Frances Hillier-Brown ◽  
Adam Todd ◽  
Courtney McNamara ◽  
Tim Huijits ◽  
...  

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