Public Health Interventions: Ethical Implications

2019 ◽  
pp. 76-88
Author(s):  
David R. Buchanan
Keyword(s):  
Public Health ◽  
Educational Interventions ◽  
Health Interventions ◽  
Social Solidarity ◽  
Ethical Challenges ◽  
Individual Liberty ◽  
Public Health Interventions ◽  
Environmental Interventions ◽  
Ethical Implications ◽  
The Individual

Public health interventions present distinct ethical challenges relative to clinical medical interventions, primarily because of their focus on prevention (rather than treatment) and their intended impact on the health of a population as a whole (rather than the individual). Public health interventions can be broadly categorized as falling into two main types: educational and environmental. Educational interventions aim to change individual behaviors, whereas environmental interventions seek to change the social and environmental conditions that encourage, require, or reinforce behaviors that are either beneficial or harmful to health. Public health interventions raise normative concerns with respect to three key ethical principles: the potential for harm (including stigmatization, lost opportunity costs, and threats to autonomy), justice, and social solidarity, particularly with respect to the problem of free riders. The high value placed on individual liberty in the modern era makes the task of asking individuals to give up freedoms to protect and promote population health increasingly difficult.

Control of Mosquito-Borne Illnesses: A Challenge to Public Health Ethics

2019 ◽  
pp. 458-471
Author(s):  
Laura Greisman ◽  
Barbara Koenig ◽  
Michele Barry
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Mosquito Control ◽  
Virus Disease ◽  
Health Interventions ◽  
Ethical Challenges ◽  
Insecticide Treated Nets ◽  
Public Health Interventions ◽  
Middle Income ◽  
Public Health Agencies

This chapter delves into the ethical issues surrounding the implementation of public health interventions for control of mosquito-borne illnesses. Emerging and reemerging mosquito-borne infections remain a public health threat worldwide, prompting public health agencies to strengthen individual and population-wide measures for mosquito control. Ethical issues surrounding surveillance activities and key public health interventions for mosquito control are discussed, including provision of insecticide-treated nets (ITNs), the spraying of aerial pesticides, and the introduction of genetically modified mosquitoes. A case study of Zika virus disease highlights specific ethical challenges surrounding the safety of insect repellent use in pregnancy and the complex issue of women’s reproductive rights arising in a fast-moving epidemic. The chapter emphasizes the need for community engagement at all levels of mosquito control interventions, and it highlights the disproportionate impact of mosquito-borne disease on the poor, calling to action the need to strengthen health systems in low- and middle-income countries.

scholarly journals Etica e Sanità Pubblica: massimizzare la relazione

2015 ◽  
Vol 64 (4) ◽  
Author(s):  
Massimiliano Colucci
Keyword(s):  
Public Health ◽  
Clinical Medicine ◽  
Health Interventions ◽  
Ethical Framework ◽  
Individual Autonomy ◽  
Public Health Interventions ◽  
The Public ◽  
The Social ◽  
The Individual ◽  
The Relationship

A causa del maggior sviluppo della bioetica negli ambiti della clinica e della sperimentazione biomedica, e per la difficoltà di definire la stessa sanità pubblica, quest’ultima manca ancora di un quadro etico di riferimento. Dopo un breve profilo storico e semantico, si esamina perciò l’antitesi, in letteratura, tra bioetica ed etica di sanità pubblica. Quindi si rileggono e sfatano le tre principali dicotomie su cui viene costruita tale antitesi – pazienti vs. assistiti, individuo vs. popolazione, paternalismo vs. autonomia. Si può affermare che la salute individuale e la salute collettiva sono fini simultanei e inseparabili degli interventi di sanità pubblica. Inoltre, l’autonomia relazionale è l’unica alternativa all’autonomia d’impronta liberale. L’autonomia individuale, infatti, si sviluppa attraverso l’influenza di legami umani e la giustizia sociale. La relazione – come capacità di promuovere la partecipazione e di mantenere la fiducia – è la sostanza della sanità pubblica, e fonte assiologica della sua etica. È cioé il primo valore e il principale criterio per indirizzare gli interventi di sanità pubblica, che saranno tanto più etici quanto più saranno in grado di massimizzare la relazione nel contesto in cui vengono attuati. ---------- Owing to a greater development of bioethics in the fields of clinical medicine and biomedical research, and because of the difficulty to define the public health itself, the latter still lacks an ethical framework. Therefore, after a brief historical and semantic outline, we examine the antithesis, as proposed in the literature, between bioethics and public health ethics. Then, we reread and debunk the three main dichotomies on which such an antithesis is built – patients vs. healthcare users, individual vs. population, paternalism vs. autonomy. We may state that the individual health and the collective health are simultaneous and inseparable purposes of public health interventions. Moreover, the relational autonomy it is the only alternative to the liberal-shaped autonomy. Indeed, the individual autonomy develops through the influence of human bonds and the social justice. The relationship – as the capability to promote the engagement and to maintain trust – is the substance of public health, and the axiological source of its ethics. In other words, it is the first value and the main criterion to address public health interventions; these will be ethical as much as they will be able to maximize the relationship in the context of their fulfilment.

Environmental Health in Latin American Countries

2020 ◽  
Author(s):  
Luiz Augusto Cassanha Galvao ◽  
Volney Câmara ◽  
Daniel Buss
Keyword(s):  
Public Health ◽  
Environmental Health ◽  
Latin American ◽  
Biodiversity Loss ◽  
Well Being ◽  
Health Interventions ◽  
Global Changes ◽  
Public Health Interventions ◽  
Environmental Interventions ◽  
Health And Well Being

The relationship between environment and health is part of the history of medicine and has always been important to any study of human health and to public-health interventions. In Latin America many health improvements are related to environmental interventions, such as the provision of better water and sanitation services. Latin America’s development, industrialization, and sweeping urbanization have brought many improvements to the well-being of its populations; they have also inaugurated new societies, with new patterns of consumption. The region’s basic environmental-health interventions have needed to be updated and upgraded to include disciplines such as toxicology, environmental epidemiology, environmental engineering, and many others. Multidisciplinary and inter-sector approaches are paramount to understanding new profiles of health and well-being, and to promoting effective public-health interventions. The new social, economic, labor, and consumption aspects of modern Latin American society have become more and more relevant to understanding the complex interactions in the region’s social, biological, and physical environment, which are essential to explaining some of the emerging and re-emerging public-health problems. Environmental health, as concept and as intervention, is simple and easily understood, but no longer sufficient to achieve the levels of health and well-being expected and required by these new realities. Many global changes such as climate change, biodiversity loss, and mass migrations has been identified as main cause of ill health and are at the center of the sustainable development challenges in general, and many are critical and specific public health. To face this development, other frameworks have emerged, such as planetary health and environmental and social determinants of health. Public health remains central to some, such as the improved environmental-health agenda, while others assign public health a relative position in a variety of overarching frameworks.

scholarly journals An analysis of COVID-19 clusters in India

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Pooja Sengupta ◽  
Bhaswati Ganguli ◽  
Sugata SenRoy ◽  
Aditya Chatterjee
Keyword(s):  
Public Health ◽  
Cluster Analysis ◽  
Population Density ◽  
Case Studies ◽  
Compartment Model ◽  
Health Interventions ◽  
Disease Spread ◽  
Second Phase ◽  
Public Health Interventions ◽  
Homogeneous Groups

Abstract Background In this study we cluster the districts of India in terms of the spread of COVID-19 and related variables such as population density and the number of specialty hospitals. Simulation using a compartment model is used to provide insight into differences in response to public health interventions. Two case studies of interest from Nizamuddin and Dharavi provide contrasting pictures of the success in curbing spread. Methods A cluster analysis of the worst affected districts in India provides insight about the similarities between them. The effects of public health interventions in flattening the curve in their respective states is studied using the individual contact SEIQHRF model, a stochastic individual compartment model which simulates disease prevalence in the susceptible, infected, recovered and fatal compartments. Results The clustering of hotspot districts provide homogeneous groups that can be discriminated in terms of number of cases and related covariates. The cluster analysis reveal that the distribution of number of COVID-19 hospitals in the districts does not correlate with the distribution of confirmed COVID-19 cases. From the SEIQHRF model for Nizamuddin we observe in the second phase the number of infected individuals had seen a multitudinous increase in the states where Nizamuddin attendees returned, increasing the risk of the disease spread. However, the simulations reveal that implementing administrative interventions, flatten the curve. In Dharavi, through tracing, tracking, testing and treating, massive breakout of COVID-19 was brought under control. Conclusions The cluster analysis performed on the districts reveal homogeneous groups of districts that can be ranked based on the burden placed on the healthcare system in terms of number of confirmed cases, population density and number of hospitals dedicated to COVID-19 treatment. The study rounds up with two important case studies on Nizamuddin basti and Dharavi to illustrate the growth curve of COVID-19 in two very densely populated regions in India. In the case of Nizamuddin, the study showed that there was a manifold increase in the risk of infection. In contrast it is seen that there was a rapid decline in the number of cases in Dharavi within a span of about one month.

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