Monash Bioethics Review最新文献

In research and clinical practice, the words chosen to describe others matter, particularly regarding race and ethnicity. Some terminologies are particularly problematic and should be avoided, given their tendency to distort cohorts of individuals based on presupposed common attributes and demographic characteristics. Racial taxonomy may unintentionally give rise to pejorative and potentially unsettling connotations. Hence, outdated racialised designations should be superseded by ethically and scientifically meaningful alternatives. The term Caucasian, as demonstrated in this manuscript, has persisted as a frequent terminology in Western biomedical parlance when referring to white individuals. The use of the term Caucasian represents a relic of an outdated and prejudiced racial classification system. In particular, the persistence of this terminology in the Australian healthcare setting is in disagreement with contemporary scientific and worldview values. Although the use of Caucasian as a descriptor has been challenged, given its inherent taxonomic and methodological flaws, several professional associations continue to include Caucasian as an acceptable category in racial classification systems, which suggests this time-worn term remains in wide use. It is likely, therefore, that the persisting use of Caucasian will continue to generate unreliable information and contribute to a misinterpretation of Australian populational composition. To the authors' knowledge, the persistent use of Caucasian as a demographic descriptor has never been questioned in the Australian scientific literature. It is hoped that the argument presented herein will prompt further debate and development regarding this critical issue.

Many public health policies are coercive and therefore, they require moral justification. Kantian political philosophy is an under-explored but appealing approach to public health ethics. According to the Kantian approach, which is centred around freedom as independence, the state has an important role in protecting that freedom. In doing so, the state is justified to use coercion. To illustrate the Kantian approach, we consider its implications in the context of coercive vaccination policy. We show coercive vaccination policies are justified, because the state is needed to provide determinacy, because such policies are needed to guarantee the systematic enjoyment of the right to freedom, and because such policies reduce the risk for dependence on others.

In the ethics of public health, questions of virtue, that is, of what it means for public health to act excellently, have received little attention. This omission needs remedy first because achieving improvements in population-wide health can be in tension with goals like respect for the liberty, self-determination, or non-oppression of various individuals or groups. A virtue-ethics approach is flexible and well-suited for the kind of deliberation required to resolve or mitigate such tension. Public health requires practically wise and careful thinking, which virtue ethics brings with it. Furthermore, too tight a focus on delivering outcomes in determining how public health should act has, in some cases, actually undermined its ability to achieve those consequences. However, the main concern about incorporating virtue into public health in a pluralistic society is likely to be that virtue is generally teleological, and we would surely need some widely agreed upon idea of something like flourishing or the common good for this to work. In this paper, I propose that for public health to express virtue in its work, it must express a commitment to justice as it goes about its business promoting and protecting the health of the population. Justice is both a contributor toward better health for groups in society, and a worthwhile goal in its own right. I will sketch an argument that justice as non-oppression - not merely health equity - is the right telos toward which excellent public health should aim in a pluralist society.