Public Health Ethics最新文献

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OUP accepted manuscript OUP接受稿件

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2022-01-01 DOI: 10.1093/phe/phac004

引用次数: 1

OUP accepted manuscript OUP接受稿件

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2022-01-01 DOI: 10.1093/phe/phac001

引用次数: 2

The Ethics of Selective Mandatory Vaccination for COVID-19 新冠肺炎选择性强制疫苗接种的伦理

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-12-15 DOI: 10.1093/phe/phab028

B. Williams

Abstract With evidence of vaccine hesitancy in several jurisdictions, the option of making COVID-19 vaccination mandatory requires consideration. In this paper I argue that it would be ethical to make the COVID-19 vaccination mandatory for older people who are at highest risk of severe disease, but if this were to occur, and while there is limited knowledge of the disease and vaccines, there are not likely to be sufficient grounds to mandate vaccination for those at lower risk. Mandating vaccination for those at high risk of severe disease is justified on the basis of the harm principle, as there is evidence that this would remove the grave public health threat of COVID-19. The risk–benefit profile of vaccination is also more clearly in the interests of those at highest risk, so mandatory vaccination entails a less severe cost to them. Therefore, a selective mandate would create fairness in the distribution of risks. The level of coercion imposed by a mandate would need to be proportionate, and it is likely that multiple approaches will be needed to increase vaccine uptake. However, a selective mandate for COVID-19 vaccines is likely to be an ethical choice and should be considered by policy-makers.

摘要有证据表明，几个司法管辖区对疫苗犹豫不决，需要考虑强制接种新冠肺炎疫苗。在这篇论文中，我认为，对严重疾病风险最高的老年人强制接种新冠肺炎疫苗是合乎道德的，但如果发生这种情况，尽管对疾病和疫苗的了解有限，但不太可能有足够的理由强制接种风险较低的人的疫苗。根据危害原则，强制为重症高危人群接种疫苗是合理的，因为有证据表明，这将消除新冠肺炎对公共健康的严重威胁。疫苗接种的风险-收益状况也更清楚地符合高危人群的利益，因此强制接种疫苗对他们来说成本较低。因此，有选择的授权将在风险分配方面创造公平。授权所施加的胁迫程度需要适度，很可能需要多种方法来提高疫苗的接种率。然而，新冠肺炎疫苗的选择性授权可能是一种道德选择，决策者应予以考虑。

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引用次数: 14

Noisy Autonomy: The Ethics of Audible and Silent Noise. 噪声自治:可听噪声与无声噪声的伦理学。

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-10-29 eCollection Date: 2021-11-01 DOI: 10.1093/phe/phab026

David Shaw

In this paper, I summarize the medical evidence regarding the auditory and non-auditory effects of noise and analyse the ethics of noise and personal autonomy in the social environment using a variety of case studies. Key to this discussion is the fact that, contrary to the traditional definition of noise, sound can be noise without being annoying, as the evidence shows that some sounds can harm without being perceived. Ultimately, I develop a theory of 'noisy autonomy' with which to guide us in discussing the public health ethics of noise and other sounds.

在本文中，我总结了关于噪音的听觉和非听觉影响的医学证据，并通过各种案例研究分析了社会环境中噪音的伦理和个人自主性。这一讨论的关键在于，与噪音的传统定义相反，声音可以是噪音而不令人讨厌，因为有证据表明，有些声音可以造成伤害而不被察觉。最后，我发展了一种“噪音自治”理论，用它来指导我们讨论噪音和其他声音的公共卫生伦理。

引用次数: 1

We Should Not Use Randomization Procedures to Allocate Scarce Life-Saving Resources 我们不应该使用随机程序来分配稀缺的救生资源

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-09-22 DOI: 10.1093/phe/phab025

Roberto Fumagalli

In the recent literature across philosophy, medicine and public health policy, many influential arguments have been put forward to support the use of randomization procedures (RAND) to allocate scarce life-saving resources (SLSR). In this paper, I provide a systematic categorization and a critical evaluation of these arguments. I shall argue that those arguments justify using RAND to allocate SLSR in fewer cases than their proponents maintain and that the relevant decision-makers should typically allocate SLSR directly to the individuals with the strongest claims to these resources rather than use RAND to allocate such resources.

在最近的哲学、医学和公共卫生政策方面的文献中，提出了许多有影响力的论点来支持使用随机化程序(RAND)来分配稀缺的救生资源(SLSR)。在本文中，我对这些论点进行了系统的分类和批判性的评价。我认为，这些论点证明使用兰德公司分配SLSR的情况比他们的支持者所坚持的要少，而且相关的决策者通常应该将SLSR直接分配给对这些资源有最强烈要求的个人，而不是使用兰德公司来分配这些资源。

引用次数: 4

Beyond Surviving to Thriving: The Case for a ‘Compassion towards Thriving’ Approach in Public Mental Health Ethics 超越生存到繁荣:公共心理健康伦理中“对繁荣的同情”方法的案例

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-08-19 DOI: 10.1093/phe/phab023

Phil Bielby

In this article, I argue for a novel understanding of compassion—what I call a ‘compassion towards thriving’ approach—to inform public mental health ethics. The argument is developed through two main parts. In the first part, I develop an account of compassion towards thriving that builds upon Martha Nussbaum’s philosophical work on compassion. This account expands the ambit of compassion from a focus on the alleviation of existing suffering to the prevention of potential future suffering through the facilitation of personal growth based on a ‘psychosocial’ understanding of mental health. In the second part of the article, I discuss the aims of public mental health and examine compassion towards thriving’s normative synergies with existing approaches in public health ethics. I explain how compassion towards thriving supports a vision of public health ethics which is concerned with solidarity, social justice and flourishing. I then apply this compassion towards thriving approach to evaluate the ‘Every Mind Matters’ public mental health campaign in England, highlighting its affinities with the ethos of the campaign. I also identify and explain two ways in which the application of a compassion towards thriving approach could enhance its delivery.

在这篇文章中，我主张对同情有一种新颖的理解——我称之为“对繁荣的同情”的方法——为公共心理健康伦理提供信息。这个论点分为两个主要部分。在第一部分中，我在玛莎·努斯鲍姆关于同情的哲学著作的基础上，对繁荣的同情进行了阐述。这篇报道将同情的范围从关注减轻现有痛苦扩展到通过促进基于对心理健康的“心理社会”理解的个人成长来预防未来潜在的痛苦。在文章的第二部分，我讨论了公共心理健康的目标，并考察了对繁荣的同情与公共卫生伦理中现有方法的规范协同作用。我解释了对繁荣的同情如何支持与团结、社会正义和繁荣有关的公共卫生伦理愿景。然后，我运用这种对繁荣的同情的方法来评估英国的“Every Mind Matters”公共心理健康运动，强调其与运动精神的密切关系。我还确定并解释了两种方式，在这两种方式中，对繁荣的方法应用同情可以加强其交付。

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引用次数: 0

‘Take the Pill, It Is Only Fair’! Contributory Fairness as an Answer to Rose’s Prevention Paradox “服用避孕药，这才是公平的”！贡献公平对罗斯预防悖论的回答

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-08-10 DOI: 10.1093/phe/phab022

Jay A. Zameska

One proposal to significantly reduce cardiovascular disease is the idea of administering a ‘polypill’—a combination of drugs that reduce the risk of heart disease and carry few side effects—to everyone over the age of 55. Despite their promise, population strategies like the polypill have not been well-accepted. In this article, I defend the polypill (and consequently, other similar population strategies) by appealing to fairness. The argument focuses on the need to fairly distribute the costs to individuals. While the fact that population strategies like the polypill impose minor costs on everyone has primarily been used to criticize such strategies, I argue that it gives us a reason to support them. I argue that implementing a population strategy with the polypill contributes to the public good of ‘health system capacity’. I then explain that public goods have widely accepted obligations: they carry an obligation to fairly distribute the costs of the goods and prevent free-riding. Thus, we have at least one pro tanto moral reason to implement the polypill. As such, this article challenges the current literature on the topic, which has largely held adopting population strategies like the polypill to be unjustifiable.

一项显著减少心血管疾病的建议是给55岁以上的人服用“多药”，这是一种降低心脏病风险且几乎没有副作用的药物组合。尽管有前景，但像息肉病这样的人口策略并没有被广泛接受。在这篇文章中，我通过呼吁公平来为polypill（以及其他类似的群体策略）辩护。争论的焦点是需要将成本公平分配给个人。虽然像polypill这样的人口策略给每个人带来的成本很小，这一事实主要被用来批评这种策略，但我认为这给了我们支持它们的理由。我认为，实施人口战略有助于“卫生系统能力”的公共利益。然后我解释说，公共产品有广泛接受的义务：它们有义务公平分配商品成本，防止搭便车。因此，我们至少有一个积极的道德理由来实施该计划。因此，这篇文章对当前关于这一主题的文献提出了挑战，该文献在很大程度上认为采用像polypill这样的人口策略是不合理的。

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引用次数: 0

Autism and the Right to a Hypersensitivity-Friendly Workspace. 自闭症和超敏感友好型工作环境的权利。

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-08-01 eCollection Date: 2021-11-01 DOI: 10.1093/phe/phab021

Bouke de Vries

Many individuals on the autism spectrum are hypersensitive to certain sensory stimuli. For this group, as well as for non-autistic individuals with sensory processing disorders, being exposed to e.g. fluorescent lights, perfume odours, and various sounds and noises can be real torment. In this article, I consider the normative implications of such offence for the design of office spaces, which is a topic that has not received any attention from philosophers. After identifying different ways in which the senses of hypersensitive workers might be protected within these spaces, I show that many of such accommodations can be made at reasonable cost, before arguing that doing so ought to be a legal requirement.

许多自闭症患者对某些感官刺激极度敏感。对于这一群体，以及有感觉处理障碍的非自闭症个体来说，暴露在荧光灯、香水气味和各种声音和噪音中是真正的折磨。在这篇文章中，我考虑了这种冒犯对办公空间设计的规范含义，这是一个尚未受到哲学家关注的话题。在确定了在这些空间中保护超敏感工人感官的不同方式之后，我指出，许多这样的安排都是可以以合理的成本完成的，然后才提出这样做应该是一项法律要求。

引用次数: 4

The 'Ethical' COVID-19 Vaccine is the One that Preserves Lives: Religious and Moral Beliefs on the COVID-19 Vaccine. 新冠肺炎“伦理”疫苗是拯救生命的疫苗：新冠肺炎疫苗的宗教和道德信仰。

IF 1.4 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-07-19 eCollection Date: 2021-11-01 DOI: 10.1093/phe/phab018

Alberto Giubilini, Francesca Minerva, Udo Schuklenk, Julian Savulescu

Although the COVID-19 pandemic is a serious public health and economic emergency, and although effective vaccines are the best weapon we have against it, there are groups and individuals who oppose certain kinds of vaccines because of personal moral or religious reasons. The most widely discussed case has been that of certain religious groups that oppose research on COVID-19 vaccines that use cell lines linked to abortions and that object to receiving those vaccine because of their moral opposition to abortion. However, moral opposition to COVID-19 vaccine research can be based on other considerations, both secular and religious. We argue that religious or personal moral objections to vaccine research are unethical and irresponsible, and in an important sense often irrational. They are unethical because of the risk of causing serious harm to other people for no valid reason; irresponsible because they run counter to individual and collective responsibilities to contribute to important public health goals; and in the case of certain kinds of religious opposition, they might be irrational because they are internally inconsistent. All in all, our argument translates into the rather uncontroversial claim that we should prioritize people's lives over religious freedom in vaccine research and vaccination roll out.

尽管新冠肺炎大流行是一场严重的公共卫生和经济紧急事件，尽管有效的疫苗是我们对抗它的最佳武器，但仍有一些团体和个人出于个人道德或宗教原因反对某些疫苗。讨论最广泛的案例是某些宗教团体的案例，他们反对研究使用与堕胎有关的细胞系的新冠肺炎疫苗，并因道德上反对堕胎而反对接种这些疫苗。然而，道德上反对新冠肺炎疫苗研究可能基于世俗和宗教的其他考虑。我们认为，对疫苗研究的宗教或个人道德反对是不道德和不负责任的，在重要意义上往往是不合理的。他们是不道德的，因为他们有可能在没有正当理由的情况下对他人造成严重伤害；不负责任，因为它们违背了为重要公共卫生目标做出贡献的个人和集体责任；在某些宗教对立的情况下，它们可能是不合理的，因为它们在内部是不一致的。总的来说，我们的论点转化为一个毫无争议的主张，即在疫苗研究和疫苗推广中，我们应该将人民的生命置于宗教自由之上。

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引用次数: 0

Against the Medicalization of Public Health (Ethics) 反对公共卫生医疗化(伦理)

IF 2.1 3区哲学 Q2 ETHICS

Public Health Ethics

Pub Date : 2021-07-01 DOI: 10.1093/phe/phab024

D. Goldberg

引用次数: 3

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