Stanford Encyclopedia of Philosophy Public Health Ethics First published Mon Apr 12, 2010; substantive revision Thu Feb 19, 2015 At its core, public health is concerned with promoting and protecting the health of populations, [ 1 ] broadly understood. Collective interventions in service of population health often involve or require government action. In the United States, for example, the Centers for Disease Control and Prevention, the Food and Drug Administration, the Environmental Protection Agency and the Consumer Protection Agency are in part or in whole public health agencies. All nations and most states or provinces and municipalities have health departments whose functions include everything from the inspection of commercial food service to the collection and use of epidemiological data for population surveillance of disease. Collective action to promote and protect population health also occurs at the global level, as exemplified by the activities of the World Health Organization. Public health ethics deals primarily with the moral foundations and justifications for public health, the various ethical challenges raised by limited resources for promoting health, and real or perceived tensions between collective benefits and individual liberty. One view of public health ethics regards the moral foundation of public health as an injunction to maximize welfare, and therefore health as a component of welfare (Powers & Faden 2006). This view frames the core moral challenge of public health as balancing individual liberties with the advancement of good health outcomes. Consider, for example, how liberties are treated in government policies that fluoridate municipal drinking water or compel people with active, infectious tuberculosis to be treated. An alternative view of public health ethics characterizes the moral foundation of public health as social justice. While balancing individuals' liberties with promoting social goods is one area of concern, it is embedded within a broader commitment to secure a sufficient level of health for all and to narrow unjust inequalities (Powers & Faden, 2006). [ 2 ] , [ 3 ] Thus, another important area of concern is the balancing of this commitment with the injunction to maximize good aggregate or collective health outcomes. Understood this way, public health ethics has deep moral connections to broader questions of social justice, poverty, and systematic disadvantage. Against the backdrop of these two normative approaches, this paper proceeds as follows: Section 1 lays out some of the distinctive challenges of public health ethics. Section 2 discusses different justifications for public health interventions, including the role of paternalism and how it bears on the permissibility of public health interventions. Also discussed in Section 2 are broader questions of democratic legitimacy. Section 3 focuses on questions of justice and fairness in public health ethics. Finally, Section 4 discusses global justice as it intersects with public health. Overall, this entry strives to provide a general lay of the land of the central
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- Public health ethics