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11 - Equity and population health

Toward a broader bioethics agenda

Published online by Cambridge University Press:  05 July 2011

By
Norman Daniels
Edited by
Angus Dawson
Norman Daniels
Affiliation:
Harvard University
Angus Dawson
Affiliation:
Keele University
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Summary

Introduction

In its early decades, bioethics concentrated on two important problem areas: (1) the dyadic, very special relationships that hold between doctors and patients and researchers and subjects; and (2) Promethean challenges, the powers and responsibilities that come with new knowledge and technologies in medicine and the life sciences, including those that bear on extending and terminating life. The dyadic relationships yield important goods, impose significant risks, are rife with inequalities in power and authority, and yet are bound by complex rights and obligations. They provide a rich field for ethics to explore. The Promethean challenges are the favourites of the media: how god-like can we become in our relations with people, with animals, and with our environment without losing our moral footing? They attract serious inquiries about how to use knowledge and technology responsibly for the individual and collective good. Unfortunately, they also form the frontline trenches for contemporary culture wars.

Bioethics' focus on the largely non-institutional examination of these dyadic relations and the emergence of exotic technologies means other important issues concerning population health and its equitable distribution were not addressed. (There are exceptions to this generalization.) The doctor–patient relationship and the researcher–subject relationship do have a bearing on population health, since medicine and medical research have impact on the health of individuals and populations. By not examining the broader institutional settings and policies that mediate population health, bioethics has sometimes been myopic, not seeing the context in which these relationships operate.

Type
Chapter
Information
Public Health Ethics
Key Concepts and Issues in Policy and Practice
 , pp. 191 - 210
Publisher: Cambridge University Press
Print publication year: 2011

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