Research

Philosophy, Ethics, and Humanities in Medicine

, 5:1

Open Access This content is freely available online to anyone, anywhere at any time.

Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?

  • Jacquineau AzétsopAffiliated withFaculté de Médécine Teilhard de Chardin, Complexe Médical le Bon Samaritain Email author 
  • , Stuart RennieAffiliated withDepartment of Philosophy, University of Cape TownDepartment of Social Medicine, University of North Carolina School of Medicine Chapel Hill

Abstract

Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.