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Canadian Journal of Public Health

, Volume 101, Issue 1, pp 9–11 | Cite as

Re-visioning Public Health Ethics: A Relational Perspective

  • .Nuala P. KennyEmail author
  • Susan B. Sherwin
  • Françoise E. Baylis
Ethics in Public Health
  • 2 Downloads

Abstract

Canada is in the forefront of thinking about the unique and complex issues of contemporary public health ethics. However, an inordinate focus on the urgent issues of emergency preparedness in pandemic and reliance on bioethical analysis steeped in the autonomy and individual rights tradition of health care and research do not serve adequately as the basis for an ethic of public health with its focus on populations, communities and the common good.

This paper describes some concerns regarding the focus on pandemic ethics in isolation from public health ethics; identifies inadequacies in the dominant individualistic ethics framework; and summarizes nascent work on the concepts of relational autonomy, relational social justice and relational solidarity that can inform a re-visioning of public health ethics. While there is still much work to be done to further refine these principles, they can help to reclaim and centre the common and collective good at risk in pandemic and other emergency situations. Minimally, these principles require a policy-making process that is truly transparent, fair and inclusive; is sensitive and responsive to the workings of systemic inequalities; and requires public recognition of the fact that we enter any crisis with varying degrees of inequity. Public policy response to crisis must not forseeably increase existing inequities.

Keywords

Ethics social justice community solidarity 

Résumé

Le Canada est à l’avant-garde de la pensée contemporaine sur les enjeux complexes et particuliers de l’éthique en santé publique. Cependant, une attention démesurée aux problèmes urgents de la préparation antipandémique et une analyse bioéthique ancrée dans les traditions d’autonomie et de droits individuels dans les soins de santé et la recherche en santé ne constituent pas des bases assez solides pour une éthique de la santé publique axée sur les populations, les communautés et le bien commun.

Nous présentons ici certains problèmes qu’il peut y avoir à étudier l’éthique des interventions en cas de pandémie en la séparant de l’éthique en santé publique; nous cernons les lacunes du cadre éthique individualiste dominant; et nous résumons les travaux naissants sur les concepts d’autonomie relationnelle, de justice sociale relationnelle et de solidarité relationnelle qui peuvent étayer une nouvelle vision d’avenir pour l’éthique en santé publique. Il y a encore beaucoup de travail à faire pour peaufiner ces principes, mais ils peuvent déjà contribuer à revaloriser et à remettre au centre de nos préoccupations le bien commun et collectif fragilisé durant les pandémies et autres situations d’urgence. À tout le moins, ces principes nécessitent un processus décisionnel vraiment transparent, équitable et inclusif, un processus sensible et réceptif aux rouages des inégalités systémiques, et qui reconnaisse publiquement qu’au début de chaque crise il existe déjà des inégalités à divers degrés. Les politiques publiques élaborées en réponse aux crises doivent se garder de creuser ces inégalités.

Motsclés

éthique justice sociale communauté solidarité 

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Copyright information

© The Canadian Public Health Association 2010

Authors and Affiliations

  • .Nuala P. Kenny
    • 1
    Email author
  • Susan B. Sherwin
    • 2
  • Françoise E. Baylis
    • 1
    • 3
    • 4
  1. 1.Department of BioethicsDalhousie UniversityHalifaxCanada
  2. 2.Department of PhilosophyDalhousie UniversityHalifaxCanada
  3. 3.PhilosophyDalhousie UniversityHalifaxCanada
  4. 4.Obstetrics and GynaecologyDalhousie UniversityHalifaxCanada

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