From Justice to Protection

1. Front Matter

   Pages i-vii

   PDF

2. On Justice and Health Inequities

   • Miguel Kottow

   Pages 1-11

3. Rights and Duties, Needs, and Merits

   • Miguel Kottow

   Pages 13-21

4. Public Health Transitions and the “New Public Health”

   • Miguel Kottow

   Pages 23-31

5. Bioethics in Public Health

   • Miguel Kottow

   Pages 33-44

6. Ethics of Protection I: Theoretical Fundaments

   • Miguel Kottow

   Pages 45-54

7. Ethics of Protection II: Basic Outline

   • Miguel Kottow

   Pages 55-61

8. Protective Bioethics

   • Miguel Kottow

   Pages 63-70

9. Health Care Strategies

   • Miguel Kottow

   Pages 71-82

10. Public Health and Medical Care

    • Miguel Kottow

    Pages 83-91

11. Ethics and Epidemiology

    • Miguel Kottow

    Pages 93-99

12. Integrating Bioethics in Public Health

    • Miguel Kottow

    Pages 101-108

In most developed countries, the epidemiological disease profile has changed from infectious to degenerative, causing major alterations in epidemiological thinking and public health policies. Less developed nations have to deal with a more complex situation, because social disparities create highly unequal health conditions, the affluent being afflicted by degenerative conditions, whereas the poorer social segments continue to suffer infectious diseases, but also begin to feel the effects of chronic illness. At the turn of the 21st century, equity in health care is not being served, and social justice has lost credibility as a conceptual driving force of public health policies. Rampant injustice confirms that theories, reality and suggested practices of just social orders are flawed, leaving the needy without help or hope in a world of flagrant ethical inadequacy. And yet, mainstream bioethics loses meaning and relevance as it clings to the principle of justice and hails such concepts as global justice and universal health-care equity, misleadingly focusing on justice as a desideratum. This book pleads for an urgent turn towards directly addressing injustice as a reality that requires pressingly needed arguments and proposals to inspire realistic public health policies and programs based on an ethics of protection. Ever since Hobbes, all shades of political philosophy accept that the basic obligation of the ruling power is to protect its subjects. The ethics of protection emphasizes aiding the needy and the disempowered in obtaining access to basic goods and services related to health-care. Public health is called upon to fulfill protective obligations to guarantee disease prevention and medical services to the population, taking special care to safeguard those unable to cover their health-care needs in market-oriented medical services and institutions. The bioethics of protection developed in this text presents specific and explicit guide-lines to assure that protective public health actions be efficacious (problem-solving), efficient (sustainable cost/benefit relation) and ethically sound (respecting human rights and the common weal). These guide-lines are designed to give ethical support and justification to public health policies even when they require some unavoidable limitations of individual autonomy to promote social health benefits.

• Distributive justice
• Ethics of protection
• Global health
• Health and human rights
• Health disparities
• Health equity
• Public health and ethics

From the reviews:

“This book in the Springer Briefs in Public Health series identifies conceptual and practical difficulties of the ‘New Public Health’ model and offers a protective model, attentive to regional variation in needs … . the book is geared toward public health and bioethics professionals and students, whether in the field or in academia.” (Gina M. Fullam, Doody’s Review Service, May, 2012)

• , Public Health School, Universidad de Chile, Correo, Santiago, Chile

  Miguel Kottow

Policies and ethics