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Informed consent and public health.

Onora O'Neill1

  • 1Newnham College, University of Cambridge, Cambridge CB3 9DF, UK. oso1000@cam.ac.uk

Philosophical Transactions of the Royal Society of London. Series B, Biological Sciences
|August 13, 2004
PubMed
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Medical ethics must shift focus from individual patient care to public health. Public health measures, unlike clinical treatments, are public goods requiring compulsory participation, not individual consent.

Area of Science:

  • Bioethics
  • Public Health Ethics
  • Political Philosophy

Background:

  • Contemporary medical ethics predominantly focuses on clinical medicine and individual patient treatment.
  • This individualistic approach views medical services as quasi-consumer goods, subject to personal choice.
  • This framework is inadequate for addressing public health provision, which differs fundamentally from clinical care.

Purpose of the Study:

  • To re-evaluate the ethical underpinnings of public health provision.
  • To propose an ethical framework for public health that moves beyond individual informed consent.
  • To explore the role of compulsion and political philosophy in public health ethics.

Main Methods:

  • Conceptual analysis of the nature of public health as a public good.
Keywords:
Health Care and Public Health

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  • Critique of the applicability of individualistic ethics and informed consent to public health.
  • Engagement with principles from political philosophy regarding collective goods and just compulsion.

    • Main Results:

    • Public health measures, such as infectious disease control, are public goods benefiting all.
    • The provision of public goods necessitates collective action and cannot be contingent on individual consent.
    • Public health ethics requires consideration of the ethical limits of compulsion for the common good.

    Conclusions:

    • An adequate ethics for public health must prioritize collective well-being over individual autonomy in certain contexts.
    • Debates on informed consent are less relevant to public health than discussions on the justification of compulsory measures.
    • Public health ethics would benefit from integrating insights from political philosophy concerning collective action and social justice.