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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
Summary

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.

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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.
  • 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.
Keywords:
Health Care and Public Health

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