Showing papers on "Environmental health ethics published in 2002"

Public Health Ethics: Mapping the Terrain

Abstract: , 30 (2002): 170 –178.© 2002 by the American Society of Law, Medicine & Ethics.ublic health ethics, like the field of public health itaddresses, traditionally has focused more on practiceand particular cases than on theory, with the resultthat some concepts, methods, and boundaries remain largelyundefined. This paper attempts to provide a rough concep-tual map of the terrain of public health ethics. We begin bybriefly defining public health and identifying general fea-tures of the field that are particularly relevant for a discussionof public health ethics.Public health is primarily concerned with the health ofthe entire population, rather than the health of individuals.Its features include an emphasis on the promotion of healthand the prevention of disease and disability; the collectionand use of epidemiological data, population surveillance,and other forms of empirical quantitative assessment; a rec-ognition of the multidimensional nature of the determinantsof health; and a focus on the complex interactions of manyfactors — biological, behavioral, social, and environmental— in developing effective interventions.How can we distinguish public health from medicine?While medicine focuses on the treatment and cure of indi-vidual patients, public health aims to understand andameliorate the causes of disease and disability in a popula-tion. In addition, whereas the physician-patient relationshipis at the center of medicine, public health involves interac-tions and relationships among many professionals andmembers of the community as well as agencies of govern-ment in the development, implementation, and assessmentof interventions. From this starting point, we can suggestthat public health systems consist of all the people and ac-tions, including laws, policies, practices, and activities, thathave the primary purpose of protecting and improving thehealth of the public.

A code of ethics for public health

Abstract: The mandate to ensure and protect the health of the public is an inherently moral one. It carries with it an obligation to care for the well-being of communities, and it implies the possession of an element of power to carry out that mandate. The need to exercise power to ensure the health of populations and, at the same time, to avoid abuses of such power are at the crux of public health ethics. Until recently, the ethical nature of public health has been implicitly assumed rather than explicitly stated. Increasingly, however, society is demanding explicit attention to ethics. This demand arises from technological advances that create new possibilities and, with them, new ethical dilemmas; new challenges to health, such as the advent of HIV; and abuses of power, such as the Tuskegee study of syphilis. Medical institutions have been more explicit about the ethical elements of their practice than have public health institutions. However, the concerns of public health are not fully consonant with those of medicine. Thus, we cannot simply translate the principles of medical ethics to public health. In contrast to medicine, public health is concerned more with populations than with individuals, and more with prevention than with cure. The need to articulate a distinct ethic for public health has been noted by a number of public health professionals and ethicists.1–5 A code of ethics for public health can clarify the distinctive elements of public health and the ethical principles that follow from or respond to those elements. It can make clear to populations and communities the ideals of the public health institutions that serve them, ideals for which the institutions can be held accountable.

Environmental justice: building a unified vision of health and the environment.

Abstract: The assorted and multidimensional concerns that give rise to the issue of environmental justice have proved to be intellectually daunting and highly resistant to positive change. Low-income, people of color, and tribal communities confronting environmental stressors are beset by stressors in both the physical and social environments. For this reason, while the bifurcation of the public health and environmental fields taking place over the past several decades has yielded generally negative impacts in areas of public health, environment, and planning, the consequences for low-income and disadvantaged communities have been especially grievous. This commentary builds on the recent Institute of Medicine workshop titled "Rebuilding the Unity of Health and the Environment: A New Vision of Environmental Health for the 21st Century." The workshop organizers posited that only by thinking about environmental health on multiple levels will it be possible to merge various strategies to protect both the environment and health. In this commentary we examine how such a new vision of uniting public health and the environment can contribute to attaining environmental justice for all populations.

Urban Environmental Justice Indices

Abstract: Environmental justice is the principle that environmental costs and amenities ought to be equitably distributed within society Due to the ethical, political, and public–health implications, and because many choices confront those researching environmental justice, standardized measures are needed to inform public dialogue and policy We develop and test seven indices on three Colorado cities to measure the relationship between the distribution of environmental hazards and minority and poverty–stricken populations, and recommend the Comparative Environmental Risk Index as a preliminary, standardized measure for comparing urban areas This index is particularly relevant to disadvantaged communities, regional planning organizations, environmental–justice networks and scholars, and state and federal agencies

Contemporary Environmental Ethics From Metaethics to Public Philosophy

Abstract: In the past thirty years environmental ethics has emerged as one of the most vibrant and exciting areas of applied philosophy. Several journals and hundreds of books testify to its growing importance inside and outside philosophical circles. But with all of this scholarly output, it is arguably the case that environmental ethics is not living up to its promise of providing a philosophical contribution to the resolution of environmental problems. This article surveys the current state of the field and offers an alternative path for the future development of environmental ethics toward a more publicly engaged model of applied philosophy.

Commitment to health: a shared ethical bond between professions

Abstract: It is commonly assumed that Codes of Ethics are supported by concrete ethical principles, that adherence to Codes of Ethics guarantees ethical behaviour and that there is widespread agreement about ethical standards. Each of these assumptions is false. Codes of Ethics are inevitably open to wide interpretation, and it is impossible to demonstrate absolute moral standards. Health and social care workers should not adhere to unexplained 'ethical principles' insufficient to guide practical decision making. Anyone who recognises that all human actions potentially have ethical content may choose to make an ethical commitment. In order to work for health, health workers ought to commit to a substantial theory of health. One such theory--the foundations theory of health--is briefly explained and illustrated. The foundations theory can form a shared ethical bond between health and social care professionals, since both professions regularly strive to achieve foundational health for their patients and clients.

Ethics Instruction in an Issues-Oriented Course on Public Health Genetics

Abstract: Public health ethics and genetics in public health have in the last decade emerged as fields in their own right. This article describes the ethics component of an "Issues in Public Health Genetics" course uniting the fields of genetics, ethics, and public health. As the third member of the University of Michigan Interdepartmental Concentration in Genetics, the course emphasizes the translation of ethical-social issues into substantive policies. A central tension repeated throughout the course exists between respect for individuals' libertarian interests and the welfare of the entire population. Students become familiar with the process of resolving conflicting values through interactive exercises addressing the health needs of diverse communities. Key lessons in course design are described.

Co-evolutionary relationships between environmental ethics and environmental assessment

Abstract: The dissertation traces the development of environmental assessment and environmental ethics as these disciplines have evolved independently in response to the global environmental crisis. The aim is to determine the extent to which they can promote the integration of the dissociated objective and subjective spheres of human valuation of the environment. This is a necessary condition, it is argued, for arresting the pathology in the human-environment relationship. The study concludes that both disciplines were initially trapped in narrow, monistic approaches, which rendered them largely ineffective. However, their evolutionary advancement, and a common grounding in a radical conceptualization of sustainable development, greatly enhances their usefulness in environmental decisionmaking.

Environmental health 2012: a key partner in delivering the public health agenda.

Abstract: Describes a project carried out the the HDA, with the Chartered Institute of Environmental Health (CIEH), to support the environmental health profession in developing a strategic vision for its contribution to health development and wellbeing. Captures the challenges, constraints and ideas from mixed groups of environmental health, public health and health improvement professionals from local authorities, the NHS, organisations, environment, voluntary, and community.

Some Pragmatic Observations About Radical Critique in Environmental Law

Abstract: Critics of environmental law often condemn the law for its anthropocentric foundations and for its failure to incorporate a platform of deep environmental ethics. Such “radical environmental critiques” propose perspectives and norms for our treatment of the environment that diverge from existing legal vocabularies and concepts. This article questions the effectiveness of radical environmental critique for two related reasons: first, because the conceptual scheme underlying radical alternative theories undercuts their normative force; and, second, because deeply held beliefs alone are ill-equipped to achieve progress in environmental law. This article offers environmental pragmatism as a means to avoid the problems, while maintaining the goals, of radical environmental critique. In particular, this article argues that the challenge of integrating environmental ethics and law requires the pragmatic distrust of claims of ultimate truth and the replacement of that concept with a recognition of the importance of persuasion. In support of this thesis, this article generalizes what might be called the traditional adversaries in environmental matters - property rights and non-use environmental values - as environmental paradigms. This article then questions whether the debate on environmental values is necessarily polemic - that is, whether we are all limited to being either property rights proponents or environmental activists. Environmental pragmatism, by its own terms a middle ground to any debate, offers a means to fuse the various value paradigms into a coherent system of law. Environmentalists are beginning to experiment with this type of visionary thinking, and have initially succeeded in convincing adversaries to see the other side of the land--the side not defined by its economic value.

Environmental Economics and Human Health

Abstract: Environmental economics has made numerous contributions to both the theory and the applied problems surrounding pollution control. Given that the primary benefits of controlling most pollutants are health benefits, there is a close link between human health and environmental economics. One of the most important contributions that economics has made to the problem of pollution control is to clarify the objective of social policy. The objective of controlling pollution is to minimize the total costs to society, where these costs include the damages from remaining pollution and the abatement cost required to eliminate pollution. The optimal policy keeps the total cost to society from pollution as small as possible. Additional pollution should be removed as long as the damages removed are less than the cost of additional abatement. Although this is a straightforward application of common sense, this optimal policy is nonetheless controversial, as many environmental advocates would prefer simply to minimize pollution itself. Even within the health community, there are many who would advocate minimizing health effects regardless of cost. However, going beyond the optimal strategy and minimizing health effects would eliminate only a small amount of health loss while costing a great deal of abatement resources. Rather than spending huge resources chasing the last elements of pollution, environmental economics suggests diverting those resources to save more lives in other more promising activities such as reducing driving fatalities or fighting curable diseases. Another major contribution of environmental economics is proof that government intervention is necessary to control pollution. A few observers, such as Ronald Coase (1), dissented and argued that victims would willingly bribe polluters for clean air. But the profession recognizes that, in general, victims do not and cannot organize themselves to make offers to polluters. There are simply too many people damaged by most emissions of pollution for them to act as a single coordinated agent. With victims having different tastes and incomes, they cannot agree how much to pay and how much to control the pollution. In the absence of government intervention, the market simply does not get organized and so fails to abate. At first, government intervention meant regulations or standards. The Clean Air Act in 1970 began federal control of the primary air pollutants (sulfur dioxide, particulates, carbon monoxide, ozone, nitrogen dioxide, and lead). The Clean Water Act followed suit and provided federal regulations to protect water resources. Further laws have been passed to …

An Ecological Approach to Environmental Ethics

Abstract: This paper serves as an introduction to the Forum on Environmental Ethics. The Forum is built around contributions to the Environmental Ethics Symposium within the 10th Pacific Science Inter-Congress, held in Guam, USA 1–6 June 2001. The contributions to the Symposium differed in commitment and intent and this diversity has been enhanced by the addition of several additional papers to this Forum. The paper suggests a view of action as resulting from the interaction between often unexamined values, goes on to comment on the role of values in science classrooms, and applies both to a general treatment of Environmental Ethics. The paper then positions the remaining contributions to the Forum and concludes with a substantial bibliography which should prove useful to any readers wishing to dip deeper into Environmental Ethics.

The changing focus of health care ethics: implications for health care professionals.

Abstract: Contemporary health care ethics has become preoccupied with the issue of people’s rights to and in health care (eg the rights to informed consent, confidentiality, quality of life, death with dignity, etc).There is no question that this preoccupation has achieved some morally significant and beneficial outcomes in health care domains. Nevertheless, it is evident that health care ethics has not achieved its most basic task, namely, to promote and protect the genuine wellbeing and welfare interests of those who are among the most vulnerable people in society and whose health status is at risk. A key contention of this paper is that if health professionals are going to be able to meet future moral challenges posed by the complex question of human health, then the nature, aims, purpose, significance, and modus operandi of contemporary health care ethics needs to be revisited, re-visioned, and revitalised.

Outline of the Ethical Implications of Earth's Limits for Health Care

Abstract: In addition to good medical services, all aspects of an economy must work together to ensure a high level of public health. However, the abundant economies of the North are contributing heavily to global environmental disaster, with increasing concomitant damage to human health. Environmental health problems result from toxicity (i.e., pollution), scarcity (i.e., poverty), and energy degradation (i.e., entropy). Common to these three factors in environmental demise are the limits of the Earth. Production has evolved to a point where the Earth is no longer safe from radical depletion. Therefore, simple living is a necessary feature of global public health. Rarely do readers of this journal see these limits first hand, but they are real. Our limited perceptions and efforts hinder our ability to understand how to reduce the impact of production on natural ecosystems. Contrary to standard media portrayals, growth and technology cannot solve our public health problems, because they are unequally distributed across the world and neither can they solve the problem of limits. The need for modest consumption in developed nations is an essential and almost completely ignored element of the answer to environmental and associated health problems. A radical and rapid change to public health is needed in order to avoid abysmal global health consequences during the next century. These changes involve a restructuring of our economy, including the health care industry. In the short run, this is an ethical demand. In the long run, this is an inevitability. The actual and appropriate role of bioethicists in championing these changes is unclear. (Abstract by Bruce R. Smith)

Children's Environmental Health: New Gains in Science and Policy

Abstract: Recognition of the interconnectedness of the environment and human health stimulated the sanitary reform movement of the nineteenth century, a massive effort to bring clean water, decent housing, and effective waste removal to cities in Europe and the United States. The movement achieved great gains in public health and resulted in substantial enhancement of the quality and length of human life. Paradoxically, in much of the twentieth century, the relation between the environment and human health was forgotten. The result was that little concern was given in environmental law and regulation to protecting public health. In the 1990s, a new recognition of interconnections between environment and health was established, with children's health as the focal point. This article reviews the historical relation between environmental protection and public health. It traces the separation of these two fields and focuses on the role of children's environmental health in the current rejoining of the disciplines.

Environmental health : framework for transformation

Abstract: This chapter reviews some recent developments in the environmental health sector and their implications for improved access to the basic services necessary for poverty alleviation, socio-economic development and health improvement, particularly in rural areas. It cannot be assumed that the excellent potential for improved coordination between environmental health and basic services provision, provided for in the National Health Bill, will be achieved. Far-reaching advocacy initiatives will be required by the Department of Health, other departments, the South African Institute of Environmental Health and broader role-players - notably civil society - to motivate municipalities to make the necessary staff and funds available to resource this role, and to strengthen inter-sectoral and inter-governmental relationships. In tandem with this, a far-reaching re-orientation is needed in the way environmental health professionals are trained, deployed and regard their own role.

Environmental Ethics, Green Politics and the History of Predator Biology

Abstract: Understanding the ethics and politics of environmentalism, as well as predator biology, means thinking in new ways about objectivity. The history of predator biology shows how scientists order nature as they interact with non-humans. If science ultimately orders nature as its comprehends it, the implications for environmental ethics and politics, which continue to call on the authority of objective science, loom large.

A Strategy for Improving K-12 Environmental Health Science Education in the United States

Abstract: The National Institute of Environmental Health Sciences (NIEHS) supports an array of environmental health science education activities through a variety of extramural and intramural programs. The purpose of these initiatives is to help individuals better understand the effects and risks to human health from physical and social factors. These initiatives stem from the NIEHS' recognition that the lay community requires greater knowledge about environmental health issues as the public is increasingly challenged to make decisions on the risks and benefits of agents that permeate society. In addition, the NIEHS sees these programs as an investment in the future of our society and environmental health sciences. We describe the programs and highlight projects that demonstrate how these efforts are being applied.

Environmental health policy in a time of change

Abstract: In Australia, as elsewhere, environmental health policy has only recently emerged from being in the background, where it has been has been subsumed under more general public health and environmental policies, into the policy foreground where it is the primary vehicle for responding to the increasing environmental risks to health (enHealth Council, 2000 and Environmental Health Commission, 1997). Global changes to the environmental systems of the planet; and national increases in urban pollution and water and soil degradation, are requiring a strategic policy response. In 1999, the first National Environmental Health Strategy (NEHS) was formally accredited by federal and state governments, and acknowledged by a formal budget allocation, thus establishing a public policy direction for Environmental Health in Australia for the first time (enHealth Council, 1999). This chapter explores the inauguration of environmental health policy in relation to its key stakeholders (the community, the professions, those in government, and those with the task of integrating environment and health), in the light of the new human/environment relationships of the 21st century

Resolving Ethical Dilemas: Applying the Institute for Global Ethics' Ethical Fitness™ Model to Occupational and Environmental Health Practice Issues

Abstract: 1. Technological advancements have rapidly increased the need for careful ethical choices to preserve life and environment of the global community. 2. No formula exists to resolve ethical dilemmas, but using an ethical decision making model can help maintain a state of ethical fitness. 3. The Ethical Fitness model relies on the assumption that certain core values are universal. Maintaining ethical fitness is essential to resolve ethical dilemmas. 4. The process of resolving ethical dilemmas consists of analyzing the dilemma using nine checkpoints, four dilemma paradigms, and three resolution principles.

The Environmental Ethics of Sustainable Development

Abstract: The theory and fullfilment of sustainable development greatly improved the development of environment ethics .In the past, the humancentrism, nonhumancentrism excluded each other. But now, humancentrism and nonhumancentrism and sustainable development theory are three major parts of environmental ethics. The environmental ethics of sustainable are based on humancentrism environmental ethics and nonhumancentrism environmental ethics .The goal of which is sustainable development, which requires human being pay more attention to nature and future.