Transcript Presentation

CPHA Conference
Halifax (04/06/08)
Ethics and the
Implementation of
Infectious Disease Policy
Angus Dawson
University of Toronto, Canada
Keele University, UK
[email protected]
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Structure of Talk: Ethics &
Infectious Disease Policy
Introduction





Policy Aims
PH Intervention
Prevention
Harm
Inequalities
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Introduction 1

When think of ethics, it might seem
natural to start with individuals and what
they will choose

However, this perhaps a problem here
given nature of infectious diseases etc

Much depends on nature of medical
facts for each disease etc
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Introduction 2

There is a broad range of interventions
that are part of Infectious Disease
Policy:
– Information
– Vaccination
– Contact tracing
– Treatment
– Isolation
– Quarantine etc
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1a. Policy: Need Clear Aims

What is the aim of the programme?
– Reduction of clinical cases
– Create herd protection
– Eradication
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1.b. Policy: Other Influences

Some other influences on policy:
– ‘We can do it’
– Political pressures
– Campaign pressure groups
– Cost-effectiveness
– Events
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2. Public Health Interventions

Can move to thinking about things at
the collective or population level

‘Public’ in PH. A group and collective
action

Does not mean that the individual is not
important
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3. Prevention

Prevention – better than cure?

The risk from intervention (e.g.
vaccination) might be very small – but
because you are doing something to
many people – the total harm might be
held to be too great
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4. Harm

Harm to others arguments
If you are infectious it is not just you at
risk of harm. Others may be unable to
protect themselves
 What harms?
 What level of harm?

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5. Inequalities
Availability of preventive measures
 Access to treatment
 Inappropriate targeting?


(Issues within own community – but
also on global scale)
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Conclusion: Public Health Ethics

Complex set of ethical arguments
interacting with policy issues

Must take PH arguments seriously

PHE: Look to other ethical elements
beyond individual (e.g. common goods,
public goods, solidarity, community etc)
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