ETHIEK BINNEN GEZONDHEIDSBEVORDERING
INHOUD
Inhoud............................................................................................................................................... 1
Fundamenten van public healths ethics en modellen......................................................................... 5
Is-ought gap ................................................................................................................................... 5
Ethische theorieën ......................................................................................................................... 6
Public health ethics ........................................................................................................................ 7
Behandeling van onderwerp in 3 fases........................................................................................ 7
Public health............................................................................................................................... 8
Publiek ....................................................................................................................................... 8
Preventie.................................................................................................................................... 8
Overheid .................................................................................................................................... 9
Outcome orientation .................................................................................................................. 9
Scope en boundary ..................................................................................................................... 9
Ethical justifications ..................................................................................................................... 10
Overall benefit.......................................................................................................................... 10
Collective action and efficiency ................................................................................................. 10
Fairness in distribution ............................................................................................................. 11
Prevention of harm .................................................................................................................. 11
Paternalism .............................................................................................................................. 12
Modellen public health ethics ...................................................................................................... 13
Brede categorieën .................................................................................................................... 13
Dawson .................................................................................................................................... 13
Population ................................................................................................................................ 14
Narrow liberal views ................................................................................................................. 14
Moral luck ................................................................................................................................ 14
Redenen ................................................................................................................................... 15
Moderate liberal views ............................................................................................................. 15
Substantive public health ethics ............................................................................................... 15
Interests, goods and harms....................................................................................................... 15
Congruent ................................................................................................................................ 16
Convergent............................................................................................................................... 16
Stelling ..................................................................................................................................... 16
Common interest...................................................................................................................... 16
Social justice ............................................................................................................................. 17
Tussenconclusie ........................................................................................................................... 17
Equality, equity en public health ...................................................................................................... 17
Amarty sen .................................................................................................................................. 17
1
, Klassiek ........................................................................................................................................ 18
Language matters ........................................................................................................................ 18
Whitehead ................................................................................................................................... 18
Rechtvaardigheid ......................................................................................................................... 18
Egalitarisme.............................................................................................................................. 19
Justice and public health ................................................................................................................. 19
Govind Persad: Centrale vragen ................................................................................................... 19
1 Wat meten me....................................................................................................................... 19
2 Distributieve rechtvaardigheid ............................................................................................... 20
3 Grenzen ................................................................................................................................. 21
4 waar van toepassing .............................................................................................................. 21
5 Toepassingsgebied................................................................................................................. 22
6 Wie beslist ............................................................................................................................. 22
reconciling two ethics goals of public health .................................................................................... 22
Daniels......................................................................................................................................... 22
Prioriteit ................................................................................................................................... 23
Procedurele rechtvaardigheid................................................................................................... 23
Conclusie ..................................................................................................................................... 24
Public health............................................................................................................................. 24
Daniels ..................................................................................................................................... 24
Concepties van rechtvaardigheid ..................................................................................................... 24
Voorbeeld .................................................................................................................................... 24
Staphylococcus aureus ............................................................................................................. 24
Toepassing ............................................................................................................................... 26
Tussenconclusie ........................................................................................................................... 27
Public health and data ..................................................................................................................... 28
Data ............................................................................................................................................. 28
Data lfie cycle ........................................................................................................................... 28
European health data space ..................................................................................................... 29
Innovatief (of niet?) .................................................................................................................. 29
Privacy...................................................................................................................................... 30
Ethische vragen ........................................................................................................................ 30
Stigma ...................................................................................................................................... 31
Essentiële vragen...................................................................................................................... 31
Ballantyne ....................................................................................................................................... 31
Kerngedachte .............................................................................................................................. 31
Klassieke focus ............................................................................................................................. 31
Data research .............................................................................................................................. 32
2
, Sharing data for health surveillance ............................................................................................. 32
Focus op publieke ........................................................................................................................ 32
Public health approach ............................................................................................................. 32
Reassessing the Ethics of molecular HIV surveillance ....................................................................... 33
molecular hiv surveillance ............................................................................................................ 33
Achtergrond................................................................................................................................. 33
Bezorgdheid? ............................................................................................................................... 34
Critical bioethics .......................................................................................................................... 34
Case 1 .......................................................................................................................................... 34
Case 2 .......................................................................................................................................... 35
Bedenking ................................................................................................................................ 35
Case 3 .......................................................................................................................................... 36
Conclusie ..................................................................................................................................... 36
Concepties van rechtvaardigheid ..................................................................................................... 37
Genetic carrier screening ................................................................................................................. 37
Reproductieve geneeskunde ........................................................................................................ 37
Terminologie................................................................................................................................ 38
Categorie 1 .................................................................................................................................. 39
Categorie 2 .................................................................................................................................. 39
België ....................................................................................................................................... 39
P4 medicine en toegepast op genetische testing .......................................................................... 40
Ethische vragen............................................................................................................................ 40
Screening ..................................................................................................................................... 41
Klinische ethiek ............................................................................................................................ 41
Public health ................................................................................................................................ 41
Eugenetica................................................................................................................................ 42
2 andere kritieken .................................................................................................................... 42
Wilson & Jungner (1968) .............................................................................................................. 42
Genetische screening ............................................................................................................... 43
Dawson .................................................................................................................................... 43
Maatschappij ............................................................................................................................ 43
Wilkinson (utilitarist dus het is het doel) ................................................................................... 44
Concerns .................................................................................................................................. 44
Dive and newson ...................................................................................................................... 44
Intentie en effect ...................................................................................................................... 45
Hun conclusie ........................................................................................................................... 45
Discussiepunten ........................................................................................................................... 45
3
, Public health communicatie ............................................................................................................ 46
TAMIFLU ...................................................................................................................................... 47
Grice & Austin .............................................................................................................................. 47
Communicatie.............................................................................................................................. 48
Persuasion, coercion, manipulation ............................................................................................. 48
Frameworks ................................................................................................................................. 49
Predominant account................................................................................................................... 49
Kritiek 1 .................................................................................................................................... 49
Kritiek 2 .................................................................................................................................... 49
Kritiek 3 .................................................................................................................................... 50
Kritiek 4 .................................................................................................................................... 50
Counterargument ..................................................................................................................... 51
Brown & De Barra ........................................................................................................................ 51
Non-honest .............................................................................................................................. 51
Forms of non-honesty .............................................................................................................. 52
Intention .................................................................................................................................. 53
De relatie tussen public en private interests .................................................................................... 54
PUblic .......................................................................................................................................... 55
WHO voorbeelden .................................................................................................................... 55
Complexiteit ................................................................................................................................ 55
Faden et al................................................................................................................................ 56
corporate social responsibility .................................................................................................. 56
Beleid ....................................................................................................................................... 56
Bezorgdheid ............................................................................................................................. 57
Focus ........................................................................................................................................... 57
Invloed......................................................................................................................................... 58
Civil society .............................................................................................................................. 58
Marketing................................................................................................................................. 59
Epistemic authority ...................................................................................................................... 61
Onderzoek ................................................................................................................................... 61
Link .......................................................................................................................................... 62
Drastische optie om er mee om te gaan ................................................................................... 62
Moral jeopardy ......................................................................................................................... 62
Peril .......................................................................................................................................... 62
Filantropie ................................................................................................................................ 67
Conclusie ..................................................................................................................................... 68
Examen ........................................................................................................................................... 69
4
INHOUD
Inhoud............................................................................................................................................... 1
Fundamenten van public healths ethics en modellen......................................................................... 5
Is-ought gap ................................................................................................................................... 5
Ethische theorieën ......................................................................................................................... 6
Public health ethics ........................................................................................................................ 7
Behandeling van onderwerp in 3 fases........................................................................................ 7
Public health............................................................................................................................... 8
Publiek ....................................................................................................................................... 8
Preventie.................................................................................................................................... 8
Overheid .................................................................................................................................... 9
Outcome orientation .................................................................................................................. 9
Scope en boundary ..................................................................................................................... 9
Ethical justifications ..................................................................................................................... 10
Overall benefit.......................................................................................................................... 10
Collective action and efficiency ................................................................................................. 10
Fairness in distribution ............................................................................................................. 11
Prevention of harm .................................................................................................................. 11
Paternalism .............................................................................................................................. 12
Modellen public health ethics ...................................................................................................... 13
Brede categorieën .................................................................................................................... 13
Dawson .................................................................................................................................... 13
Population ................................................................................................................................ 14
Narrow liberal views ................................................................................................................. 14
Moral luck ................................................................................................................................ 14
Redenen ................................................................................................................................... 15
Moderate liberal views ............................................................................................................. 15
Substantive public health ethics ............................................................................................... 15
Interests, goods and harms....................................................................................................... 15
Congruent ................................................................................................................................ 16
Convergent............................................................................................................................... 16
Stelling ..................................................................................................................................... 16
Common interest...................................................................................................................... 16
Social justice ............................................................................................................................. 17
Tussenconclusie ........................................................................................................................... 17
Equality, equity en public health ...................................................................................................... 17
Amarty sen .................................................................................................................................. 17
1
, Klassiek ........................................................................................................................................ 18
Language matters ........................................................................................................................ 18
Whitehead ................................................................................................................................... 18
Rechtvaardigheid ......................................................................................................................... 18
Egalitarisme.............................................................................................................................. 19
Justice and public health ................................................................................................................. 19
Govind Persad: Centrale vragen ................................................................................................... 19
1 Wat meten me....................................................................................................................... 19
2 Distributieve rechtvaardigheid ............................................................................................... 20
3 Grenzen ................................................................................................................................. 21
4 waar van toepassing .............................................................................................................. 21
5 Toepassingsgebied................................................................................................................. 22
6 Wie beslist ............................................................................................................................. 22
reconciling two ethics goals of public health .................................................................................... 22
Daniels......................................................................................................................................... 22
Prioriteit ................................................................................................................................... 23
Procedurele rechtvaardigheid................................................................................................... 23
Conclusie ..................................................................................................................................... 24
Public health............................................................................................................................. 24
Daniels ..................................................................................................................................... 24
Concepties van rechtvaardigheid ..................................................................................................... 24
Voorbeeld .................................................................................................................................... 24
Staphylococcus aureus ............................................................................................................. 24
Toepassing ............................................................................................................................... 26
Tussenconclusie ........................................................................................................................... 27
Public health and data ..................................................................................................................... 28
Data ............................................................................................................................................. 28
Data lfie cycle ........................................................................................................................... 28
European health data space ..................................................................................................... 29
Innovatief (of niet?) .................................................................................................................. 29
Privacy...................................................................................................................................... 30
Ethische vragen ........................................................................................................................ 30
Stigma ...................................................................................................................................... 31
Essentiële vragen...................................................................................................................... 31
Ballantyne ....................................................................................................................................... 31
Kerngedachte .............................................................................................................................. 31
Klassieke focus ............................................................................................................................. 31
Data research .............................................................................................................................. 32
2
, Sharing data for health surveillance ............................................................................................. 32
Focus op publieke ........................................................................................................................ 32
Public health approach ............................................................................................................. 32
Reassessing the Ethics of molecular HIV surveillance ....................................................................... 33
molecular hiv surveillance ............................................................................................................ 33
Achtergrond................................................................................................................................. 33
Bezorgdheid? ............................................................................................................................... 34
Critical bioethics .......................................................................................................................... 34
Case 1 .......................................................................................................................................... 34
Case 2 .......................................................................................................................................... 35
Bedenking ................................................................................................................................ 35
Case 3 .......................................................................................................................................... 36
Conclusie ..................................................................................................................................... 36
Concepties van rechtvaardigheid ..................................................................................................... 37
Genetic carrier screening ................................................................................................................. 37
Reproductieve geneeskunde ........................................................................................................ 37
Terminologie................................................................................................................................ 38
Categorie 1 .................................................................................................................................. 39
Categorie 2 .................................................................................................................................. 39
België ....................................................................................................................................... 39
P4 medicine en toegepast op genetische testing .......................................................................... 40
Ethische vragen............................................................................................................................ 40
Screening ..................................................................................................................................... 41
Klinische ethiek ............................................................................................................................ 41
Public health ................................................................................................................................ 41
Eugenetica................................................................................................................................ 42
2 andere kritieken .................................................................................................................... 42
Wilson & Jungner (1968) .............................................................................................................. 42
Genetische screening ............................................................................................................... 43
Dawson .................................................................................................................................... 43
Maatschappij ............................................................................................................................ 43
Wilkinson (utilitarist dus het is het doel) ................................................................................... 44
Concerns .................................................................................................................................. 44
Dive and newson ...................................................................................................................... 44
Intentie en effect ...................................................................................................................... 45
Hun conclusie ........................................................................................................................... 45
Discussiepunten ........................................................................................................................... 45
3
, Public health communicatie ............................................................................................................ 46
TAMIFLU ...................................................................................................................................... 47
Grice & Austin .............................................................................................................................. 47
Communicatie.............................................................................................................................. 48
Persuasion, coercion, manipulation ............................................................................................. 48
Frameworks ................................................................................................................................. 49
Predominant account................................................................................................................... 49
Kritiek 1 .................................................................................................................................... 49
Kritiek 2 .................................................................................................................................... 49
Kritiek 3 .................................................................................................................................... 50
Kritiek 4 .................................................................................................................................... 50
Counterargument ..................................................................................................................... 51
Brown & De Barra ........................................................................................................................ 51
Non-honest .............................................................................................................................. 51
Forms of non-honesty .............................................................................................................. 52
Intention .................................................................................................................................. 53
De relatie tussen public en private interests .................................................................................... 54
PUblic .......................................................................................................................................... 55
WHO voorbeelden .................................................................................................................... 55
Complexiteit ................................................................................................................................ 55
Faden et al................................................................................................................................ 56
corporate social responsibility .................................................................................................. 56
Beleid ....................................................................................................................................... 56
Bezorgdheid ............................................................................................................................. 57
Focus ........................................................................................................................................... 57
Invloed......................................................................................................................................... 58
Civil society .............................................................................................................................. 58
Marketing................................................................................................................................. 59
Epistemic authority ...................................................................................................................... 61
Onderzoek ................................................................................................................................... 61
Link .......................................................................................................................................... 62
Drastische optie om er mee om te gaan ................................................................................... 62
Moral jeopardy ......................................................................................................................... 62
Peril .......................................................................................................................................... 62
Filantropie ................................................................................................................................ 67
Conclusie ..................................................................................................................................... 68
Examen ........................................................................................................................................... 69
4
