Morality, Paternalism, And Justice : Ethical Priorities

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Critique #1: Autonomy, Paternalism, and Justice: Ethical Priorities in Public Health

Olawale Akinbobola
The University of Memphis School of Public Health
PUBH 7180 – Fall 2017

Within public health, the issue of paternalism has become a controversial topic. Broadly, paternalism is defined as the interference of a state or individual with a subordinate overpowering the will of the subordinate, claiming the subordinate will be better off (Dworkin, 2017). Autonomy is the right of an individual to be independent and govern himself. These polarizing terms have raised questions pertaining to the ethical rights of public health working in conjunction with the government to develop policies meant to create healthy conditions for the …show more content…

A justifiable case of paternalism is when a population’s safety is endangered. For example, impending threats to health, like bioterrorism, present the possibility of significant harm to populations (Buchanan, 2008). While some support the idea of government intervention, this view of paternalism upsets others. The Centers for Disease Control and Prevention suggestion that a pregnant woman should not drink alcohol during pregnancy has been widely criticized as being unnecessarily paternalistic, but the CDC goes further into explaining that “alcohol consumed during pregnancy increases the risk of alcohol related birth defects, including growth deficiencies, facial abnormalities, central nervous system impairment, behavioral disorders, and impaired intellectual development” (CDC, 2016). Buchanan identifies 3 arguments in justifying paternalistic actions: informed consent, weak paternalism, and utilitarianism. To support his argument of informed consent, Buchanan admits there is no significant ethical concern because an individual may reach out to the professional for help, but it is problematic when an intervention is targeting the entire population (Buchanan, 2008). This point of view from Buchanan is flawed and completely limits what public health is all about. The Institute of Medicine (IOM) defines public health as “what we, as a society, do collectively to assure the conditions for people to be healthy.” With its use of the phrase “we, as a

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