One of the ways in which public health officials control outbreaks of epidemic disease is by attempting to control the situations in which the infectious agent can spread. This may include isolation of infected persons, quarantine of persons who may be infected and detention of persons who are present in or have entered premises where infected persons are being treated. Most who have analysed such measures think that the restrictions in liberty they entail and the detriments in welfare they impose (...) can be justified and this paper proceeds from the assumption that detention measures are justifiable in some circumstances. Such measures are often implemented without any compensation being given to the persons who are detained. This raises the question: What do we owe to those whose liberty is justifiably restricted (e.g. through isolation, quarantine or detention) as a public health measure during a public health emergency? More specifically, do we owe them compensation for any losses they experience? The paper falls in four main sections. The first section provides examples of the current regulatory state of affairs from the US, Canada and WHO. The second section lays out the liberal, welfarist and pragmatic arguments for providing compensation. The third section discusses the arguments against compensation and the fourth and final section provides the conclusion. It is argued that the arguments for providing compensation clearly outweigh the counterarguments and that the default public policy therefore should be that compensation is provided. (shrink)

BackgroundBariatric surgery for children and adolescents is becoming widespread. However, the evidence is still scarce and of poor quality, and many of the patients are too young to consent. This poses a series of moral challenges, which have to be addressed both when considering bariatric surgery introduced as a health care service and when deciding for treatment for young individuals. A question based (Socratic) approach is applied to reveal underlying moral issues that can be relevant to an open and transparent (...) decision making process.DiscussionA wide range of moral issues with bariatric surgery for children and adolescents is identified in the literature. There is a moral imperative to help obese minors avoiding serious health problems, but there is little high quality evidence on safety, outcomes, and cost-effectiveness for bariatric surgery in this group. Lack of maturity and family relations poses a series of challenges with autonomy, informed consent, assent, and assessing the best interest of children and adolescents. Social aspects of obesity, such as medicalization, prejudice, and discrimination, raise problems with justice and trust in health professionals. Conceptual issues, such as definition of obesity and treatment end-points, present moral problems. Hidden interests of patients, parents, professionals, industry, and society need to be revealed.SummaryPerforming bariatric surgery for obese children and adolescents in order to discipline their behavior warrants reflection and caution. More evidence on outcomes is needed to be able to balance benefits and risks, to provide information for a valid consent or assent, and to advise minors and parents. (shrink)

This collection features comprehensive overviews of the various ethical challenges in organ transplantation. International readings well-grounded in the latest developments in the life sciences are organized into systematic sections and engage with one another, offering complementary views. All core issues in the global ethical debate are covered: donating and procuring organs, allocating and receiving organs, as well as considering alternatives. Due to its systematic structure, the volume provides an excellent orientation for researchers, students, and practitioners alike to enable a deeper (...) understanding of some of the most controversial issues in modern medicine. (shrink)

Childhood obesity is an increasing health problem. Prior empirical research suggests that, although discussing lifestyle behaviours with parents could help prevent childhood obesity and its health-related consequences, physicians are reluctant to address parental responsibility in the clinical setting. Therefore, this paper questions whether parents might be responsible for their children’s obesity, and if so, whether parental responsibility ought to be addressed in the physician–patient/parent encounter. We illustrate how different ideal-typical models of the physician–patient/parent interaction emphasise different understandings of patient autonomy (...) and parental responsibility and argue that these models advocate different responses to an appeal for discussing parents’ role in childhood obesity. We suggest that responsibility should be attributed to parents because of their parental roles in providing for their children’s welfare. We also argue that whether, and how, this responsibility gives rise to a requirement to act depends on the parents’ capacities. A deliberative-oriented physician–patient/parent interaction best captures the current ideals of antipaternalism, patient autonomy, and shared and evidence-informed decision-making, and might facilitate parental role development. We conclude that, while not discussing parental responsibility for childhood obesity in the clinical setting can be warranted in particular cases, this cannot be justified as a general rule. (shrink)

Das von Cass Sunstein und Richard Thaler ausgearbeitete Projekt eines Libertären Paternalismus stellt fraglos einen der zurzeit meistdiskutierten neopaternalistischen Theorieentwürfe dar. Als hybride Mischung zwischen Theorieprogramm, politischer Bewegung und praxis- und anwendungsorientiertem Policy-Manual, das zuweilen Züge eines populären philosophischen Lebensratgebers trägt, hat Libertärer Paternalismus viel Zuspruch, aber auch heftige Kritik auf sich gezogen, die in diesem Aufsatz auf ihre Plausibilität geprüft werden. Zu diesem Zweck geben die Autoren zunächst einen kurzen Überblick über Ausgangspunkte, Leitorientierungen und Problemvorgaben des Theorie- und Politikprogramms (...) des Libertären Paternalismus. In einem zweiten Schritt werden zentrale Konzepte und Unterscheidungen des libertär paternalistischen Rationales vorgestellt und problematisiert. Daran anschließend werden drei der prominentesten Kritikpunkte an Libertärem Paternalismus auf den Prüfstand gestellt. Hierzu gehören der Manipulationseinwand, Kritiken, die sich auf grundlegende Rechtfertigungsprobleme des Libertären Paternalismus beziehen, und Einwände, die auf langfristige negative Folgen des Nudging verweisen. (shrink)

More than ever, the way we live our lives has become subject to our own decisionmaking. Our whole way of living, in particular what we do to our body, has become the expression of personal lifestyle choices. Because we can make changes to our body according to our own individual preferences, every aspect of our life begins to be seen as the result of individual and voluntary decisions. The comparison with advertising is pertinent here: we should no longer accept the (...) way we are but can choose from a variety of options. Go to any supermarket and look around: innumerable products are promoted because of their healthy ingredients, whether to lower our cholesterol or heighten our natural resistance. And, of course, we buy what is on offer. (shrink)

Beliefs about the moral status of children have changed significantly in recent decades in the Western world. At the same time, knowledge about likely consequences for children of individual, parental, and societal choices has grown, as has the array of choices that (prospective) parents may have at their disposal. The intersection between these beliefs, this new knowledge, and these new choices has created a minefield of expectations from parents and a seemingly ever-expanding responsibility towards their children. Some of these new (...) challenges have resulted from progress in genetics and neuroscience. It is these challenges that we focus on in this introduction and volume. (shrink)