Since Mill's seminal work On Liberty, philosophers and political theorists have accepted that we should respect the decisions of individual agents when those decisions affect no one other than themselves. Indeed, to respect autonomy is often understood to be the chief way to bear witness to the intrinsic value of persons. In this book, Sarah Conly rejects the idea of autonomy as inviolable. Drawing on sources from behavioural economics and social psychology, she argues that we are so often irrational in (...) making our decisions that our autonomous choices often undercut the achievement of our own goals. Thus in many cases it would advance our goals more effectively if government were to prevent us from acting in accordance with our decisions. Her argument challenges widely held views of moral agency, democratic values and the public/private distinction, and will interest readers in ethics, political philosophy, political theory and philosophy of law. (shrink)

Too often, we as individuals do things that harm us, that seriously interfere with our being able to live in the way that we want. We eat food that makes us obese, that promotes diabetes, heart failure and other serious illness, while at the same time, we want to live long and healthy lives. Too many of us smoke cigarettes, even while acknowledging we wish we had never begun. We behave in ways that undercut our ability to reach some of (...) our most valued goals, despite education and despite incentives to choose the right thing. What should be done?If I were to try to harm someone else in a way that alters his future seriously and perhaps irrevocably for the worse, I would be stopped. When it comes to hurting myself, though, we have a common belief that it is wrong to interfere, even if I foresee that I will very much regret what I have done, often when it is too late to fix what I have let happen. I think this makes no sense. If it is permissible, even obligatory, to stop me when I do something that seriously interferes with someone else's chances of achieving the life he wants, I think …. (shrink)

In the near future, experts predict, an influenza pandemic will likely spread throughout the world. Many countries have been creating a contingency plan in order to mitigate the severe health and social consequences of such an event. Examination of the pandemic plans of Canada, the United Kingdom and the United States, from an ethical perspective, raises several concerns. One: scarcity of human and material resources is assumed to be severe. Plans focus on prioritization but do not identify resources that would (...) be optimally required to reduce deaths and other serious consequences. Hence, these plans do not facilitate a truly informed choice at the political level where decisions have to be made on how much to invest now in order to reduce scarcity when a pandemic occurs. Two: mass vaccination is considered to be the most important instrument for reducing the impact of infection, yet pandemic plans do not provide concrete estimates of the benefits and burdens of vaccination to assure everyone that the balance is highly favorable. Three: pandemic plans make extraordinary demands on health care workers, yet professional organizations and unions may not have been involved in the plans' formulation and they have not been assured that authorities will aim to protect and support health care workers in a way that corresponds to the demands made on them. Four: all sectors of society and all individuals will be affected by a pandemic and everyone's collaboration will be required. Yet, it appears that the various populations have been inadequately informed by occasional media reports. Hence, it is essential that plans are developed and communication programs implemented that will not only inform but also create an atmosphere of mutual trust and solidarity; qualities that at the time of a pandemic will be much needed. (shrink)

As healthcare institutions expand and vertically integrate, healthcare delivery is less constrained by geography, nationality, or even by institutional boundaries. As part of this trend, some aspects of the healthcare process are shifted from medical centers back into the home and communities. Telehealth applications intended for health promotion, social services, and other activitiesprovide services outside clinical settings in homes, schools, libraries, and other governmental and community sites. Such developments include health information web sites, on-line support groups, automated telephone counseling, interactive (...) health promotion programs, and electronic mail exchanges. Concomitant with these developments is the growth of consumer health informatics, in which individuals seeking medical care or information are able to find various health information resources that take advantage of new information technologies. (shrink)

This book presents the first critical examination of the overlapping ethical, sociocultural, and policy-related issues surrounding disasters, global bioethics, and public health ethics. These issues are elucidated under the conceptual rubric: Public health disasters. The book defines PHDs as public health issues with devastating social consequences, the attendant public health impacts of natural or man-made disasters, and latent or low prevalence public health issues with the potential to rapidly acquire pandemic capacities. This notion is illustrated using Ebola and pandemic influenza (...) outbreaks, atypical drug-resistant tuberculosis, and the health emergencies of earthquakes as focal points. Drawing on an approach that reckons with microbial, existential, and anthropological realities; the book develops a relational-based global ethical framework that can help address the local, anthropological, ecological, and transnational dynamics of the ethical issues engendered by public health disasters. The book also charts some of the critical roles that relevant local and transnational stakeholders may play in translating the proposed global ethical framework from the sphere of concept to the arena of action. This title is of immense benefit to bioethics scholars, public and global health policy experts, as well as graduate students working in the area of global health, public health ethics, and disaster bioethics. (shrink)