An ethics framework for public health
An ethics framework for public health
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DOI：
10.2105/ajph.91.11.1776
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发表时间：
2001-11-01
影响因子：
12.7
通讯作者：
Kass, NE
中科院分区：
文献类型：
--
作者：
Kass, NE
一百多年前，公共卫生作为一门有组织的学科开始出现，其目的是改善人群而不是个人的健康。然而，鉴于其以人口为基础的关注点，公共卫生长期面临着其影响范围的适当范围以及其活动是否以道德上令人不安的方式侵犯个人自由的困境。本文提出了公共卫生项目伦理分析的框架。为了推进传统的公共卫生目标，同时最大限度地提高个人自由和促进社会正义，公共卫生干预措施应降低发病率或死亡率；数据必须证实一项计划（或该计划所属的一系列计划）将降低发病率或死亡率；必须确定并尽量减少该计划的负担；该计划必须公平实施，并且有时必须尽量减少先前存在的社会不公正现象；必须使用公平的程序来确定哪些负担是社区可以接受的。
More than 100 years ago, public health began as an organized discipline, its purpose being to improve the health of populations rather than of individuals. Given its population-based focus, however, public health perennially faces dilemmas concerning the appropriate extent of its reach and whether its activities infringe on individual liberties in ethically troublesome ways. In this article a framework for ethics analysis of public health programs is proposed.To advance traditional public health goals while maximizing individual liberties and furthering social justice, public health interventions should reduce morbidity or mortality; data must substantiate that a program (or the series of programs of which a program is a part) will reduce morbidity or mortality; burdens of the program must be identified and minimized; the program must be implemented fairly and must, at times, minimize preexisting social injustices; and fair procedures must be used to determine which burdens are acceptable to a community.