Volume 24, Issue 12, December 2024, Page 6-7.

There is more to modern health than new scientific discoveries, the development of new technologies, or emerging or re‐emerging diseases. World events and experiences, such as the AIDS epidemic and the humanitarian emergencies in Bosnia and Rwanda, have made this evident by creating new relationships among medicine, public health, ethics, and human rights. Each domain has seeped into the other, making allies of public health and human rights, pressing the need for an ethics of (...) public health, and revealing the rights‐related responsibilities of physicians and other health care workers. (shrink)

This paper problematizes the precision medicine approach embraced by the All of Us Research Program (US) and by Genomics England (UK) in terms of benefits distribution, by arguing that current “diversity and inclusion” efforts do not prevent exclusiveness, unless the framing and scope of the projects are revisited in public health terms. Grounded on document analysis and fieldwork interviews, this paper analyzes efforts to address potential patterns of exclusion upstream (from participating in precision medicine research) and (...) downstream (from benefitting from precision medicine outputs). It argues that efforts for inclusion upstream are not corresponded downstream, and this unbalance jeopardizes the equitable capacities of the projects. It concludes that enhanced focus on socio-environmental determinants of health and aligned public health interventions as precision medicine outputs would be to the benefit of all and especially of those who are most at risk of (upstream as well as downstream) exclusion. (shrink)

Liao and Carbonell explore how oppressive medical technologies constitute materiality insofar as they reflect past oppression, embody oppression in the present day, and carry oppression into the fu...

The rise of personalised medicine can be seen as an extension of individualism and as a threat to the common good.

a This paper is a revised and shortened version of my chapter, “Justice in Allocations for Terrorism, Biological Warfare, and Public Health” in Public Health Ethics, edited by Michael Boylan, Kluwer; 2004. Portions of this material were presented at the International Bioethics Retreat, Pavia, Italy, June 2003, and at the meetings of the Association for Politics and the Life Sciences, Philadelphia, September 2003.

This book presents the promises of Precision Medicine (PM) and the challenges of its implementation in daily clinical routine, while addressing the anticipated ethical and social implications. It is the first book that critically analyzes the potential and the dilemmas relevant to genomics and precision medicine from healthcare, public health and global perspectives. The nine chapters presented in this book elaborate on pharmacogenomics' crucial role in maximizing the potential benefits and minimizing medication's potential risks in groups (...) of people, especially in cancer treatment and other health conditions. Infectious and non-communicable diseases (NCDs) are also discussed in this book by identifying challenges and ways to overcome them. Essential concepts are addressed, such as health-related benefits and harm to individuals and the broader community, including threats to individual privacy and autonomy, which warrant just distribution of scarce resources. The book also identifies and addresses the lack of competency in the healthcare workforce in the era of PM and discusses the path to laying the ethical foundation for the implementation of PM in healthcare organizations. (shrink)

The negotiations of the intergovernmental group known as the ‘IGWG’, undertaken by the Member States of the WHO, were the result of a deadlock in the World Health Assembly held in 2006 where the Member States of the WHO were unable to reach an agreement on what to do with the 60 recommendations in the report on ‘Public Health, Innovation and Intellectual Property Rights submitted to the Assembly in the same year by a group of experts designated (...) by the Director General of the WHO. The result of these negotiations was the ‘Global strategy and plan of action on public health, innovation and intellectual property’ which was approved by the World Health Assembly in 2008. The intention of the Global Strategy and Plan of Action (GSPOA) which was produced by the IGWG was to substantially reform the pharmaceuticals' research and development system in view of the findings that this system, whose purpose is to produce medicines for diseases which affect the greater part of the world population which lives in developing countries, had failed. The intellectual property rights imposed by the Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) and the recent trade agreements could become one of the main obstacles to access to medicines. The GSPOA makes a critical analysis of this reality, and opens the door to searching for new solutions to this problem. (shrink)

ABSTRACT The history of Latin America, the history of disease, medicine, and public health, and global history are deeply intertwined, but the intersection of these three fields has not yet attracted sustained attention from historians. Recent developments in the historiography of disease, medicine, and public health in Latin America suggest, however, that a distinctive, global approach to the topic is beginning to emerge. This essay identifies the distinguishing characteristic of this approach as an attentiveness (...) to transfers of contagions, cures, and medical knowledge from Latin America to the rest of the world and then summarizes a few episodes that demonstrate its promise. While national as well as colonial and neocolonial histories of Latin America have made important contributions to our understanding, works taking the global approach have the potential to contribute more directly to the decentering of the global history of disease, medicine, and public health. (shrink)

This article explores a unique opportunity for shaping public health law and policy to reflect a greater balance between public and private goods in two areas of primary concern to human well-being: medicine and human biosecurity. This opportunity is presented both by the rapid changes likely to occur in these areas as a result of nanotechnology and the fact that multinational corporate actors have not yet had the opportunity to use their well-honed techniques of governance influence (...) to modify public health policy and law in this area to their own narrowly focused advantage. Such a rare opportunity to rethink some fundamental assumptions about a regulatory framework for globally important health issues in advance is one reason why issues concerning nanotechnology regulation in medicine and human biosecurity should have considerable interest to health law and policy scholars. (shrink)

Bioethics has developed approaches to address ethical issues in health care, similar to how technology ethics provides guidelines for ethical research on artificial intelligence, big data, and robotic applications. As these digital technologies are increasingly used in medicine, health care and public health, thus, it is plausible that the approaches of technology ethics have influenced bioethical research. Similar to the “empirical turn” in bioethics, which led to intense debates about appropriate moral theories, ethical frameworks and (...) meta-ethics due to the increased use of empirical methodologies from social sciences, the proliferation of health-related subtypes of technology ethics might have a comparable impact on current bioethical research. This systematic journal review analyses the reporting of ethical frameworks and non-empirical methods in argument-based research articles on digital technologies in medicine, health care and public health that have been published in high-impact bioethics journals. We focus on articles reporting non-empirical research in original contributions. Our aim is to describe currently used methods for the ethical analysis of ethical issues regarding the application of digital technologies in medicine, health care and public health. We confine our analysis to non-empirical methods because empirical methods have been well-researched elsewhere. Finally, we discuss our findings against the background of established methods for health technology assessment, the lack of a typology for non-empirical methods as well as conceptual and methodical change in bioethics. Our descriptive results may serve as a starting point for reflecting on whether current ethical frameworks and non-empirical methods are appropriate to research ethical issues deriving from the application of digital technologies in medicine, health care and public health. (shrink)

Se realizó una revisión bibliográfica de materiales disponibles en revistas electrónicas de la base SciELO con el objetivo de fundamentar la contribución de la Medicina Tradicional y Natural a la Salud Pública cubana y las interrelaciones ciencia-tecnología-sociedad. La perspectiva Ciencia, Tecnología y Sociedad contribuye a construir una cultura científica para que la población en general pueda llegar a sentirla como propia, lo cual requiere priorizar la aplicación de la Medicina Tradicional y Natural socialmente útil y culturalmente relevante con el compromiso (...) social basado en la erradicación de la pobreza, la armonía con la naturaleza y el desarrollo sustentable. Se enfatizó en la importancia de la medicina preventiva, además de poner en evidencia la necesidad de reconceptualizar la investigación en las ciencias médicas sobre la base de una visión interdisciplinaria que permita revelar fenómenos no explicados hasta el momento, aspecto que necesita del enfoque desde la perspectiva de la ciencia, tecnología y sociedad como complemento esencial. We conducted a bibliographic review of materials available in electronic journals in SciELO base aiming to substantiate the contribution of Natural and traditional medicine to the Cuban public health and the interrelationships of science-technology - society. Science, technology and society perspective contributes to build a scientific culture so the population can in general get to feel it as their own, which requires to prioritize the application of traditional medicine and Natural, socially useful and culturally relevant social commitment based on the eradication of poverty, the harmony with nature and sustainable development. Emphasized the importance of preventive medicine, as well as highlight the need to reconceptualize the research in the medical sciences on the basis of an interdisciplinary view that reveal phenomena not explained so far, issue that needs the approach from the perspective of science, technology and society as essential complement. (shrink)

This work resulted from a conference held in 2003 that was jointly sponsored by the Rockefeller Archive Center and Quinnipiac University. Drawing upon perspectives from history, philosophy, and the social sciences, as well as public health and medicine, the authors in this volume examine and critique the role of Foundations, most prominently the Rockefeller Foundation, in promoting and expanding the development of Western medicine around the world during the 20th century. The first half of the book (...) examines the historical involvement of philanthropic foundations in public heath, basic medical research, and related social and political issues. These studies range from an examination of the Rockefeller's Foundation's anti-malaria campaigns to the involvement of Foundations in promoting eugenic ideology and population control. The second half of the book considers current situations in which philanthropic foundations are active in promoting public health and westernized medicine, including consideration of the fight against AIDS in Africa, the resurgence of tuberculosis as a major public health threat, and the ongoing war against malaria. Finally, the book concludes with thoughts on the future of health, disease, and public health by Peter C. Goldmark, Jr., a former president of the Rockefeller Foundation. By considering issues of public health and health policy from a wide range of perspectives, this book seeks to contribute both to our understanding of the past successes and failures of growing dominance of Westernized medicine over global health, and to consider present and future possibilities for improving the delivery of health services to the population of the world. (shrink)

What position on dualism does medicine require? Our understanding of that ques- tion has been dictated by holism, as defined by the biopsychosocial model, since the late twentieth century. Unfortunately, holism was characterized at the start with con- fused definitions of ‘dualism’ and ‘reductionism’, and that problem has led to a deep, unrecognized conceptual split in the medical professions. Some insist that holism is a nonreductionist approach that aligns with some form of dualism, while others insist it’s a reductionist (...) view that sets out to eradicate dualism. It’s important to consider each version. Nonreductive holism is philosophically consistent and clinically unprob- lematic. Reductive holism, however, is conceptually incoherent—yet it is the basis for the common idea that the boundary between medical and mental health disorders must be vague. When we trace that idea through to its implementation in medical practice, we find evidence that it compromises the safety of patient care in the large portion of cases where clinicians grapple with diagnosis at the boundary between psychiatry and medicine. Having established that medicine must embrace some form of nonreduc- tionism, I argue that Chalmers’ naturalistic dualism is a stronger prima facie candidate than the nonreductive alternatives. Regardless of which form of nonreductionism we prefer, some philosophical corrections are needed to give medicine a safe and coherent foundation. (shrink)

Hastings Center Report, Volume 52, Issue S1, Page S46-S49, March‐April 2022.

“I want my leadership to be judged by the impact of our work on the health of two populations: women and the people of Africa.” This is how Dr. Margaret Chan, the current Director-General of the World Health Organization , described her leadership mission. The reason behind this mission is evident. Women and girls constitute 70% of the world’s poor and 80% of the world’s refugees. Gender violence against women aged 15–44 is responsible for more deaths and disability (...) than cancer, malaria, traffic accidents, and war. An estimated 350,000 to 500,000 women still die in childbirth every year. The negative health implications of absolute poverty are worst in Sub-Saharan Africa and South Asia. Hence, Chan aims to have the biggest impact on the world’s poorest people. (shrink)

Dr Devi Sridhar, Department of Politics and International relations, University of Oxford, All Souls College, High St, OX1 4AL UK, Email: devi.sridhar{at}politics.ox.ac.uk ' + u + '@' + d + ' '//--> Abstract This paper discusses the politics of access to essential medicines and identifies ‘space’ in the current system where health concerns can be strengthened relative to trade. This issue is addressed from a global governance perspective focusing on the main actors who can have the greatest impact. These (...) include developing country coalitions and citizens in developed countries though participation in civil society organisations. These actors have combined forces to tackle this issue successfully, resulting in the 2001 Doha Declaration on Public Health. The collaboration has been so powerful due to the assistance of the media as well as the decision to compromise with pharmaceutical companies and their host countries. To improve access to essential medicines, six C's are needed: coalitions, civil society, citizenship, compromise, communication and collaboration. CiteULike Connotea Del.icio.us What's this? (shrink)

Objectives: To foster the development of a privacy-protective, sustainable cross-border information system in the framework of a European public health project. Materials and methods: A targeted privacy impact assessment was implemented to identify the best architecture for a European information system for diabetes directly tapping into clinical registries. Four steps were used to provide input to software designers and developers: a structured literature search, analysis of data flow scenarios or options, creation of an ad hoc questionnaire and conduction (...) of a Delphi procedure. Results: The literature search identified a core set of relevant papers on privacy. Technicians envisaged three candidate system architectures, with associated data flows, to source an information flow questionnaire that was submitted to the Delphi panel for the selection of the best architecture. A detailed scheme envisaging an “aggregation by group of patients” was finally chosen, based upon the exchange of finely tuned summary tables. Conclusions: Public health information systems should be carefully engineered only after a clear strategy for privacy protection has been planned, to avoid breaching current regulations and future concerns and to optimise the development of statistical routines. The BIRO project delivers a specific method of privacy impact assessment that can be conveniently used in similar situations across Europe. (shrink)