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A core function of public health is to protect and promote the health of the general public (Dawson & Verweij, 2007). Generally, all countries have health departments that are assigned with the collective action of promoting and protecting the health of the population. Various theories have been developed within the field of public health. Three of the theories, utilitarianism, distributive justice and paternalism will be analyzed. The paper will also look at a statement provided by Selgelid (2009) and provide arguments for and against his position.
The utilitarianism theory is a concept whereby the majority rules. In this case, whatever is viewed as beneficial to the general community, will benefit a single individual (Department of Health, 2009). With regard to the public health therefore, a public health intervention may be viewed as good to an individual as it benefits the whole community. Its main advantage is that it provides a cooperative approach of thinking about public health interventions. For instance, when looking at the development of a certain drug for in illness, it is basically considered that what works for the general community will work for an individual.
The principle of distributive justice implies that the community or society owes each of its members, according to the individual wants, responsibility and contribution; the resources available to the community, organization and the community’s responsibility for the common good (Dawson & Verweij, 2007). Basically, this principle means that the community has a duty to a person in serious need, and that all people have duties to others who are serious need. This principle is applicable in the field of public health as the laws in most countries stipulate that each an every person should have the access of the basic health care (Department of Health, 2009).
Paternalism is considered as interfering with an individual’s liberty of action against the individual’s will of promoting or protecting his welfare. Many of the contemporary public health programs have the paternalistic effect (Department of Health, 2009). This is because almost all programs are concerned with the basic aim of promoting and protecting the health of the individuals, and significant efforts are being directed at identifying paternalistic interventions that will take precedence over individual autonomy in order to avoid the adoption of unhealthy behaviors.
Michael Selgelid (2009) wrote an article that advocated for the development of a moderate pluralistic approach to political philosophy. He went on to describe that this approach should recognize the fact that equality, liberty and utility are independent, legitimate social values, and none of them has absolute priority over the others. Apparently, his theory generated a principled means approach for striking a balance between these three values just in case a conflict arises. Selgelid went on to highlight the fact that while most of the ethicists in the public health usually insist that the least restrictive alternative need to be applied in order to meet the objectives of the public health. This statement has generated a lot of controversies with the public health domain.
The least restrictive alternative means that an individual has the freedom to attain the least intrusive or less restrictive treatment within a less restrictive environment. This principle is basically applied within the mental health field (Department of Health, 2009). Basically, the aspects of least restrictive alternative and the least restrictive environment are applied in determining the treatment and management of the patient. This principles however, seems to introduce compulsory treatment to the community. A patient living within the community, while considered under medication, instead of the hospital will seem to be defined under the least restrictive alternative. Under the least restrictive approach, the patient has the option to choose on the type of medication he requires under the type of environment under which such medication will be administered. Thus, a patient may consider it less restrictive at an acute stage of the disease to be at the hospital and not under medication, rather than being in the community, but under medication.
With regard to the patient’s attitude to medication, some would prefer to take the oral medication instead of depot, as they consider it to be less restrictive. However, it is important to note that the least restrictive principle aims at enhancing autonomy by ensuring the patient is provided with the option to choose on the type of treatment he requires. Public Health Ethicists therefore advocate for the adoption of the least restrictive alternative in order to attain the public health goal as it provides the patients with opportunity of deciding on the type of medication or treatment they require (Department of Health, 2009).
On the other hand, Selgelid position is that the least restrictive alternative may at times entail improvement of the global health through redistributive taxation instead of coercive social distancing measures. It is apparent that there are various social classes within the society we live in. The wealthy will always prefer to go for the high quality services. With the adoption of the least restrictive alternative, the wealthy will have the option to choose on the best and certainly the most expensive options, which will in turn generate income in form of tax, which can be used to improve on the global health. Therefore, instead of advocating for the freedom of the patient, it is appropriate to think of ways in which this freedom is morally suitable (Department of Health, 2009).