Principios bioéticos en salud pública: limitaciones y propuestas

Abstract

We propose to analyze the specificity of ethical problems in public health issues and to elucidate the applicability of principlism as a problem-solving strategy in this realm. Although well-established in clinical ethics, principlism is not an adequate model to be used in public health, since it is basically intended to serve as a moral guide in the physician-patient encounter. We discuss the possible adequacy of principles like "solidarity", "ontic responsibility" (as proposed by Jonas), and "caring or diaconal responsibility" as presented by Lévinas. Solidarity appears to be insufficiently specified, whereas the other two perspectives may be adapted to public health issues by bringing together Jonas' ontological and Lévinas' transcendental concerns to form a principle of protection that might better serve the purposes of such an ethics. This principle would help to identify more clearly the goals and agents involved in the implementation of public policies that are expected to be both morally correct and pragmatically effective.

Fluoretação da água de abastecimento público: abordagem bioética, legal e política

“…The areas of bioethics and public health, despite being distinct fields, often present points of intersection related to measures or technologies that put in discussion the decisions taken by public policymakers 36 . Faced with collective health problems, strategies and actions in health are designed to protect the population of a particular location.…”

Controle da dengue sob a ótica bioética

“…According to Schramm and Kottow, the moral dilemmas inherent to collective practices and health programs cannot be satisfactorily equated with the defender of principlism model, adequate for solving conflicts of the sphere of clinic bioethics. Such authors propose for the public health area, bioethics grounded on the principle of protection, in which the State is responsible for protecting the physical and asset integrity of their citizens and assure them quality of life, putting the collective well-being above individual autonomy 7 .…”

Suplementos dietéticos para reducir de peso: dilemas médicos y éticos

“…El principio de justicia persigue que todos los recursos, derechos y obligaciones deben ser distribuidos de manera imparcial. Por último, el principio de autonomía, sostiene que todos los que participan en el acto biomédico consientan informado y voluntariamente, sea esto una terapia o investigación en la cual participan 33,34 .…”