Bruce Jennings

Center for Humans and Nature, 109 West 77th Street, Suite 2, New York, NY 10024, USA. Tel.: 212 362 7170; Fax: 212 362 9592; Email: brucejennings{at}humansandnature.org ' + u + '@' + d + ' '//--> . Abstract A fundamental question for the ethical foundations of public health concerns the moral justification for limiting or overriding individual liberty. What might justify overriding the individual moral claim to non-interference or to self-realization? This paper argues that the libertarian justification for limiting individual liberty known as the ‘harm principle’ or the ‘Millian paradigm’ is inadequate as a basis of public health ethics and policy. But simply pitting some collectivist value or utilitarian criterion over against individual liberty is not theoretically satisfactory, either. John Stuart Mill himself was not a Millian, in this sense, and his utilitarianism does not pit itself against individual liberty as a situation of balancing conflicting values. A reconsideration of Mill, particularly in light of the later work of Berlin on liberty, points toward a conception of relational liberty that is crucial for public health ethics because it contains within itself the basis for its own moral limitation. CiteULike Connotea Del.icio.us What's this?

To the Editor: The sensitive discussion by Courtney Campbell and Jessica Cox on hospice care and physician-assisted death (“Hospice and Physician-Assisted Death: Collaboration, Compliance, and Complicity,” September-October 2010) is a model blend of ethical analysis, empirical study, and policy assessment in bioethics. The legalization of physician aid in dying has raised important ethical issues for hospice that go to the broader question of its evolving mission and its place in the landscape of end-of-life care in our society. Hospice began, one might say, as a philosophy of care of the dying that formed a countercultural movement. It offered a systematic and holistic approach to care involving not ..

No single concept has been more important in the contemporary development of bioethics, and the revival of medical ethics, than the concept of autonomy, and none better reflects both the philosophical and the political currents shaping the field. This article proposes to consider autonomy in three of its facets and functions: first, as a concept in ethical theory; second, as a concept in applied ethics; and finally, as what might be called an ideological concept — that is, one that both draws from and reinforces non-philosophical interests at work in the profession of medicine, biomedical science and technology, and the broader liberal individualistic culture of Anglophone countries, particularly the United States, where a bioethical discourse centred on autonomy has flourished.

Public health involves the use of power to change institutions and redistribute resources and deliberately to shape individual thought and behavior. This requires normative legitimation and demands ethical critique. This article explores concepts that are vital to public health ethics, but have been relatively neglected. These are membership, solidarity and the concept of place. The article argues that the practice of public health should recognize the equal rights of membership in communities of health justice. Public health should also rely on a sense of obligation and mutual aid in a world of shared vulnerability and reciprocal recognition. Finally, public health achieves its goals not merely—and perhaps not most fundamentally—through information and altering the logical ratiocination of individuals or groups, but rather through the reformation of sense and sensibility

In the spirit of summer, and especially summer reading, we asked a few well-read writers for an essay on a book or books exploring bioethics issues through story. The result is a compelling look at how we face our fears and hopes about biotechnology and medicine. A reading list appears at the end. Bioethics lives in the shadow of great structures and practices of power, and yet, it has not been notable for its contributions to an understanding of power.1 Indeed, the narrative that bioethics has fashioned for itself has been mainly a liberationist romance: a quest narrative in which the individual, seeking autonomy, struggles against limitations, constraints, and inhibitions imposed by forces (rules ..