Hastings Cent Rep
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Even as public health ethics was developing as a field, major incidents such as 9/11 and the SARS epidemic propelled discourse around public health emergency preparedness and response. Policy and practice shifted to a multidisciplinary approach, recognizing the broad range of potential threats to public health, including biological, physical, radiological, and chemical threats. This propelled the development of surveillance systems to detect incidents, laboratory capacities to rapidly test for potential threats, and therapeutic and social countermeasures to prepare for and respond to a range of hazards. ⋯ Arras, Drue H. Barrett, and Barbara A. Ellis, will offer a vital compass.
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Medical research is widely thought to have a fundamentally therapeutic orientation, in spite of the fact that clinical research is thought to be ethically distinct from medical care. We need an entirely new conception of clinical research ethics - one that looks to science instead of the doctor-patient relationship.
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Bioethics' traditional focus on clinical relationships and exotic technologies has led the field away from population health, health disparities, and issues of justice. The result: a myopic view that misses the institutional context in which clinical relationships operate and can overlook factors that affect health more broadly than do exotic technologies. A broader bioethics agenda would take up unresolved questions about the distribution of health and the development of fair policies that affect health distribution.
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Medical ethics in times of war are fundamentally different from those in times of peace. War brings military and medical values into conflict, often overwhelming other moral obligations, such as a doctor's charge to relieve suffering, in the face of military necessity.
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Mediator? Moral Expert? Or both? "Discourse Ethics" suggests that consensus provides the foundation for defensible moral norms. Thus in building consensus on a moral problem, an ethicist is not just negotiating a compromise but is contributing to the construction of moral rules and principles that have a genuine claim on us. In this way, not only does expertise on a variety of moral positions facilitate mediation, but mediation opens the way to a kind of moral expertise.