Principlism, medical individualism, and health promotion in resource-poor countries: Can autonomy-based bioethics promote social justice and population health?

被引:38
作者
Azétsop J. [1 ]
Rennie S. [2 ,3 ]
机构
[1] Faculté de Médécine Teilhard de Chardin, Complexe Médical le Bon Samaritain, N'djaména
[2] Department of Philosophy, University of Cape Town, Rondebosch7701, Cape Town
[3] Department of Social Medicine, University of North Carolina School of Medicine Chapel Hill, Chapel Hill, NC 27599-7240, 333 S Columbia Street MacNider Hall
关键词
Social Justice; Poor Country; Public Health Intervention; Human Person; Biomedical Model;
D O I
10.1186/1747-5341-5-1
中图分类号
学科分类号
摘要
Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.© 2010 Azétsop and Rennie; licensee BioMed Central Ltd.
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