I have written before about the movement of at least some of the public health community into areas not traditionally thought to be within their purview such as local public health departments monitoring the hemoglobin A 1 C levels. I was not aware of the degree to which the philosophy animating this movement was developed and being expounded in very explicit terms.
Thanks to Sandy Szwarc of Junkfood Science . Her entire piece should be read but below are some of the comments made by exponents of what you might call "the new public health ethics".
In a nutshell,the basic notion is that an individual's health and health related behaviors are too important to be left to the individual as they poise a threat to society and government must act for the good of society.
Ms. Szwarc quotes from a "thought leader" in this field of public health ethics, Dr. Angus Dawson who is at the Centre for Professional Ethics at the University of Toronto as he discusses his approach to the problem of obesity.
[the educational approach to battle obesity] "will fail as it wrongly assumes..that we ought to respect an individual's existing preferences " and "an ethical obesity policy ought to focus on collective interventions [ in which] the individual will not be able to opt out.
If people will not do what we know to be best for them and society we will make them do it.This seems to be the core of the public health ethics.
Lest you think that we are dealing with the relatively, unheard voice of a fringe philosopher in the wilderness (or at least in Canada),essentially the same theme is expressed by Dr. VJ Guillory who served on the AMA Expert Committee on Obesity when he wrote in the Journal of Public Health , "The mandate to ensure and protect the health of the public is an inherently moral one...and it implies the possession of an element of power to carry out that mandate."
In this age of supposedly evidence based medicine it is interesting to read one of the comments from a report about a meeting of the AMA Expert Committee on Obesity : "The magnitude of the obesity is too great to wait for evidence-based guidelines before increasing efforts focused on prevention and intervention." So it is ready, shoot, aim- all with very generous funding from the Robert Wood Johnson Foundation and it is individual freedom and autonomy the targets.