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Title: Vulnerability, risk and disease : a normative framework for public health policy
Author: John, Stephen David
Awarding Body: University of Cambridge
Current Institution: University of Cambridge
Date of Award: 2008
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In this thesis, I provide an account of the ethical and epistemic norms that ought to guide public health policy. In Chapter 1, I argue that assessment of physical well-being should ask not only whether we have met our “vital needs”, but how “secure” we are. I motivate this claim by analogy with epistemology: the reasons we equate epistemic well-being with knowledge also support the claim that physical well-being consists in security. In Chapter 2, I use my account of physical well-being to explain why public health policy is valuable. I contrast my account of public health policy with accounts which locate its value in terms of individuals’ health (or opportunity for good health). I argue that a “security”-based account of well-being is preferable to a “capabilities”-based account. In Chapter 3, I outline the normative considerations that ought to guide public health policy. I develop a theory of when risks are and when they are not tolerable. I show how my theory of tolerability generates a novel account of public health ethics which places familiar problems in a new light. I show how my arguments relate to sufficientarian positions in political philosophy. In Chapter 4, I apply my arguments to debates over the ethical legitimacy of medical research. I first argue that it might be legitimate for the State to enforce participation in medical research. I show how such arguments relate to problems over the distribution of medical care. In Chapter 5, I consider the defensibility of the “precautionary principle” in public health policy. I argue that we can best understand the principle as an epistemic rule governing the generation of fact-inputs into policy. In the second half of the chapter, I defend my policy recommendation against the charge that it is un- or anti-scientific.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available