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Public Health Ethics

1. The present situation of the world is enough to explain the importance of restriction over social liberties. The outbreak of COVID- 19 infection made it essential for the governments to impose lockdown and quarantine norms all over the world to break the chain of infection effectively. The author also asked the question that- Is there any scientific evidence that shows individual rights are exploited during government restrictions during the spread of infectious disease? However, it has also been seen in the cases where some public domain or cities disrespect the actions of the government and faced severe consequences of the disease (Gostin, Friedman & Wetter, 2020). Ample of evidence shows that social distancing measures involving the closing of public places like schools, workplaces, transportation, etc. and cancelling community events like religious celebrations, sports activity, etc. are proved efficient to control the infection. As the infection of the coronavirus accelerates, government restrictions proved an effective manner to control the chain of infection. The government put particular stringent for people at higher risk of observing physical distancing because the infection may lead them to ventilation or even to death. These restrictions make the people aware of practices and precautions to be taken to stop the chain growth of infection. The provincial challenges in the control of rising communicable diseases are dreadful and vary from influencing the causes that force the emergence of disease, to building observation systems robust for the reason, and guaranteeing that provincial governance methods work efficiently to develop control intrusions (Jordan, Adab & Cheng, 2020).

However, to respect civil liberties, courts have persisted that restrictions imposed on human beings must be developed as narrow as possible. Moreover, the order of staying at home in previous days is less interfering in several respects (Studdert & Hall, 2020). By reports, quarantined people are subjected to at zero or less risk of getting infected from the disease. For example, during the SARS epidemic in Taiwan, 131132 people were quarantined and only 12 of them were SRAS positive. However, SARS cases continued to increase in both China and Taiwan after the extensive quarantine was being imposed in both the countries (Barbisch, Koenig, & Shih, 2015).

At-risk here is the problem of paternalism, is it appropriate for the government to inflict boundaries/restrictions on an individual’s liberties to prevent themselves from getting infected. Taking the resemblance from John Stuart Mill of saying “No”, people oppose the restriction by saying that public health officials can warm and instruct about the precautions but could not compel. However, public health advocates repeatedly need to emphasize that social consequences or harmful externalities of such behaviours call for intervention. The public domain believes that self-absorbed harms are transmitted into other-regarding harms (Sutton, 2017). However, it is also been argued that despite restricting individual liberty, government law should focus on improving access to contraceptives and vaccinations. Moreover, screening, counselling, and education of infection risk should be increased rather than restricting people's liberty. Though, public health authorities should limit the contact of infected people and regulate emergency controls in response to disease occurrence (Gostin et al., 2017).

2. Stigma is a negative feeling of shame or discrete towards a person having health disorders e.g. mental illness, disability or infected by the communal disease. Other distinctiveness including gender, sexuality, contest, religious conviction, and civilization falls under a social stigma. Stigma also regulates as a powerful social method that is determined by labelling, typecasting, and division, which leads to loss of status and experiencing discrimination from the perspective of authority (Nyblade et al., 2019). Stigma and be deficient in parity due to health condition is kind of hurdles for the person’s family suffering from any disease. The public health policies and promotional practices of disease prevention and control often include conflicting values and rights. The issue of infection stigmatization and its results are habitually related to intellectual factors or ignorance of disease severity (Schmidt, 2016). In health promotion, stigmatization is a kind of potential concern and another key concept of health promotion ethics. Stigma can further be defined as a communal unacceptability and a kind of spoiled personality. Thus stigmatization may lead to societal discrimination and prejudice (Carter et al., 2011).

Considering the ethics of health promotion, the normative ideal of developing a good society is a chief perspective. An ideal society knows the importance of health and cares for the person suffering from any kind of disease. However, the stigmatization of a person based on his health condition is against the norms of health promotion ethics. For this purpose, the most imperative agenda for health support ethics is to involve with societies in the procedure of explaining the role and responsibilities of people in promoting and developing good health of the society (Carter, 2014). For justifying public health ethics, numerous theoretical pieces of evidence have been put ahead including externalities reduction or promoting social distancing in public places. In the US the rule of law is a primary concept in the US systems. The general assembly of the US has recognized that promoting rule law at the domestic and international level is essential to protect public health (Magnusson, 2017).

Stigmatization is becoming the chief concern for health promotion workers. In the studies, minority and vulnerable communities also suffered from stigmatization which in some cases leads to mental illness. Hence, the promotion of ethical equity is often becoming a priority in their norms. Therefore, the study concluded that health promotion personnel should be well-known to the National Statement on Ethical Conduct in Human Resource. The activity will be more successful if it is developed and planned under ethical considerations of society (Sainsbury, 2016). The disease stigmatization puts burden on infected people and their families. This discrimination may also lead to a professional and personal risk to their livelihood. A person’s rights may be despoiled when heath condition becomes the source of biased treatment or for the thrashing of opportunity or liberty (Barrett et al., 2016). Moreover, the ultimate goal of health promotion workers is to motivate people to improve their health. Pressurized by this goal is an ethical problem due to the stigmatization of diseased persons (McPhail-Bell, Bond, Brough, & Fredericks, 2016).

References for Risk Factors for Severe Disease and Death

Barbisch, D., Koenig, K. L., & Shih, F. Y. (2015). Is there a case for quarantine? Perspectives from SARS to Ebola. Disaster Medicine and Public Health Preparedness9(5), 547-553.

Barrett, D. H., Ortmann, L. H., Dawson, A., Saenz, C., Reis, A., & Bolan, G. (2016). Public health ethics: Cases spanning the globe. Springer Nature.

Carter, S. M. (2014). Health promotion: an ethical analysis. Health Promotion Journal of Australia25(1), 19-24.

Carter, S. M., Rychetnik, L., Lloyd, B., Kerridge, I. H., Baur, L., Bauman, A., & Zask, A. (2011). Evidence, ethics, and values: a framework for health promotion. American Journal of Public Health101(3), 465-472.

Gostin, L. O., Friedman, E. A., & Wetter, S. A. (2020). Responding to COVID‐19: How to Navigate a Public Health Emergency Legally and Ethically. Hastings Center Report50(2), 8-12.

Gostin, L. O., Magnusson, R. S., Krech, R., Patterson, D. W., Solomon, S. A., Walton, D., & Kieny, M. P. (2017). Advancing the Right to Health—The Vital Role of Law. American Journal of Public Health107(11), 1755.

Jordan, R. E., Adab, P., & Cheng, K. K. (2020). Covid-19: risk factors for severe disease and death.

Magnusson, R. (2017). Advancing the right to health: the vital role of law. Advancing the Right to Health: The Vital Role of Law, World Health Organization, Switzerland.

McPhail-Bell, K., Bond, C., Brough, M., & Fredericks, B. (2016). ‘We don’t tell people what to do’: ethical practice and Indigenous health promotion. Health Promotion Journal of Australia26(3), 195-199.

Nyblade, L., Stockton, M. A., Giger, K., Bond, V., Ekstrand, M. L., Mc Lean, R., ... & Turan, J. (2019). Stigma in health facilities: why it matters and how we can change it. BMC Medicine17(1), 1-15.

Sainsbury, P. (2016). Development and oversight of ethical health promotion quality assurance and evaluation activities involving human participants. Health Promotion Journal of Australia26(3), 176-181.

Schmidt, H. (2016). Chronic disease prevention and health promotion. In Public Health Ethics: Cases Spanning the Globe (pp. 137-176). Springer, Cham.

Studdert, D. M., & Hall, M. A. (2020). Disease control, civil liberties, and mass testing—calibrating restrictions during the COVID-19 pandemic. New England Journal of Medicine.

Sutton, M. (2017). Forced Quarantine & Isolation: Does the Law Adequately Balance Individual Rights and Societal Protection. U. La Verne L. Rev.39, 98.

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