Gerald M. Oppenheimer, PhD, MPH and Ronald Bayer, PhD
The alarm generated by the AIDS epidemic left civil liberties proponents fearful that traditional public health responses might be imposed on newly susceptible or infected populations.
The AAP’s guidelines on lipid screening for children raise concerns about the fundamental purpose of prevention and its role in balancing individual autonomy with the benefits of society at large.
Given the well-established correlation across cultures between poverty and unhealthy lifestyles, can it be just to hold individuals responsible for choices typical of their socioeconomic sector? Aren’t patient-responsibility programs simply conspiracies to shrink benefits to the poor?
With heterosexual transmission the chief cause of global HIV spread, those without the power to select sexual partners, choose the timing of sexual encounters, or insist on safer sex practices are unable to protect themselves from infection.
Undocumented patients in the United States with end-stage renal disease receive “compassionate” dialysis. Such patients oscillate between being marginally well and “ill enough” to receive dialysis while clinicians wrestle with complicity in a system that both offers and withholds life-saving therapy.
AMA J Ethics. 2018;20(8):E778-779. doi:
10.1001/amajethics.2018.778.