Department of Family and Community Medicine, Canada Research Chair in Primary Care Research, University of Toronto, Room E349B 2075 Bayview Avenue, Toronto, Ontario, Canada M4N 3M5.
J Bioeth Inq. 2013 Mar;10(1):19-28. doi: 10.1007/s11673-012-9422-7. Epub 2013 Feb 6.
Obesity has been described as pandemic and a public health crisis. It has been argued that concerted research efforts are needed to enhance our understanding and develop effective interventions for the complex and multiple dimensions of the health challenges posed by obesity. This would provide a secure evidence base in order to justify clinical interventions and public policy. This paper critically examines these claims through the examination of models of public health and public health ethics. I argue that the concept of an effective public health intervention is unclear and underdeveloped and, as a consequence, normative frameworks reliant on meeting the effectiveness criterion may miss morally salient dimensions of the problems. I conclude by arguing for the need to consider both an ecological model of public health and inclusion of a critical public health ethics perspective for an adequate account of the public health challenges posed by obesity.
肥胖症被描述为一种流行疾病和公共卫生危机。有人认为，需要集中精力进行研究，以增进我们对肥胖症所带来的复杂和多方面健康挑战的理解，并制定有效的干预措施。这将为临床干预和公共政策提供可靠的证据基础。本文通过考察公共卫生模式和公共卫生伦理，对这些观点进行了批判性的审查。我认为，有效的公共卫生干预的概念是不清楚和不发达的，因此，依赖于满足有效性标准的规范框架可能会忽略问题的道德上显著的方面。最后，我认为有必要考虑公共卫生的生态模型，并纳入批判性的公共卫生伦理观点，以充分说明肥胖症所带来的公共卫生挑战。
