Ismaili M'hamdi H, de Beaufort I, Jack B, Steegers E A P
1Department of Medical Ethics and Philosophy,Erasmus MC,Rotterdam,the Netherlands.
2Department of Family Medicine,Boston University School of Medicine,USA.
J Dev Orig Health Dis. 2018 Feb;9(1):58-62. doi: 10.1017/S2040174417000654. Epub 2017 Aug 22.
Insights from the Developmental Origins of Health and Disease paradigm and epigenetics are elucidating the biological pathways through which social and environmental signals affect human health. These insights prompt a serious debate about how the structure of society affects health and what the responsibility of society is to counteract health inequalities. Unfortunately, oversimplified interpretations of insights from Developmental Origins of Health and Disease and epigenetics may be (mis)used to focus on the importance of individual responsibility for health rather than the social responsibility for health. In order to advance the debate on responsibility for health, we present an ethical framework to determine the social responsibility to counteract health inequalities. This is particularly important in a time where individual responsibility often justifies a passive response from policymakers.
健康与疾病的发育起源范式和表观遗传学的见解正在阐明社会和环境信号影响人类健康的生物学途径。这些见解引发了一场关于社会结构如何影响健康以及社会应对健康不平等的责任是什么的严肃辩论。不幸的是,对健康与疾病的发育起源和表观遗传学见解的过度简化解释可能会(被)用于强调个人对健康的责任而非社会对健康的责任。为了推进关于健康责任的辩论,我们提出一个伦理框架来确定应对健康不平等的社会责任。在个人责任常常使政策制定者采取被动应对措施的时代,这一点尤为重要。