Silva Diego S, Smith Maxwell J
Sydney Health Ethics, School of Public Health, University of Sydney, Sydney New South Wales, Australia.
School of Health Studies, Western University, London Ontario, Canada.
Asian Bioeth Rev. 2022 Sep 10;15(1):19-35. doi: 10.1007/s41649-022-00218-1. eCollection 2023 Jan.
Efforts to improve public health, both in the context of infectious diseases and non-communicable diseases, will often consist of measures that confer risk on some persons to bring about benefits to those same people or others. Still, it is unclear what exactly justifies implementing such measures that impose risk on some people and not others in the context of public health. Herein, we build on existing autonomy-based accounts of ethical risk imposition by arguing that considerations of imposing risk in public health should be centered on a relational autonomy and relational justice approach. Doing so better captures what makes some risk permissible and others not by exploring the importance of power and context in such deliberations. We conclude the paper by applying a relational account of risk imposition in the cases of (a) COVID-19 measures and (b) the regulation of sugar-sweetened beverages to illustrate its explanatory power.
改善公众健康的努力，无论是在传染病还是非传染病方面，通常都包括一些措施，这些措施会给某些人带来风险，以给这些人或其他人带来益处。然而，在公共卫生背景下，究竟是什么确切地证明了实施这些给一些人而非其他人带来风险的措施是合理的，这一点尚不清楚。在此，我们在现有的基于自主性的道德风险施加观点基础上进行拓展，认为在公共卫生中施加风险的考量应以关系自主性和关系正义方法为核心。这样做通过探究权力和背景在此类考量中的重要性，能更好地理解哪些风险是可允许的，哪些不是。我们通过将风险施加的关系性观点应用于（a）新冠疫情措施和（b）含糖饮料监管案例来结束本文，以说明其解释力。
