10:832:356 Lecture Notes - Lecture 2: Seat Belt Legislation, Zombie, Paternalism
9 May 2018
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Lecture #2: Doing Ethics: The Practice of Ethics in a Public Health Context
I. Paternalistic Versus Patient-Centered Approach
• Paternalistic Approach- “Do what I tell you to do.” Offensive to some and necessary to others.
• Patient-Centered Approach- “So what you think?” Treating the whole patient rather than only
what is wrong.
II. Paternalism Defined
• Paternalism- A system under which an authority undertakes to supply needs or regulate
conduct of those under its control in matters affecting them as individuals as well as in their
relations to authority and to each other.
• Not the same as parens patria (http://www.merriam-webster.com/dictionary/paternalism.
• Government is telling what you need to do and supplying you with what you need to live.
• “Parent of the country.”
• Role of the state as sovereign and guardian of persons under legal disability (Black’s Law
Dictionary).
III. U.S. Constitution- Article II
• Section 3:
• “…(the executive government) shall take Care that the Laws be faithfully executed…”
• Article II is often called the “police powers” provision of the US Constitution.
• Article II has been interpreted to confer the powers of protecting the public to the
Executive Branch of the government.
• Federal level, not state level.
• President and all of the branches that fall under federal government.
• State level has something very similar.
• This branch is essentially the “parent” to the general public.
• Public health organizations often fall under the auspices of the executive branch.
• Under departments of health, department of environmental policy, etc.
• There are not a lot of public health organizations do not have government funding.
Page !1
Document Summary
Page !1: the ability of the government to get the aide to where it is supposed to go to, and the executive branch signs that off. State has no power to restrict an individual"s voluntary activities: considered anti-paternalism. , example: the purge, 2. ) The common good is best served by maximizing individual freedoms for everyone: survival of the fittest, serves people who are the strongest and/or smartest, 3. ) Health and safety are private interests: rich versus the poor, dependent on what you can afford, the very wealthy and the very powerful become the same thing, 4. ) Depends on the person: voluntary and self-regarding behavior, example: seat belts are only helping you; will not affect anyone else, cigarettes are a different story because of second-hand smoking, gostin, pages 35-36. Realities of paternalism: us government uses their spending power to manipulate states into enacting certain public health policies, drinking age of 21, seat belt laws.
