SAC360

1. Copyright © 2021 by Jones & Bartlett Learning, LLC an Ascend Learning Company. www.jblearning.com.
CHAPTER 2
Why Is Public
Health
Controversial?

2. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Social Justice Versus Market Justice
 Differences:
– Social justice: The common good
– Market justice: Individual responsibility
 Questions about the scope of public health
 Importance of economic factors for health
– Politically controversial

3. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Sources of Controversy
 Economic impact
 Individual liberty
 Moral and religious opposition
 Political interference with science

4. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Economic Impact
 Most public health measures have a negative economic impact on some
segment.
 Businesses often resist public health measures because they affect profits.
 Those who must pay may not be the ones who benefit.
 Costs may be short-term, while benefits may be long-term.
 Costs are easier to calculate than benefits.

5. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Tragedy of the Commons
 Is exemplified in many environmental laws
 Freedom of individuals should be restricted for the well-being of the population.
 Do laws overly restrict “freedom” to pollute?
 What should be included among protected resources?

6. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
When Can Government Restrict Individual Freedom?
 Restrictions to prevent harm to others is generally acceptable.
 Paternalism is only acceptable for laws concerning children.
– For protecting individuals from their own actions? (Libertarians are opposed.)
 Libertarian view has a strong tradition in the U.S.
 Argument for restrictions for the “common good” leaves lots of room for
controversy.

7. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Moral and Religious Opposition
 Concerns:
– Sex and reproduction
 AIDS, STDs, teenage pregnancy, and low birth-weight babies are major U.S. public
health concerns.
 Public health solutions are often viewed as promoting immoral behavior.
– Alcohol and drugs
 Such opposition may discourage scientists and funding agencies from
conducting research on many important health problems.

8. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Politics Versus Science
 There is always the possibility of tension.
 Conservative control of federal government intensifies the conflict.
 Under Bush administration, EPA changed a section of a major report.
 Obama administration made efforts to inform policy decisions based on honest
science.
 Under Trump administration, EPA director proposal would bring politics into
initial review and synthesis of research step.

9. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 1
 Do you agree that the philosophy of social justice is preferable to the
philosophy of market justice?
 Which is likely to lead to greater improvements in public health?

10. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 2
 Give an example of a measure that would benefit public health but that might
be expensive to implement.
 Who would benefit?
 Who would pay the cost?

11. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 3
 Give an example of a measure that would improve public health but that might
limit some people’s freedom.
 Who would benefit?
 Whose freedom would be limited?

12. Copyright
©
2021
by
Jones
&
Bartlett
Learning,
LLC
an
Ascend
Learning
Company.
www.jblearning.com
Discussion Question 4
 How far do you believe government should go in advocating and/or enforcing
moral behavior?