Denaturalizing scarcity: a strategy of enquiry for public- health ethics.
Most scarcities that underpin health disparities within and among countries are not natural; rather, they result from policy choices and the operation of social institutions. Using examples from the United States of America: the Chicago heat wave and hurricane Katrina, this paper develops "denaturalizing scarcity" as a strategy for enquiry to inform public-health ethics in an interconnected world. It first describes some of the resource scarcities that are of greatest concern from a public-health perspective, and then outlines two (not mutually exclusive) lines of ethical reasoning that demonstrate their importance. One of these involves the multiple relationships that link rich and poor across national borders in today's interconnected world. The paper then briefly describes ways in which globalization and the associated institutions are linked to health-threatening scarcities. The paper concludes that denaturalizing scarcity represents a valuable alternative to mainstream health ethics, directing our attention instead to why some settings are "resource poor" and others are not.
Schrecker
Ted
T
University of Ottawa, Ottawa, ON, Canada. tschrecker@sympatico.ca).
D003906:Developing Countries / Q000191:economics; D014943:Global Health; D006292:Health Priorities; D006301:Health Services Needs and Demand; D054625:Healthcare Disparities; D006801:Humans; D038622:Internationality; D011203:Poverty; D011204:Poverty Areas; D011634:Public Health / Q000941:ethics*; D040841:Resource Allocation / Q000941:ethics*; D012941:Social Responsibility; D026712:Value of Life
Obes Rev. 2006 Feb;7(1):5-12
16436098
Lancet. 2005 Jun 25-Jul 1;365(9478):2193-200
15978927
PLoS Med. 2007 Oct;4(10):1561-6
17958462
J Epidemiol Community Health. 2006 Nov;60(11):998-1003
17053290
Lancet. 2007 Sep 29;370(9593):1153-63
17905168
Int J Health Serv. 2007;37(1):63-87
17436986
Global Health. 2007 Jun 19;3:6
17578569
Global Health. 2008 Mar 25;4:6
18364048
Environ Health Perspect. 2002 May;110(5):537-42
12003760