Principlism, medical individualism, and health promotion in resource-poor countries: can autonomy-based bioethics promote social justice and population health?
Through its adoption of the biomedical model of disease which promotes medical individualism and its reliance on the individual-based anthropology, mainstream bioethics has predominantly focused on respect for autonomy in the clinical setting and respect for person in the research site, emphasizing self-determination and freedom of choice. However, the emphasis on the individual has often led to moral vacuum, exaggeration of human agency, and a thin (liberal?) conception of justice. Applied to resource-poor countries and communities within developed countries, autonomy-based bioethics fails to address the root causes of diseases and public health crises with which individuals or communities are confronted. A sociological explanation of disease causation is needed to broaden principles of biomedical ethics and provides a renewed understanding of disease, freedom, medical practice, patient-physician relationship, risk and benefit of research and treatment, research priorities, and health policy.
Azétsop
Jacquineau
J
Faculté de Médécine Teilhard de Chardin, Complexe Médical le Bon Samaritain, N'djaména, BP 456, Chad. maishaze@yahoo.com
Rennie
Stuart
S
D001675:Bioethics; D003906:Developing Countries; D006293:Health Promotion; D006801:Humans; D026684:Personal Autonomy; D012935:Social Justice