Studies of early modern dress frequently focus on its connection with status and identity, overlooking clothing’s primary function, namely to protect the body and promote good health. The daily processes of dressing and undressing carried numerous considerations: for example, were vital areas of the body sufficiently covered, in the correct fabrics and colours, in order to maintain an ideal body temperature? The health benefits of clothing were countered by the many dangers it carried, such as toxic dyes, garments (...) that were either too tight or voluminous, or harboured dirt and diseases that could infect the body. This article draws on medical treatises and health manuals printed and read in Italy and England, as well as personal correspondence and diaries, contextualised with visual evidence of the styles described. It builds on the current, wider interest in preventative medicine, humoral theory, health and the body in the early modern period by focusing in depth on the role of clothing within these debates. (shrink)

We commend the authors for their comprehensive discussion on consent and episiotomies.1 They correctly observe that informed consent for all proposed interventions in maternity care is always necessary. The claim that consent for maternity health services does not always have to be fully informed or explicit, however, is erroneous. We are especially concerned with, and surprised by, the endorsement of ‘opt-out consent’. ‘Opt-out consent’ (a.k.a. substitute decision making) is already standard practice in maternity healthcare, with obstetric violence a normalised (...) response to conclusive refusals or requests for explanations. Informed consent is based on the fundamental human rights to bodily autonomy and integrity, which healthcare providers are obliged to respect. Healthcare structured around human rights violations is not care. It is cruel and inhumane treatment—a violation of yet another fundamental human right—and a reflection of poor-quality care. To be valid, consent must always be informed, specific, timely, freely given and reversible. The provider must provide information specific to each and every proposed intervention in a timely manner. The consumer has the right to consider, freely accept or refuse before providers can act. They can also change their mind at any time. Provider attempts to substitute consumer decision-making rights constitute assault and battery. Whether the infraction was major or minor is of no consequence to human rights law. National courts create artificial …. (shrink)

An excellent critical analysis and scientific assessment of the nature and actual level of risk leading environmental health hazards pose to the public. Issues such as radiation from nuclear testing, radon in the home, and the connection between electromagnetic fields and cancer, environmental factors and asthma, pesticides and breast cancer and leukemia clusters around nuclear plants are discussed and how scientists assess these risks is illuminated.

The stigmatisation of the gecekondu in post-1945 Turkey is a common theme in the literature. However, these studies have drawn little connection with health issues, even though these are known to be important in the mechanisms of stigmatisation. Policies for tuberculosis (TB) control—then Turkey's “number one health issue”—have tended to focus on individual and biological factors, to the detriment of social or environmental ones that could contribute to making TB a matter of politics and not only of policies. (...) A close study of the practices of the numerous TB-control actors nevertheless reveals an entanglement of the social, the environmental, and the medical questions. Through the emblematic but unknown case study of the TB-control pilot area created in Zeytinburnu in 1961, this article studies discourses, but also graphic representations, portraying the gecekondu as unhealthy, revealing an underlying environmental conception of TB among Turkish public health actors. The choice of Istanbul's biggest gecekondu neighbourhood to be a pilot area originated from a common conception of the gecekondu areas as pathogenic, but also contributed to reinforcing this vision and adding it to the very definition of the gecekondu. It thus participated in the stigmatisation of these areas and their inhabitants, even if some of the study's conclusions undermined the common vision of the gecekondu as populated by poor, rural migrants. However, the pilot project was also conceived as a way to integrate the inhabitants into the modern city. The “pilot” character of the area, if characteristic of the vocabulary of the 1960s, which were also the time of the attempt to “socialise the health services” in Turkey, is questionable. The project displayed a desire to know and control this specific territory rather than a genuine promotion of broader environmental changes to be replicated on a national scale. (shrink)

In their recent article, Brown et al analyse several ethical aspects around immunity passports and put forward some recommendations for implementing them. Although they offer a comprehensive perspective, they overlook two essential aspects. First, while the authors consider the possibility that immunological passports may appear to discriminate against those who do not possess them, the opposite viewpoint of immune people is underdeveloped. We argue that if a person has been tested positive for and recovered from COVID-19, becoming immune to it, (...) she cannot be considered a hazard to public health and, therefore, the curtailment of her fundamental rights is not legitimate. Second, they omit that vaccine distribution will create similar problems related to immunity-based licenses. Vaccine certificates will de facto generate a sort of immunity passport. In the next phases of the pandemic, different immunity statuses will be at stake, because the need to identify who can spread COVID-19 is unavoidable. If a person does not pose a threat to public health because she cannot spread the infection, then her right to freedom of movement should be respected, regardless of how she acquired that immunity. (shrink)

When environmental health researchers study hazards in the home, they often discover information that may be relevant to protecting the health and safety of the research subjects and occupants. This article describes the ethical and legal basis for a duty to warn research subjects and occupants about hazards in the home and explores the extent of this duty. Investigators should inform research subjects and occupants about the results of tests conducted as part of the research protocol (...) only if the information is likely to be accurate, reliable, and medically useful. Investigators should warn subjects and occupants about hazards they happen to discover while they are in the home, if a reasonable person would warn the subjects and occupants about those hazards. Investigators should not report illegal hazards discovered in the home to the authorities, unless those hazards constitute abuse or neglect of children or mentally disabled people living in the home. When investigators decide to warn research subjects and occupants about hazards in the home, they should take some steps to help them make effective use of this information, such as providing additional counselling or making a referral for remediation or medical treatment. Investigators should discuss these issues with research subjects during the informed consent process. (shrink)

This essay begins by summarizing the reasons why unregulated health-care markets are inefficient. The inefficiencies stem from the asymmetries of information among providers, patients and payers, which give rise to moral hazard and adverse selection. Attempts to ameliorate these inefficiencies by means of risk-adjusted insurance and monetary incentives such as co-pays and deductibles lessen the inefficiencies at the cost of increasing inequalities. Another possibility is to rely on non-monetary incentives, including ordeals. While not a magic bullet, these are feasible (...) methods for addressing the inadequacies of market provision of health care, such as moral hazard. (shrink)

Artificial intelligence holds great promise for improved health‐care outcomes. But it also poses substantial new hazards, including algorithmic discrimination. For example, an algorithm used to identify candidates for beneficial “high risk care management” programs routinely failed to select racial minorities. Furthermore, some algorithms deliberately adjust for race in ways that divert resources away from minority patients. To illustrate, algorithms have underestimated African Americans’ risks of kidney stones and death from heart failure. Algorithmic discrimination can violate Title VI of (...) the Civil Rights Act and Section 1557 of the Affordable Care Act when it unjustifiably disadvantages underserved populations. This article urges that both legal and technical tools be deployed to promote AI fairness. Plaintiffs should be able to assert disparate impact claims in health‐care litigation, and Congress should enact an Algorithmic Accountability Act. In addition, fairness should be a key element in designing, implementing, validating, and employing AI. (shrink)

This study examines the ethical position and behaviour of multinational mining companies regarding hazardous employment and health and safety of employees in the South African mining industry. Mining companies have long had a reputation for being unethical on health and safety issues. Too often there are occurrences of fatal accidents, which bring the ethical behaviour of multinational mining companies into question. The litmus test for the mining companies is to devise benchmark standards that will reduce accidents tremendously at (...) their place of operations. This study addresses this issue by examining measures and regulations set up to check the occurrences of mining accidents in South Africa. It follows that the remedy needs to be fundamental and thoroughgoing. (shrink)

Lead (Pb) contamination of the environment is an important human health problem. Children are vulnerable to Pb toxicity; it causes damage to the central nervous system and, in some extreme cases, can cause death. Lead is widespread, especially in the urban environment, and is present in the atmosphere, soil, water and food. Pb tends to accumulate in surface soil because of its low solubility, mobility, and relative freedom from microbial degradation of this element in the soil. Lead is present (...) in soil as a result to weathering and other pedogenic processes acting on the soil parent material; or from pollution arising caused by the anthropogenic activities; such as mining, smelting and waste disposal; or through the adoption of the unsafe and unethical agricultural practices such as using of sewage sludge, and waste water in production of vegetable crops or cultivation of vegetables near highways and industry regions. Lead concentrations are generally higher in the leafy vegetables than the other vegetables. Factors affecting lead uptake included its concentration in the soil, soil pH, soil type, organic matter content, plant species, and unsafe agriculture practices. Generally, as Pb concentration increased; dry matter yields of roots, stems and leaves as well as total yield decreased. The mechanism of growth inhibition by lead involve: a decrease in number of dividing cells, a reduction on chlorophyll synthesis, induced water stress to plants, and decreased NO 3 - uptake, reduced nitrate and nitrite reductase activity, a direct effect of lead on protein synthesis, a decrease on the uptake and concentration of nutrients in plants. The strategies to minimize Pb hazard can be represented in: (a) Phytoremediation, through natural plants are able to bio-accumulate Pb in their above–ground parts, which are then harvested for removal such as, using Indian Mustard (Brassica juncea), Ragweed (Ambrosia artemisiifolia), Hemp Dogbane (Apocynum cannabium), or Poplar trees, which sequester lead in its biomass. (b) Good and ethical agricultural practices such as cultivation of vegetables crops as far from busy streets or highways and industry regions as well as nonuse of sewage sludge and waste water in cultivated soils. (c) Increasing the absorptive capacity of the soil by adding organic matter and humic acid. (d) Growing vegetable crops and cultivars with a low potential to accumulate lead, especially in soils exposed to atmospheric pollution. (e) Washing of leafy vegetables by water containing 1 % vinegar or peeling roots, tubers, and some fruits of vegetables before consumption may be an important factor in reducing the lead concentration. (shrink)

This text suggests that imagination is a powerful tool that can be used creatively or destructively, and argues that by becoming more conscious of how we use fantasy and are affected by it, we can learn to apply imagination more constructively.

Major concerns about privacy have limited health professionals’ usage of popular social networking sites such as Facebook. However, the landscape of social media is changing in favor of more sophisticated privacy controls that enable users to more carefully manage public and private information. This evolution in technology makes it potentially less hazardous for health professionals to consider accepting colleagues and patients into their online networks, and invites medicine to think constructively about how social media may add value to (...) contemporary healthcare. (shrink)

There is a belief that exercise has a major role to play in the current health and wellbeing agendas. Consequently, health interventions are implemented based upon the recommendations of the ACSM and similar exercise research organizations. However this development has been challenged through both social and political perspectives. Specifically accusations of medicalization have been raised against the increasing relationship between the exercise and medical domains. The purpose of this article is to present a similar critique of the growing (...) emergence of a medical paradigm within the exercise domain. In this instance the focus will examine the relationship between exercise professional, exercise science and the proposed medical paradigm. Through the use of philosophical essay and systematic review of literature, it is argued that a continuing shift by exercise science to mirror the medical paradigm will cause a number of issues and potential hazards in the working practices of its professionals. (shrink)

In their article “Moral Hazards in Pediatrics” (2016), Brunnquell and Michaelson remind us that the child's perspective is of utmost importance when making health care decisions and express concern...

In their article “Moral Hazards in Pediatrics” (2016), Brunnquell and Michaelson remind us that the child's perspective is of utmost importance when making health care decisions and express concern...

Law is indispensable to the public's health. The twentieth century proved this true as law contributed to each of the century's ten great public health achievements: vaccination, healthier mothers and babies, family planning, safer and healthier foods, fluoridation of drinking water, the control of infectious diseases, the decline in death from heart disease and stroke, recognition of tobacco use as a health hazard, motor vehicle safety, and safer workplaces.The readers of this journal can give examples of the (...) relevant types of laws with ease: Jacobson v. Massachusetts, the 1905 U.S. Supreme Court case that upheld the constitutionality of compulsory vaccination; mandatory immunization for school admission; authorization of state prenatal care programs; mandatory fortification of foods; Title X of the Public Health Service Act; the Pure Food and Drugs Act of 1906; the Safe Drinking Water Act of 1974, and hundreds of state and local enactments regulating food; fluoridation ordinanceswater, and sanitation; the Surgeon General's warning notices on cigarette packs and restrictions on marketing tobacco; seat belt laws and mandated vehicle and highway design features; and laws like the federal Occupational Safety and Health Act of 1970 that regulate working conditions. (shrink)

McDonough Hall, Room 508, 600 New Jersey Ave, NW, Washington, DC 20001, USA; Email: gostin{at}law.georgetown.edu ' + u + '@' + d + ' '//--> Abstract As a consequence of rapid globalization, the need for a coherent system of global health law and governance has never been greater. This article explores the health hazards posed by contemporary globalization on human health and the consequent urgent need for global health law to facilitate effective multilateral cooperation in (...) advancing the health of populations equitably. It sets forth the first definition of the emerging field of "global health law." After explicating the central features identified in the definition, the article examines the "grand challenges" to reaching the full potential of global health law to advance human health in just and effective ways. CiteULike Connotea Del.icio.us What's this? (shrink)

Although Jonathan Herington, Angus Dawson, and Heather Draper offer valuable insights on how to conceptualize health hazards and understand their effects on populations, I resist the label “public health emergency” for obesity, and here is why. It is important—politically and pragmatically—to be judicious with words that have legal and real‐world consequences. Once a concept is stretched to encompass a broad swath of events, it loses its power. The broader the application of the term “public health emergency,” (...) the more it loses the core idea of an emergent event. Thus, framing a long‐simmering health hazard such as obesity as an emergency would mute the voices of public health authorities seeking a surge response to a truly emergent event, such as a rapidly spreading novel disease or a natural or man‐made disaster. (shrink)

Law is indispensable to the public's health. The twentieth century proved this true as law contributed to each of the century's ten great public health achievements: vaccination, healthier mothers and babies, family planning, safer and healthier foods, fluoridation of drinking water, the control of infectious diseases, the decline in death from heart disease and stroke, recognition of tobacco use as a health hazard, motor vehicle safety, and safer workplaces.The readers of this journal can give examples of the (...) relevant types of laws with ease: Jacobson v. Massachusetts, the 1905 U.S. Supreme Court case that upheld the constitutionality of compulsory vaccination; mandatory immunization for school admission; authorization of state prenatal care programs; mandatory fortification of foods; Title X of the Public Health Service Act; the Pure Food and Drugs Act of 1906; the Safe Drinking Water Act of 1974, and hundreds of state and local enactments regulating food; fluoridation ordinanceswater, and sanitation; the Surgeon General's warning notices on cigarette packs and restrictions on marketing tobacco; seat belt laws and mandated vehicle and highway design features; and laws like the federal Occupational Safety and Health Act of 1970 that regulate working conditions. (shrink)

A "moral hazard" is a market failure most commonly associated with insurance, but also associated by extension with a wide variety of public policy scenarios, from environmental disaster relief, to corporate bailouts, to natural resource policy, to health insurance. Specifically, the term "moral hazard" describes the danger that, in the face of insurance, an agent will increase her exposure to risk. If not immediately clear, such terminology invokes a moral notion, suggesting that changing one's exposure to risk after becoming (...) insured is morally problematic. This paper challenges that position. It argues that there is nothing inherently moral about the moral hazard. It does so by arguing against three proposed claims regarding the wrongness of the moral hazard: first, the view that conceives of it as deception; then, the view that conceives of it as cheating; and finally, the view that conceives of it as stealing. (shrink)

Background The world is urbanizing rapidly; more than half the world’s population now lives in urban areas, leading to significant transition in lifestyles and social behaviours globally. While offering many advantages, urban environments also concentrate health risks and introduce health hazards for the poor. In Bangladesh, although many public policies are directed towards equity and protecting people’s rights, these are not comprehensively and inclusively applied in ways that prioritize the health rights of citizens. The country is (...) thus facing many issues that raise moral and ethical concerns. Methods A narrative literature review was conducted between October 2016 and November 2017 on issues related to social justice, health, and human rights in urban Bangladesh. The key questions discussed here are: i) ethical dilemmas and inclusion of the urban poor to pursue social justice; and ii) the ethical obligations and moral responsibilities of the state and non-state sectors in serving Bangladesh’s urban poor. Using a Rawlsian theory of equality of opportunity to ensure social justice, we identified key health-related ethical issues in the country’s rapidly changing urban landscape, especially among the poor. Results We examined ethical dilemmas in Bangladesh’s health system through the rural–urban divide and the lack of coordination among implementing agencies. The unregulated profusion of the private sector and immoral practices of service providers result in high out-of-pocket expenditures for urban poor, leading to debt and further impoverishment. We also highlight policy and programmatic gaps, as well as entry points for safeguarding the right to health for Bangladeshi citizens. Conclusions The urban health system in Bangladesh needs a reform in which state and non-state actors should work together, understanding and acknowledging their moral responsibilities for improving the health of the urban poor by engaging multiple sectors. The social determinants of health should be taken into account when formulating policies and programs to achieve universal health coverage and ensure social justice for the urban poor in Bangladesh. (shrink)

By the mid-1960s, nonhuman primates had become key experimental organisms for vaccine development and testing, and was seen by many scientists as important for the future success of this field as well as other biomedical undertakings. A major hindrance to expanding the use of nonhuman primates was the dependency on wild-captured animals. In addition to unreliable access and poor animal health, procurement of wild primates involved the circulation of infectious diseases and thus also public health hazards. This (...) paper traces how the World Health Organization (WHO) became involved in the issue of primate supply, and shows how by the late 1960s concerns for vaccine development and the conservation of wildlife began to converge. How did the WHO navigate public health and animal health? What characterized the response and with what implications for humans and animals? The paper explores how technical standards of care were central to managing the conflicting concerns of animal and human health, biological standardization, and conservation. While the WHO’s main aim was to prevent public health risks, I argue that imposing new standards of care implied establishing new hierarchies of humans and animals, and cultures of care. (shrink)

In this article, we argue that the scope of bioethical debate concerning justice in health should expand beyond the topic of access to health care and cover such issues as occupational hazards, safe housing, air pollution, water quality, food and drug safety, pest control, public health, childhood nutrition, disaster preparedness, literacy, and many other environmental factors that can cause differences in health. Since society does not have sufficient resources to address all of these environmental factors (...) at one time, it is important to set priorities for bioethical theorizing and policy formation. Two considerations should be used to set these priorities: (1) the impact of the environmental factor on health inequality, and (2) the practicality of addressing the factor. (shrink)

An example of illegal trade is presented in the context of hazardous waste movement across internaional borders. It highlights the fact that unethical conduct can have negative enviromental health consequences, especially for improverished countries. The example exposes how ethical principles are breached through illegal trade in hazardous waste, and points to the role that environmental epidemiology plays in the assessment of risk associated with trade in hazardous waste.

In recent years more support has been given to the idea of Health Education and there are strong reasons for believing that such schemes of prevention may receive much more financial backing from governments. It is being realised, also, that many of our 'ills' may be attributed to an over-reliance on medical technology. There is reason to believe that in years to come the emphasis will be placed on the fostering of mental health in programmes of Health (...) Education enabling the individual to take a responsible attitude in learning how to seek out health hazards for himself without over-reliance on others. (shrink)

This article will examine the Catholic concept of global justice within a health care framework as it relates to women's needs for delivery doctors in the developing world and women's demands for assisted reproduction in the developed world. I will first discuss justice as a theory, situating it within Catholic social teachings. The Catholic perspective on global justice in health care demands that everyone have access to basic needs before elective treatments are offered to the wealthy. After exploring (...) specific discrepancies in global health care justice, I will point to the need for delivery doctors in the developing world to provide basic assistance to women who hazard many pregnancies as a priority before offering assisted reproduction to women in the developed world. The wide disparities between maternal health in the developing world and elective fertility treatments in the developed world are clearly unjust within Catholic social teachings. I conclude this article by offering policy suggestions for moving closer to health care justice via doctor distribution. (shrink)

In an earlier piece in these pages, I described the health effects of the still massive problem of global poverty: The poor worldwide face greater environmental hazards than the rest of us, from contaminated water, filth, pollution, worms, and insects. They are exposed to greater dangers from people around them, through traffic, crime, communicable diseases, sexual violence, and potential exploitation by the more affluent. They lack means to protect themselves and their families against such hazards, through clean (...) water, nutritious food, satisfactory hygiene, necessary rest, adequate clothing, and safe shelter. They lack the means to enforce their legal rights or to press for political reform. (shrink)

Environmental health research produces scientific knowledge about environmental hazards crucial for public health and environmental justice movements that seek to prevent or reduce exposure to these hazards. The environment in environmental health research is conceptualized as the range of possible social, biological, chemical, and/or physical hazards or risks to human health, some of which merit study due to factors such as their probability and severity, the feasibility of their remediation, and injustice in their (...) distribution. This paper explores the ethics of identifying the relevant environment for environmental health research, as judgments involved in defining an environmental hazard or risk, judgments of that hazard or risk's probability, severity, and/ or injustice, as well as the feasibility of its remediation, all ought to appeal to non-epistemic as well as epistemic values. I illustrate by discussing the case of environmental lead, a housing-related hazard that remains unjustly distributed by race and class and is particularly dangerous to children. Examining a controversy in environmental health research ethics where researchers tested multiple levels of lead abatement in lead-contaminated households, I argue that the broader perspective on the ethics of environmental health research provided in the first part of this paper may have helped prevent this controversy. (shrink)

In this paper we argue the need to reimagine research ethics frameworks to include notions of environmental sustainability. While there have long been calls for healthcareethics frameworks and decision-making to include aspects of sustainability, less attention has focused on howresearchethics frameworks could address this. To do this, we first describe the traditional approach to research ethics, which often relies on individualised notions of risk. We argue that we need to broaden this notion of individual risk to consider issues associated with (...) environmental sustainability. This is because research is associated with carbon emissions and other environmental impacts, both of which cause climate change health hazards. We introduce how bioethics frameworks have considered notions of environmental sustainability and draw on these to help develop a framework suitable for researchers. We provide a case study of data-driven health research to apply our framework. (shrink)

One of the major objectives in a democratic state is ensuring health security of the citizens including combating epidemic diseases. The subject matter of this article is the presentation and analysis of legal regulations regarding preventive vaccination in Poland, in particular the aspect of imposing a legal obligation and restricting parents’ right to express consent for medical intervention. The reflections made herein are aimed at finding an answer to the question whether the adopted legal solutions are admissible in a (...) democratic state with regard to ensuring health security. The purpose of the analysis is also to assess whether the abovementioned legal regulations have been formulated in a clear way and do not raise interpretation doubts and, consequently, whether they are comprehensible to the parents obliged to comply with them. As it follows from analysis of the legal provisions, parents must not refuse to subject a child to obligatory preventive vaccination and their consent is not required by law, both as regards the medical qualifying examination to exclude contraindications to performing vaccination and the vaccination itself. It is a legal obligation, from which exemption is only possible on grounds of certain medical conditions that would render vaccination inadvisable. The legal provisions that concern obligatory preventive vaccination in Poland, including in particular those referring to its enforceability, have not been formulated in a way that is sufficiently comprehensible to parents who are under the obligation of complying with them, irrespective of the fact that the language of the provisions of law should be clear and raise no interpretative doubts. In a democratic state the protection of public health against epidemic hazards justifies the implementation of legal solutions that restrict an individual’s freedom of self-determination, thus limiting the right of patients or their statutory representatives to grant or refuse consent for a medical intervention in the form of preventive vaccination – the purpose of this legal solution being to prioritize the safeguarding of state health security. It is vitally important to engage in a social dialogue with the purpose of convincing the public of the need for vaccination, its significance and its implementation for the better good. (shrink)

This article addresses how health professionals should monitor and safeguard their patients’ ability to participate in making clinical decisions and making subsequent decisions regarding the implementation of their treatment plan. Patient participation in clinical decision-making is essential, e.g. in self-care, where patients are responsible for most ongoing care. We argue that one common, fact-oriented patient education strategy may in practice easily tend to take a destructive form that we call error trawling. Illustrating with empirical findings from a video study (...) of consultations between clinicians and adolescent patients with diabetes, we argue on independent grounds that this strategy not only risks to overlook significant weaknesses in patient decision competence, but also to undermine patient capacity for decision-making and implementing care. In effect, this strategy for clinically monitoring and addressing the problem of fragile decision-making capacity brings hazards in need of address. We clo... (shrink)

Public health agencies undertake a broad range of health promotion and injury and disease prevention activities in collaboration with an array of actors, such as the community, businesses, and non-profit organizations. These activities are “multisectoral” in nature and centered on public health agencies that oversee and engage with the other actors. Public health agencies can influence the hazardous activities in the private sector in a variety of ways, “ranging from prohibition and regulation to volunteerism, and from (...) cooperation to cooption.” Hence, a public health agency that possesses the necessary administrative resources and authority is vital to the effective implementation of health policies and regulations.In the developing world, however, many state health agencies lack these basic capacities in dealing with critical health threats, including their ability to avert epidemics of communicable diseases arising from poor sanitary conditions. A serious constraint is the shortage of public health funding for health agencies in the developing world for typical agency functions. This is often aggravated by the transaction-intensive demands entailed in enforcing regulations among an array of private and public sector actors including individuals, businesses, and local bodies responsible for providing civic services. (shrink)

Preemption is a powerful strategy used by special interest groups to undermine strong, local public health standards. Currently, 20 states in the U.S. have preemption ordinances in place related to clean indoor air initiatives. These preemption laws are the direct result of an ongoing and aggressive campaign of tobacco companies to thwart clean indoor air initiatives, which ultimately, according to tobacco industry internal documents, cause significant reductions in their annual revenues. Clean indoor air policies have arisen from a greater (...) understanding of the documented health risks associated with exposure to secondhand smoke and action by local government to protect the public from these hazards. The efforts of the tobacco industry undermine local authority and seek to shift policy action to the state and federal levels, where the industry has greater political influence. (shrink)

Blue-collar workers throughout the world generally face higher levels of pollution than the public and are unable to control many health risks that employers impose on them. Economists tend to justify these risky workplaces on the grounds of the compensating wage differential (CWD). The CWD, or hazard-pay premium, is the alleged increment in wages, all things being equal, that workers in hazardous environments receive. According to this theory, employees trade safety for money on the job market, even though they (...) realize some of them will bear the health consequences of their employment in a risky occupational environment. To determine whether the CWD or hazard-pay premium succeeds in justifying alleged environmental injustices in the workplace, this essay (1) surveys the general theory behind the “compensating wage differential”; (2) presents and evaluates the “welfare argument” for the CWD; (3) offers several reasons for rejecting the CWD, as a proposed rationale for allowing apparent environmental injustice in the workplace; and (4) applies the welfare argument to an empirical case, that of US nuclear workers. The essay concludes that this argument fails to provide a justification for the apparent environmental injustice faced by the 600,000 US workers who have labored in government nuclear-weapons plants and laboratories. (shrink)

BackgroundInternational codes of ethics play an important role in guiding professional practice in developing countries. In the occupational health setting, codes developed by international agencies have substantial import on protecting working populations from harm. This is particularly so under globalisation which has transformed processes of production in fundamental ways across the globe. As part of the process of revising the Ethical Code of the International Commission on Occupational Health, an Africa Working Group addressed key challenges for the relevance (...) and cogency of an ethical code in occupational health for an African context through an iterative consultative process.DiscussionFirstly, even in the absence of strong legal systems of enforcement, and notwithstanding the value of legal institutionalisation of ethical codes, guidelines alone may offer advantageous routes to enhancing ethical practice in occupational health. Secondly, globalisation has particularly impacted on health and safety at workplaces in Africa, challenging occupational health professionals to be sensitive to, and actively redress imbalance of power. Thirdly, the different ways in which vulnerability is exemplified in the workplace in Africa often places the occupational health professional in invidious positions of Dual Loyalty. Fourth, the particular cultural emphasis in traditional African societies on collective responsibilities within the community impacts directly on how consent should be sought in occupational health practice, and how stigma should be dealt with, balancing individual autonomy with ideas of personhood that are more collective as in the African philosophy of ubuntu. To address stigma, practitioners need to be additionally sensitive to how power imbalances at the workplace intersect with traditional cultural norms related to solidarity. Lastly, particularly in the African context, the inseparability of workplace and community means that efforts to address workplace hazards demand that actions for occupational health extend beyond just the workplace.SummaryA stronger articulation of occupational health practice with advocacy for prevention should be an ethical norm. Ethical codes should ideally harmonize and balance individual and community needs so as to provide stronger moral authority guidelines. There is a need to consider an African Charter on Bioethics as complementary and strengthening of existing codes for the region. (shrink)

The United States-Vietnam War appeared on television at the time and later in Hollywood movies. It is being interpreted again through documentary film as part of an international effort to bring attention to the devastating and continuing health effects of the American wartime use of the herbicide Agent Orange in Vietnam. This article analyzes documentary films about Vietnam and their representation of Agent Orange, disabilities, children, and gender.

United States Air Force planes fly across mountains of green forest; behind them, fine white streams of chemical spray fill the sky. The planes fly alone or in formation covering wide swaths of the entire landscape. These images of the herbicide spraying during the United States-Vietnam War are ubiquitous in media material about Agent Orange, the most heavily used of the fifteen herbicides sprayed during the war. This representation of the war does not include guns, grenades, tanks, bombs, or dead (...) bodies. Instead, contemporary documentary filmmakers offer images of airplanes and chemical barrels to provide evidence of another weapon of war, pan dead and leafless forests in an otherwise lush landscape of green, and zero in on children’s deformed bodies to show the lasting environmental and health effects of Agent Orange. In this essay I share preliminary thoughts from my new project on Agent Orange and film in the United States and Vietnam. The bulk of social science writing on Agent Orange has focused on American veterans and their fight to secure benefits, while film scholars have analyzed the Vietnam War in Hollywood movies and television. I investigate documentary film, the transnational activism that generates these films, and the representations of gender, disabilities, bodies, history and culture within them. Here I offer a close reading of two turn-of-the-twenty-first-century documentaries about Agent Orange in Vietnam. (shrink)

The controversy over genetically modified [GM] organisms is often framed in terms of possible hazards for human health. Articles in a previous volume of this *Encyclopedia* give a general overview of GM crops [@Mulvaney2014] and specifically examine human health [@Nordgard2014] and labeling [@Bruton2014] issues surrounding GM organisms. This article explores several other aspects of the controversy: environmental concerns, political and legal disputes, and the aim of "feeding the world" and promoting food security. Rather than discussing abstract, hypothetical (...) GM organisms, this article explores the consequences of the GM organisms that have actually been deployed in the particular contexts that they have been deployed, on the belief that there is little point in discussing GM organisms in an idealized or context-independent way. (shrink)

The question whether rights to health care should be altered by smoking behaviour involves wideranging implications for all who indulge in hazardous behaviours, and involves complex economic utilitarian arguments. This paper examines current debate in the UK and suggest the major significance of the controversy has been ignored. That this discussion exists at all implies increasing division over the scope and purpose of a nationalised health service, bestowing health rights on all. When individuals bear the cost of (...) their own health care, they appear to take responsibility for health implications of personal behaviour, but when the state bears the cost, moral obligations of the community and its doctors to care for those who do not value health are called into question. The debate has far-reaching implications as ethical problems of smokers' rights to health care are common to situations where health as a value comes into conflict with other values, such as pleasure or wealth. (shrink)