Hygiena 2015, 60(4):143-148 | DOI: 10.21101/hygiena.a1353

The Ethical Obstacles and Challenges of Hygiene and Epidemiology in the Context of a Contemporary Health Service

Vladimír Bencko
Univerzita Karlova v Praze, 1. lékařská fakulta, Ústav hygieny a epidemiologie, Praha

Medicine is a specific area that draws not only on empirical knowledge of sciences but also on principles from the humanities, and the fact that health and disease are not only exclusively categorised as natural science but as value based entities where it is necessary to maintain proportionality between the legitimate requirements of biomedical research and ethical requirements and the moral imperatives of medical practice. It is here that we find the niche for ethics and ethical approaches to solving unclear or disputed issues of our actions; questions that are very sensitively perceived by the public, often leading to a loss of confidence in both health care professionals and the health system but also in the whole social system as such. Ethical principles in medicine, including hygiene and epidemiology are based on two basic assumptions: the first is the professional ethic of responsibility, which ensures quality of care with a high degree of expertise from assisting physicians and prevention of possible harm (primum non nocere) and the second is the right to self-determination (individual autonomy) with the right to be informed. It likewise comprises informed consent based on clear information regarding planned diagnostic procedures, therapeutic and preventive measure and informed consent regarding epidemiological studies in which patient's cooperation is requested. The paper deals with methodological questions of ethical approaches to health related problems, stressing problems related to infections and chronic noncommunicable diseases of high incidence with a view to preventive measures.

Keywords: public health, hygiene, epidemiology, ethics

Received: December 2014; Accepted: September 30, 2015; Published: December 1, 2015  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Bencko V. The Ethical Obstacles and Challenges of Hygiene and Epidemiology in the Context of a Contemporary Health Service. Hygiena. 2015;60(4):143-148. doi: 10.21101/hygiena.a1353.
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. Šetka J. Relationship of medicine and physician toward patient at the advent of 3rd milénium. Sb Lék. l997;98(l):11-9.
    2. Kříž J, BenckoV, Cikrt M, Kříž B. Primární prevence a podpora zdraví v České republice: současné problémy, rizika a možná východiska. Prakt Lék. 1996;76(10):478-82.
    3. Frank AL. Scientific and ethical aspects of human monitoring. Environ Health Perspect. 1996;104 Suppl 3:659-62. Go to original source... Go to PubMed...
    4. Frenk J, Sepúlveda J, Gómez-Dantés O, McGuinness MJ, Knaul F. The New World order and international health. BMJ. 1997 May 10;314(7091):1404-7. Go to original source...
    5. BenckoV. Environment, health, primary prevention and quality of life. In: Lasker GE, Lomeiko V, editors. A design for peace: advances in systems research of peace: Proceedings of the International Symposium on Culture of Peace; 1997 Aug 18-21; Baden-Baden, Germany. Tecumseh: International Institute for Advanced Studies in Systems Research and Cybernetics; 1997.
    6. WMA Declaration of Sao Paulo on Pollution, adopted by the 30th World Medical Assembly Sao Paulo, Brazil, October 1976 and revised by the 36th World Medical Assembly Singapore, October 1984 and rescinded at the WMA General Assembly, Santiago 2005. Ferney-Voltaire: The World Medical Association. Available from: http://www.wma.net/en/30publications/10policies/20archives/p22/index.html.
    7. BenckoV. Současné etické problémy v epidemiologii prostředí. Epidemiol Mikrobiol Imunol. 1995;44(4):180-3. Go to PubMed...
    8. Šetka J. Přístup věřícího lékaře k nemoci a nemocnému. Prakt Lék. 1994;74(1):35-6.
    9. Gruber HG. Subjektivní nebo objektivní etika. Teolog Texty. 1994;(3):79-83.
    10. Honecker M. Qualität des Lenbens. In: Eser A, editor. Lexikon Medizin, Ethik, Recht. Freiburg im Breisgau: Herder; 1989. p. 873-9.
    11. Selbmann HK. Qualitätssicherung und Qualitätskontroll. In: Eser A, editor. Lexikon Medizin, Ethik, Recht. Freiburg im Breisgau: Herder; 1989. p. 880-5.
    12. Bencko V, Honzák R. Význam psychosociálních faktorů pro racionální management zdravotních rizik prostředí. Prakt Lék. 1997;77(8):379-81.
    13. BenckoV. Psychosomatic and psychosocial aspects of risk perception. In: Simeonov LI, Macaev FZ, Simeonova BG, editors. Environmental security assessment and management of obsolete pesticides in Southeast Europe. NATO science for peace and security series. Series C, Environmental security. Dordrecht: Springer; 2013. p. 85-90. Go to original source...
    14. Barsky AJ, Borus JF. Somatization and medicalization in the era of managed care. JAMA. 1995 Dec 27;274(24):1931-4. Go to original source...
    15. Wohl HP. Arzt und Patient. In: Sass HM, editor. Medizin und Ethik. Stuttgart: Reclam; 1989. p. 184-221.
    16. Bencko V. Člověk, prostředí a paragrafy. Prakt Lék. 1994;74(10):492-4.
    17. Vollmann J, Dörries A. Responsibility for the individual or the whole? Ethical considerations on medical responsibility. Z Arztl Fortbild (Jena). 1996 Oct;90(6):527-32. (In German.)
    18. Levine RJ. Ethics and regulation of clinical research. 2nd ed. Baltimore: Urban and Schwarzenberg; 1986.
    19. Bradley P, Burls A, editors. Ethics in public and community health. London: Routledge; 2000.
    20. Council for International Organizations of Medical Sciences; World Health Organization. International ethical guidelines for biomedical research involving human subjects. Geneva: CIOMS; 1993.
    21. Ptáček R, Bartůněk P a kol. Etika a komunikace v medicíně. Praha: Grada; 2011.
    22. Soskolne CL, Bertollini R. Ethical and philosophical issues in environmental epidemiology. Sci Total Environ. 1996;184(1-2):1-4. Go to original source...
    23. Soskolne CL, Jhangri GS, Hunter B, Close M. Interim report on the Joint International Society for Environmental Epidemiology (ISEE) - Global Environmental Epidemiology Network (GEENET) Ethics Survey. Sci Total Environ. 1996;184(1-2):5-11. Go to original source...
    24. BenckoV, Zelený T. Princip neziskovostí ve zdravotnictví: šance pro jeho trvale udržitelné financování? Tempus Medicorum (Olomouc). 2013;22(1):24-5.
    25. Želízko M, Janek B, Hrnčárek M, Pořízka V, KarmazínV, Malý J, et al. Intervenční kardiologie: co nabízí v roce 2011. Prakt Lék. 2011;91(1):42-8.
    26. BenckoV. Primární prevence nemocí: současná úskalí a šance. Tempus Medicorum (Olomouc). 2013;22(4):28-9.
    27. Schott H. Kronika medicíny. Praha: Fortuna Print; 1994.
    28. BenckoV, Šetka J. Etické nároky na postupy obvyklé v epidemiologických studiích vztahu prostředí a zdraví člověka. Prakt Lék. 1998;78(8):437-9.
    29. Rahu M, Vlassov VV, Pega F, Andreeva T, Ay P, Baburin A, et al. Population health and status of epidemiology: WHO European Region I. Int J Epidemiol. 2013 Jun;42(3):870-85. Go to original source... Go to PubMed...
    30. BenckoV. Toxoalergické komplikace vakcinace a odmítání očkování. Tempus Medicorum (Olomouc). 2013;22(12):20-1.
    31. Bencko V. Informed consent in the Czech Republic. Sci Total Environ. 1996;184(1-2):77-81. Go to original source...
    32. Williamson S. The vaccination controversy: the rise, reign and fall of compulsory vaccination for smallpox. Liverpool: Liverpool University Press; 2007. Go to original source...
    33. BenckoV. Odmítání očkování a falešné karty v rukou antivakcinátorů: vážný problém veřejného zdravotnictví. Hygiena. 2014;59(2):89-91. Go to original source...

    Return to the content