ETHICAL MODELS UNDERPINNING RESPONSES TO THREATS TO PUBLIC HEALTH: A COMPARISON OF APPROACHES TO COMMUNICABLE DISEASE CONTROL IN EUROPE

To purchase or authenticate to the full-text of this article, please visit this link: http://dx.doi.org/10.1111/j.1467-8519.2008.00698.x Byline: SABINA GAINOTTI (1), NICOLA MORAN (2), CARLO PETRINI (3), DARREN SHICKLE (4) Keywords: infectious diseases; public health ethics; public health law; Europe Abstract: ABSTRACT Increases in international travel and migratory flows have enabled infectious diseases to emerge and spread more rapidly than ever before. Hence, it is increasingly easy for local infectious diseases to become global infectious diseases (GIDs). National governments must be able to react quickly and effectively to GIDs, whether naturally occurring or intentionally instigated by bioterrorism. According to the World Health Organisation, global partnerships are necessary to gather the most up-to-date information and to mobilize resources to tackle GIDs when necessary. Communicable disease control also depends upon national public health laws and policies. The containment of an infectious disease typically involves detection, notification, quarantine and isolation of actual or suspected cases; the protection and monitoring of those not infected; and possibly even treatment. Some measures are clearly contentious and raise conflicts between individual and societal interests. In Europe national policies against infectious diseases are very heterogeneous. Some countries have a more communitarian approach to public health ethics, in which the interests of individual and society are more closely intertwined and interdependent, while others take a more liberal approach and give priority to individual freedoms in communicable disease control. This paper provides an overview of the different policies around communicable disease control that exist across a select number of countries across Europe. It then proposes ethical arguments to be considered in the making of public health laws, mostly concerning their effectiveness for public health protection. Author Affiliation: (1)Italian National Institute of Health, National Center for Epidemiology, Surveillance and Health Promotion (2)Social Policy Research Unit (SPRU) at the University of York in the United Kingdom (3)Italian National Institute of Health (4)University of Leeds in the United Kingdom Article note: Sabina Gainotti, National Institute of Health, National Centre of Epidemiology, Surveillance and Health Promotion, via Giano della Bella 34, Rome 00162, Italy. T: 00390649904245 F: 00390649904303, Email: sabina.gainotti@iss.it