Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions
Identifieur interne : 000223 ( Pmc/Checkpoint ); précédent : 000222; suivant : 000224Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions
Auteurs : Sebastian F. Winter [Allemagne] ; Stefan F. Winter [Allemagne]Source :
- International Journal of Health Policy and Management [ 2322-5939 ] ; 2017.
Abstract
Url:
DOI: 10.15171/ijhpm.2017.67
PubMed: 29524950
PubMed Central: 5890066
Affiliations:
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<author><name sortKey="Winter, Sebastian F" sort="Winter, Sebastian F" uniqKey="Winter S" first="Sebastian F." last="Winter">Sebastian F. Winter</name>
<affiliation wicri:level="3"><nlm:aff id="A01">Faculty of Medicine, Charité - University Medicine Berlin, Berlin, Germany.</nlm:aff>
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<author><name sortKey="Winter, Stefan F" sort="Winter, Stefan F" uniqKey="Winter S" first="Stefan F." last="Winter">Stefan F. Winter</name>
<affiliation wicri:level="1"><nlm:aff id="A02">Centre for Public Health Care, Hannover Medical School, Hanover, Germany.</nlm:aff>
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<wicri:noRegion>Hanover</wicri:noRegion>
<wicri:noRegion>Hanover</wicri:noRegion>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions</title>
<author><name sortKey="Winter, Sebastian F" sort="Winter, Sebastian F" uniqKey="Winter S" first="Sebastian F." last="Winter">Sebastian F. Winter</name>
<affiliation wicri:level="3"><nlm:aff id="A01">Faculty of Medicine, Charité - University Medicine Berlin, Berlin, Germany.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Allemagne</country>
<wicri:regionArea>Faculty of Medicine, Charité - University Medicine Berlin, Berlin</wicri:regionArea>
<placeName><region type="land" nuts="3">Berlin</region>
<settlement type="city">Berlin</settlement>
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<author><name sortKey="Winter, Stefan F" sort="Winter, Stefan F" uniqKey="Winter S" first="Stefan F." last="Winter">Stefan F. Winter</name>
<affiliation wicri:level="1"><nlm:aff id="A02">Centre for Public Health Care, Hannover Medical School, Hanover, Germany.</nlm:aff>
<country xml:lang="fr" wicri:curation="lc">Allemagne</country>
<wicri:regionArea>Centre for Public Health Care, Hannover Medical School, Hanover</wicri:regionArea>
<wicri:noRegion>Hanover</wicri:noRegion>
<wicri:noRegion>Hanover</wicri:noRegion>
<wicri:noRegion>Hanover</wicri:noRegion>
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<series><title level="j">International Journal of Health Policy and Management</title>
<idno type="eISSN">2322-5939</idno>
<imprint><date when="2017">2017</date>
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<front><div type="abstract" xml:lang="en"><p><bold>Background:</bold>
There is ample evidence that since the turn of the millennium German health policy made a considerable
step towards prevention and health promotion, putting the strategies of ‘personal empowerment’ and ‘settings based
approach’ high on the federal government’s agenda. This phenomenon has challenged the role of ethics in health policy.
Concurrently, increasing relevance of the <italic>Concept of Human Dignity</italic>
for health and human rights has been discussed.
However, a direct relationship between Human Dignity and Public Health Ethics (PHE) has surprisingly not yet been
established.
</p>
<p><bold>Methods:</bold>
We here conduct a systematic ethical analysis of eminent German health prevention policy case-examples
between the years 2000–2016. Specifically, our analysis seeks to adapt and apply the principalism (autonomy,
beneficence, justice)-based <italic>Concept of Human Dignity</italic>
of Italian philosopher Corrado Viafora, contextualizing it with
the emerging field of PHE. To further inform this health policy analysis, index databases (PubMed, Google Scholar)
were searched to include relevant published and grey literature.
</p>
<p><bold>Results:</bold>
We observe a systematic approach of post-millennial health policy decisions on prevention and on defined
health targets in Germany, exemplified by (1) the fostering of the preparedness against pandemic infectious diseases,
(2) the development and implementation of the first cancer vaccination, (3) major legal provisions on non-smokers
protection in the public domain, (4) acts to strengthen long term care (LTC) as well as (5) the new German E-Health
legislation. The ethical analysis of these health prevention decisions exhibits their profound ongoing impact on social
justice, probing their ability to meet the underlying <italic>Concept of Human Dignity</italic>
in order to fulfill the requirements of
the principle of non-maleficence.
</p>
<p><bold>Conclusion:</bold>
The observed health policy focus on prevention and health promotion has sparked new public debates
about the formation of/compliance with emerging standards of PHE in Germany. We believe that the overall impact of
this novel policy orientation will gradually show over mid- and long-term periods, both in terms of improvements in
health system performance and concurrently in diagnostics, therapies and health outcome on individual patient level.
The <italic>Concept of Human Dignity</italic>
may soon play an even greater role in European PHE debates to come.
</p>
</div>
</front>
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<pmc article-type="research-article"><pmc-dir>properties open_access</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-ta">Int J Health Policy Manag</journal-id>
<journal-id journal-id-type="iso-abbrev">Int J Health Policy Manag</journal-id>
<journal-id journal-id-type="publisher-id">Kerman University of Medical Sciences</journal-id>
<journal-id journal-id-type="publisher-id">Int J Health Policy Manag</journal-id>
<journal-title-group><journal-title>International Journal of Health Policy and Management</journal-title>
</journal-title-group>
<issn pub-type="epub">2322-5939</issn>
<publisher><publisher-name>Kerman University of Medical Sciences</publisher-name>
</publisher>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">29524950</article-id>
<article-id pub-id-type="pmc">5890066</article-id>
<article-id pub-id-type="doi">10.15171/ijhpm.2017.67</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Human Dignity as Leading Principle in Public Health Ethics: A Multi-Case Analysis of 21st Century German Health Policy Decisions</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Winter</surname>
<given-names>Sebastian F.</given-names>
</name>
<xref ref-type="aff" rid="A01"><sup>1</sup>
</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Winter</surname>
<given-names>Stefan F.</given-names>
</name>
<xref ref-type="aff" rid="A02"><sup>2</sup>
</xref>
<xref rid="COR1" ref-type="corresp">*</xref>
</contrib>
</contrib-group>
<aff id="A01"><sup>1</sup>
Faculty of Medicine, Charité - University Medicine Berlin, Berlin, Germany.</aff>
<aff id="A02"><sup>2</sup>
Centre for Public Health Care, Hannover Medical School, Hanover, Germany.</aff>
<author-notes><corresp id="COR1"><label>*</label>
<bold>Correspondence to:</bold>
Stefan F. Winter Email: <email>Winter.StefanF@MH-Hannover.de</email>
</corresp>
</author-notes>
<pub-date pub-type="collection"><month>3</month>
<year>2018</year>
</pub-date>
<pub-date pub-type="epub"><day>10</day>
<month>6</month>
<year>2017</year>
</pub-date>
<volume>7</volume>
<issue>3</issue>
<fpage>210</fpage>
<lpage>224</lpage>
<history><date date-type="received"><day>23</day>
<month>12</month>
<year>2016</year>
</date>
<date date-type="accepted"><day>27</day>
<month>5</month>
<year>2017</year>
</date>
</history>
<permissions><copyright-statement>© 2018 The Author(s); Published by Kerman University of Medical Sciences</copyright-statement>
<copyright-year>2018</copyright-year>
<license><license-p>This is an open-access article distributed under the terms of the Creative Commons Attribution License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0">http://creativecommons.org/licenses/by/4.0</ext-link>
), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
</license-p>
</license>
</permissions>
<self-uri xlink:href="http://ijhpm.com">http://ijhpm.com</self-uri>
<abstract><p><bold>Background:</bold>
There is ample evidence that since the turn of the millennium German health policy made a considerable
step towards prevention and health promotion, putting the strategies of ‘personal empowerment’ and ‘settings based
approach’ high on the federal government’s agenda. This phenomenon has challenged the role of ethics in health policy.
Concurrently, increasing relevance of the <italic>Concept of Human Dignity</italic>
for health and human rights has been discussed.
However, a direct relationship between Human Dignity and Public Health Ethics (PHE) has surprisingly not yet been
established.
</p>
<p><bold>Methods:</bold>
We here conduct a systematic ethical analysis of eminent German health prevention policy case-examples
between the years 2000–2016. Specifically, our analysis seeks to adapt and apply the principalism (autonomy,
beneficence, justice)-based <italic>Concept of Human Dignity</italic>
of Italian philosopher Corrado Viafora, contextualizing it with
the emerging field of PHE. To further inform this health policy analysis, index databases (PubMed, Google Scholar)
were searched to include relevant published and grey literature.
</p>
<p><bold>Results:</bold>
We observe a systematic approach of post-millennial health policy decisions on prevention and on defined
health targets in Germany, exemplified by (1) the fostering of the preparedness against pandemic infectious diseases,
(2) the development and implementation of the first cancer vaccination, (3) major legal provisions on non-smokers
protection in the public domain, (4) acts to strengthen long term care (LTC) as well as (5) the new German E-Health
legislation. The ethical analysis of these health prevention decisions exhibits their profound ongoing impact on social
justice, probing their ability to meet the underlying <italic>Concept of Human Dignity</italic>
in order to fulfill the requirements of
the principle of non-maleficence.
</p>
<p><bold>Conclusion:</bold>
The observed health policy focus on prevention and health promotion has sparked new public debates
about the formation of/compliance with emerging standards of PHE in Germany. We believe that the overall impact of
this novel policy orientation will gradually show over mid- and long-term periods, both in terms of improvements in
health system performance and concurrently in diagnostics, therapies and health outcome on individual patient level.
The <italic>Concept of Human Dignity</italic>
may soon play an even greater role in European PHE debates to come.
</p>
</abstract>
<kwd-group><kwd>German Health Policy</kwd>
<kwd>Prevention</kwd>
<kwd>Human Dignity</kwd>
<kwd>Public Health Ethics</kwd>
<kwd>Bioethics</kwd>
<kwd>Multi-Case Study</kwd>
</kwd-group>
<counts><table-count count="3"></table-count>
<ref-count count="103"></ref-count>
<page-count count="15"></page-count>
</counts>
</article-meta>
<notes><p><bold>Citation:</bold>
Winter SF, Winter SF. Human dignity as leading principle in public health ethics: a multi-case analysis of 21st century German health policy decisions. Int J Health Policy Manag. 2018;7(3):210–224. doi:10.15171/ijhpm.2017.67
</p>
</notes>
</front>
</pmc>
<affiliations><list><country><li>Allemagne</li>
</country>
<region><li>Berlin</li>
</region>
<settlement><li>Berlin</li>
</settlement>
</list>
<tree><country name="Allemagne"><region name="Berlin"><name sortKey="Winter, Sebastian F" sort="Winter, Sebastian F" uniqKey="Winter S" first="Sebastian F." last="Winter">Sebastian F. Winter</name>
</region>
<name sortKey="Winter, Stefan F" sort="Winter, Stefan F" uniqKey="Winter S" first="Stefan F." last="Winter">Stefan F. Winter</name>
</country>
</tree>
</affiliations>
</record>
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