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Evidence-based Public HealthEffectiveness and efficiency$
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Amanda Killoran and Mike P. Kelly

Print publication date: 2009

Print ISBN-13: 9780199563623

Published to Oxford Scholarship Online: February 2010

DOI: 10.1093/acprof:oso/9780199563623.001.0001

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Ethics and public health: the ethics of intervention choices

Ethics and public health: the ethics of intervention choices

(p.169) Chapter 11 Ethics and public health: the ethics of intervention choices
Evidence-based Public Health

Lord Krebs (Contributor Webpage)

Harald Schmidt

Oxford University Press

This chapter summarizes some of the conclusions and recommendations that were published in the report Public health: ethical issues in November 2007. The context to the public health debate is set out in the first section, and the ‘stewardship model’ is presented and the role of evidence is considered. This model outlines the legitimate goals and constraints of liberal states in pursuing public health measures. The next section describes the ‘intervention ladder’, which is a tool that helps use of the stewardship model in practice. It enables an assessment of the acceptability of different interventions in terms of their level of intrusiveness and evidence that is required. The final section considers the case of obesity, which illustrates the role of both the stewardship model and the intervention ladder in policy and practice. The discussion emphasizes the need to consider in particular the situation of vulnerable groups such as children and the socio-economically disadvantaged, and underlines that public health issues concern not only tensions between the individual and the state, but also require consideration of the role of third parties such as industries.

Keywords:   public health, ethics of intervention, stewardship model, public health intervention, obesity

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