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S. Holland 2007: Public health ethics. Cambridge: Polity Press. 214 pp, £15.99 paperback. ISBN:978-07456-3303-9.

Published online by Cambridge University Press:  01 January 2009

Cath Fenton*
Affiliation:
Public Health Enfield PCT Holbrook House, Cockfosters RoadBarnet EN4 0DR, UK
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Abstract

Type
Book Review
Copyright
Copyright © Cambridge University Press 2009

This book is a thorough introduction to the major philosophical theories underpinning public health practice. The book is split quite distinctly into two parts, both providing many practical examples of the relevance of philosophical theories to public health activities. The first part of the book details the moral and political philosophies pertinent to public health ethics. The second part looks at the ethical dimensions of selected public health activities. The book is clearly structured, though for those who want to dip in and out, the index provides a better guide than the brief table of contents.

The introduction provides a history of the origins of public health ethics and clarifies how this differs from medical ethics or bioethics. Part 1 of the book considers the moral philosophy theories consequentialism and neo-consequentialism. Principles are explained with reference to public health examples, thus clarifying the situation for those of us with limited philosophical knowledge. This section concludes with a chapter considering political philosophy detailing both liberalism and communitarianism.

The second part of the book looks at a mixture of public health issues, namely epidemiology, the concept of health, health promotion and behaviour modification as well as the more specific activities of immunisation and screening.

I was particularly drawn to the chapter on epidemiology but felt it could form part of a larger chapter on informing public health, to include, for example, surveillance, health needs assessment, the use of qualitative data and disease registers. Some of these issues are mentioned in passing but could be more detailed. This section could also neatly lead onto the ethical debate around evidence-based practice.

The next chapter discusses the concept of health. I was encouraged to see mental health discussed, as so often this is omitted from discussions on public health. The chapter introduces the theory of health promotion, and this is expanded in the following chapter in the context of behaviour modification.

I found the chapters on immunisation and screening most relevant. I would have also liked to see other practical issues discussed in a similar way; for example, other health protection matters such as exclusion from work/school following diagnosis of an infectious disease and ethical consideration of informing contacts of infectious disease cases.

The book meets its aim of introducing and discussing both the theoretical perspectives and main issues within public health ethics. It is promoted as an ideal textbook for students taking courses in public health ethics. I feel it would also be of interest to those studying for the Faculty of Public Health’s examinations. It is an interesting and thought-provoking book, but could be extended to cover other public health activities and roles.