A shot in the arm for preventive medicine


Overcoming negative attitudes to mass vaccination is vital if we are to address major threats to public health worldwide, explains Angus Dawson, Professor of Public Health Ethics at Birmingham.

When we hear the phrase ‘saving lives’ in a health care context we might first think about treating people for the disease which they already have. Indeed, such a focus is important, and there are many issues relating to the appropriate way to provide such care, how it is funded, and what our funding priorities might be. However, at least some health care is focused not on treatment but on preventing disease in the first place. Much public health activity, for example, attempts to identity threats to health not just from disease, but also from the social, political and physical environment. Once such threats are recognised, the emphasis often changes to seeking to prevent them.

Much of my own recent work has explored the ethical, legal and policy issues that emerge in this preventive context. There are a large number of important matters to discuss, such as what role does the state have in acting to protect the health of citizens where this restricts the freedom of a minority (e.g. smokers)? What is the appropriate role for surveillance of data about a population’s health? Should individuals always have to consent to their data being used in such a manner? Which, if any, identified health inequalities are important, and what should we do about them? What is the appropriate balance to be struck between prevention and treatment within a health care system?