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PoPulationand Public HealtH etHics

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practice<br />

contributing to “contraction.” Part of the resources thereby saved then<br />

could go towards uplifting developing country economies, thus reducing<br />

the gap between rich and poor countries, leading to a world of diminishing,<br />

rather than widening, disparities. If achieved, this would contribute<br />

to the attainment of the Millennium Development Goals (MDgs) as set in<br />

2000 by the United Nations.<br />

Finally, the precautionary principle encourages policies that protect human<br />

health and the environment in the face of uncertain risks. It has been defined<br />

as follows: “When an activity raises threats of harm to human health<br />

or the environment, precautionary measures should be taken even if some<br />

cause and effect relationships are not fully established scientifically.” 12 Its<br />

application would require concerted global action in the face of uncertainty<br />

on a scale of the harm expected through global warming and, indeed, global<br />

heating under existing climate change models. 13, 14 In tandem with this principle<br />

is the principle of solidarity. Under the Kyoto Accord, solidarity would<br />

trump precaution, and certainly local/regional short-term economic interests<br />

in order to act to prevent worsening trends in global warming. The tension<br />

between local short-term and global longer-term interests is, in turn, trumped<br />

by other principles, including intergenerational equity. Respect for autonomy<br />

(i.e., the right to self-determination) in the affected community appears to<br />

have been minimized and even marginalized to date in all actions taken by<br />

more-powerful interests.<br />

Identify the key stakeholders in the case and the most appropriate<br />

decision-maker(s) and/or legal authorities to approach the ethical<br />

issue, if applicable<br />

Key stakeholders include elected government officials who, on the one hand,<br />

represent regional values, but are not immune to pressure from powerful<br />

vested interests; federal and provincial government departments of health,<br />

environment and industry; the oil industry; and, the communities, local,<br />

downstream, national and global, that not only rely on a secure supply of<br />

oil, but also are at increased risk of harm from the pollution resulting from<br />

the industry. The medical officer of health for the region is also a key stakeholder,<br />

as is the provincial cancer board and its cancer registry.<br />

PoPulation anD <strong>Public</strong> <strong>HealtH</strong> <strong>etHics</strong><br />

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