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PoPulationand Public HealtH etHics

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How might the decision and/or action be evaluated?<br />

Net benefits of this course of action could be measured by economic activity<br />

and by assessing indicators of social health and well being. Declines in<br />

childhood morbidity and premature mortality would be a worthy goal. Infrastructure<br />

that supports health and safety and that could be expanded to<br />

include diseases other than those related specifically to occupational diseases<br />

would be an achievement. Education and training about health and safety<br />

would likely improve community health. A reduction in the earnings disparity<br />

between poor subsistence farmers and other stakeholders should be<br />

set as a short-term goal. Finally, if criminal acts were to be established, case<br />

law would then exist to prevent future such harms in the region/country by<br />

providing clear disincentives for such exploitation.<br />

reFerences<br />

1 Beauchamp, T. L. and Childress, J. F. (2008). Principles of Biomedical Ethics (Sixth<br />

Edition). Oxford, UK: Oxford University Press.<br />

2 Jonsen, A. R. (1991). Casuistry as methodology in clinical ethics. Theoretical<br />

Medicine. 12(4):295–307.<br />

3 Soskolne, C. L. (1991). Ethical Decision-Making in Epidemiology: The Case Study<br />

Approach. J Clin Epidemiol. 44(Suppl. 1):125S-130-S.<br />

Whose role is it to deal with societal determinants of health?<br />

185

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