SPECIAL SECTION: DISSECTING BIOETHICS | |
From Public Interest to Political Justice
RICHARD E.
ASHCROFT
a1
a1 Richard E. Ashcroft, Ph.D., is Leverhulme Senior
Lecturer in Medical Ethics at Imperial College of Science, Technology,
and Medicine, United Kingdom. He is working on ethical,
social, and policy issues in genetics, epidemiological research, and
clinical data management. Other research interests include healthcare
in the developing world, clinical trials, and the application of
“continental” philosophical thought in medical ethics
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In this paper I examine the ways in which the concept of
“public interest” is used in biomedical policymaking to
justify the preemption or overruling of decisions made by individuals
about their own, their family's, or group interests in the field
of healthcare. I discuss six variants of public-interest justification,
before going on to consider a concrete example, the use of personal
health data in health services management and medical research. I
distinguish between the global public interest and particular public
interests and consider critically how the global public interest can be
said to arise from private interests. I show that there is always room
for the private individual to defeat appeals to public interest on
moral grounds, and hence that public interest cannot have overriding
moral force. Hence, public-interest claims need to be considered as
political appeals about competing claims and conceptions of justice,
rather than as shortcuts to defining the universal solidary
interest.
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