The Ethics of Health Service Delivery: A Challenge to Public Health Leadership

1. Allocating Health Care Resources : A Moral Dilemma, Canadian Medical Association Journal, 132 (February 15, 1985), p. 466.

2. For a discussion of this problem, see Marilyn J. Littlejohn, Balancing Competing Health Needs, CRS Review: Public Health Policy and the Congress, Congressional Research Service, March 1989, pp. 23-24.

3. “Leadership Development for Health for All, ” address delivered to the Regional Conference on Health Development, SEARO/WHO, New Delhi, 1988.

4. Cited in Ellen Goodman, U.S. Pushing Tobacco Overseas, Sunday Star-Bulletin and Advertiser, March 1989, p. A13.

5. The Ethics of Paternalism in Public Health, Canadian Journal of Public Health, 78 (February 1987), p. 3.

6. The Universal University, World Health (April 1988), p. 22.

7. Tropical Forests: An Endangered Species, Der Spiegel, rept. World Press Review (May 1989), p. 36. Der Spiegel asks the question, “Do economic gains justify such largescale ‘ecocide’?”

8. Midyear Progress Report, The Governor's Health Promotion and Development Center, Honolulu, Hawaii, 1988, pp. 9-10.

9. The following ethical guidelines are adapted from Michael Josephson's article, Doing it Right : Principled and Practical Decision Making in the Trenches, (Los Angeles: The Josephson Institution for the Advancement of Ethics, 1988).

10. David Mechanic , Social Justice, in Health Care Policy in a Changing Environment, ed. Roger M. Battistella and Thomas G. Rundall (Berkeley, CA: McCutchan Publishing, 1978), p. 255.

11. Towards a Comprehensive Health Policy for the 1970s: a White Paper in Resolved: That the Federal Government Should Enact a Program of Comprehensive Medical Care for All American Citizens, House Document 92-375 (Washington, DC: Government Printing Office, 1972), p. 47

12. Edward Klebe, Promoting Health : What Can One Person Do?, CRS Review: Public Health Policy and the Congress, p. 20.

13. Public Education on AIDS: Not Only the Media's Responsibility, Hasting Center Report (August 1985), p. 28.

14. Health Promotion : Ethical and Social Dilemmas of Government Policy, Health Affairs (Summer 1986), p. 82.