Consequently, collective interests may have to override individual interests if necessary to protect the population s health. Another strategy for public health decisionmaking would be to allow the community to decide the merits of public health interventions. The problem, of course, is that the community is a complex abstraction often without clearly identified leaders who can speak on its behalf. In a representative democracy, the government makes decisions on behalf of the population. Ideally, the government would set public health policy by reference to scientific or objective knowledge, maximizing the value of health and wellbeing within the population.
Many forward thinkers urge greater community participation in public health decisionmaking.
They argue that public involvement will result in stronger support for health policies and encourage citizens to take a more active role in protecting themselves and the health of their neighbors. In summary, public health goods could be determined by public health authorities, using the best available scientific evidence of population health, and with active community participation. This chapter maps the relevant issues in these fields and describes the similarities and differences in goals, methods, and terminology. Chapter 2 provides many of the classic analytical studies in public health, together with modern controversies about the field s appropriate role and scope. Chapter 3 examines the emerging discipline of public health ethics, explaining the differences between traditional bioethics and the values inherent in more communal ways of thinking about health.