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Reviewed by:
  • Public Health Law & Ethics: A Reader
  • Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT (bio) and William A. Wilson, BIS (bio)
Public Health Law & Ethics: A Reader, 2nd ed. Edited by Lawrence O. Gostin. Berkeley, CA: University of California Press, 2010. 564 pp.

Public Health Law & Ethics is an interdisciplinary anthology that explores the influence of legal and ethical domains on the practice of public health. The editor adopts this holistic perspective out of an appreciation for the limits of viewing public health from a strictly biological-epidemiological viewpoint.

The anthology is intended for a broad audience, including scholars, practitioners, and the informed public in the fields of law, public health, medicine, nursing, and public administration. The content was chosen with a primary focus on practice, and can be combined with a companion volume that focuses on theory and methods. The material is timely, with classical readings included for background.

Selections include scholarly articles, reports, and court cases, with the author-editor providing original articles and discussions. The editor takes an active role in discussion and analysis, rather than presenting a simple aggregate of relevant work with summary paragraphs. The content includes useful frameworks and critical thinking tools for approaching the topic. A good example is the section listing different types of analytic perspectives that can be applied to ethical problems. The editor does a good job organizing the material and framing the issues in context, which makes the reader a very good stand-alone primer for exploring the broad subject matter.

Public health practice is inherently regulatory in nature, so the material may seem politically biased toward paternalism and market controls. Important court cases include both majority and dissenting opinions, which help illustrate a variety of opinions and interests. The editor consistently presents a variety of viewpoints on the issues, and thoroughly explores the conflicts between public and individual interests.

Several topics in the book may be of special interest to JHCPU readers. Social justice in the forms of equal opportunities, access to health care, political enfranchisement, and distribution of wealth, are seen as core components of population well-being, along with traditional concerns such as sanitation and nutrition. These factors all tend to disproportionately affect the poor.

An example of how socioeconomic disparity can affect public health is the so-called brain drain that occurs when locally-trained medical personnel from underserved regions move to areas with better financial opportunities or working conditions. The end result is an even wider disparity in human capital between richer and poorer regions. [End Page 389]

The author cites evidence of an epidemiological shift in chronic, lifestyle-related "diseases of affluence." Obesity, diabetes, and lung cancer are on the rise in poorer populations, resulting in an increase in health disparities, since the poor already suffered a disproportionate risk for acute diseases. Access to alcohol, tobacco, and junk food in developing areas has far outrun access to affordable good food, health care, and education.

Poor and underserved populations are also at disproportionate risk in times of public health emergencies. Isolation and quarantine disproportionately affect the poor, who can less afford lost wages. In an epidemic, biological warfare, or bioterrorism situation there will be population disparities in exposure, susceptibility, and treatment.

Advances in the field of genomics are also likely to affect public health differently across populations. Advances in genetic detection and therapy will be expensive, and not available to the poor.

Public Health Law & Ethics is a comprehensive and balanced anthology that explores an important, complex, and dynamic field of study. The structure and content are most appropriate for graduate-level studies, although the material is reasonably accessible for undergraduate students. The reviewers highly recommend it for practitioners, instructors, and students in the fields of public health, law, and public administration.

Debra Rose Wilson and William A. Wilson

Debra Wilson is affiliated with the Middle Tennessee State University School of Nursing and William Wilson is affiliated with Tennessee State University.

Please address correspondence to Debra Rose Wilson, PhD, RN, 303 Luna Drive, Nashville, TN 37211-4120; (615) 833-3504; debrarosewilson@comcast.net.
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