Equity and Population Health: Toward a Broader Bioethics Agenda‪.‬

Bioethics' traditional focus on clinical relationships and exotic technologies has led the field away from population health, health disparities, and issues of justice. The result: a myopic view that misses the institutional context in which clinical relationships operate and can overlook factors that affect health more broadly than do exotic technologies. A broader bioethics agenda would take up unresolved questions about the distribution of health and the development of fair policies that affect health distribution. In its early decades, bioethics concentrated on problems arising in two important areas: the dyadic, very special relationships that hold between doctors and patients and between researchers and subjects, and Promethean challenges--the powers and responsibilities that come with new knowledge and technologies in medicine and the life sciences, including those that bear on extending and terminating life. The dyadic relationships yield important goods, impose significant risks, are rife with inequalities in power and authority, and yet are bound by complex rights and obligations. They provide a rich field for ethics to explore. The Promethean challenges are the favorites of the media: how god-like can we become in our relations with people, with animals, and with our environment without losing our moral footing? They attract serious inquiries about how to use knowledge and technology responsibly for the individual and collective good. Unfortunately, they also form the frontline trenches for the contemporary culture wars.