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Public Health Ethics Advance Access published online on October 13, 2009
Public Health Ethics, doi:10.1093/phe/php030
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© The Author 2009. Published by Oxford University Press. Available online at www.phe.oxfordjournals.org

Ethics and Epidemiology: Residual Health Inequalities

Gopal Sreenivasan*

Duke University

* Corresponding author: Duke University, 201 West Duke Building, Box 90743, Durham, NC 27708, USA. Email: gopal.sreenivasan{at}duke.edu.


  Abstract

This paper examines the fairness of avoidable inequalities in health. It contrasts two approaches to this question, a direct approach and an indirect approach. Most of the discussion focuses on the indirect approach advocated by Daniels, Kennedy and Kawachi (2000). Their argument that avoidable inequalities in health are not unfair when their causes are otherwise fair is criticised on two counts. First, it encounters a surprising difficulty when one attends carefully to the point at which ethics intersects with epidemiology here. Second, it fails to address the fundamental issue, which is whether any version of the direct approach is valid.


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