A public health ethics approach to non-communicable diseases.

Although bioethicists have written about public health problems for many decades (e.g., Faden and Faden 1978; Bayer and Moreno 1986), public health ethics as a distinct field is not much older than the Journal of Bioethical Inquiry (JBI) itself. Around 2000, there was a rapid increase in the number of ethicists writing about public health problems (e.g., Kass 2001; Upshur 2002) as well as engagement of public health practitioners with ethical dilemmas and questions (e.g., Thomas et al. 2002; Jennings et al. 2003). Public health ethics has tended to focus on communicable diseases, pandemics, contagion, and crises. This is not surprising given the acute problems they raise, not least questions regarding coercion and harm to others. However, in public health policy and practice, there is increasing attention to the significance of non-communicable diseases. This concern was sufficient to stimulate the second only United Nations high-level meeting on a health issue in the history of that organization, held September 2011 in New York (United Nations Secretary-General 2011). This meeting produced official acknowledgement and agreement between member states that worldwide changes in prevalence of non-communicable diseases such as diabetes, cardiovascular disease, cancer, and respiratory illnesses are associated with particular kinds of development and that prevention of these diseases is an important global political and economic challenge.