In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US.

In this book, public health ethicist Daniel S. Goldberg sets out to characterize the subjective experience of pain and its undertreatment within the US medical establishment, and puts forward public policy recommendations for ameliorating the undertreatment of pain. The book begins from the position that the overwhelming focus on opioid analgesics as a means for improving the undertreatment of pain is flawed, and argues instead that dominant Western models of biomedicine and objectivity delegitimize subjective knowledge of the body and pain in the US. This general intolerance for the subjectivity of pain is part of a specific American culture of pain in which a variety of actors take part, including not only physicians and health care providers, but also pain sufferers, caregivers, and policymakers. Concentrating primarily on bioethics, history, and public policy, the book brings a truly interdisciplinary approach to an urgent practical ethical problem. Taking up the practical challenge, the book culminates in a series of policy recommendations that provide pathways for moral agents to move beyond contests over drug policy to policy arenas that, based on the evidence, hold more promise in their capacity to address the devastating and inequitable undertreatment of pain in the US.

This progressive resource places concepts of social determinants of health in the larger contexts of contemporary health ethics and the evolution of social reform. It provides needed analysis of the larger causes behind the immediate causes of illness and epidemics, particularly injustice, systemic inequities, and the cumulative effect of compound disadvantages. This moral approach to collective and individual responsibilities-on the part of practitioners as well as the public-supports a sound blueprint for finding answers to longstanding global and local concerns. Readers are challenged to recognize the critical role of social determinants to their perception of health issues, controversies, and possibilities as the book: * Details the epidemiologic evidence regarding social determinants of health. * Key ethical implications of the evidence regarding social determinants of health. * Considers the role of risky health behaviors in determining population health outcomes. * Addresses ethical questions of priority-setting at the policy and practice levels. * Translates social determinants of health into health policy goals. Half textbook, half monograph, Public Health Ethics and the Social Determinants of Health Is geared toward students in MPH programs as well as public health professionals in diverse contexts such as local health departments and non-profit organizations. It informs public health scientists and scholars, and can also serve as an introductory text for students in public health ethics, or as part of a general applied ethics course.