These frameworks assume the need for complex trade-offs between moral concerns. There is rarely a clear right or wrong answer in ethics: rather, there are degrees of justifiability that depend on the moral commitments of the person doing the evaluating. Several strategies for trading off have been suggested by framework authors. These include: Ensure that action is necessary and in proportion to the problem.11 The greater the risk of harm, the stronger the evidence required to justify action.12 Consider all alternatives, choose the least burdensome or potentially harmful strategy; in particular, recognise that strategies range from least to most coercive and prefer less coercive strategies.11–14 It is more justifiable to prevent people from imposing harms on one another than to prevent people harming themselves (although in health that distinction is often not entirely clear).13–15 Prioritise fairness in distribution of burdens and benefits.11,12 Work on causes of ill health or the social determinants of health.12,14 Be transparent and open in decision-making, include everyone likely to be affected by a strategy, seek a mandate for intervention.11–13 Communicate honestly and build trust.11,13 Establish reciprocal relationships with citizens: if citizens are expected to act to improve community or public health, then they should be provided with the support or assistance they need to be able to fulfil that expectation.13

liberty-restricting actions may well be justified byvalues such as solidarit

Andthe obligation to fulfil human rights requires governmentto adopt appropriate legal, budgetary, and other measuresto ensure that individuals’ human rights are fully realized.

Often, a resolution can befound, but sometimes respectful disagreement will be theonly option

empirical realitie

Healthethics