TACKLING SOCIALLY DETERMINED DENTAL INEQUALITIES: ETHICAL ASPECTS OF CHILDSMILE, THE NATIONAL CHILD ORAL HEALTH DEMONSTRATION PROGRAMME IN SCOTLAND

Authors: SHAW, DAVID¹; MACPHERSON, LORNA²; CONWAY, DAVID³

Source: Bioethics, Volume 23, Number 2, February 2009 , pp. 131-139(9)

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Abstract:

Many ethical issues are posed by public health interventions. Although abstract theorizing about these issues can be useful, it is the application of ethical theory to real cases which will ultimately be of benefit in decision-making. To this end, this paper will analyse the ethical issues involved in Childsmile, a national oral health demonstration programme in Scotland that aims to improve the oral health of the nation's children and reduce dental inequalities through a combination of targeted and universal interventions. With Scotland's level of dental caries among the worst in Europe, Childsmile represents one of the largest programmes of work aimed at combating oral health inequalities in the UK. The areas of ethical interest include several contrasting themes: reducing health inequalities and improving health; universal and targeted interventions; political values and evidence base; prevention and treatment; and underlying all of these, justice and utility.

Keywords: social determinants; inequalities; disparities; dentistry; oral health; justice; Rawls

Document Type: Research article

DOI: http://dx.doi.org/10.1111/j.1467-8519.2008.00715.x

Affiliations: 1: University of Glasgow's Dental School and Centre for Applied Ethics and Legal Philosophy 2: Dental School, Faculty of Medicine, University of Glasgow and Childsmile Programme 3: University of Glasgow Medical Faculty Dental School, and NHS National Services Scotland

Publication date: 2009-02-01