Lost in translation: An ethics based model to bridge science to public health policy.

摘要

The premise of this thesis is that success in reversing the growing epidemic of diseases related to chronic inflammation in the body will not be realized unless those designing and implementing interventions to benefit public health ensure ethics based guidelines become integrated as an analytical foundation to both support and justify action fighting chronic inflammatory disease. One such ethics based model proposed by Nancy E. Kass, ScD is examined throughout this thesis to illustrate how applying ethics based analytical tools can successfully translate cures to chronic inflammatory disease and stop its upward trend in the US. Scientific research has provided significant insight into how to reverse the trend of this disease but the facts revealed by science can become lost in translation to public understanding, resulting in public health policy that fails to achieve its stated goals. The modern diseases of inflammation are unlike diseases of the past where an outside infectious agent was identified and cured by medicine. This disease process is fueled by overindulgence of food, poor diet selection (made plentiful by modern technology) and lifestyles of low physical activity. This environment, pervasive in affluent countries, is exacerbated through mistranslation of science, creating poor choices made on the individual level as well as at the most complex system level. This mistranslation along with failure to utilize knowledge of process improvement often generates public health policy that is paternalistic and restrictive in selective areas, while permitting other processes that feed the problem to continue unabated. A leading example of the latter category is the dietary supplement industry, which uses techniques of marketing and advertising enabled by regulatory agencies that can cloud individual choices for products by implying cure and relief from disease without being held accountable to prove safety or efficacy. This thesis explains that, by distinguishing between common versus special causes (a concept initially developed for improving manufacturing processes), and applying an ethics based methodology can generate public health policy that increases the individual's ability to protect his or her own health while systematically improving the processes that feed the upward trend of chronic inflammatory disease in the US.