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date: 15 July 2019

Abstract and Keywords

Cancer is the second-leading cause of death in the United States. Social and structural inequalities and poor public health infrastructure, low-quality treatment, and lack of patient engagement in health-related decision-making increase the cancer burden among some populations. This chapter details ethical challenges to alleviating the cancer burden due to these health disparities from a public health perspective. Specific challenges relate to the just distribution of resources (resource allocation), balancing clinician judgment with respect for patient autonomy, medical paternalism, and reducing the social inequalities that contribute to disparities in cancer diagnosis and outcomes. This chapter discusses these challenges in relation to cancer prevention, screening, and treatment. The focus is on the United States, but many of the issues raised are relevant to other high-income countries.

Keywords: cancer, health disparities, medical paternalism, resource allocation, public health ethics, public health infrastructure

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