Ethics in Public Health Practice

Abstract

This chapter outlines a perspective that can serve as a foundation for addressing ethical concerns in public health practice. It argues that ethics in public health practice is shaped by the mission of public health and that the ethical obligations of public health practitioners are grounded in their commitment to that mission and in their voluntary assumption of responsibility for the public's health. Society also has an interest in the public's health and that endorsement provides partial justification for infringing on certain individual rights for the sake of the common good. Though public health ethics is not as highly developed as clinical ethics, research ethics, or other subfields of bioethics, recent developments have made clear that it must make use of bioethical methods and concepts and incorporate ethical reasoning in decision-making processes. The resulting public health ethics will include expanded or modified concepts of justice and respect for persons, human rights, communitarianism, utilitarianism, and virtue ethics.

Are Contact Precautions ethically justifiable in contemporary hospital care?

“…The formal principle of justice demands that ‘equals should be treated equally’ and that benefits and costs or harms are fairly distributed or received. 1 Questions considering how equality is determined or characterised, and whether it is in fact realistic to attempt to treat people equally, have led to the development of numerous competing and distinct theories. 17 Within egalitarian theories, the concept of fair opportunity and unfair discrimination is founded on the premise that to base actions or policies on differences that the affected individual has no control over is not acceptable.…”

“…The need for more research into a range of infection prevention and control challenges has been suggested, 30,65 –67 and it is recognised that a reliance on quantitative methods to measure the effectiveness of Contact Precautions without qualitatively considering the impact on the lives of affected people fails to acknowledge and respect the integrity of the community and its autonomy. 1 Further qualitative analysis of the ethical issues surrounding the application of Contact Precautions would support a more holistic understanding of the topic.…”

“…The control of infectious disease is a key public-health objective which derives from the Sanitary Movement of the 18th and 19th centuries 1 and focusses on population health rather than the health and well-being of individuals. 2 Within accepted public-health paradigms, a person with an infection is bestowed the status of vector; they are a reservoir of the pathogen and can be responsible for facilitating its ongoing transmission to others.…”

What Do Ethical Guidelines for Epidemiology Say About an Ethics Review? A Qualitative Systematic Review

“…The difference between research and public health practice has rather a legal and institutional than essential character (E10). Some suggest that in case of doubt, whether a certain activity constitutes research or practice the question should be answered by an IRB/REC (McKeown and Leaner 2009 ).…”