Principles of the Ethical Practice of Public Health
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Consider how ethical principles and values can shed light on the decision to choose program components. In planning health programs, decision makers generally think about values and ethical principles such as social justice and equity, but often only consider them implicitly. Applied ethicists have observed that the result is a minimalist approach…anything that does not directly violate law or policy becomes ethical and acceptable…compliance with law and policy is necessary but not sufficient for an ethical decision…ethics is not simply about turning away from what is wrong or bad, but about turning towards what is right and good. In contrast to clinical and research ethics, in public health ethics society is the “patient,” rather than individuals.
Dawson and Verweijj frame the issues by identifying three salient features of public health that distinguish it from clinical and research ethics:
- The initiative usually comes from public health professionals, not individual patients.
- Personal autonomy is much less important in public health than in the clinic.
- Public health interventions may be so pervasive that they may affect all aspects of people’s lives, for example the lives of smokers in a society that has banned public smoking in restaurants and workplaces.