PUBLIC HEALTH ETHICS

Public Health Ethics

Public Health Ethics

Introduction

The leading ethical framework in medicine is principlism. The four prima facie principles of respect for autonomy, beneficence, non-maleficence, and justice are widely recognized as shared professional values from which ethical rights and duties can be derived. Public health shares a commitment to these ethical principles but may weigh them differently in a particular circumstance due to an emphasis on collective risks and benefits. Additional principles such as utility and consideration of the common good are also characteristic of public health (Anand, 2004).

Ethical Principles of Public Health

Beneficence. One of the basic ethical mandates of public health is to provide benefits. In addition to protecting the population from immediate and future threats to health and safety, public health interventions and research should also avoid causing direct harm and make every reasonable attempt to minimize risks.

Respect for the Common Good. An individual's actions affect not only his or her own health but also the health of other humans, nonhuman organisms, and ecosystems. Most definitions of public health emphasize interdependence and collective action, obligation, and benefit. Focus on the common good (specifically population-level health outcomes) is the primary difference between the ethics of public health and medical ethics. Public health efforts often require pooled resources and cooperation. For example, vaccination can effectively prevent the spread of infectious disease (provide herd immunity) only if a majority of citizens participate.

Respect for Persons. Public health activities should respect individual rights, but autonomy must be balanced with promotion of the common good. In some cases, it may be necessary to override individual rights in order to protect community health. For example, in the case of infectious disease, the population-level benefits of quarantining exposed persons may justify a temporary infringement on personal freedom. However, public health officials must be certain ...