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Ethics in Public Health: Principles and Applications, Study notes of Ethics

The concept of ethics in public health through various definitions and principles. It covers medical ethics, public health ethics, research ethics, and the philosophy of public health. the importance of addressing the causes of disease, respecting individual rights, seeking community input, and striving for health for all. It also touches upon the use of power in public health, ethical conduct of research, and conflicting public health goals.

What you will learn

  • What are the principles of ethical practice in public health?
  • What is the definition of ethics in public health?
  • How does the philosophy of public health inform ethical decision-making?
  • What is the role of ethics in medical research?
  • What are the ethical considerations when implementing public health policies and interventions?

Typology: Study notes

2021/2022

Uploaded on 09/12/2022

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Definition of Ethics (1)
The discipline of dealing with what is good
and bad, with moral duty and obligation
A set of moral principles or values
The principle of conduct governing an
individual or group
Webster’s Ninth New Collegiate Dictionary
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Definition of Ethics (1)

  • The discipline of dealing with what is good

and bad, with moral duty and obligation

  • A set of moral principles or values• The principle of conduct governing an

individual or group

  • Webster’s Ninth New Collegiate Dictionary

Definition of Ethics (2)

A Dictionary of Epidemiology, 4th ed, 2001

(J.M. Last (ed))

The branch of philosophy that dealswith distinctions between right andwrong – with the moralconsequences of human actions

PRINCIPLES OF ETHICAL

PRACTICE OF PUBLIC HEALTH (1)

(adapted from PH Leadership Society, 2002)

  • PH should address the causes of disease

and requirements for health

  • PH must respect the rights of individuals• PH should seek input from communities• PH should strive for health for all

PRINCIPLES OF ETHICAL

PRACTICE OF PUBLIC HEALTH (2)

  • PH should base policies on evidence• PH should obtain community consent for

implementation of policies/interventions

  • PH should respond to health problems in a

timely manner

  • PH must respect diverse values, beliefs

and cultures

PRINCIPLES OF PUBLIC HEALTH^ • Interdependence of individuals is the

essence of community

  • The health of the individual is tied to their

community

PHILOSOPHY OF PUBLIC HEALTH (1)

  • People have a right to the resources

necessary for health

  • PH leaders need to identify the

fundamental requirements for healthycommunities; e.g., safe parks/recreationalareas

PHILOSOPHY OF PUBLIC HEALTH (3)^ • Scientific evidence should provide the basis

for policy decisions

  • It is unethical to approve and support poor

quality research

  • In the absence of scientific evidence PH

values should inform policy decisions

  • Given the necessary knowledge and essential

resources individuals will act responsibly

PUBLIC HEALTH AND POWER^ • The need to use power to ensure health• What should be the limits of that power?

PUBLIC HEALTH ACTION (2)

  • Personal autonomy vs. community action e.g.

fluoridation of water

  • Regulation of personal behavior e.g.

mandatory condom use in brothels (Thailand,Nevada)

  • Proportionality – cost versus benefit

(especially relevant for developing countries)

CONFLICTING PUBLIC HEALTHCONFLICTING PUBLIC HEALTH

GOALSGOALS

  • Protect the uninfected• Protect the infected

ETHICAL CONDUCT OF

RESEARCH

Justification of Research in Humans (1)

-^

Impossible to reach the importantconclusions without studying humans^ 

Human physiologic studies, because

animal responses often are not the same

Epidemiological studies, because theythey depend on human susceptibilitiesand human interactions

Agents for treating humans becauseanimal experiments don’t always predictresults

History of the EthicalResearch Movement

The Nuremberg Code

(World War II)

-^

Informed consent is absolutely essential

-^

Qualified researchers must use appropriateresearch designs

-^

There must be a favorable risk/ benefit ratio

-^

Participants must be free to stop at anytime