Public health ethics

‘Public health ethics involves a systematic process to clarify, prioritize and justify possible courses of public health action based on ethical principles, values and beliefs of stakeholders, and scientific and other information.’

(CDC, 2017)

Compared to medical ethics, public health ethics is a relatively new field. It shares many of the foundations of medical ethics, but with the crucial difference that it concerns the judgements and decisions that affect the health and wellbeing of populations.

Ethical conflicts can arise in the practice of public health in much the same way as they do in the field of medical research:

  • Controlling infectious diseases might restrict an individual’s freedom of movement.
  • Using routinely collected healthcare data to investigate the epidemiology of sensitive conditions (such as drug-resistant gonorrhoea) has implications for individual privacy and right to personal data.

Activity 4: Reflecting on Covid-19 responses

Timing: Allow about 15 minutes

There has been significant debate in many societies about the impact of lockdown measures to contain and suppress Covid-19 outbreaks. What are some of the public health ethical issues and conflicts that arise in response to Covid-19?

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Discussion

There are many issues that you might have considered.

For example, there is clear evidence that lockdown measures reduce the transmission of SARS-CoV-2, which means fewer cases and fewer deaths in these populations. These measures benefit vulnerable individuals, who do not suffer illness or death as a result, as well as their families, and wider society. This means that ethical principles of public health, such as social justice and fundamentality, are guiding action.

However, there are negative impacts of lockdown measures, such as increased incidence of mental illness and delays to surgical or other hospital procedures. Some of these impacts are more common in some populations than others. For example, while many people experience negative mental health impacts from lockdown measures, it is an ethical issue for children and young people in particular, who are generally at low risk of severe illness or death from Covid-19. This is consistent with the public health ethics principle of interdependence, but policy-makers need to balance the potential health risks to individual patients due to lockdown impacts against the public health benefits of lockdown measures.

Research ethics

1.2 Animal ethics