The 130th Annual Meeting of APHA

4190.1: Tuesday, November 12, 2002 - 2:30 PM

Abstract #42837

Focusing on principles of public health ethics

Craig M Klugman, PhD, Dept. of Health Ecology/Nevada Center for Ethics and Health Policy, University of Nevada Reno, MS 274, Reno, NV 89557-0036, 775-784-4041x229, cmk@unr.edu

Although bioethics has been a force in helping reshape medicine and patient care for over thirty years, its impact on issues of public health has not been as strong. Partly this lack is a result of the differences between public health and medicine and partly it comes from the different focuses of these two health fields. Broadly speaking, public health focuses on communities and prevention; medicine on individuals and acute care. Although principlism has many critics, medical practitioners have adopted principlism (autonomy, beneficence, nonmaleficence, and justice) as an ethical framework for practice. Despite its problems, principlism works and is popular because it’s easy to remember and apply in the field. Recent attempts to develop an ethics for public health have relied on adopting medical ethics, concentrating on expanding justice, or providing bulky lists of questions. I propose a set of principles for public health ethics that does not draw on medical ethics and offers the same ease-of-use as principlism. The principles of public heath ethics practice take a community perspective and include solidarity, benefit, tolerance and dignity. Solidarity means having a common vision for the society and that a community-level perspective is necessary. Fitness requires that public health practices be based in sound scientific methods and be effective. Tolerance means respecting cultures and their values when developing and deploying interventions. Dignity requires respecting human beings from a human rights perspective. In this presentation I will discuss these principles and apply them to public health cases to demonstrate how they function.

Learning Objectives:

Keywords: Bioethics, Ethics

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The "Medical Police": Autonomy and Paternalism in Public Health

The 130th Annual Meeting of APHA