Public health ethics and the accreditation of public health agencies

What is the role of ethics in efforts to accredit public health agencies? Emerging standards for accreditation of public health agencies do not adequately address consideration of public health ethics or public health research ethics, even though research is an essential public health service. This panel uses the Principles of the Ethical Practice of Public Health as a framework to explore different tools, such as quality management and evaluation, that can be used in accreditation. First, the Principles can provide rationale for including public health ethics as an explicit consideration in the development of accreditation standards. Justification provided in support of accreditation often cites the ethical value of accountability; however, application of the Principles demonstrates that other values are relevant, such as the role of accreditation in increasing transparency of decisions and fostering community trust. Second, the Principles are flexible, and allow public health ethics to be incorporated into a variety of different accreditation approaches, at both the local and state agency levels. The Principles do not require particular mechanisms, such as ethics committees, but allow for experimentation with various approaches to community involvement. Third, Principles are extensible, and can be applied in different areas of public health practice, ranging from traditional areas such as disease control to novel areas such as public health genomics. Finally, the Principles are compatible with movements to accredit particular programs, including efforts to accredit public health research ethics review. Presenters will keep their presentations short to allow audience members time to share their experiences.