Ethical implications of complexity theory and public health research ethics in the 21st century

The development of advanced bio-technology during the 20th century contributed to the development of new medical fields such as genomics and immunotherapy and has created novel ethical challenges for society. The increasing ability of bio-technology to intervene in complex biological processes creates ethical challenges that are due to the inherent characteristics of complex systems such as the uncertainty of predicting behavior and assigning responsibility. Part of the challenge of 21st century public health will be to develop an adequate ethical framework that will deal with the complexity inherent in interventions involving biological processes and society. Complexity theory's analysis of complex systems may offer a rational approach to identifying and analyzing the complexity faced by public health related research. Central to such an approach would be the concept of ‘responsibility.' Ethical approaches to the issue of responsibility are discussed, including the theories of Emmanuel Levinas, Hans Jonas, and Alisdair MacIntyre. An ethics of responsibility, as contained in the theory of Virtue Ethics and the notion of ‘professionalism' are proposed as a way to specify and apply the notion of responsibility as implied within complexity theory. An approach to public health ethics acknowledging the centrality of complexity, would lead to consistent ethical reasoning involving the technical detail of research ethics as well as its larger implications for society.