Public health ethics at the Centers for Disease Control and Prevention (CDC)

Public health addresses complex problems that have multiple risk factors and competing stakeholder values. Public health operates at the population level where policies to protect the common good are often in conflict with on individual orientation. Moreover, incomplete scientific evidence and inconsistent health laws contribute to uncertainty about the best course of action. When ambiguity or value conflicts prevail, public health ethics challenges can arise. In 2005, the Centers for Disease Control and Prevention (CDC) established the Public Health Ethics Committee and created an Ethics Subcommittee within the CDC Advisory Committee to the Director. These two groups are working together to provide leadership in public health ethics at CDC and to integrate the tools of ethical analysis into the day-to-day activities and decisions of CDC staff. This presentation will provide an overview of the main components of CDC's public health ethics infrastructure and will describe efforts at CDC to establish an internal consultation process that is intended to develop competencies in the identification, analysis, and resolution of public health ethics issues. Such consults are convened when a program identifies an area of ethical uncertainty or conflict for which it wishes to obtain guidance. Public health ethics consults involve a systematic approach to clarifying the issues, determining the pertinent ethical principles and values, and identifying possible alternative courses of action. The presentation will also include a discussion of an assessment of CDC staff members' knowledge and comfort with using the tools of public health ethics.