217890 Ethics of Public Health Surveillance

Tuesday, November 9, 2010 : 10:30 AM - 10:50 AM

Angus J. Dawson, PhD , Centre for Professional Ethics, Keele University, Staffordshire, United Kingdom
This paper discusses the ethical justification of surveillance as a core methodology for public health. First, surveillance is distinguishing from the related concepts of screening and research. Second, it is argued that there are a number of possible reasons to support the use of surveillance, but these must be articulated and defended: surveillance contributes to the monitoring, maintenance and improvement of population health; it provides the opportunity to detect and assess the current scale of health problems, as well as the effectiveness of any interventions to address them; and it is of key relevance in priority-setting decisions. Such justifications for surveillance are powerful. However, a number of ethical concerns have been raised as surveillance activities may override or threaten some important ethical considerations. For example, informed consent may not be sought, or transfer of patient information for reasons other than those related to direct individual clinical care may occur. Where such issues arise in a research context, there are procedures in place to protect individuals from various harms, but similar protections do not tend to exist for surveillance. Of course, surveillance in such situations may still be justified but the case needs to be made. This paper outlines a framework to aid deliberation by persons/committees required to consider ethical issues related to proposed surveillance activities in public health. The arguments are illustrated by using the example of a childhood weights surveillance activity recently proposed in Ontario, Canada.

Learning Areas:
Epidemiology
Ethics, professional and legal requirements
Planning of health education strategies, interventions, and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related laws, regulations, standards, or guidelines
Public health or related public policy

Learning Objectives:
1. Identify some differences between surveillance, research and screening 2. Evaluate the key ethical issues relating to public health surveillance 3. Analyze some ethical objections to surveillance as well as how surveillance may be defended from them

Keywords: Surveillance, Ethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an internationally respected expert in public health ethics, a professor at a University in the UK, and co-editor-in-chief of the journal 'Public Health Ethics'.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.