When vulnerable populations are disliked: How may ethical resources inform public health policy

Some vulnerable populations are actively disliked by a majority in a society, in ways that result in legal and policy regimes that oppress or restrict rights, benefits, and privileges within the vulnerable population, impacting the health of the population in its communities, families, and individuals. LGBT (lesbian, gay, bisexual, and transgender) populations are vulnerable populations, at risk for a wide variety of health disparities and inequities associated with sexual and gender minority identities. Public health research shows associations between state-sponsored legal and policy regimes that oppress or restrict lgbt persons, families, and communities, and health disparities in lgbt populations. While some jurisdictions are overcoming these barriers, disparities, and inequities, others are not. What ethical resources are available to discuss ethical issues involved with overcoming these barriers to the health of vulnerable populations? The Common Rule requires ethical assessment regarding vulnerable populations in the protection of research participants: does the Common Rule assist ethical reflection about the public health of vulnerable populations? A panel of experts in public health ethics described among several principles that public health should advocate and work for the empowerment of disenfranchised community members, aiming to ensure that the basic resources and conditions necessary for health are accessible to all: how does this discussion guide reflection and action about the health of vulnerable populations? What have we learned from our practice in the fields of public health research, public health policy, ethics consultation and expertise, community health advocacy, and other domains of public health practice?