Beginning life right: A public health perspective on ethical challenges facing pregnant woman, newborns, and children with special needs

The goal of public health is to gain knowledge that will help protect and promote the health of communities and populations. Unlike in medical ethics where individual autonomy is paramount, in public health ethics, the benefits to community may override an individual's autonomy. The Children's Health Act of 2000, passed by Congress and signed into law by former President Clinton, required the establishment of the National Center on Birth Defects and Developmental Disabilities (NCBDDD) at the Centers for Disease Control and Prevention (CDC). In April 2001, the NCBDDD was officially established to promote the health of babies, children and adults and to enhance individuals' potential for full, productive living. This presentation will focus on public health ethical challenges and applications at the NCBDDD and how both research and non-research public health studies can create ethical challenges. In particular, ethical issues will be addressed relating to pregnant women, newborns, and children with special needs during crises, such as floods, natural disasters and in preparations for infectious disease outbreaks, such as the 2009 H1N1 pandemic. Lastly, ethical considerations in genetic testing and newborn screening will be discussed.