Public health organizational ethics : Consumer and provider concerns in conversation

Ethical reflection on human wellbeing is ancient, and widespread through many cultural foundations and histories, with commentators throughout domains and levels of society (academic, political, religious, elite, popular, literate, non-literate). Ethical reflection on clinical health care and clinical research involving humans and animals - bioethics – has been an important discussion from the second half of the 20th century, primarily among elites, and particularly in across the American and European continents. Public health ethics has emerged largely within the 21st century, with numerous commentators paying attention to dimensions of ‘community', ‘trust', and ‘cultural competence' that respect consumers and other non-elite stakeholders and participants in the health of populations. These inclusive overtures are encouraging but incomplete if not vested within the codes and standards of public health organizations. We will (1) introduce briefly some resources significantly influencing formation of public health organizational ethics, in the US and in global contexts (2) compare and contrast among these resources, (3) identify examples of diffusion of ethical deliberation within public health organizations (e.g. HIV Community Planning with local and state public health departments in the United States), and briefly discuss how these may extend and expand the role, capacity, and efficacy of public health organizational ethics. A brief case description and analysis – regarding criminalization of HIV transmission - a topic of contemporary concern in US and global contexts - will summarize elements of the presentation as an ethical conversation among providers and consumers of public health.