Green light ethics: Expediting decision making in public health practice

Public health ethics has carved out a distinctive niche for itself in relation to its allied fields (i.e., bioethics, clinical ethics, and research ethics). However, many public health practitioners view ethics as employed by these other fields. That is, they view ethical analysis largely as a normative process by which the ethically correct course of action is identified by determining whether it complies with ethical principles or with legal statutes.  This often leads to a focus on a compliance approach, what I call ‘stop sign ethics.’ This approach prevents violations of principles or laws by clearly demarcating parameters of action. The primary task in ‘stop sign ethics’ is to distinguish right from wrong, good from evil.  In this presentation, I will describe a contrasting approach to ethics, one which is well suited to addressing the ethical challenges associated with public health practice.  I refer to this contrasting approach as ‘green light ethics.’ Whereas ‘stop sign ethics’ makes the ethicist a judge, ‘green light ethics’ puts the ethicist in the role of an ethics counsel whose job is to help expedite the translation of public health values and science into action. ‘Green light ethics’ seeks to determine the best option from among all available alternatives while considering the sometimes competing values and interests of stakeholders, including subject matter experts. This approach is particularly useful when there are no legal statutes that specifically govern practice.  I will illustrate how these two ethics approaches can complement each other for addressing ethical challenges that arise in public health practice.