Public Health Ethics

Background

As the nation's leading public health agency, CDC primarily takes a population-based approach to public health, targeting communities or populations in its activities. The public health problems that CDC addresses are often complex, involving multiple risk factors and multiple stakeholders. There are also many different perspectives on how to prevent or help health concerns and promote well-being.

CDC staff use a variety of scientific tools in their work. They use epidemiology, behavioral and social science, communication science, laboratory science, and many others. Another critical tool for public health decision making and action is public health ethics. Public health ethics brings considerations, such as principles and values, to the discussion. Public health ethics uses a systematic approach to clarify, prioritize, and justify possible courses of public health action. These actions are based on ethical principles, values and beliefs of stakeholders, and scientific and other information.

CDC and public health ethics

What public health ethics are

Public health ethics can be broken down into a field of study and a field of practice. As a field of study, public health ethics seeks to understand and clarify principles and values which guide public health actions. Principles and values provide a framework for decision making and a means of justifying decisions. Because public health actions are often undertaken by governments and are directed at the population level, the principles and values which guide public health can differ from those which guide actions in biology and clinical medicine (bioethics and medical ethics) which are more patient or individual-centered.

As a field of practice, public health ethics is the application of relevant principles and values to public health decision making. In applying an ethics framework, public health ethics inquiry carries out three core functions, namely:

1. Identifying and clarifying the ethical dilemma posed.
2. Analyzing it in terms of alternative courses of action and their consequences.
3. Resolving the dilemma by deciding which course of action best incorporates and balances the guiding principles and values.

Goals and structure for public health ethics at CDC

The CDC Office of Science supports CDC's public health ethics capacity to foster an environment and culture that:

• Supports and develops ethical practices.
• Raises staff awareness of public health ethics
• Provides support for analyzing ethical issues.

Public health training links

To request a copy of the Facilitator Manual, please email PHEthics@cdc.gov.

• Good Decision Making in Real Time: Public Health Ethics Training for Local Health Departments
• Web-on-Demand e-Learning Module

Below are additional public health ethics cases that can be used in conjunction with this training manual:

• Emergency Preparedness: Impact of Regulatory Compliance and Resource Allocation Decisions on Laboratory Capacity
• Ensuring Biosafety/Biosecurity during a Public Health Emergency
• Short-course Zidovudine Compared to What? A Trial to Prevent Mother-to-Infant HIV Transmission
• Unsafe Injections: Duty to Warn?
• Use of Restraint and Physical Force by First Responders: Duty to Investigate and Educate?
• Ethical Considerations for Allocating Medical Countermeasures in an Anthrax Incident
• Policies for Restricting Use of Electronic Nicotine Delivery Systems (ENDS) in Indoor Public Spaces
• Public Health Ethics: Cases Spanning the Globe
• Narrative Ethics in Public Health: The Value of Stories

Resources