Ethical principles and ethical issues in public health

Public health ethics considers moral dimensions of public health practice and research. While medical ethics dates back hundreds of years, and bioethics writings emerged in the 1960s and 1970s, ‘public health ethics’, articulated as such, did not appear significantly in the literature for several more decades. There has been great interest recently in defining public health ethics, examining how it resembles or differs from medical ethics or bioethics, outlining frameworks and codes, and providing conceptual and practical guidance on how ethics can inform public health practice and research. This chapter describes the emergence of public health ethics; work in bioethics with relevance for public health; the relevance of social justice theory in addressing public health problems; and discusses literature on ethics and public health research, including whether public health research ethics might differ from ethical guidance for other human research. The chapter concludes with an overview of ethics issues related to genetic research and emerging technologies.

Does India’s Menstrual Hygiene Management Scheme exclude the disabled?

The Menstrual Hygiene Scheme of the Government of India wishes to generate awareness among adolescent girls, and provide them with hygienic and affordable sanitary napkins. The scheme has been criticised for many reasons by various reviewers. However, we draw attention to a hitherto unaddressed gap that the scheme has effectively overlooked, the menstrual hygiene needs of disabled adolescent girls, and has thereby denied them their right to health and healthcare. This exacerbates health disparities, and raises questions of public health ethics. We conclude with recommendations on how to redress the situation and make the scheme more inclusive.

Solidarity as a Regulatory Principle for Digital Technologies Used in the Pandemic Response (Preprint)

UNSTRUCTURED In addition to existing epidemiological methods, the on-going COVID-19 pandemic requires effective approaches for controlling the disease spread. The use of digital technologies has been discussed in this context, and digital contact tracing technology (DCTT) and vaccine passport are representative examples of such technologies. Ethical discussions on the application of these technologies have noted privacy breach and undermining social trust as concerns, arguing that these two aspects should be balanced with the public benefits of technology application. Discussions of digital technologies, including DCTT, as a pandemic response have called for a new perspective on existing public health ethics. This viewpoint paper proposes that applying solidarity as a regulatory principle to digital technologies can offer ways to pursue privacy and public interest as complementary instead of competitive values. Existing studies and discussions of digital technologies in the COVID-19 context were explored, particularly those focusing on the utilization and ethical aspects of DCTT. The development of solidarity in biomedical ethics and its application to public health ethics were also considered. The conclusion was reached that the acceptability of DCTT can increase when privacy is secured, which results in increased overall effectiveness of the technology. This can be achieved by applying solidarity as a regulatory principle, which requires individuals to participate, while empowering the privacy and social trust of participating individuals at the national level. Thus, this paper presents an ethical approach based on the principle of solidarity that reciprocates the interests of individuals and the collective instead of making them compete. This approach is expected to pave the way for an extended framework for both the pandemic response and digital approaches in public health that empower privacy and social trust.

Solidarity and the Common Good

This chapter offers an account of individual rights and agency, and it considers both the liberal dimension and the communitarian dimension of public health ethics. It examines the relationship between social justice and social epidemiology and offers a particular interpretation of social justice as being crucially informed by a relational ethics of mutuality and solidarity. It provides a study premised on the hypothesis that relational theorizing and conceptualization developed in ecological epidemiology has its analogue in ethics. The chapter discusses how relational theorizing in both ethics and epidemiology can provide a promising pathway to a critical public health ethics. It considers the philosophy of epidemiology and the constitutive concepts guiding relational or social theorizing in the field.

Ethical issues for e-cigarette control policies in Australia

Although tobacco smoking in Australia is at a historical low, electronic cigarette (e-cigarette) use, especially among the youth is increasing. Policies around e-cigarette control in Australia are currently evolving, even during the pandemic, thus demonstrating its priority status. The current article discusses ethical issues for e-cigarette control policies in Australia using a public health ethics framework. The article is structured using the domains of the WHO-MPOWER framework of tobacco control to enable a comprehensive coverage of all elements of e-cigarette control policies in Australia. It highlights several ethical issues, from different stakeholder perspectives, and indicates moral and ethical tensions in different public health actions that might be considered in framing policies around e-cigarette control.