Ethical issues in epidemiologic research and public health practice Steven

A rich and growing body of literature has emerged on ethics in epidemiologic research and public health practice. Recent articles have included conceptual frameworks of public health ethics and overviews of historical developments in the field. Several important topics in public health ethics have also been highlighted. Attention to ethical issues can facilitate the effective planning, implementation, and growth of a variety of public health programs and research activities. Public health ethics is consistent with the prevention orientation of public health. Ethical concerns can be anticipated or identified early and effectively addressed through careful analysis and consultation. Introduction A rich and growing body of literature has emerged on ethics in epidemiologic research and public health practice [1-11]. Recent articles have included conceptual frameworks of public health ethics and overviews of historical developments in the field [7,8,11]. Several important topics in public health ethics have also been highlighted [7,11,12]. This article provides an overview of ethical issues in epidemiologic research and public health practice for readers who do not necessarily have an in-depth knowledge of public health ethics. In the discussion that follows, a summary is provided of current definitions and conceptualizations of public health ethics and key ethical concerns in the field. Definitions and conceptualizations of public health ethics The starting point for conceptualizations of public health ethics has often been general definitions of public health, such as the definition provided by the Institute of Medicine in 1988: "Public health is what we, as a society, do collectively to assure the conditions in which people can be healthy." As noted by Childress et al. [8], "Public health is primarily concerned with the health of the entire population, rather than the health of individuals. Its features include an emphasis on the promotion of health and the prevention of disease and disability; the collection and use of epidemiological data, population surveillance, and other forms of empirical quantitative assessment; a recognition of the multidimensional nature of the determinants of health; and a focus on the complex interactions of many factors – biological, behavioral, social, and environmental – in developing effective interventions." Public health activities also include community collaborations and partnerships for health and the identification of priorities for public health action. Previous authors have identified ethical issues and core values in public health, and highlighted differences and similarities between public health ethics and other areas of bioethics [5,7]. Public health ethics, which can be defined as the identification, analysis, and resolution of ethical problems arising in public health practice and Published: 03 October 2006 Emerging Themes in Epidemiology 2006, 3:16 doi:10.1186/1742-7622-3-16 Received: 16 May 2006 Accepted: 03 October 2006 This article is available from: http://www.ete-online.com/content/3/1/16 © 2006 Coughlin; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.