The mandate to assure and protect the health of the public is an inherently moral one. It carries
with it an obligation to care for the well being of others and it implies the possession of an element
of power in order to carry out the mandate. The need to exercise power to ensure health and at the
same time to avoid the potential abuses of power are at the crux of public health ethics.
Until recently, the ethical nature of public health has been implicitly assumed rather than explicitly
stated. Increasingly, however, society is demanding explicit attention to ethics. This demand arises
from: technological advances that create new possibilities, and with them, new ethical dilemmas;
new challenges to health such as the advent of human immunodeficiency virus; abuses of power,
such as the Tuskegee study of syphilis; and an increasingly pluralistic society in which we can no
longer simply adopt the values from a single culture or religion, but we must work out our common
values in the midst of diversity.
Historically, medical institutions have been more explicit about the ethical elements of their practice
than have public health institutions. The concerns of public health are not fully consonant with
those of medicine, however, thus we cannot simply translate the principles of medical ethics to pub-
lic health. For example, in contrast to medicine, public health is concerned more with populations
than with individuals, and more with prevention than with cure. Thus, the purview of public health
includes those who are not presently ill, and for whom the risks and benefits of medical care are not
immediately relevant.
What does a code of ethics accomplish?
A code of ethics for public health clarifies the distinctive elements of public health and the ethical
principles that follow from or respond to those distinct aspects. It makes clear to populations and
communities the ideals of the public health institutions that serve them. A code of ethics thus serves
as a goal to guide public health institutions and practitioners and as a standard to which they can be
held accountable.
Codes of ethics are typically relatively brief; they are not designed to provide a means of untangling
convoluted ethical issues. That process requires deliberation and debate over the multitude of factors
relevant to a particular issue. Nor does a code typically provide a means of resolving a particular dis-
pute. It does, however, provide those in a dispute over a public health concern with a list of issues
and principles that should be considered in the dispute.
Principles of the Ethical Practice of Public Health, Version 2.2
© 2002 Public Health Leadership Society
Rationale for a Public Health Code of Ethics
Rationale for a Public Health Code of Ethics
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