Workshop review — Committed Professionals: Handling Obstacles to Ethics in Public Health

Matthew Prior

Abstract Public health professionals face tough ethical questions in our daily practice and need guidance on how to handle the ethical contours of our complex profession. Public health is a multidisciplinary field with professionals from epidemiology to education, medicine to microbiology, engineering to environmental sciences, veterinary medicine to virology, and many more. Public health professionals work in a variety of settings — public and private, state and local, national and international. We are professionals committed to social justice and health equity who bring our varied discipline-specific skills to bear on complex problems that affect health and wellbeing. Our ‘patient’ is the community as well as the individual. We come from a variety of ethical traditions, not all of which map well to the goals of public health. As a nascent field, public health ethics borrowed heavily from other ethical approaches in medicine and health. Numerous frameworks have extended these early approaches by adding a clear focus on justice — social justice and distributive justice — and on public beneficence — doing good for the community. In parallel, a public health code of ethics — the field’s ethical expectations of professionals — was developed in the early 2000s. APHA is working to revise the field’s code of ethics to encompass expectations for organizations as well as individuals. We must continue to develop tools and train public health professionals to identify, articulate, and handle the inevitable ethical dimensions of our field.

On Friday, November 13, Dr. Lisa M. Lee, Executive Director for the Presidential Commission for the Study of Bioethical Issues, presented a keynote address for The Future of Professional Ethics workshop series hosted by Indiana University‘s School of Public Health and the Poynter Center for the Study of Ethics and American Institutions.

The workshop event began with a panel discussion featuring Dr. Lee and Indiana University Bloomington faculty members Albert Gay, Jon Macy, and Antonio Williams of the School of Public Health, and Mark Bauman of Medical Sciences Program. This discussion focused on a number of ethical public health topics ranging from the Public Health Service Syphilis Study at Tuskegee project to health communication pertaining to e-cigarettes. The discussions sparked dialogue about the role of ethics in public health from the panelists and the audience of faculty and students alike.

Dr. Lee’s keynote presentation, “Committed Professionals: Handling Obstacles to Ethics in Public Health,” highlighted several key topics, including the evolution of public health ethics over the years, professional ethics in public health, and ethical obstacles and opportunities in public health. Dr. Lee emphasized the importance of being “good” (beneficent) public health professionals; some of their qualities, she noted, include accountability to the public they serve, transparency, and the ability to make ethical decisions when faced with real ethical conflicts. She highlighted some of the work of the Bioethics Commission on the topic of democratic deliberation as a strategy for coming to ethical conclusions when faced with conflicts.

Dr. Lee noted several barriers to public health ethics highlighted by a lack of ethics training in many schools on public health, poorly defined ethics competencies required by many professional accrediting organizations, and an outdated, but persistent, view of ethics as an obstacle to public health work. Further referring to the Bioethics Commission’s work, she noted that ethical considerations, when integrated “early and explicitly” in public health preparedness and practice, facilitate public health activities by anticipating potential concerns and providing decision-making tools to resolve conflicts should they arise.

Dr. Lee closed by suggesting some opportunities and resources for people to get involved in public health ethics, including IUB’s very-own Association for Practical and Professional Ethics (APPE).

This well-attended presentation shows how highly Indiana University students and faculty value professional and public health ethics. In attendance were representatives from a variety of schools, programs, and departments including business, medical sciences, kinesiology, and public health. The audience was engaged throughout and offered many thoughtful questions during the discussion period, including many from students with well-formed thoughts on ethics.

Dr. Lee and the Bioethics Commission staff would like to thank the School of Public Health and the Poynter Center for being such wonderful hosts and for the zeal in which it embraced this very important topic.

Matthew Prior
Communication and Outreach Lead
Presidential Commission for the Study of Bioethical Issues
November 24, 2015

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Ken Pimple

About Ken Pimple

I've been involved in the Association for Practical and Professional Ethics before its actual creation. I am coordinating the international conversation on the future of practical and professional ethics for APPE, and organizing five workshops that will be held at Indiana University in Bloomington in academic year 2014-15.

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