Skip to main content

Editorial: Why a Theme Issue on Public Health Ethics?

Abstract

This issue of Public Health Reviews is dedicated to exploring the origins of the modern dialogue on public health ethics, which are based on historic religious and humanistic origins and long held medical and public health values. The concept of solidarity is fundamental to public health ethics as health is not only an individual phenomenon, it is also a societal issue, and those working in health must have ethical guidelines within the law and civil protections of the courts and public opinion. However, in the 20th century, medical doctors provided leadership and participation in euthanasia and genocide, which peaked with the Holocaust during World War II. From these horrif c events emerged the Nuremberg Doctors Trials (1946), the Universal Declaration of Human Rights (1948), the United Nations Convention on the Prevention and Punishment of the Crime of Genocide (1948), the World Medical Association Declaration of Helsinki — Ethical Principles for Medical Research Involving Human Subjects (1964 and subsequently revised many times) to protect against such abuses. But the horrors continue to occur well into the 21st century with incitement and acts of genocide. Biomedical ethics of individual patient care and protection of human rights in research are vital outcomes of these international codes. Public health is responsible for population health, are its ethical base is not synonymous with individual bioethics. The ideas of societal solidarity, social inequalities, culture and physical environment all play a role in the epidemiology of health and disease. Such determinants are interdependent and influence, shape and control the health status of individuals and communities. In this issue of PHR we explore both gross violations of human rights in public health experimentation and in genocide of the last century. We also address current dilemmas of community rights versus individual rights in current public health. Ethical issues in public health apply both when evidence-based interventions are implemented as well as when there is neglect or failure to implement current best practices. The study and conversation of public health ethics are essential components of education of health professionals and the practice of public health.

References

  1. ABIM Foundation, American Board of Internal Medicine, ACP–ASIM Foundation, American College of Physicians-American Society of Internal Medicine, European Federation of Internal Medicine. Medical professionalism in the new millennium: a physician charter. Ann Intern Med. 2002;136:243–6. Available from URL: http://annals.org/article.aspx?articleid=474090 (Accessed 28 September 2013).

    Article  Google Scholar 

  2. Tulchinsky TH, Birt CA, Kalediene R, Meijer A. ASPHER’s values, vision, mission and aims: a working paper. ASPHER: December 2007. Available from URL: http://www.publichealthreviews.eu/show/a/90 (Accessed 9 July 2013).

    Google Scholar 

  3. Coleman, CH, Bouësseau M-C, Reis A. The contribution of ethics to public health. Bull World Health Organ. 2008;86:578. Available from URL: http:// www.who.int/bulletin/volumes/86/8/08-055954/en/index.html (Accessed 7 August 2012).

    Article  PubMed  PubMed Central  Google Scholar 

  4. Rothstein MA. The future of public health ethics. Am J Public Health. 2012;102:9. Available from URL: http://ajph.aphapublications.org/doi/full/10.2105/AJPH.2011.3003655 (Accessed 25 September 2012).

    Article  PubMed  PubMed Central  Google Scholar 

  5. Lee LM. Public health ethics theory: review and path to convergence. J Law Med Ethics. 2012;85–98.

    Google Scholar 

  6. Dawson A, Jennings B. The place of solidarity in public health ethics. Public Health Rev. 2012;34:65–79.

    Article  Google Scholar 

  7. Shuster E. Fifty years later: the significance of the Nuremberg Code. N Engl J Med. 1997;337:1436–40.

    Article  CAS  PubMed  Google Scholar 

  8. McKee M. A preface: how ethics failed: lessons for public health for all time Public Health Rev. 2012;34:93–5.

    Google Scholar 

  9. Lindert J, Stein Y, Guggenheim H, Jaakkola JJK, Strous RD. How ethics failed — the role of psychiatrists and physicians in Nazi programs from exclusion to extermination, 1933–1945. Public Health Rev. 2012;34:96–121.

    Article  Google Scholar 

  10. Last JM. Dictionary of Public Health. New York (NY): Oxford University Press; 2007.

    Google Scholar 

  11. Evans RJ. The Third Reich at War. New York (NY): Penguin Press; 2006.

    Google Scholar 

  12. Haque OS, De Freitas J, Viani I, Niederschulte B, Bursztajn HJ. Why did so many German doctors join the Nazi Party early? Int J Law Psychiatry. 2012;35:473–9.

    Article  PubMed  Google Scholar 

  13. Strous RD. Dr. Irmfried Eberl (1910–1948): mass murdering MD. Isr Med Assoc J. 2009;11:216–8.

    PubMed  Google Scholar 

  14. Kolb S, Weindling P, Roelke V, Seithe H. Apologising for Nazi medicine: a constructive starting point. Lancet. 2012;380:722–3.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Noack H. Governance and capacity building in German and Austrian public health since the 1950s. Public Health Rev. 2011;33:264–76.

    Article  Google Scholar 

  16. The Nuremberg Code. Trials of War Criminals before the Nuremberg Military Tribunals under Control Council Law No. 10. Nuremberg, October 1946–April 1949. Washington (DC): U.S. G.P.O, 1949–1953. Available from URL: http://www.ushmm.org/research/doctors/Nuremberg_Code.htm (Accessed 11 September 2013).

    Google Scholar 

  17. United Nations. The Universal Declaration of Human Rights. UN: Paris; 1948. Available from URL: http://www.un.org/en/documents/udhr/ (Accessed 19 July 2013).

    Google Scholar 

  18. United Nations. Convention on the Prevention and Punishment of the Crime of Genocide. UN: Paris; 9 December 1948. Available from URL: http://untreaty.un.org/cod/avl/ha/cppcg/cppcg.html (Accessed 9 September 2013).

    Google Scholar 

  19. United Nations. Remembrance and beyond. Available from URL: http://www.un.org/cyberschoolbus/holocaust/index.asp (Accessed 9 September 2013).

    Google Scholar 

  20. Richter ED. Commentary. Genocide: can we predict, prevent, and protect? J Public Health Policy. 2008;29:265.

    Article  PubMed  Google Scholar 

  21. Thomas J, Sage M, Dillenberg J, Guillory VJ. A Code of Ethics for public health. Am J Public Health. 2002;92:1057–9.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Jennings B, Kahn J, Mastroianni A, Parker LS (editors). Ethics and Public Health: Model Curriculum. The Hastings Center: Pittsbugh (PA); 2003.

    Google Scholar 

  23. Fauci AS. Preface: Evolving ethical issues over the course of the AIDS pandemic. Public Health Rev. 2012;34:19–24.

    Article  Google Scholar 

  24. El-Amin AN, Parra MT, Kim-Farley R, Fielding JE. Ethical issues concerning vaccination requirements. Public Health Rev. 2012;34:207–26.

    Google Scholar 

  25. Reverby SM. Ethical failures and history lessons: the U.S. Public Health Service research studies in Tuskegee and Guatemala. Public Health Rev. 2012;34:189–206.

    Article  Google Scholar 

  26. Carter SM, Cribb A, Allegrante JP. How to think about health promotion ethics. Public Health Rev. 2012;34:122–45.

    Article  Google Scholar 

  27. Coughlin SS, Barker A, Dawson A. Ethics and scientific integrity in public health, epidemiological and clinical research. Public Health Rev. 2012;34:80–92.

    Google Scholar 

  28. Teutsch S, Rechel B. Ethics of resource allocation and rationing medical care in a time of f scal restraint — US and Europe. Public Health Rev. 2102;34:227–36.

    Google Scholar 

  29. Gray S. The ethics of publication in public health. Public Health Rev. 2012;34: 174-88.

  30. Edwards N, Viehbeck S, Hämäläinen R-M, Rus D, Skovgaard T, van de Goor I, Valente A, Syed A, Aro AR. Challenges of ethical clearance in international health policy and social sciences research: experiences and recommendations from a multi-country research programme. Public Health Rev. 2012;34:156–73.

    Article  Google Scholar 

  31. Aceijas C. The ethics in substitution treatment and harm reduction. An analytical review. Public Health Rev. 2012;34:251–62.

    Google Scholar 

  32. Zusman SP. Water Fluoridation in Israel: ethical and legal aspects. Public Health Rev. 2012;34:237–50.

    Article  Google Scholar 

  33. Aceijas C, Brall C, Schröder-Bäck P, Otok R, Maeckelberghe E, Stjernberg L, Strech D, Tulchinsky TH. Teaching ethics in schools of public health in the European Region: findings from a screening survey. Public Health Rev. 2012;34:146–55.

    Google Scholar 

  34. US Presidential Commission on Bioethical Issues. Moral science: protecting participants in human subjects research. Washington (DC): US Presidential Commission for the Study of Bioethical Issues; December 2011. Available from URL: http://bioethics.gov/sites/default/fles/Moral%20Science%20June%202012.pdf www.bioethics.gov (Accessed 10 January 2013).

    Google Scholar 

  35. Johnson CJ. Female inmates sterilized in California prisons without approval. Center for Investigative Reporting. 7 July 2013. Available from URL: http://cironline.org/reports/female-inmates-sterilized-california-prisons-without-approval-4917 (Accessed 9 September 2013).

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Open Access  This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.

The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/.

The Creative Commons Public Domain Dedication waiver (https://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

Reprints and permissions

About this article

Cite this article

Tulchinsky, T.H., Flahault, A. Editorial: Why a Theme Issue on Public Health Ethics?. Public Health Rev 34, 1 (2012). https://doi.org/10.1007/BF03391653

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/BF03391653

Key Words