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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.

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Correspondence to Theodore H. Tulchinsky MD, MPH.

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Key Words

  • Public health ethics
  • human rights
  • community health rights
  • solidarity
  • case studies health ethics
  • Eugenics
  • Genocide