PoPulationand Public HealtH etHics

Case discussion in response to
an e. coli outbreak in wales
Leonard Ortmann, Ph.D. and Drue Barrett, Ph.D.
Public Health Ethics Unit, Office of Science Integrity,
Office of the Associate Director for Science,
U.S. Centers for Disease Control and Prevention
Atlanta, USA
Hsq3@CDC.goV
Introduction
This case illustrates failures relating to the violation of laws, professional ethics
and larger issues in public health ethics. On the surface, assigning blame in this
case appears straightforward. The butcher criminally disregarded food-safety
measures and, in a cover up, falsified records and lied to inspectors. However,
the case is not so simple. The food inspectors failed in their primary duty to
properly carry out food inspections. Senior government officials did not appropriately
monitor staff performance or provide guidance on inspection protocols.
A comprehensive analysis of this case requires examination of broader ethical
considerations, including issues about allocation of scarce resources and protections
owed to vulnerable populations. These broader issues will be explored
in a discussion of the three scenario shifts described in the case.
Adherence to the legally established regulatory mechanism would have
averted the outbreak by identifying problems with the butcher at a much
earlier stage. However, the inspectors were not properly trained nor did senior
officials have the appropriate experience to offer adequate oversight.
No one has a legitimate duty to perform tasks for which they have not been
trained and for which they lack the appropriate skills. It is the responsibility
of health officials to ensure that inspectors are competent and well trained
and that necessary follow-up occurs. Ensuring competency of the workforce
An E.coli outbreak in Wales
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