PoPulationand Public HealtH etHics

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practice that the professional places the client’s interests above his own. This higher standard enables the vulnerable client to place trust in the professional. In our case, although the public is not an individual client, the professional food inspector acts as a steward of a public trust, namely, protecting the food supply from contagion or poison, to which all are susceptible or vulnerable. In this regard, we can propose a simple ratio: the greater the degree of susceptibility or vulnerability (which varies in different situations), the greater the obligation to protect and place the interest of the public over personal interest and, consequently, the greater culpability and penalty for dereliction of duty. This analysis does not attempt to provide specific recommendations. Doing so would require a more penetrating analysis of the facts of the case and a deeper understanding of local conditions and contexts. Hopefully, we have provided sufficient guidance to begin examining the ethical issues raised by this case. reFerences 1 Public Health Leadership Society. (2002). Principles of the Ethical Practice of Public Health. Retrieved from: http://phls.org/CMSuploads/Principles-of-the- Ethical-Practice-of-PH-Version-2.2-68496.pdf 2 Pennington, H. (2009). The Public Inquiry into the September 2005 Outbreak of E. coli O157 in South Wales. Cardiff, Wales: HMSO. Retrieved from: www. ecoliinquirywales.org 3 McKie, J. and Richardson, J. (2003). The rule of rescue. Social Science and Medicine, 56(12):2407–19. 4 Ruger, J. P. (2010). Health and Social Justice, New York, NY: Oxford University Press. 5 Jennings, B. and Arras, J. (2010). Ethical Guidance for Public Health Emergency Preparedness and Response: Highlighting Ethics and Values in a Vital Public Health Service. Prepared for the Ethics Subcommittee of the Advisory Committee to the Director, Centers for Disease Control and Prevention, 2010. Retrieved from: http://www.cdc.gov/od/science/integrity/phethics/ESdocuments.htm 6 Pellegrino, E. D., Veatch, R. M. & Langan, J. P. (1991). Ethics, Trust and the Profession: Philosophical and Cultural Aspects. Washington, DC: Georgetown University Press. PoPulation anD Public HealtH etHics 132
use oF eviDence For PrograM Decision Making Resources for tobacco cessation Donna Ciliska, Ph.D. National Collaborating Centre for Methods and Tools, McMaster University Hamilton ON CIlIska@MCMasteR.Ca Introduction Tobacco use is one of the strongest risk factors associated with morbidity and premature mortality. In Canada, use has declined to 17.5% of the population, but the decline appears to be levelling off. 1 Many population- and individualbased prevention and cessation strategies are implemented by public health workers. 2 “Quit and Win” programs are one example, involving a partnership between the Canadian Cancer Society and local public health/regional health authorities. A media campaign, “Quit and Win,” encourages smokers to sign up and commit to quitting smoking for a month. Names are entered in a draw for various prizes in each participating region. In some provinces, the program has been “encouraged” or even mandated as an intervention by the provincial ministry. Research, even if it is of very high quality, does not solely drive decision making in public health; several other factors have to be considered, such as local burden of illness, community preferences, political will and available skills and resources. 3 But sometimes, programs carry on despite evidence that they may not be effective for your population, the best use of resources 133 Megan Ward and Sheila Datta Region of Peel, Public Health Mississauga ON
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PoPulationand Public HealtH etHics
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contents Acknowledgements - page 5
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acknowleDgeMents The Partners would
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» Create a tool to support instruc
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Each of the discussants took on thi
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Twenty years on, things have change
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intervention (say reduction in mort
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ethics understands dilemmas not onl
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priority setting. 17 Once more, usi
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6 See for example the WHO Commissio
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obesity surveillance in scHool cHil
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esearch 2 Inevitably children will
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esearch Case discussion in response
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It would be ideal to get active inf
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esearch participation, leading to a
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to sHare or not to sHare? Secondary
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esearch Scenario shift » What if t
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esearch Many different parties have
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esearch of his concern for people w
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esearcH etHics anD conFlicts oF int
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esearch and non-public information
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esearch reFerences 1 Public Health
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esearch Key ethical dimensions Perh
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esearch such support, seen across t
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esearch Proposed resolution Enablin
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a tool For etHical analysis oF Publ
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esearch are explicit. In Quebec, su
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esearch reFerences 1 Bayer, R. and
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Part two Policy
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policy being increasingly introduce
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policy behaviour. Therefore, the et
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policy 18 Chapman, S. and Freeman,
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policy through outdoor smoking, any
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policy that this is an injustice. W
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DeFerring blooD Donation FroM Men w
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policy 26 per cent of new infection
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policy 6 NHS Blood and Transplant.
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policy public trust might also incl
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policy lived in certain regions in
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policy 4 Zou, S., Musavi, F., Notar
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Page 144 and 145: using PersonalizeD letters oF invit
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practice The ethical principle of b
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practice Identify the options avail
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