PoPulationand Public HealtH etHics

Case discussion in response to
researcH etHics anD conFlicts oF interest
at a local Public HealtH DePartMent
Christopher McDougall
Health Policy, Management & Evaluation, and Joint Centre for Bioethics
University of Toronto, Toronto ON
CHRIstoPHeR.MCDougall@utoRonto.Ca
Introduction
One thing is certain in this case: the Provincial Ministry for Children (PMC),
through its lack of transparency and heavy-handedness in introducing a possibly
legitimate and laudable change to public health practice, has succeeded
primarily in alienating the front-line professionals essential to that practice,
as well as in raising their suspicions about the motives behind the transition.
Indeed, the PMC has so mismanaged the development and implementation
of a standardized screening tool to improve identification of children at risk
of suboptimal development that there is insufficient space here for a respectable
analysis of the research ethics questions raised by the authors, let alone
of the public health dimensions of the case. Bearing in mind the ampleness
of the existing literature on the application of research ethics principles to
population-screening projects, the availability of tools for distinguishing
between research and other evaluative activities in public health,* the meagreness
of the information by which to adjudicate between the conflicting
views of the PMC and the Public Health Department (PHD) and the focus in
this volume on the distinctiveness of public health ethics analysis, I propose to
use the research ethics angle mainly as a springboard toward less-commonly
discussed matters of population health practice and policy as they relate to
early childhood development screening and support programs.
* The most notable of these for Canadian health professionals is perhaps the suite of ARECCI
guides and tools developed recently in Alberta (http://www.aihealthsolutions.ca/arecci/
areccitools.php).
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