Lesson 4. Application of Public Health Ethics to Interventions and Programs

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Headshot of Robert (Bob) Lutz, MD, MPH · Public Health course director
Robert (Bob) Lutz
MD, MPH · Public Health course director
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Headshot of Jaime Bowman, MD · Vice Chair, Family Medicine
Jaime Bowman
MD · Vice Chair, Family Medicine
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Headshot of Chaise Zozaya, MPH MBA · Course director
Chaise Zozaya
MPH MBA · Course director
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Table of Contents

Balancing the needs of the population with respect for individual rights.

What is Public Health ethics?

Let’s begin by understanding the historical tension: Physicians have both advanced and resisted health system change. 

required reading

Narrative Ethics in Public Health: The Value of Stories, Springer

Public Health Ethics is a framework that helps guide decision-making where actions intended to promote the common good may conflict with individual freedoms. Unlike clinical ethics, which focuses on individuals, public health ethics consider population-level interventions and how to ensure they are just, equitable, and respectful. 

Core functions of Public Health ethics

Principles of Public Health ethics

required reading

Kent State Blog: Exploring Ethical Issues in Public Health Practice, 2024

Because this is a relatively new field of study, there are no agreed-upon principles – that said, the following provide a nice collection that necessarily overlap with biomedical ethics: 

Autonomy
Respecting individuals’ right to make their own choices.
Beneficence
Acting for the good of the public; preventing and removing harm.
Justice
Fair distribution of benefits, burdens, and resources.
Civil liberties
Upholding rights such as privacy, freedom of movement, and free expression.
Informed consent
Ensuring interventions are voluntary and transparent.
Confidentiality
Safeguarding personal information and maintaining trust.
Distributive justice
Ensuring fair allocation of public health resources.
Efficiency
Achieving the best outcomes with available resources.
Harm principle
Restricting individual freedom only to prevent harm to others.
Advocacy ethics
Acting on behalf of vulnerable or marginalized populations.
Occupational safety + health
The ethical responsibility to protect and promote the health, safety, and well-being of workers in all types of employment settings.
Health maximization
Achieving the greatest possible improvement in population health outcomes using the resources available.

Case studies for application

congenital syphilis and partner notification

Ethical tension
Privacy/confidentiality vs. Community protection

Questions to answer via Slack (required)

  • Should partners be notified without the patient’s consent?
  • How do we protect the newborn while respecting the mother’s autonomy?

tuberculosis (TB) control

Ethical tension
Individual liberty vs. Mandatory treatment/quarantine

Questions to answer via Slack (required)

  • When is it justified to isolate or detain someone for non-compliance?
  • What safeguards must be in place to ensure fairness?

summary

Public Health Ethics is not just about doing what’s good—it's about doing what’s right, fair, and just while being effective.

  • Guides policy decisions in vaccination, outbreak response, screening programs, and more. 
  • Balances individual rights with population-level needs. 
  • Promotes trust, fairness, and community engagement.