What is health ethics?What are key ethical issues in public health?What are key ethical issues of health organizations and systems?

 What is health ethics?What are key ethical issues in public health?What are key ethical issues of health  organizations and systems?

Health  ethics is the interdisciplinary field of study and practice that seeks specifically to understand the values undergird-ing decisions and actions in health care, health research and health policy, and to provide guidance for action when these values conflict.

Health ethics has a  broad focus, taking in ethical issues faced by health professionals, health policy-makers and health researchers, as well as by patients, families, and communities in a  range of contexts related to health, including clinical care, health services and systems, public health, epidemiology, information technology and the use 

of animals in research.

Health ethics is built on a  sound appreciation of the empirical realities of particular health issues.

 For example, if authorities have a limited supply of 

vaccine, an ethical analysis of the situation is likely to take into account clinical concerns about vaccine side-effects, epidemiological concerns about herd immunity and pop-ulation risk, and logistic concerns about maintaining an effective and efficient delivery system. 

What are key ethical issues in public health?

Both public health practice and policy raise diverse ethi-cal considerations. An important set of issues concerns the relationship between the liberty of the individual and broader societal concerns. Other important issues include such things as equity, solidarity, social justice, reciprocity, and trust. Underlying all approaches to public health ethics 

is a strong commitment to collective action as a means of protecting individuals and the public from harm and pro-moting the highest attainable standard of health.

What are key ethical issues of health  organizations and systems?

Ethical issues arise in the governance and management of health institutions and systems, particularly where there are competing stakeholder needs and values. Some exam-ples are given below.

¢ Resource allocation across health services and 

programmes. How should priorities be set to ensure 

that resources are allocated fairly and appropriately to meet the community’s health needs? How much prior-ity should be given to disease prevention as opposed to treatment? In a public health crisis, such as an influenza pandemic, who should have priority access to vaccines, drugs, and hospital services? Because normal health care systems may cease to function during a  severe public health crisis, efforts should be made to achieve consensus on these questions in advance.

¢ Corporate partnerships and philanthropic fun-

draising. In the face of scarce resources, are there 

restrictions on the kinds of funding sources from which a health institution may accept support? What if there is a conflict of interest between the values of the poten-tial funder and the health institution?

¢ Workplace ethics. What obligations do health institu-tions have to their staff to ensure that the workplace is safe, respectful, and just? What supports ought to be in place to assist staff at all levels in dealing with ethical issues in their daily practice?

¢ Equitable access. What obligations do health institu-

tions or systems have to care for the uninsured, patients 

beyond their catchment area or jurisdictional borders, 

or future patients?

¢ Individual versus population health. How much 

priority ought to be given to population health needs 

versus individual patient needs, if not all needs can be 

met? This question overlaps with the issues discussed 

above regarding the appropriate allocation of resources 

between prevention and treatment.

¢ Public accountability. What obligations do health 

institutions and systems have to the communities they 

serve to be transparent about how health resources are 

used and to reflect community values in their decisions?

In some cases, these issues may highlight the challenge of 

resolving tensions between different ethical values, such as 

efficiency, equity and choice. The decisions made may have significant implications for patients, families, clinicians, and other key stakeholders.

Organizational and health system ethics are also con-

cerned with the institutional environment within which 

decisions are made and the conditions that contribute to 

the development of a culture that supports and reinforces 

ethical decision-making. Experience shows that the insti