The design of a public health ethics framework in support of the objectives of a public health agenda
Keywords:Ethics, Social determinants in public health, Public health, Public health ethics, World Health Organisation
As a general observation one can claim that although the public health agenda has been set, a shortcoming is the lack of a supportive ethics framework. This observation is based on, amongst others, a former Director-General of the World Health Organisation’s (WHO) Report on public health (2017) and advice given what the priorities are for the new WHO Director-General to address health challenges in Africa.
For a public health ethics framework to be promoted, the authors first determine the scope in terms of what public health is, and then discuss public health ethics. The research design is based on a qualitative research approach to describe phenomena and to apply them to practice.
Following from a literature review, the study defines public health as strategies and preventions to promote, secure and sustain quality of health and well-being based on a public health value chain. The value chain is further defined to emphasise the integrated role of ethics in the health system. This definition is in line with the global move towards preventative healthcare.
The literature review informing public health ethics concludes that public health ethics can be defined as the values informing the public health value chain to secure quality of health and well-being.
The study highlights five specific foci for public health ethics, namely that public health ethics should identify values to address community health problems; that it should advocate the overarching value of community health and social justice; that there should be skilled workers who have knowledge and skill to deal with dilemmas in public health; that it should participate in effective healthcare delivery; and that professional behaviour is required since healthcare practitioners have to act in a virtuous way. Public health ethics should promote equality and access, safety and security, individual interest and responsibility, and economic freedom.
The study contributes further towards the discussion what input can a Christian-informed public health ethics make towards such a framework.
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