Chapter One: Public Health Ethics

Theoretical Approaches

Ruth Faden and Sirine Shebaya (2015), “Public Health Ethics,” in Edward N. Zalta (ed.), The Stanford Encyclopedia of Philosophy (winter 2016 ed.)
Faden and Shebaya provide an overview of the distinctive challenges of public health ethics, including moral justifications for public health policies.

Craig M. Klugman (2007), “Public Health Principlism,” Online Journal of Health Ethics 4, no. 1
Klugman suggests that a principlist approach (similar to that used in clinical medicine) applies in public health ethics. The principles he suggests are solidarity, efficacy, integrity, and dignity.

Alex Broadbent (9 March 2020), “Thinking Rationally About Coronavirus COVID-19,” The Daily Nous [blog]
Broadbent proposes using a cost-benefit analysis to evaluate public health responses to the pandemic. This analysis should consider effectiveness, speed of the response, and economic effects on human welfare (including health), weighing rights, quality of life, and egalitarian concerns, and must consider the possible benefits of economic downturns such as reduced poaching and pollution.

Marika Warren (18 March 2020), “Roles for Ethicists in COVID-19 Response,” Impact Ethics [blog]
Warren suggests that ethicists can play a role in pandemics by minimizing the number of difficult choices that health-care providers must make. Ethicists can articulate the values embedded in response plans.

Ethical Guidelines

Centers for Disease Control and Prevention (n.d.), Ethics Subcommittee Documents: Ethical Guidance for Public Health Emergency Preparedness and Response: Highlighting Ethics and Values in a Vital Public Health Service
This website includes links to the CDC’s official recommendations on an ethical approach to pandemic preparedness, resource allocation, and the stockpiling of medicines.

Public Health Leadership Society (2002), Principles of the Ethical Practice of Public Health
Ethical Guidelines from the Public Health Leadership Society; adopted by the American Public Health Association.

Abha Saxena, et al. (2021), “WHO Guidance on Ethics in Outbreaks and the COVID-19 Pandemic: a Critical Appraisal,” Journal of Medical Ethics 47
In 2016, the World Health Organization (WHO) released guidelines for dealing with pandemics based on their experiences with influenza and Ebola outbreaks. Saxena et al. analyze some ethical issues that were important to decision-makers responding to the COVID-19 pandemic, but that were absent from the WHO’s guidance surrounding pandemic response. They suggest ways the WHO could update its guidance based on our experiences with COVID-19.

Religion and Ethics

Public health decision making is not guided by moral theories alone. Various religious traditions can be applied to analyze issues of public health ethics. In The Ethics of Pandemics, reading 4.6 by Shai Held introduces a perspective from a Jewish Rabbi.

Mohammed Ghaly (27 April 2020), “Religion During the Coronavirus Pandemic: Islamic Bioethical Perspectives,” The Hastings Center Bioethics Forum [blog]
This article considers the pandemic from an Islamic perspective.

Nuala Kenny (19 March 2020), “The Perils and Possibilities of a Pandemic,” La Croix International [archived by the Archdiocese of Halifax-Yarmouth]
Kenny provides a Catholic account of the pandemic.

Case Discussions

Drue Barrett, et al. (2016), Public Health Ethics: Cases Spanning the Globe
This open-access book contains various cases and discussions addressing many public health topics including pandemics.

Canadian Institutes of Health Research—Institute of Population and Public Health (eds.), Population and Public Health Ethics: Cases from Research, Policy, and Practice (Toronto: University of Toronto Joint Centre for Bioethics, 2013)
This book includes discussions of many of the ethical issues that arise in public health, including governmental responses to previous pandemics.