Science, ethics, and professional public health practice

PUBLIC HEALTH PRACTICE

At the core of professional public health practice is a promise to help society by preventing disease and promoting health. Public health is a calling, as much an art as it is steeped in scientific theory, method, and evidence. We, the public health professionals, learn theory and practice in the classroom and hone them in experience. We define core values and embrace integrity, prudence, honesty, and trust. We develop standards of excellence and codes of ethics to guide our professional pursuits.1,2 Our practice is a complex blend of acquiring scientific knowledge and participatory policymaking. We study communities and individuals, the healthy as well as those who suffer from disease, injury, malnutrition, and untimely death. We recommend and advocate policies with others, for others, and for ourselves.

Ethics as an academic discipline and as a pragmatic dimension of our daily professional lives offers a conceptual framework and methods for thinking about and improving the practice of public health. Inevitably, we encounter situations marked by tension between competing values and obligations. Of the many problems that require attention, we choose three: evidence to action; the pitfalls and promise of public advocacy, and the balance between individual freedom and the common good.

EVIDENCE TO ACTION

The scientific knowledge that matters to public health interventions extends from the physical and biological sciences to epidemiology and on to the environmental, social and behavioural sciences. The problem of deciding when to act on the basis of that knowledge is as much synthetic as …