New report: Ethical issues in public health

3 December 2007

The Nuffield Council on Bioethics has published a new report and policy recommendations, Public health: ethical issues, which examines “the responsibilities of governments, individuals and other parties, such as the food and drink industry, in achieving a healthy society” (see news article).

The report is has been produced by a Working Group and incorporates material from a workshop, public consultation (see previous news) and stakeholder meetings held over the past three years; it concludes that both the state and relevant industries have a duty to promote good health throughout society, and makes recommendations for policy development in four key areas: infectious disease, obesity, alcohol and tobacco, and water fluoridation.

The report sets out what it terms a ‘stewardship model’ for appropriate state intervention to promote public health, stopping short of coercion of adults to lead healthy lives and minimising interventions that are  “introduced without the individual consent of those affected” or “perceived as unduly intrusive”. At the same time, it notes the multi-factorial origins of disease, including genetic and socio-economic factors, and warns against an overemphasis on individual behaviour as the causative factor in ill-health.

The report emphasises the importance of reliable evidence on both the causes of ill health and the efficacy and effectiveness of interventions, saying that “evidence should be based on peer-reviewed research” and claims of absolute safety or certainty should be treated with caution. With respect to genetic research relevant to public health, the report stresses that accurate reporting of evidence is of particular importance “given the potential for adverse consequences on population health”, and states that all those who report or communicate research findings have a duty to do so in a responsible manner, identifying the source and status of information; it also commends “initiatives that provide independent information that is accessible to the public on the accuracy and reliability of medical stories reported in the media”.

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