Finding Strength in Difficult Times: Principles of Ethical Practice Can Guide Our Practice

The unnecessary war and human suffering in Ukraine reminds us as public health professionals of the tremendous power of prevention, if exercised. The National Network of Public Health Institutes joins the American Public Health Association’s opposition to this unnecessary war.

With war comes years of highly adverse public health outcomes. As the events unfold over the next few months and years, a robust public health response will be paramount to help all individuals and communities impacted, both in Ukraine and around the world. As this work begins to support Ukrainians at home and wherever they may be displaced, I am also reminded of our mutual responsibility to uphold the Principles of the Ethical Practice of Public Health, which include:

  1. Public health should address principally the fundamental causes of disease and requirements for health, aiming to prevent adverse health outcomes.
  2. Public health should achieve community health in a way that respects the rights of individuals in the community.
  3. Public health policies, programs, and priorities should be developed and evaluated through processes that ensure an opportunity for input from community members.
  4. Public health should advocate and work for the empowerment of disenfranchised community members, aiming to ensure that the basic resources and conditions necessary for health are accessible to all.
  5. Public health should seek the information needed to implement effective policies and programs that protect and promote health.
  6. Public health institutions should provide communities with the information they have that is needed for decisions on policies or programs and should obtain the community’s consent for their implementation.
  7. Public health institutions should act in a timely manner on the information they have within the resources and the mandate given to them by the public.
  8. Public health programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs, and cultures in the community.
  9. Public health programs and policies should be implemented in a manner that most enhances the physical and social environment.
  10. Public health institutions should protect the confidentiality of information that can bring harm to an individual or community if made public. Exceptions must be justified on the basis of the high likelihood of significant harm to the individual or others.
  11. Public health institutions should ensure the professional competence of their employees.
  12. Public health institutions and their employees should engage in collaborations and affiliations in ways that build the public’s trust and the institution’s effectiveness.

Perhaps most importantly, the following values undergird these principles:

Humans have a right to the resources necessary for health.

Humans are inherently social and interdependent.

The effectiveness of institutions depends heavily on the public’s trust.

Collaboration is a key element to public health.

People and their physical environment are interdependent.

Each person in a community should have an opportunity to contribute to public discourse.

Identifying and promoting the fundamental requirements for health in a community are of primary concern to public health.

Knowledge is important and powerful.

Science is the basis for much of our public health knowledge.

People are responsible to act on the basis of what they know.

Action is not based on information alone.

I thank and applaud the original members of the Public Health Leadership Society responsible for organizing the values and principles we should all consider in our practice. I invite all colleagues to join NNPHI in a more intentional approach to adopt them in our practice and to share them broadly will all in leadership positions, including newly appointed and elected leaders.

Let this be our collective legacy for tomorrow’s children who deserve a more peaceful and healthy environment, and let us be exceptionally dedicated to helping all people recover from devastation caused by war and all forms of human oppression.

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