Strengthening the Capacity for Ethical Public Health

In Uncategorized on January 23, 2018 at 4:47 pm

Originally posted on Better Health For All, the blog for the Faculty of Public Health.

Public health is proudly an evidence-based field. But evidence without values cannot tell us what we should do.

We need public health ethics if we are to understand and explain, by reference to the classic definition of public health advanced by Winslow, what we, as a society, ought to do to assure the conditions in which people can enjoy good health and equitable prospects for health. Using the ‘organised efforts of society’ to protect and promote health and well-being is an ethical goal—indeed, as many of us would argue, it is an ethical imperative. And to be achieved, it requires law and policy. To evaluate when threats to health warrant a public health response, scientific analyses must be complemented by matters such as the balancing of values, an assessment of the relative merits of different possible interventions, an appreciation of the likely risks and impacts of intervening, and a sensitivity to political and cultural contexts and realities.

At a workshop convened in London, at the Royal College of Physicians on 18th January 2018, Public Health practitioners, trainees, leaders, researchers, and policy-makers convened with scholars in public health ethics to discuss how Public Health Ethics and Law (PHEL) might be established as a professional competency, and how we might ensure that it is robust and rigorous through education and training. This is part of a project I am involved in with A.M. Viens at the University of Southampton, and Farhang Tahzib, Chair of the Faculty of Public Health (FPH)’s ethics committee and a champion for bringing academic public health ethics into practice.

We argue that the Public Health workforce needs a clearly defined PHEL competency, secured within Public Health education and ongoing professional training. This builds on further work that we have done regarding PHEL expertise to support the Public Health Skills and Knowledge Framework. As contributions throughout the day affirmed, such a competency requires to be explained in a way that is academically robust: is it based on sound and coherent principles? It must be practically realisable: is it clear how to apply the PHEL competency in the vast, complex, and challenging range of practical situations covered by public health? And it must be treated properly as an essential part of public health capacity: how, for example, can we ensure it is taken seriously as part of CPD requirements? The feedback and engaged discussion from all participants were complemented and further stimulated by contributions from Bruce Jennings—described by Farhang as one of the fathers of Public Health Ethics—as well as an expert panel on which Bruce was joined by Angus Dawson, Vikki Entwistle, Kevin Fenton, and Fiona Sim.

Just as areas such as statistical analysis and detection of disease require skills and expertise, so do legal and ethical understanding and practice. As FPH President John Middleton suggested at the start of the day, we need to consider how questions of justice impact public health practice, and how our overall political agendas should be shaped if we are to achieve a sustainably fairer society. For good practice, and good frameworks for practice, PHEL experts need to work with the public health community to ensure that ethical challenges, big and small, can be addressed with proper knowledge, understanding, and skills in ethical, legal, and political reasoning.

We look forward to publishing a full report on our findings, detailing how the PHEL competency should be defined, and a range of model materials for PHEL education and training through the FPH’s website, as well as wider academic papers. It is an exciting time to be engaging with FPH and other partners to advance these agendas, strengthening capacity for ethics and law in public health.

John Coggon, Professor of Law and Honorary Member of the Faculty of Public Health, Centre for Health, Law, and Society, University of Bristol Law School


Uterus Transplants – A Reproductive Revolution or Cause for Concern?

In Uncategorized on November 19, 2017 at 9:47 am

Upcoming HEAL seminar. We look forward to seeing you there.

Dr Natasha Hammond-Browning (University of Southampton)

Uterus Transplants – A Reproductive Revolution or Cause for Concern?

Wednesday, 13 December 2017, 1-2pm
Building 4, Room 1035, Highfield Campus

Uterus transplantation involves IVF, major surgery on at least two occasions, use of immunosuppressant drugs, and (possibly) high-risk pregnancies. It is recognised that at least four people will be affected by a uterus transplant the recipient, the donor, the recipient’s partner, and a future child, however, the focus of this paper is on the women involved – the recipient and the donor. This paper considers concerns with uterus transplant research including the criteria to participate in the clinical trials, the motivation of the recipients to participate in the research trials, the expected gestational experience of recipients, the welfare of recipients, maternal care, and the welfare of donors.

Dr Natasha Hammond-Browning is a Lecturer in Medical Law and Ethics and Co-Director of the REPROLaw research group at the University of Southampton. Her research interests are in medical law and ethics, principally in start of life issues and stem cell research. She is researching the regulation, regulatory bodies and reform of these sensitive areas of law and ethics.

Possible Outcomes for Tainted Blood Scandal Victims

In Uncategorized on September 29, 2017 at 8:13 am

Dr Melinee Kazarian has written about the recent decision to hold a public inquiry into the 1980s contaminated blood scandal that affected thousands of victims, and the recent court ruling that victims may now sue the government for compensation for the harm caused. It provides an analysis on what possible outcomes there might be at the end of the inquiry and whether this will successfully help the victims’ search for the truth.