title: Ethical perspectives for public and environmental health: fostering autonomy and the right to know.
abstract: In this paper we develop an ethical perspective for public and environmental health practice in consideration of the "right to know" by contrasting consequential and deontological perspectives with relational ethics grounded in the concept of fostering autonomy. From the consequential perspective, disclosure of public and environmental health risks to the public depends on the expected or possible consequences. We discuss three major concerns with this perspective: respect for persons, justice, and ignorance. From a deontological perspective, the "right to know" means that there is a "duty" to communicate about all public health risks and consideration of the principles of prevention, precaution, and environmental justice. Relational ethics develops from consideration of a mutual limitation of the traditional perspectives. Relational ethics is grounded in the relationship between the public and public/environmental health providers. In this paper we develop a model for this relationship, which we call "fostering autonomy through mutually respectful relationships." Fostering autonomy is both an end in public health practice and a means to promote the principles of prevention, precaution, and environmental justice. We discuss these principles as they relate to practical issues of major disasters and contaminants in food, such as DDT, toxaphene, chlordane, and mercury.
authors.affiliation: Department of Environmental Health, Calgary Health Region, Community Health Sciences, University of Calgary, Calgary, Alberta, Canada. tim.lambert@calgaryhealthregion.ca
authors.forename: Timothy William
authors.initials: TW
authors.lastname: Lambert
authors.forename: Colin L
authors.initials: CL
authors.lastname: Soskolne
authors.forename: Vangie
authors.initials: V
authors.lastname: Bergum
authors.forename: James
authors.initials: J
authors.lastname: Howell
authors.forename: John B
authors.initials: JB
authors.lastname: Dossetor
mesh_terms: D004189:Disaster Planning; D004190:Disasters; D004777:Environment; D004782:Environmental Health / Q000331:legislation & jurisprudence; D004785:Environmental Pollutants / Q000009:adverse effects; D004991:Ethics, Institutional; D005506:Food Contamination; D006801:Humans; D026684:Personal Autonomy; D011634:Public Health; D018570:Risk Assessment; D014342:Truth Disclosure
chemical_list: D004785:Environmental Pollutants