The ethics of public health practice: balancing private and public interest within tobacco policy.
BACKGROUND
Public health practice is characterized by measuring population health, assessing needs for health care and the provision (directly or indirectly) of services to protect and promote the public's health. It is increasingly explicitly concerned with issues of equity.


METHODS
Publications discussing ethical issues in public health.


RESULTS
Unlike the duties of clinicians, professional standards for public health practice are not well defined. An ethics framework would help the development and implementation of public health policy.


RESULTS
Public health strategies have been criticized for being paternalistic and restrictive of personal choice behaviours or for being too pragmatic, and appearing to endorse illegal activities.


CONCLUSIONS
Historically public health programmes have been delivered at a population level for large groups of people with varying capacity to benefit. Within more autonomy, consumer-orientated political environment, strategy must be more targeted to facilitate healthy choices as defined by the individual.


CONCLUSIONS
Debate is needed on the aims of public health, rights and responsibilities of professionals and citizens and mechanisms for developing and implementing policy.
Shickle
Darren
D
Academic Unit of Public Health, Institute of Health Sciences, University of Leeds, Charles Thackrah Building, 101 Clarendon Road, Leeds LS2 9LJ, UK. d.shickle@leeds.ac.uk
D000437:Alcoholism / Q000517:prevention & control; D026688:Bioethical Issues; D006291:Health Policy; D006293:Health Promotion / Q000941:ethics; D006801:Humans; D026706:Paternalism / Q000941:ethics; D015980:Public Health Practice / Q000941:ethics*; D000074606:Smoking Prevention; D012941:Social Responsibility; D014028:Tobacco Smoke Pollution / Q000517:prevention & control
D014028:Tobacco Smoke Pollution