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LETTER |
Correspondence: Requests for reprints should be sent to Christian T. Stadtländer, PhD, MPH, MBA, 3267 North View Ln, St Paul, MN 55125-8402 (e-mail: jmpstadtlander{at}aol.com or ctstadtlande{at}stthomas.edu).
I read with great interest Dickens’s column about the challenges and opportunities of ethics.1 Dickens discussed the Belmont Report2 and the Public Health Code of Ethics3 and stated that these widely respected core principles offer guiding values for both research and epidemiological practice and that the challenge to public health practitioners is to apply these principles not just individually but at the collective "macroethical" level. I fully agree with Dickens’s point of view. Ethical behavior (i.e., behavior conforming to accepted principles of right and wrong that govern the conduct of a profession4) is very important in public health, not least because it helps maintain a positive relationship among public health professionals and between these professionals and society as a whole.
The unique mission of public health is to protect, promote, and restore the health of the population. Public health could not function without ethics. An important question to answer is how can we as individuals and members of society identify the positive values that make up our belief system and ultimately guide our behavior. I think adopting core values from existing ethics codes is insufficient. We should identify our own values, discuss them with our colleagues, and then compare them with existing codes of ethics.
I have recently come across several books that I would like to recommend to interested readers. The first, by Kenneth Majer, describes how to identify our own values and how to build values-based teams and organizations.5 The second, by Nancy J. Adler, describes the international dimensions of organizational behavior and includes discussions on the complexity of ethical decisionmaking in multicultural settings.6 The third, edited by Francis L. Macrina, is about scientific integrity as it relates to the responsible conduct of research.7
The development of ethical behavior requires introspection and continuous self-reflection. Written codes of ethics can be useful in this educational journey as guidelines and as means of correcting, collaboratively, behaviors that have ethical implications. Although we like to adhere to the highest standards of integrity, we may sometimes be confronted with situations in which we have to make trade-offs between competing positive values. Such situations (which can be defined as ethical dilemmas or defining moments) pose, I believe, the real challenges in human and organizational behavior.
References
1. Dickens BM. The challenges and opportunities of ethics. Am J Public Health. 2005;95:1094.
2. The Belmont Report: ethical principles and guidelines for the protection of human subjects of research. Available at: http://ohsr.od.nih.gov/guidelines/belmont.html. Accessed July 14, 2005.
3. American Public Health Association. Public Health Code of Ethics. Available at: http://www.apha.org/codeofethics/ethics.htm. Accessed July 14, 2005.
4. Webster’s II New Riverside University Dictionary. Boston, Mass: Houghton Mifflin Co; 1984.
5. Majer K. Values-Based Leadership: A Revolutionary Approach to Business Success and Personal Integrity. San Diego, Calif: Majer Communications; 2004.
6. Adler NJ. International Dimensions of Organizational Behavior. 4th ed. Cincinnati, Ohio: South-Western College Publishers; 2002.
7. Macrina FL. Scientific Integrity: Text and Cases in Responsible Conduct of Research. Washington, DC: American Society for Microbiology Press; 2005.
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