Nuffield Council seeks views on the ethics of public health

The Nuffield Council on Bioethics today launched a consultation on the ethical issues surrounding public health. Public health has been described as ‘what we, as a society, collectively do to assure the conditions for people to be healthy’, but what are the responsibilities of governments, individuals and other parties, such as industry, in achieving this? The Nuffield Council established a Working Party in January 2006 to consider the ethical dilemmas related by public health, such as the difficulties in balancing individual choice and community benefit. The period of consultation will last for four months, closing on Friday 15th September 2006. There is a range of factors that can affect public health, such as the environment, available health services and the lifestyles of individuals. Equally, there are several ways in which governments can influence public health, from education programmes to legislation. A Consultation Paper provides background information on these issues and asks questions in the context of five case studies: infectious diseases, obesity, smoking, alcohol, and the supplementation of food and water. For example:

• Are there cases where the vaccination of children against the wishes of their parents could be justified?
• Would measures such as forced quarantine, which helped to control the outbreak of SARS in Asia, be acceptable in countries such as the UK?
• What are the roles and obligations of parents, schools, school-food providers and the government in tackling childhood obesity?
• Should people who smoke or drink excessively be entitled to fewer resources from the public healthcare system, or should they be asked for increased contributions?
• Fortification of foodstuffs such as flour and margarine have been accepted for some time. Why does the fluoridation of water meet with such resistance?

“We are looking forward to hearing a wide range of views on these and other questions,” said Professor Sir John Krebs, Chair of the Working Party and Principal, Jesus College, Oxford. “We would welcome comments from both individuals and organisations to help us develop advice for policy makers.” All comments received will be carefully considered by the Working Party, which includes members with expertise in health economics, law, philosophy, public health policy, health promotion and social science. The group will meet throughout 2006 and 2007, and their discussions will be informed by the consultation and a number of fact-finding meetings. A Report is expected to be published in autumn 2007.

Notes to editors

1. For further information please contact: Catherine Joynson Communications & External Affairs Manager Nuffield Council on Bioethics 28 Bedford Square London WC1B 3JS Tel: +44 (0)20 7681 9619 Fax: +44 (0)20 7637 1712 Email: cjoynson@nuffieldbioethics.org Web: www.nuffieldbioethics.org 2. Media briefing, Thursday 18th May, 10.00-11.00 am Science Media Centre, 21 Albemarle St, London W1S 4BS Members of the Working Party will brief the media, at the Science Media Centre, on the consultation in advance of the public launch. Copies of the Consultation Paper will be available at the briefing. The speakers will be: Professor Sir John Krebs FRS (Chair of the Working Party), Principal of Jesus College, Oxford Professor Jonathan Montgomery, Professor of Health Care Law, University of Southampton School of Law Julia Unwin OBE, Deputy Chair, Food Standards Agency and Senior Associate, King’s Fund To attend the briefing, for more information, or to arrange an interview please contact: Catherine Joynson Tel: 020 7681 9619 Email: cjoynson@nuffieldbioethics.org 3. Background The Nuffield Council on Bioethics is an independent body which examines the ethical issues raised by developments in medicine and biology. Established in 1991, it is funded by The Nuffield Foundation, the Medical Research Council and The Wellcome Trust. 4. Consultation Paper Advance copies of the Consultation Paper are available to media representatives on request. It will be available to download from the Council website at www.nuffieldbioethics.org from 10.00 am on Friday 19th May 2006. For a printed copy please e-mail: bioethics@nuffieldbioethics.org. 5. Members of the Working Party Professor Sir John Krebs FRS (Chair) Principal, Jesus College, Oxford Dr Raghib Ali Clinical Lecturer, Department of Clinical Pharmacology, Green College, University of Oxford Professor Tom Baldwin Department of Philosophy, University of York, Member of the Council (up to January 2006) Professor Roger Brownsword Professor of Law, King’s College London, Member of the Council Professor Sir Kenneth Calman KCB FRCS DL FRSE Vice-Chancellor and Warden, University of Durham, Member of the Council Professor Christine Godfrey Professor of Health Economics, Centre for Health Economics and Department of Health Sciences and Clinical Evaluation, University of York Professor Trisha Greenhalgh OBE Professor of Primary Health Care, Department of Primary Care and Population Sciences (PCPS), University College London Professor Anne Johnson FMedSci Professor of Infectious Disease Epidemiology and Head of Department, Department of Primary Care and Population Sciences (PCPS), University College London Professor Sally Macintyre OBE FRSE Director, Medical Research Council Social and Public Health Sciences Unit, University of Glasgow Professor Jonathan Montgomery Professor of Health Care Law, University of Southampton School of Law Julia Unwin OBE Deputy Chair, Food Standards Agency and Senior Associate, King’s Fund 6. Terms of Reference 1 To identify and consider ethical, legal and social issues arising when designing measures to improve public health. 2 To consider, by means of case studies:

• the variety of aims for such measures, such as informing individual choices and protecting the wider community, and their relative priorities;
• the role of autonomy, consent and solidarity;
• issues raised by decisions about, and perceptions of, risk;
• criteria for the allocation of resources in specific areas of public health;
• the special situation of children and those who are poor or socially excluded.

3 To examine the implications of the above for the development of frameworks for policy making in public health.