The ethics of public health research: Moral obligations to communities

Public health research often involves human participants. Although some authors have argued that there are significant moral differences between public health research and public health practice, few have claimed that public health research presents unique ethical issues from other types of human participant research. Definitions of public health research have been slow to develop and, it has been suggested, are largely unsatisfying attempts to resolve ethical problems through categorization and redefinition. In this article, we focus on the ethics of one type of public health research in which the overall goal is to contribute to our understanding of how to prevent the onset of disease or injury within an otherwise healthy population. In this respect, we focus on population-based research that often involves a specified group or community. The purpose of this article is to highlight the ethical issues related to public health research that traditional human participant regulations and guidelines have not adequately addressed, presumably because the regulations were not written with this type of research in mind. In particular, we argue that the current regulatory framework does not provide adequate moral guidance for investigators conducting primary prevention research in community settings. Assuming communities as well as individuals have interests, and perhaps even rights, investigators studying communities should consider these interests and the correlative responsibilities they generate in thinking through the ethics of their research. Specifically, at least three possible kinds of duties to communities need to be considered: The duty to respect the community, the duty not to harm the community, and whether a duty to benefit the community exists. © 2008