Ethical issues in public health surveillance: a systematic qualitative review

BMC Public Health

Research Article

Diego Steven Silva¹  Abha Saxena²  Andreas Alois Reis²  Christopher Schuermann³  Daniel Strech³  Corinna Klingler⁴ 

[1] Faculty of Health Sciences, Simon Fraser University, Blusson Hall, Room 11008, 8888 University Drive, V5A 1S6, Burnaby, B.C, Canada;Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;Global Health Ethics Unit, World Health Organization, Avenue Appia 20, 1211, Geneva, GE, Switzerland;Institute for History, Ethics and Philosophy of Medicine, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany;Institute of Ethics, History and Theory of Medicine at LMU Munich, Lessingstr. 2, 80336, Munich, Germany;

关键词: Public health surveillance;    Ethics;    Informed consent;    Systematic review;    Qualitative evidence synthesis;   

DOI  :  10.1186/s12889-017-4200-4

 received in 2016-12-12, accepted in 2017-03-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundPublic health surveillance is not ethically neutral and yet, ethics guidance and training for surveillance programmes is sparse. Development of ethics guidance should be based on comprehensive and transparently derived overviews of ethical issues and arguments. However, existing overviews on surveillance ethics are limited in scope and in how transparently they derived their results. Our objective was accordingly to provide an overview of ethical issues in public health surveillance; in addition, to list the arguments put forward with regards to arguably the most contested issue in surveillance, that is whether to obtain informed consent.MethodsEthical issues were defined based on principlism. We assumed an ethical issue to arise in surveillance when a relevant normative principle is not adequately considered or two principles come into conflict. We searched Pubmed and Google Books for relevant publications. We analysed and synthesized the data using qualitative content analysis.ResultsOur search strategy retrieved 525 references of which 83 were included in the analysis. We identified 86 distinct ethical issues arising in the different phases of the surveillance life-cycle. We further identified 20 distinct conditions that make it more or less justifiable to forego informed consent procedures.ConclusionsThis is the first systematic qualitative review of ethical issues in public health surveillance resulting in a comprehensive ethics matrix that can inform guidelines, reports, strategy papers, and educational material and raise awareness among practitioners.

【 授权许可】

CC BY   
© The Author(s). 2017