Exploring ethical terrain in public health

Public health is rife with ethical challenges. Ethical principles and values are intrinsic to public health decision making, although they are generally not identified explicitly. One purpose of this article is to discuss public health goals as an ethical/value concern with attention to values that do and should underlie health care in the United States. A second purpose is to introduce frameworks for public health decision making that incorporate ethical considerations into community and health promotion perspectives of public health decision makers. Public health policy makers and providers are urged to explore ethical/value dimensions of the health care system and to use the ethical frameworks in their decision making, expanding the more individualistic perspective of traditional bioethics.