Ethics in public health surveillance

Public health programmes pose some very important ethical problems. One of the most pressing is the possible conflict between individual interests (and rights) and collective interests, which becomes particularly important in the public health surveillance setting. The present article first looks at the definitions of "public health surveillance" in a historical context and then identifies the key ethical problems that are raised. These reveal the differences - and sometimes deviations - between the bioethical issues typically encountered in a clinical setting and those that prevail in a public health context. Human rights are suggested as a possible common ground between the two. The article then draws on the specialised literature to indicate tools and checklists to help evaluate the ethical acceptability of public health surveillance programmes. It concludes with a description of the key criteria underlying these tools and checklists.