Ethics and public health surveillance

The struggle to resolve the tension between the claims of individuals and the needs of the community is a central theme in the history of public health surveillance. Although there has been controversy within public health ethics about how to achieve this balance, the field has historically prioritized the common good. This emphasis was challenged in the 1960s when research scandals raised doubts that professionals could reliably police themselves. The acquired immunodeficiency syndrome epidemic gave birth to a robust dialogue about surveillance ethics, illuminating core principles and changing the nature of practice. Yet ethical quandaries persist. Questions about whether surveillance constitutes research, when data may be used to intervene with patients, and what circumstances may warrant disclosure of identifiable information continue to spark debate. In this chapter, we argue that addressing these issues requires a focus on developing mechanisms to help practitioners ensure that questions are addressed in a consistent fashion, not merely when controversies arise. This edition first published 2013