Putting ethics at the centre of health promotion practice: lessons from Australia

Abstract

This article examines recent developments to strengthen ethical health promotion practice in Australia and their global relevance. Ethical health promotion practice requires a dual foundation: structured ethical oversight combined with practitioners’ ability to implement ethical values and principles in their decision-making processes, leading to evidence-informed health promotion practice. However, health promotion organizations and practitioners report barriers to ethical practice, including limited resources and access to human research ethics committees and formal ethical oversight. Growing global recognition of inadequacies of traditional procedural approaches to ethical practice in health promotion highlights the need for initiatives and frameworks emphasizing decolonizing methodologies, relational and reflexive ethics, participatory and community-led oversight, and social justice embedded as a core principle. In response to barriers faced by health promotion practitioners and organizations in Australia, the Australian Health Promotion Association developed the Health Promotion Ethics Project to support ethical practice of the Australian health promotion workforce. A comprehensive ethics framework was developed comprising: (i) specialized ethics training and tools for health promotion practitioners; (ii) an ethical oversight committee with relevant expertise; (iii) customized submission processes and templates tailored to health promotion practice contexts; and (iv) advice to guide practitioners through ethical challenges. A pilot project to evaluate the framework was undertaken in 2024 with five diverse health promotion organizations across Australia, with findings informing several key recommendations for the global context. Continued investment in workforce development and tailored ethical oversight systems is vital for advancing the health promotion discipline and strengthening the global health promotion workforce.