The Ethics of Public Health Practice for the Prevention and Control of STDs

Abstract

The goal of public health is to promote the health of all persons for the good of the entire population. While this is a straightforward intention, in practice, public health regularly raises ethical dilemmas that result primarily from conflicts between individual interests and community interests. With respect to sexual health, ethical public health practice is made all the more challenging by the private nature of sexual behavior, and by the social stigma associated with many sexual practices and sexually transmitted diseases (STDs). This chapter provides an overview of the ethical topics that arise in STD prevention and control, in order both to heighten awareness and understanding of these issues and to provide readers with some guidance for articulating and exploring these issues. We examine the ethics of STD prevention and control in both public health practice and in the delivery of health care. Here, we circumscribe public health practice as the set of activities intended to improve the health of a specific community or population by preventing or controlling disease (1–3). We define delivery of health care as the provision of preventive and treatment services to individuals, including the use of screening and diagnostic tests and the implementation of vaccination programs (4,5).