The American Public Health Association’s “Principles of the Ethical Practice of Public Health” (http://www.apha.org/codeofethics/ethics.htm) strikes me as most admirable and useful. For their intellectual quality, commitment, and energy, those responsible for filling such an important gap in public health practice deserve commendation and gratitude from all of us in this field. However, I am also struck by the total absence of public representation in the drafting and review of this document.
Good appropriate public representatives—individuals (e.g., members of boards of health and institutional review boards who are not health professionals, health-focused legislators) and public advocacy organizations with impressive relevant track records (e.g., Public Citizen, Children’s Defense Fund, Act-Up/Philadelphia)—are certainly available. Was there a conscious decision not to include public representation? If so, disclosure of the rationale for this decision would be appreciated. If there was not a conscious decision, was the process followed here another sad and significant example of the insensitivity, perhaps even hostility, of public health professionals toward the public when it comes to public health policy decisionmaking?