6th  draft:  January  2009  

 
A  FRAMEWORK  FOR  
   
     
 
A  FRAMEWORK  FOR  
ETHICAL  HEALTH  PROMOTION  
 
 
CONTENTS  
 
1. Why  do  we  need  a  framework?  
 
2. Who  is  the  framework  for  and  how  can  it  be  used?  
 
3. Health  promotion  ±  definition  and  ways  of  working  
 
4. STATEMENT  OF  VALUES  AND  PRINCIPLES  
 
5. Examples  for  discussion  
 
6. Some  important  ethical  issues  for  health  promotion  
 
7. Some  principles  of  professional  practice  
 
8. Sources  and  further  information  
 
9. Diagram  of  the  Framework  
 
 
SHEPS  Cymru  (the  Society  of  Health  Education  and  Promotion  Specialists  in  Wales)  and  the   Shaping  
the  Future  Collaboration  have  worked  together  to  develop  this  framework.  
 
The   Shaping   the  Future  Collaboration   is   led  by  the   Royal   Society   for   Public   Health,   in  partnership  
with   the   Faculty   of   Public   Health,   the   UK   Public   Health   Register   and   the   Institute   of   Health  
Promotion   and   Education.     However,   it   should   be   noted   that   these   organisations   have   not   yet  
individually  endorsed  this  document.    This  version  takes  account  of  comments  made  at  a   Shaping  
the  Future  workshop  in  October  2008.  
 
This  is  a  living  document  which  we  would  like  to  develop  further.    Ethical  issues  require  
continuous  discussion.    Please  send  comments  to  Nelly  Araujo  at  the  Royal  Society  for  
Public  Health,  NAraujo@rsph.org.uk.  
 

1
6th  draft:  January  2009  

1. Why  do  we  need  a  framework  for  ethical  health  promotion?  

 
1.1 Ethically-­based  practice  is  as  important  as  evidence-­based  practice.  
 
1.2     Evidence-­based  practice  and  technical  efficiencyVXFKDVµEHQFKPDUNLQJ¶DQGµEHVWSUDFWLFH¶  
have  been  emphasised  in  recent  years  within  public  health.    This  focus  has  highlighted  the  
many  things  that  can  be  done,  rather  than  what  should  be  done.  
 
1.3 Values  are  important  to  the  way  that  we  think  and  act.    What  should  we  be  doing?    For  
whom   should   we  be   doing   it?    Who   should   decide   and   how?     These  questions  are  
fundamental   to   the   planning,   commissioning   and   practice   of   health   promotion   and   public  
health   and   well-­being   generally   and   should   be  debated   frequently.     It   is   some   years   since  
the   Society   for   Health   Education   and   Promotion   Specialists   ±   SHEPS   ±   issued   an   ethical  
framework;;  but  the  need  for  it  has  certainly  not  diminished.  
 
1.4 ³9DOXHVLQIOXHQFHWKHZD\VWKDWKHDOWKLVVXHVDUHXQGHUVWRRGWKHZD\VWKDWNQRZOHGJHDQG
theoretical   bases   are   developed   and   the   nature   of   strategies   identified   for   health  
LPSURYHPHQW´1  A  value  implies  a  positive  ethical  ideal.    Ethics  is  a  branch  of  philosophy  
concerned  with  the  basis  of  moral  judgements,  principles  and  values.  
 
1.5 Health   is   a   fundamental   human   right.     Furthermore,   self-­actualisation   is   central   to   both  
health  and  well-­being.    It  follows  therefore  that  equity  and  empowerment  are  core  values.  It  
has   been   internationally   acknowledged   that   peace,   social   justice   and   equity   are   pre-­
requisites  for  health.  
 
1.6 If  these  values  and  ethical  principles  are  accepted,  then  the  mandate  to  promote  health  and  
well-­being   is  a   moral  one.     The  development   of  health  promotion  includes   a  strong  values  
base  reflected  in  World  Health  Organisation  documents  from  the  Ottawa  Charter2  through  to  
the  Bangkok  Charter3.  
 
1.7 Ethical   practice   is   included   in   most   competence   frameworks,   including   the   Public   Health  
Skills  and   Career  Framework   (2008),  and  in  the  NHS  the  Knowledge  and  Skills  Framework  
for  Agenda  for  Change.      
 
1.8 This  document  therefore  summarises  some  of  the  key  ethical  issues  in  health  promotion  and  
restates  some  values  and  principles  that  should  guide  its  practice.  
 
1.9 Health  promotion  and  public  health  are  and  must  be  innovative.    Values  need  to  be  brought  
to  bear  on  innovation,  but  not  unnecessarily  restrict  it.  
 
1.10 This  is  not  a  code  of  conduct  for  the  practice  of  health  promotion.    But  it  ends  with  a  short  
statement   of   principles   of   professional   practice,   which   is   consistent   with   codes   of  
professional   practice   or   conduct   issued   by   professional   bodies   or   groups,   for   example,  
SHEPS   in   Wales   (www.       ),   the   Faculty   of   Public   Health   (www.fph.org.uk),   or   the   Royal  
Society  for  Public  Health  (www.rsph.org.uk).  
 

1
Tilford,  S.,  Green,  J.  and  Tones,  B.K.  (2003)  Values,  Health  Promotion  and  Public  Health.  Leeds  Centre  for  
Health  Promotion  Research,  Leeds  Metropolitan  University
2
WHO  (1986)  The  Ottawa  Charter  for  Health  Promotion.    Geneva:  World  Health  Organisation  
3
WHO  (2005)  The  Bangkok  Charter  for  Health  Promotion  in  a  Globalized  World .  Geneva:  World  Health  
Organisation  

2
6th  draft:  January  2009  

2.     Who  is  the  framework  for  and  how  can  it  be  used?  
 
2.1     The   framework   is   for   use   in   daily   working   practice   by   all   individual   and   organisations   who  
promote  health  and  well-­being:  
 
In  the  voluntary  and  community  sector,  in  local  authorities,  in  businesses  of  all  sizes,  
and  in  health  services  
 
In  planning  and  commissioning  public  health  and  health  promotion  interventions  
 
In  service  specifications  for  health  improvement  interventions  and  services  
 
In  assuring  the  quality  of  public  health,  health  promotion  and  health  care  services  
 
In   working   in   partnerships,   for   example   the   NHS   and   local   authorities,   to   raise  
awareness  of  ethical  issues  and  support  debate  on  what  should  be  done,  for  whom  
and  by  whom  in  health  promotion  and  community  well-­being  
 
2.2     The   framework   could   be   used   in   recruitment   packs   for   posts   in   health   promotion,   health  
improvement,   community   well-­being   and   public   health,   and   cited   in   job   applications   and  
interviews  
 
2.3     It   could   also   be   used   as   a   basis   for   discussion   in   induction,   training   and   education  
programmes.      
 
2.3     It  could  be  used  to  provide  information  for  the  public  about  the  ideals  of  health  promoters  
whom  they  may  meet.  
 
2.4     The   framework   is   not   only   for   people   with   health   promotion   in   their   job   title.     The   term  
µKHDOWKSURPRWLRQSUDFWLWLRQHU¶LVXVHGJHQHULFDOO\LQWKLVGRFXPHQWWR  describe  all  those  who  
promote  health  and  well-­being.  
 
 

3
6th  draft:  January  2009  

3. Health  promotion  ±  definition  and  ways  of  working  

 
3.1 Health  promotion  aims  to  empower  people  and  communities  to  control  their  own  health  and  
well-­being,   by   gaining   control   over   the   underlying   factors   that   influence   health   and   well-­
being.  
 
3.2     7KHPDLQGHWHUPLQDQWV RIKHDOWKDUHSHRSOH¶VFXOWXUDOVRFLDOHFRQRPLFDQGHQYLURQPHQWDO
living   conditions,   and   the   social   and   personal   behaviours   that   are   strongly   influenced   by  
those   conditions.4     7KH WHUP µYLFWLP EODPLQJ¶ LV RIWHQ XVHG WR describe   interventions   that  
place  the  responsibility  for  health  solely  with  the  individual  and  fail  to  recognise  these  wider  
health  determinants.    
 
3.3     +HDOWK SURPRWLRQ LV µHYHU\RQH¶V EXVLQHVV¶ DQG UHTXLUHV FROOHFWLYH DFWLRQ   from   all   sectors   of  
society.    The  broad  practice  of  health  promotion  involves:  
 
ƒ Developing   healthy   public   policy   to   bring   about   changes   in   political,  
organisational  and  institutional  systems  and  structures  to  improve  health  and  foster  
greater  equity;;  
ƒ Creating   supportive   environments   and   ensuring   the   settings,   such   as   schools,  
workplaces  and  neighbourhoods  are  a  source  of  health  for  people;;      
ƒ Enabling   individuals   to   make   informed   choices   about   their   health   and   health  
behaviour   by   increasing   awareness   and   knowledge   and   developing   attitudes   and  
skills  ±  both  specific  skills  and  more  generic  skills  associated  with  health  literacy;;  
ƒ Mobilising   and   empowering   communities   to   enhance   social   support   and  
community  cohesion  and  actively  participate  in  strategies  to  improve  health  and  well-­
being;;  
ƒ Tackling  inequalities  in  health  by  engaging  disadvantaged  and  socially  excluded  
groups.    
 
3.4     The   specialised   health   promotion   workforce   aims   to   build   capacity   for   health  
improvement  by:  
 
ƒ Developing   an   understanding   of   the   factors   that   influence   health   and   health  
behaviour  through  health  needs  assessment  and  health  impact  appraisal  
ƒ Incorporating   health   intelligence   (felt,   expressed,   comparative   and   normative  
needs)   into   the   planning   and   delivery   of   health   promotion   programmes   by   working  
with  communities;;  
ƒ Drawing   on   theory   and   empirical   evidence   to   plan   effective   programmes   to  
improve  health;;  
ƒ Building  partnerships  and  networks  to  engage  individuals  and  groups  in  action  
to  promote  health;;  
ƒ Developing   health   promoting   settings   (e.g.   Healthy   Cities,   Health   Promoting  
Schools);;  
ƒ Providing  resources,  training  and  support  for  the  wider  public  health  workforce  
including  peer  educators;;  
ƒ Evaluating  interventions  to  assess  health  impact  and  contributing  to  the  building  
of  an  evidence  base  of  effective  practice.  

4
International  Union  for  Health  Promotion  and  Education  &  Canadian  Consortium  for  Health  Promotion  
Research  (2007)  Shaping  the  Future  of  Health  Promotion:  Priorities  for  Action.    www.iuhpe.org  

4
6th  draft:  January  2009  

4.0 Statement  of  values  and  principles  

 
This   section  states  values  and   principles   which   reflect   a  liberal   standpoint,   seeking  both  to  
protect   personal   autonomy   and   promote   the   welfare   of   all   people.     The   underlying   issues  
and  tensions  are  discussed  in  sections  5  and  6.  
 
Values  can  be  grouped  into  three  inter-­linked  clusters:  
 
Generic  ethical  principles  
Ultimate  goals  
Ways  of  working5  
 
4.1     Generic  ethical  principles:  

ƒ Do  good  (beneficence)  -­  act  in  the  best  interests  of  others    
ƒ Avoid  doing  harm  (non-­maleficence)  
ƒ Respect   for   autonomy   -­   act   so   as   to   maximise   the   freedom   of   an   individual   or  
community    
ƒ Justice  -­  act  fairly  

4.2     Ultimate  goals,  including:  

 
ƒ Health  as  a  basic  human  right  
 
ƒ A   holistic   understanding   of   health   encompassing   physical,   mental   and   social   well-­
being  
 
ƒ Equity  in  health  -­  the  avoidance  of  unfair  and  unjust  inequalities  in  health  
 
ƒ Empowerment  ±  enabling  individuals  and  communities  to  achieve  control  over  the  
factors  that  influence  their  health  
 
4.3     Ways  of  working,  that  is  ways  of  implementing  the  ultimate  goals,  including:  
 
ƒ Responsibility   -­   LQFOXGLQJ ERWK VRFLDO UHVSRQVLELOLW\ IRU KHDOWK DQG LQGLYLGXDOV¶
responsibility  for  their  own  health  along  with  their  collective  concern  for  the  health  of  
others  
 
ƒ Working   in   ways   which   enable   individuals   and   communities   to   have  
control   over   their   health,   i.e.   in   ways   which   are   empowering   and   promote   self-­
esteem  
 
ƒ Participation  -­  involving  individuals  and  communities  in  identifying  and  responding  
to  their  health  needs  
 
Addressing  the  needs  of  disadvantaged  and  marginalised  groups  of  people  
 

5
µ8OWLPDWHJRDOV¶  can  be  GHVFULEHGDVµWHUPLQDOYDOXHV¶,  DQGµZD\VRIZRUNLQJ¶can  be  described  
DVµLQVWUXPHQWDOYDOXHV¶  

5
6th  draft:  January  2009  

Attempting   to   counter   discrimination   and   be   sensitive   to   the   needs   of  

individuals  and  groups,  whatever  their  gender,  age,  ethnic  origin,  social  background,  
religion,  culture,  sexuality,  ability  or  health  status  
 
ƒ Working   in   partnership   with   individuals,   communities   and   the   range   of   different  
sectors  which  impact  on  health  
 
ƒ Promoting  trust   by   delivering  on  what  is  promised  to  people  or  explaining  why   if  
this  is  not  possible,  and  ensuring  that  interventions  are  as  effective  and  efficient  as  
possible  
 
ƒ Endeavouring   to   ensure   that   services   have   long-­term   positive   effects,   by  
leaving  individuals  and  groups  stronger  and  more  empowered  
 
ƒ A  commitment  to  sustainable  development,   including  the  adoption  of  a  socio-­
ecological   PRGHO RI KHDOWK WKDW UHVSHFWV WKH OLPLWV RI WKH HDUWK¶V QDWXUDO UHVRXUFHV
(such  as  land,  water  and  sources  of  energy)  
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

6
6th  draft:  January  2009  
 
 
 
  ETHICAL  
  HEALTH  
  PROMOTION  
 
  GENERIC  ETHICAL  PRINCIPLES  
   
  Do  good  (beneficence)  
 
Avoid  doing  harm    
(non-­malificence)  
 
Respect  for  autonomy    
 
Justice  
 

 
ULTIMATE  GOALS  
 Including    
 
Health  as  a  basic  human  right  
 
Holistic  understanding  of  health  
 
Equity  in  health  
 
Empowerment  

WAYS  OF  WORKING  

 Including  
 
Addressing  the  needs  of  disadvantaged  and  marginalised  groups    
Working  participatively    
Enabling  individuals  and  communities  to  have  control  over  their  health,  i.e.  in  ways  which  are  empowering  
Working  in  partnership  with  individuals,  communities  and  sectors  
Endeavouring  to  ensure  that  services  have  long-­term  positive  effects  
Encouraging  social  UHVSRQVLELOLW\IRUKHDOWKDQGLQGLYLGXDOV¶UHVSRQVLELOLW\IRUWKHLURZQKHDOWK    
Attempting  to  counter  discrimination  
7
Promoting  trust  
A  commitment  to  sustainable  development  and  a  socio-­ecological  model  of  health  
6th  draft:  January  2009  

5.0 Examples  for  discussion6  

 
5.1 Beneficence  and  non-­maleficence  
 
It   is   not   always   possible   to   simultaneously   do   good   and   to   avoid   harm.     For   example,   by  
making   individuals   aware   of   the   threat   of   terrorism   and   encouraging   vigilance,   one   is  
potentially  doing  good  by  reducing  the  likelihood  of  successful  terrorist  attack.    But  one  may  
also  be  doing  harm  by  inadvertently  encouraging  public  fear  and  insecurity.  
 
Screening   has   the   potential   benefit   of   enabling   early   diagnosis   of   disease   and   successful  
treatment.    But  it  creates  worry,  anxiety  and  stress  and,  sometimes,  results  in  unnecessary  
treatment.    You  will  be  able  to  think  of  examples.  
 
5.2 Respect  for  autonomy  
 
Are   there   groups   in   society   who   might   be   seen   as   incapable   of   autonomy,   and   who   are  
treated   as   dependent?     For   what   reasons?     Think   about   people   with   learning   disabilities,  
children,  prisoners.  
 
If   an   individual   makes   a   choice   that   you   consider   harmful,   you   may   be   torn   between  
UHVSHFWLQJWKDWSHUVRQ¶VDXWRQRP\GRLQJJRRGDQGDYRLGLQJKDUPThe  key  question  is:  by  
what   right   am   I   intervening   and   how   do   I   justify   the   action   I   am   taking?     Abortion,  
sectioning  in  mental  health  and  care  orders  are  obvious  examples.  
 
5.3 Justice  
 
The   principle   of   distributive   justice   is   bound   up   with   the   principles   of   avoiding   harm   and  
doing   good.     Health   promotion   involves   difficult   decisions   in   the   dividing   of   time   and  
resources   between   individuals   and   communities,   between   high-­risk   groups   and   whole  
SRSXODWLRQV+RZGR\RXEDODQFHJHQHUDOµKHDOWKHGXFDWLRQ¶RQKHDOWK\OLYLQJIRUWKHZKROH
population  with  targeted  interventions,  such  as  setting  up  a  youth  centre  for  young  people  
excluded  from  school?  
 
5.4 Some  ethical  questions  to  ask  yourself  and  debate  with  others  
 
Does  the  proposed  action:  
ƒ Safeguard  equity,  respect  and  further  the  creation  of  autonomy?  
ƒ Is  it  avoiding  harm?  
ƒ Will  the  consequences  of  the  action  be  good  and  for  whom?  
 
When  planning  interventions:  
ƒ What  should  we  be  doing?  
ƒ For  whom  should  we  be  doing  it  and  at  what  cost/risk  to  others?  
ƒ Who  should  decide  and  how?  
ƒ How  can  you  achieve  the  right  balance  between  the  rights  of  the  population  and  the  
rights  of  the  individual?  
 
You  may  find  the  next  section  useful  to  read  before  debating  these  questions.  

6
This  section  is  adapted  from  Earle,  S.  (2007)  Promoting  public  health:  exploring  the  issues,  
Chapter  1  in:  Earle,  S.,  Lloyd,  C.E.,  Sidell,  M.  and  Spurr,  S.  Theory  and  research  in  promoting  
public  health.    Sage  publications  in  association  with  the  Open  University.  

8
6th  draft:  January  2009  

6.0 Some  important  ethical  issues  for  health  promotion  

 
The  population  and  the  individual  

6.1     Health   promotion   can   be   seen   as   paternalistic:   DQ H[WHQVLRQ RI WKH µQDQQ\ VWDWH¶ ZKLch  
LQWHUIHUHVZLWKSHUVRQDOOLEHUW\DQGIUHHGRP6RPHKROGWKHYLHZWKDWµGRLQJQRWKLQJ¶LVWKH
most  morally  acceptable  option  as  it  gives  individuals  the  greatest  freedom.    However,  this  
does  not  redress  the  distribution  of  power  in  society  which  may  limit  the  ability  of  individuals  
(particularly   vulnerable   groups)   to   act   autonomously.     Health   promotion   addresses   this   by  
empowering   individuals   and   communities   to   increase   control   over   factors   that   affect   their  
health  and  well-­being.  

6.2     A   fundamental   ethical   question   facing   health   promotion   practitioners   is   the   relationship  
EHWZHHQWKHVWDWH¶VDXWKRULW\DQGWKHSRVLWLRQRILQGLYLGXDOSHRSOHDQGLQWHUPHGLDWHERGLHV
At  the  one  end  of  the  spectrum  there  is  a  libertarian  perspective  (which  limits  involvement  in  
social  welfare  issues)  and  at  the  other  is  a  collectivist  point  of  view  (which  includes  utilitarian  
or  social  contract  approaches).  
 
6.3     Health   promotion   can   be   concerned   with   the   individual   level,   but   tends   to   focus   on   the  
population   level.     The   interplay   and   interaction   between   individuals,   communities   and   the  
wider   populations   is   important   and   central   to   socio-­ecological   models   of   health   promotion.    
One   of   the   difficulties   in   applying   ethical   principles   in   health   promotion   is   the   tension  
between  the  LQGLYLGXDODQGSRSXODWLRQLHLQZKDWLQVWDQFHVVKRXOGDQLQGLYLGXDO¶VULJKWVEH
overridden   in   the   interests   of   the   greater   good?).     Similar   conflicts   arise   when   action   to  
ensure  social  justice  and  equity  leads  to  an  infringement   of  individual  rights  and/or  overall  
health  gain  within  the  population.    
 
7KH1XIILHOG&RXQFLORQ%LRHWKLFV7KHµVWHZDUGVKLSPRGHO¶    
 
6.4     The  empowerment  model  of  health  promotion  is  compatible  with  what  has  been  termed  the  
µVWHZDUGVKLS PRGHO¶ E\ WKH 1XIILHOG &RXQFLO RQ %LRHWKLFs   (2007)7  ³7KH FRQFHSW RI
µVWHZDUGVKLS¶ LV LQWHQGHG WR FRQYH\ WKDW OLEHUDO VWDWHV KDYH D GXW\ WR ORRN DIWHU LPSRUWDQW
needs   of   people   individually   and   collectively.     It   emphasises   the   obligation   of   states   to  
provide   conditions   that   allow   people   to   be   healthy   and,   in   particular,   to   take   measures   to  
UHGXFHKHDOWKLQHTXDOLWLHV´  
 
6.5     Core  characteristics,  proposed  by  the  Nuffield  Council,  of  public  health  programmes  carried  
out  by  a  stewardship-­guided  state  include:  
 
ƒ Aim   to   reduce   the   risks   of   ill   health   by   regulations   that   ensure   environmental  
conditions   that   sustain   good   health,   such   as   the   provision   of   clean   air   and   water,  
safe  food  and  appropriate  housing  
ƒ Pay  special  attention  to  the  health  of  children  and  other  vulnerable  people  
ƒ Promote   health   not   only   by   providing   information   and   advice,   but   also   by  
programmes  to  help  people  overcome  addictions  and  other  unhealthy  behaviours  
ƒ Aim   to   ensure   that   it   is   easy   for   people   to   lead   a   healthy   life,   for   example   by  
providing  convenient  and  safe  opportunities  for  exercise  
ƒ Aim  to  reduce  health  inequalities  
 

7
Nuffield  Council  on  Bioethics  (2007).    Public  Health:  Ethical  Issues  

9
6th  draft:  January  2009  

6.6   At  the  same  time,  the  stewardship-­guided  state  should  seek  to  minimise  interventions  that  
are   perceived   as   unduly   intrusive   and   in   conflict   with   important   personal   values,   including  
significant  limitations  on  individual  freedom.    The  Nuffield  Council  proposes  aQµLQWHUYHQWLRQ
ODGGHU¶ VHH EHORZ)   and   suggests   that   substantial   restrictions   on   choice   are   only   justified  
where  there  is  a  clear  indication  that  a  public  health  policy  initiative  will  produce  the  desired  
effect  and  have  a  strong  health  justification,  e.g.  banning  smoking  in  public  places.  
 
  Nuffield  Council  on  Bioethics  ±  Public  health:  ethical  issues,  2007  
  The  intervention  ladder  
  The  ladder  of  possible  government  actions  is  as  follows:  
 
  Eliminate  choice    
 

e.g.  banning  smoking  in  public  places,  drink-­driving  laws,  fluoridation  of  water  supplies  
 
 
 

Restrict  choice  
e.g.  industry  limits  on  the  fat,  salt  and  sugar  content  of  processed  food  
 
 
 

Guide  choice  through  disincentives    

e.g.  tax  on  cigarettes,  congestion  charges,  car  parking  fees  
 
 
 

Guide  choice  through  incentives  

e.g.  tax-­breaks  on  the  purchase  of  bicycles  in  conjunction  with  green  travel  plans  
 
 
 

Guide  choice  through  changes  in  policy  

e.g.  local  planning  authorities  policies  on  transport,  school  catering  policies    
 
 
 

Enable  choice  
e.g.  stop  smoking  clinics,  cycles  routes,  fruit  tuck  shops  in  schools  
 
 
 

Provide  information  
e.g.  sex  education  in  schools,  mass-­media  campaigns    
 
 
 

Do  nothing  or  monitor  the  situation  

e.g.  surveillance  of  population  health    
 
 
 
7. Some  principles  of  professional  practice  
 
In  addition  to  seeking  to  think  and  act  in  accordance  with  the  values  and  principles  set  out  
above,   health   promotion   practitioners   should   endeavour   to   adhere   to   the   following  
commonly-­accepted  principles  of  professional  practice:  
 
ƒ Work   within   the   limits   of   their   knowledge,   skills   and   experience   and   not   undertake  
work   for  which  they   consider  themselves  unqualified  or  which  might  put  individuals  
or  communities  at  risk  

10
6th  draft:  January  2009  

 
ƒ Reflect  on  their  own  practice,  assessing  what  effect  their  work  has  on  the  health  of  
individuals   and   communities,   and   use   these   reflections   to   improve   their   future  
practice  
 
ƒ Demonstrably   keep   their   knowledge   and   skills   regularly   updated   and   strive   to   be  
aware  of  improved  ways  of  increasing  their  effectiveness  
 
ƒ Set  a  good  example  in  professional  situations  
 
ƒ Base   their   work   on   evidence,   including   an   appropriate   theory   base,   and   seek   to  
evaluate  their  practice,  building  evidence  for  others  to  use  
 
 
 
8. Sources  and  further  information  
 
Faculty   of   Public   Health   (2002?)   Good   Public   Health   Practice   ±   General   Professional  
Expectations  of  Public  Health  Physicians  and  Specialists  in  Public  Health.    www.fph.org.uk  
 
Nuffield   Council   on   Bioethics   (2007).     Public   Health:   Ethical   Issues.    
www.nuffieldbioethics.org  
 
Public   Health   Leadership   Society   (2002).   Principles   of   the   Ethical   Practice   of   Public   Health.  
Version  2.2.    www.phls.org  (Publications,  Overview  of  the  Public  Health  Code  of  Ethics).  
 
SHEPS   Cymru   (2007).     The   Principles   and   Practice   and   Code   of   Professional   Conduct   for  
Health   Education   and   Promotion   Specialists   in   Wales.     (This   is   a   revised   version   of   a  
document  with  the  same  title  developed  and  published  by  SHEPS  in  1997.)  
 
Sindall,   C.   (2002)   Does   Health   Promotion   Need   a   Code   of   Ethics?   Health   Promotion  
International,  Vol.  17,  No.  3,  210-­203.  
 
Tones,   K.   and   Green,   J.   (2004).     Health   Promotion:   Planning   and   Strategies.     Sage  
Publications,  London.  [2nd  edition  in  course  of  preparation]  
 

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