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Article << Previous     |     Next >>   Contents Vol 23(6)

Evidence and ethics in public health: the experience of SARS in Canada

Ross E.G. Upshur

A Professor, Department of Family and Community Medicine, Canada Research Chair in Primary Care Research, University of Toronto
B Email: ross.upshur@sunnybrook.ca

NSW Public Health Bulletin 23(6) 108-110 http://dx.doi.org/10.1071/NB11044
Published: 28 June 2012

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Making decisions on the basis of evidence is a central tenet of all health-care disciplines, including public health. However, it is not entirely clear what it means to base decisions on evidence; debates on evidence-based approaches often lack a clear understanding of the nature of evidence and obscure the normative underpinnings of evidence. Public health decision making requires an acceptance of limitations such as the availability of funding for research to provide complete evidence for any given decision, the ethical constraints on the creation of certain types of evidence and the ongoing dilemma between the need to take action and the need to gather more information. Using the example of the SARS outbreak in Canada, the inter-relationships between evidence and ethics are explored. I outline a set of critical questions for the global public health community to discuss regarding the nature of the relationship between evidence-based public health practice and ethics.


[1]  Fisher RA. Cigarettes, Cancer and Statistics. Cent Rev 1958; 2: 151–66. Available at: http://digital.library.adelaide.edu.au/coll/special/fisher/274.pdf (Cited 17 October 2011).

[2]  Hill AB. The environment and disease: association or causation? Proc R Soc Med 1965; 58: 295–300.
| CAS |

[3]  Upshur REG. Seven characteristics of medical evidence. J Eval Clin Pract 2000; 6: 93–7.
CrossRef | CAS |

[4]  Upshur REG. If not evidence, then what? Or does medicine really need a base? J Eval Clin Pract 2002; 8: 113–9.
CrossRef |

[5]  Naylor CD, Chantler C, Griffiths S. Learning from SARS in Hong Kong and Toronto. JAMA 2004; 291: 2483–7.
CrossRef | CAS |

[6]  Bondy SJ, Russell ML, Laflèche JM, Rea E. Quantifying the impact of community quarantine on SARS transmission in Ontario: estimation of secondary case count difference and number needed to quarantine. BMC Public Health 2009; 9: 488. Available at: http://www.biomedcentral.com/1471-2458/9/488 (Cited 17 October 2011).

[7]  Campbell A. SARS Commission, Executive Summary. Spring of Fear. Volume 1 December 2006. Available at: http://www.health.gov.on.ca/english/public/pub/ministry_reports/campbell06/online_rep/V1C3.html (Cited 17 October 2011).

[8]  Childress JF, Faden RR, Gaare RD, Gostin LO, Kahn J, Bonnie RJ, et al. Public health ethics: mapping the terrain. J Law Med Ethics 2002; 30: 170–8.
CrossRef |

[9]  Kass NE. An ethics framework for public health. Am J Public Health 2001; 91: 1776–82.
CrossRef | CAS |

[10]  Upshur RE. Principles for the justification of public health intervention. Can J Public Health 2002; 93: 101–3.
| CAS |

[11]  Powers M, Faden R. Social justice: the moral foundations of public health and health policy. Oxford: Oxford University Press, 2006.

[12]  Marmot M, Friel S. Global health equity: evidence for action on the social determinants of health. J Epidemiol Community Health 2008; 62: 1095–7.
CrossRef | CAS |

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