Public-Health-Ethik-Lehre in Deutschland: Aktuelle Entwicklungen und Perspektiven

19. Mai 2025, 19.30 bis 21:00 (CET)

Bei der Veranstaltung zur Lehre der Public-Health-Ethik im deutschsprachigen Raum wurde das Thema aus zwei unterschiedlichen Perspektiven beleuchtet.

Den ersten Impuls gab Prof. Dr. Manfred Wildner, der das Thema aus Sicht des Öffentlichen Gesundheitsdienstes (ÖGD) betrachtete. Er thematisierte insbesondere die unterschiedlichen ethischen Leitbilder der im Public-Health-Bereich tätigen Akteure. Dabei wurde deutlich, dass es zu Spannungen und Interessenskonflikten zwischen dem Verwaltungsethos, dem ärztlichen Ethos sowie allgemeinen ethischen und politischen Theorien kommen kann. Ein zentraler Aspekt seines Beitrags war der dreifache Paradigmenwechsel der im ÖGD (von der staatlich hoheitlichen- zur Transparenzpflicht, von der Krankheitsvermeidung zur Salutogenese und von einer (Zwangs-)Vollzugsbehörde zu Serviceorientierung und Dienstleistung) – insbesondere seit der Coronapandemie – deutlich spürbar ist. Als Fazit betonte Prof. Wildner die Notwendigkeit einer differenzierten und zielgruppenspezifischen Public-Health-Ethik-Lehre, etwa für die Mitarbeitenden im ÖGD.

Den zweiten Beitrag lieferte PD Dr. Solveig Hansen, die den Fokus auf die Lehr-Lern-Beziehung in der Vermittlung ethischer Inhalte im Public-Health-Kontext legte. Ihr Vortrag hob hervor, wie bedeutsam es ist, einen Lernraum zu gestalten, der Aspekte wie Partizipation, Diversität, Sensibilität und Anerkennung berücksichtigt, um Studierenden einen Zugang zum Thema Ethik zu ermöglichen. Gerade in der Public-Health-Ethik sind Lehrende in besonderem Maße gefordert, sich ihrer Rolle als moralische Vorbilder bewusst zu sein. Weitere Informationen zur Einbettung von Ethik in Bremer gesundheitswissenschaftliche Studiengänge sowie zu den finden sich in den beigefügten Präsentationsfolien.

In der anschließenden Diskussion wurden verschiedene relevante Aspekte aufgegriffen. So wurde betont, dass Bevölkerungsmedizin über die bloße Summe individueller medizinischer Maßnahmen hinausgedacht werden muss. Insbesondere im Hinblick auf die Public-Health-Ethik-Lehre für den ÖGD wurde die Auseinandersetzung mit der Rolle des Gesundheitsdienstes im Nationalsozialismus als weiterhin wichtiges und zu vertiefendes Forschungsthema benannt. Der Ansatz, die Lehr-Lern-Beziehung stärker in den Mittelpunkt zu rücken, stieß auf breite Zustimmung. Es wurde über verschiedene didaktische Methoden diskutiert, wie etwa den Einsatz von Fallbeispielen zur Veranschaulichung ethischer Fragestellungen in der Lehre.

English version

At the event on teaching public health ethics in German-speaking countries, the topic was examined from two different perspectives.

The first impulse was given by Prof Dr Manfred Wildner, who looked at the topic from the perspective of the Public Health Service (ÖGD). He focussed in particular on the different ethical guiding principles of those working in the public health sector. It became clear that tensions and conflicts of interest can arise between the administrative ethos, the medical ethos and general ethical and political theories. A central aspect of his contribution was the threefold paradigm shift that is clearly noticeable in the public health service – especially since the corona pandemic. In conclusion, Prof Wildner emphasised the need for differentiated and target group-specific public health ethics teaching, for example for employees in the public health service.

The second contribution was made by PD Dr Solveig Hansen, who focused on the teaching-learning relationship in the teaching of ethical content in the public health context. Her presentation emphasised how important it is to create a learning space that takes aspects such as participation, diversity, sensitivity and recognition into account in order to enable students to access the topic of ethics. Especially in public health ethics, teachers are particularly challenged to be aware of their role as moral role models. Further information on ethical teaching content in public health degree programmes can be found in the attached presentation slides.

Various relevant aspects were addressed in the subsequent discussion. It was emphasised that population medicine must be considered beyond the mere sum of individual medical measures. Particularly with regard to public health ethics teaching for the ÖGD, the examination of the role of the health service under National Socialism was identified as a research topic that remains important and needs to be explored in greater depth. The approach of focussing more on the teaching-learning relationship met with broad approval. Various didactic methods were discussed, such as the use of case studies to illustrate ethical issues in teaching.

„The Role of Codes of Ethics in the Professionalization of the Public Health Workforce“

4. November 2024, 19.30 – 20.30 (CET)

Katarzyna Czabanowska, PhD, MA, Professor of Public Health Leadership and Workforce Development, Department of International Health, Care and Public Health Research Institute (CAPHRI), Maastricht University, The Netherlands
James C. Thomas, MPH, PhD, Emeritus Professor of Epidemiology, University of North Carolina, Chapel Hill, USA

The professionalization of its workforce has been a key topic to the field of public health for the last years, not only since the Covid-19-pandemic.

Bachelor and Master programmes in public health have been developed and taught in the last decades and public health institutions have been opened for graduates from this field. The public health community is discussing competences for learning in the field ever since. Ethics belongs to the concept of an academically educated “profession” and thus “professionalization” deals with the question how to implement an ethos, morals or ethics in the education and practice of the public health workforce.

One approach to integrate a moral point of view here is to develop and implement so called “Codes of Ethics” or “Codes of Conducts” and to learn how to apply them in practice, including solving conflicts among the norms presented in such a code. Are codes meaningful tools for this context? What norms, values and virtues should they entail? Would every local public health community develop its own “code”? These and other questions are pertinent to the international agenda of professionalization of the public health workforce – and will be raised during this academic online seminar.

Moderator: Dr. Peter Schröder-Bäck, Professor of Ethics, Institute of History and Ethics, University of Applied Sciences for Police and Public Administration North Rhine-Westphalia (HSPV NRW), Germany

„Der Aufbau des Bundesinstitut für Prävention und Aufklärung in der Medizin (BIPAM) – auch ein Thema für Philosophie und Ethik!?“

10. Juni 2024,19:30 – 20:30 MEST
Prof. Dr. Dr. hc mult Helmut Brand, Maastricht University
Prof. Dr. Ansgar Gerhardus, Universität Bremen

Das Bundesinstitut für Prävention und Aufklärung in der Medizin (BIPAM) befindet sich derzeit in Gründung. Der Bundesgesundheitsminister erhofft sich dadurch eine Stärkung von Primärprävention und öffentlicher Gesundheit. Ein genauer Zuschnitt des neuen Bundesinstituts ist noch nicht bekannt, die Bundeszentrale für gesundheitliche Aufklärung und Teile des Robert-Koch-Instituts sollen jedoch in diesem Institut aufgehen. Damit werden Institutionen der öffentlichen Gesundheit in Deutschland neu geordnet. Kritik am geplanten BIPAM selbst kommt aus Institutionen, die von der Neuordnung direkt betroffen sind als auch von Wissenschaftlern, die einen nachhaltigen Public Health-Ansatz vermissen lassen.

In unserer Diskussionsrunde haben wir Statements zu den Plänen von zwei Referenten mit ausgewiesener Expertise gehört und public-health-ethische und gesundheitsphilosophische Implikationen erörtert.

The WHO international pandemic accord

22nd April 2024

Dr. Jaouad Mahjour, Head of the WHO Secretariat to INB and IHR Amendments, was able to give an “Update on WHO international pandemic accord“: 

In December 2021, the World Health Assembly decided to establish an intergovernmental negotiating body (INB) to draft a WHO an agreement on pandemic prevention, preparedness and response. In light of the impact of the COVID-19 pandemic, the WHO member states wanted to make sure that communities, governments and all sectors of society are better prepared and protected in order to prevent and respond to future pandemics. It is one of the central goals of the accord to ensure equity in accessing both tools to prevent pandemics and health care for all people.

Is the public health “war on obesity” doing more harm than good?  

12th December 2023

Assoc. Prof. Angela Ballantyne spoke on what good the war on obesity has achieved, what harm it has caused, and whether it has generated a net increase in health and well-being, at reasonable cost.

Epistemic Corruption and Epistemic Authority: Science, Ethics and Public Trust during COVID-19

26th June 2023

Dr. Alison Thompson explained the concepts of „epistemic corruption“ and „epistemic authority“ (coined by Sergio Sismondo) and applyed them to understand the role of public trust in pandemic response.

Public health and the role of unconventional solidarity groups

22th May 2023

The topic of Dr. Peter West-Oram talk were different types of solidatity groups. He elaborated on how they differ from, relate to, and interact with one another, and the consequences that this can have for public health.

The role of Public Health Ethics in Lebanon

27th February 2023

Prof. Jihad Makoul gave a talk about the role of Public Health Ethics in Lebanon. She especially elaborated on the role of non-governmental third parties and posed interesting questions on which role they are playing in a human-rights-based approach to Public Health.

Public Health Ethics in Denmark

26th September 2022

In his talk Prof. Klaus Høye gave insights into Danish Public Health Ethics before, during and possibly after the Covid-19 pandemic.

Comparing Vaccination-Policies

7th March 2022

In short talks by Peter West-Oram (University of Sussex, UK), Ryoa Chung (Université de Montréal, Canada), Christian Munthe (University of Gothenburg, Sweden) and Georg Marckmann (LMU, Munich) the event gave an insight into the different vaccination policies in UK, Canada, Sweden and Germany.

Kick-off-Meeting

20th October 2020 

The working group’s first meeting to discuss ideas of how to work together and what topics to look at. As this was in the midst of the Covid-19 Pandemic it started out as a working group concerning Public Health ethical issues concerning the Pandemic.