| My thesis addresses the issue of ethics in public health risk communication from the perspective of environmental health sciences. The thesis explores the practice of public health risk communication through the example of chemicals in the envirornment. The thesis uses for examples, tobacco smoke, alcohol, fruits and vegetables, and the pesticide toxaphene, a chemical introduced to the environment in 1950. The thesis addresses three hypotheses as an hermeneutic (i.e., interpretative) analysis: (1) there is a need for an ethical framework for environmental health risk communication as practiced by public health agencies; (2) there are analogies from bioethics and the development of the healthcare provider-person relationship which can be applied to the public health practice of environmental health risk communication; (3) for the specific practice of issuing health advisories by public health agencies, there is a balance between the "principles of bioethics" and the relational context. The "principles of bioethics" must be integrated into risk communication with such factors as causality, degree of uncertainty, variability, legal liability, and cultural diversity.; My thesis develops the practice of public health by considering the perspective of Socrates (470--399 BC.). Socrates was a public benefactor , communicating with the public in trying to learn. In the historical Socrates, I find the ethical principles of fostering autonomy, the gadfly and midwife, beneficence, promote the good, and non-maleficence, do no harm. It is argued that any practical ethical principle develops meaning when considered in the relational context. I develop the concepts of science and risk from Socrates' perspective.; My thesis explores the history of health risk communication through analysis of the Canadian Journal of Public Health over this century. After the method of Socrates, the thesis compares the risk communication ethical desideria, the values expressed by public health providers, and the deeds of public health practice with respect to chemicals in the environment. I conclude that the words and the deeds are, in fact, not in harmony.; I propose a practical approach to health risk communication that develops the concepts of health advisories, public notification of benefits and harms, and chess advisories, public notification of the state of public health risk games. The model develops the concepts of risk assessment as decision under ignorance. The theoretical perspective, hazard identification and dose-response, is discussed in terms of the nine Hill Causal Criteria, and provides the spectacles through which to reflect upon exposure assessment. |
