Ethical frameworks have been an evolutionary process since the idea was first established. Lee (2012) states that principle-based frameworks for ethical decision making have been criticized based on claims that they lack a common moral imperative to guide behavior, offer only simple standards for behavior, which are inadequate for resolving complex ethical problems, or creating an untenable collection of “whatever works” from a variety of philosophical theories (pg. 8). Developers of frameworks for public health ethics based on specific philosophical underpinnings carefully describe the fundamental unifying theoretical basis from which all ethical decision can be derived (Lee, 2012). These theory-based frameworks summarized by Lee (2012) have common characteristics that lie within philosophical underpinnings, foundational values, and operating principles.
For the purpose of this discussion, I have chosen to investigate J.M. Mann’s “Health and Human Rights,” framework. The philosophical underpinning is human rights with the foundational values including human rights are a critical determination of health and a basic minimum that governments should ensure for all persons in order to ensure health (Lee, 2012). The operating principles within this structure include that health is contextual and more than medicine and public that public health practitioners must commit to linking human rights with public health (Lee, 2012). Human rights are rights inherent to all human beings, whatever our nationality, place of residence, sex, national or ethnic origin, religion, language, or any other status (United Nations, 2012). There rights are all interrelated, interdependent and indivisible.
According to Mann (1997) there is more to modern health than new scientific discoveries, the development of new technologies, or emerging or re-emerging diseases. World events and experiences, such as the AIDS epidemic, have made this more evident by creating new relationships among medicine, public health, ethics, and human rights. Each domain has seeped into the other, making allies of public health and human rights, and pressing the need for an ethics of public health, and revealing the rights-related responsibilities of physicians and other health care workers (Mann, 1997).
While investigating this theory-based framework, it proves there has been a tremendous amount of work done with health and human rights in mind.
In the early 1990s the late Jonathan Mann and Daniel Tarantola left the WHO Global Program on AIDS (Pawlowska, 2011). They helped establish the unit a few years before, however they disagreed with how the program was run and the philosophy that motivated its actions. Mann and Tarantola found academic “refuge” at Harvard and began thinking about the most effective framework for dealing with the AIDS epidemic (Pawlowska, 2011). Although they were both qualified physicians, it did not take them long to realize that HIV/AIDS needs to be treated with new drugs, but that it was equally important that the patients to be guaranteed respectful treatment and honored their dignity as human beings. With that being said, they decided this was the best theoretical basis for an effective fight against AIDS.
Other public health research with this theory-based practice includes human rights in patient care and human rights and mental health. Overall, the “Health and Human Rights” framework by Jonathan Mann is one that still guides many public health decisions today. HIV/AIDS is one public health issue that has utilized this particular framework most, but there are still other areas within the field that take into account this outline. This framework protects the individual and provides them with the rights they deserve.
Lee, L.M. (2012). Public health ethics theory: Review and path to convergence.Journal of Law, Medicine,& Ethics,85-98.
Mann, J.M. (1997). Medicine and public health, ethics and human rights. Retrieved from
Pawlowska, M. (2011). Human rights and Reproductive health: a primer. Retrieved from
United Nations. (2012). What are human rights? Retrieved from