Which set of ethical principles is fundamental in public health practice?

• A. Autonomy, beneficence, nonmaleficence, justice
• B. Autonomy, efficiency, privacy, innovation
• C. Beneficence, paternalism, coercion, justice
• D. Autonomy, confidentiality, utility, fairness

Answer: (A)

Public health practice is guided by four core ethical principles that help balance individual rights with the health of communities: autonomy, beneficence, nonmaleficence, and justice. Autonomy means respecting each person’s right to make informed decisions about their own health. Beneficence is the obligation to contribute to others’ well‑being by acting in their best interests. Nonmaleficence requires avoiding harm or minimizing risks to people. Justice focuses on fair distribution of benefits and burdens, ensuring equal access and protecting disadvantaged groups.

These principles come into play in real-world public health actions. For example, vaccination programs aim to protect the population (beneficence) while trying to respect individuals’ choices as much as possible (autonomy), minimize harm from procedures or side effects (nonmaleficence), and ensure equitable access across communities (justice).

Other options mix in goals like efficiency or innovation, or invoke paternalism and coercion, which are not the fundamental ethical framework used in public health. They also include elements like confidentiality or utility in ways that don’t capture the full, balanced quartet described above. Hence, autonomy, beneficence, nonmaleficence, and justice best represent the foundational ethical principles for public health practice.