Membership of the Faculty of Public Health (MFPH) Ethics, Law and Professional Practice in Public Health Syllabus

Ethics, Law and Professional Practice in Public Health syllabus — full chapter and topic list

Expand any chapter to see its topics and sub-topics. This is the whole examinable outline for Ethics, Law and Professional Practice in Public Health in Membership of the Faculty of Public Health (MFPH), not a summary of it.

1. 1

   Ethical Frameworks

   4 topics

   • Four principles of biomedical ethics
     • Autonomy
     • Beneficence and non-maleficence
     • Justice
   • Consequentialism, deontology and virtue ethics
   • Public health ethics frameworks
     • Nuffield intervention ladder
     • Stewardship model
   • Liberty, paternalism and the harm principle
2. 2

   Law Relevant to Public Health

   5 topics

   • Public health legislation and statutory duties
   • Consent, capacity and the Mental Capacity Act
   • Confidentiality and Caldicott principles
   • Data protection and UK GDPR
   • Equality Act and human rights in health
3. 3

   Research Ethics and Integrity

   4 topics

   • Research ethics committee approval
   • Informed consent in research
   • Research misconduct and conflicts of interest
   • Ethics of screening, surveillance and emergency response
4. 4

   Professional Practice and Development

   4 topics

   • Professional standards and accountability
   • Equality, diversity and inclusion in practice
   • Critical reflection and continuing professional development
   • Scientific writing and communication of evidence

Ethics, Law and Professional Practice in Public Health flashcards for Membership of the Faculty of Public Health (MFPH)

25 of 51 cards from the Ethics, Law and Professional Practice in Public Health deck — real questions with worked answers.

1. What are the four principles of biomedical ethics (Beauchamp and Childress)?

   Autonomy (respecting a person's right to self-determination), Beneficence (acting in the patient's best interest), Non-maleficence (do no harm), and Justice (fair distribution of benefits, risks and resources).

2. In Beauchamp and Childress's framework, how is the principle of non-maleficence distinguished from beneficence?

   Non-maleficence is the obligation to avoid causing harm ("first, do no harm"), while beneficence is the positive obligation to act for the benefit of others. Non-maleficence is generally treated as a stronger, more constant duty.

3. What does the principle of justice require in public health ethics, and what three types of justice are commonly distinguished?

   Justice requires fair, equitable and appropriate distribution. The three types are distributive justice (fair allocation of resources), procedural justice (fair processes/decision-making), and rights-based justice (respecting people's legal and moral rights).

4. Define consequentialism and name its most influential form.

   Consequentialism judges the moral rightness of an action solely by its outcomes/consequences. Its most influential form is utilitarianism, which seeks to maximise overall welfare or utility (the greatest good for the greatest number).

5. What is deontology, and who is its key philosopher?

   Deontology (duty-based ethics) judges actions by adherence to rules, duties and rights rather than outcomes; some acts are inherently right or wrong. Its key philosopher is Immanuel Kant, who proposed the categorical imperative (act only on maxims you could will to be universal laws; treat people as ends, never merely as means).

6. What is virtue ethics and on what does it focus?

   Virtue ethics (rooted in Aristotle) focuses on the moral character of the agent rather than rules or consequences. It asks what a virtuous person would do, emphasising virtues such as honesty, courage, compassion and practical wisdom (phronesis).

7. Contrast how consequentialism, deontology and virtue ethics would each justify a public health intervention.

   Consequentialism: justified if it produces the best overall outcomes (e.g. most lives saved). Deontology: justified if it respects duties and rights regardless of outcome (e.g. honouring consent). Virtue ethics: justified if it reflects the conduct of a person of good character (e.g. acting with compassion and integrity).

8. Name the main features that distinguish public health ethics from clinical (individual) medical ethics.

   Public health ethics focuses on populations rather than individuals, emphasises prevention and the common good, must balance individual liberty against collective benefit, addresses health equity and social justice, and often acts under conditions of uncertainty and resource constraint.

9. What is Nuffield Council on Bioethics' 'intervention ladder' and what does it represent?

   The intervention ladder ranks public health interventions by their intrusiveness on individual choice, from least to most: do nothing/monitor; provide information; enable choice; guide choice through incentives/disincentives; restrict choice; eliminate choice. More intrusive rungs require stronger justification.

10. What is the 'stewardship model' proposed by the Nuffield Council on Bioethics?

    It describes the state's responsibility to look after important needs of citizens collectively and individually—reducing health risks, providing conditions for good health, and protecting the vulnerable—while minimising coercion and respecting autonomy and equity.

11. State John Stuart Mill's harm principle.

    The harm principle holds that the only legitimate reason for which power can be exercised over an individual against their will is to prevent harm to others. A person's own physical or moral good is not sufficient warrant for coercion.

12. Define paternalism and distinguish hard (strong) from soft (weak) paternalism.

    Paternalism is interfering with a person's liberty for their own good. Soft (weak) paternalism intervenes only when the person's choice is non-voluntary or insufficiently informed; hard (strong) paternalism overrides even a fully informed, voluntary choice for the person's own benefit.

13. What is meant by 'liberty' in the context of public health, and what tension does it create?

    Liberty is the individual's freedom to make their own choices without interference. The central tension in public health is balancing individual liberty against measures that protect or promote the health of the wider population (e.g. mandatory vaccination, quarantine, smoking bans).

14. In England, which Act provides the principal statutory powers for protecting public health from infectious disease, and what does it allow?

    The Public Health (Control of Disease) Act 1984 (as amended by the Health and Social Care Act 2008). It allows measures such as notification of infectious diseases and the use of public health protection regulations, including powers to impose restrictions or requirements on persons, things or premises to protect health.

15. What is a 'notifiable disease' and to whom must it be reported in England?

    A notifiable disease is one a registered medical practitioner is legally required to report on suspicion. In England, notification is made to the local authority 'proper officer' (in practice the UK Health Security Agency), under the Health Protection (Notification) Regulations 2010.

16. What are the five statutory principles of the Mental Capacity Act 2005 (England and Wales)?

    1) Presume capacity. 2) Support the person to make their own decision before concluding they cannot. 3) An unwise decision does not itself indicate lack of capacity. 4) Acts/decisions for someone lacking capacity must be in their best interests. 5) Choose the least restrictive option of their rights and freedoms.

17. Describe the two-stage test of capacity under the Mental Capacity Act 2005.

    Stage 1 (diagnostic): is there an impairment of, or disturbance in, the functioning of the mind or brain? Stage 2 (functional): does that impairment mean the person cannot understand, retain, use/weigh the relevant information, or communicate the decision? Failing any one functional element at the time of the decision indicates lack of capacity.

18. What are the three core elements of valid informed consent to treatment?

    The person must have capacity to decide, must be given sufficient information (and understand it), and must give consent voluntarily, free from coercion or undue influence.

19. Which legal case reshaped the standard of information disclosure for consent in the UK, and what is the test?

    Montgomery v Lanarkshire Health Board (2015). The test is that a doctor must disclose material risks—those a reasonable person in the patient's position would attach significance to, or that the particular patient would—replacing the doctor-centred Bolam standard for consent.

20. What is a Caldicott Guardian?

    A senior person in an NHS or social care organisation responsible for protecting the confidentiality of patient/service-user information and enabling appropriate, lawful information sharing. The role was established following the 1997 Caldicott Report.

21. List the eight Caldicott Principles for handling confidential patient information.

    1) Justify the purpose. 2) Don't use personal confidential data unless necessary. 3) Use the minimum necessary. 4) Access on a strict need-to-know basis. 5) Everyone must be aware of their responsibilities. 6) Comply with the law. 7) The duty to share information can be as important as the duty to protect it. 8) Inform patients and service users about how their data is used.

22. Under what circumstances may patient confidentiality be lawfully breached without consent?

    When required by law (e.g. notifiable diseases, court order), or when justified in the public interest where the benefit of disclosure outweighs the duty of confidentiality (e.g. preventing serious harm to others). Disclosure should be limited to the minimum necessary.

23. What are the six lawful bases for processing personal data under UK GDPR?

    Consent; Contract; Legal obligation; Vital interests; Public task; and Legitimate interests. At least one basis must apply to all processing of personal data.

24. Under UK GDPR, what is 'special category data' and what extra requirement applies?

    Special category data includes health, genetic, biometric (for ID), racial/ethnic origin, sex life/orientation, religious or political beliefs, and trade union membership. Processing requires both a lawful basis (Article 6) and a separate Article 9 condition (e.g. explicit consent, health/social care, public health, or scientific research).

25. List the seven key principles of UK GDPR (Article 5).

    1) Lawfulness, fairness and transparency. 2) Purpose limitation. 3) Data minimisation. 4) Accuracy. 5) Storage limitation. 6) Integrity and confidentiality (security). 7) Accountability.

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