Ethical considerations in cancer epidemiology

Today the subject of bioethics has become part of formal training in all health professions (Kieffer, 1978). In earlier years, the majority of epidemiologists were physicians and governed by the constraints of medical ethics as based on the Hippocratic oath. Although research on human subjects is common to many branches of medicine, concern regarding the individual subject and the protection of his rights in such studies is of comparatively recent origin, as illustrated by the Nuremberg Code and the Declaration of Helsinki (1976).

There is currently no formal code per se for epidemiologists practising their discipline. As epidemiology has expanded, however, and become a profession in its own right, practised by scientists of varying disciplinary backgrounds, a number of issues specifically relevant to epidemiology have arisen. These include the responsibility of the epidemiologist towards the subjects in a study, his responsibility to the community at large, and his communication of the results of his studies either to the subjects involved or to the public (Soskolne, 1989). While these issues are not fundamentally different from those facing the physician, they have certain features which differentiate them from the usual problems facing the practising doctor.

Issues in epidemiology

Essentially, the task of the epidemiologist is to advance knowledge by the identification of the determinants of disease with a view to benefiting the community, and, indirectly, the individual.