Ethics Guidelines for Development and Use of Health Assessments

Used with permission of The Society of Prospective Medicine Board of Directors.
Copyright The Society of Prospective Medicine, 1999.

Introduction

Dedicated to advancing the development, utilization, and evaluation of prospective medicine strategies, The Society of Prospective Medicine (SPM) advocates the following ethics guidelines to assist developers and administrators of a wide variety of health assessments (HAs) in making appropriate decisions in construction and use of HA instruments. Health assessments include instruments known as health risk appraisals or health risk assessments (HRAs). Health status assessments (HSAs), various lifestyles-specific (e.g., nutrition, stress and physical activity) assessments instruments, wellness, and behavioral/habit inventories. In the last 40 years, health assessments technology has proliferated and diversified. Today, health assessment tools are an essential component in the planning and delivery of health care and promotion programs in heath care, business, industrial, and educational settings. Although the purpose of health assessment instruments may differ, the ethical considerations for their use are remarkably similar. The Society of Prospective Medicine establishes these general guidelines to both minimize the potential harm from misuse and to enhance the potential benefits of health assessments:

Maintenance or improvements of personal health and quality of life, and
Ability to establish disease and health risk tracking for improved care.

General Ethics Guidelines

The following seven guidelines defined by SPM help to protect the rights and safety of individual participants and to facilitate the appropriate use of health assessment instruments by both individuals by both individuals and organizations.

Health Assessment Program Planning
Each HA program should have a well defined, written statement detailing the goals, objectives, methodology, and requirements for participation.
Health Assessment Instrument Selection
Several factors should be examined when selected an HA instrument, e.g. appropriateness for the target populations, credibility of the scientific basis and/or database(s) underlying its construction, and cultural and ethic sensitivity. Other key factors include the ease of use, the types of data analyses performed, and the clarity and intelligibility of reports generated.
Health Assessment Participant Orientation
Individual participants should receive an orientation, either written or oral, before completing an HA. This orientation describes the purpose of the assessments, the science base of or approach underlying the instrument, the time commitment or completion, who has access to the results.
Health Assessment Administration
Individual participants should be free to accept or decline and HA without fear of consequences.
Health Assessment Data Security
The data and report from HAs are private and should not be shared with others unless expressly permitted by the individual participant. Administrators of HAs are responsible for protecting individual data or results from unauthorized access and must respect the wishes of the individual participant.
Health Assessment Report Interpretation
If the assessment generates individual reports, as with HRAs, the individual should receive a report that is easily understood. The reporting should be accompanied by an explanation of the implications of the results for the individual's health and well being. If possible, competent health educator or provider should be available to explain the report and answer questions.
Health Promotion Resource Accessibility
When individuals receive personal reports, as a result of the assessment process, a list should be made available to them of local and national resources that ameliorate risk factors or other problems identified. When individuals reports are not returned to participants, general resource information appropriate to the characteristics of that group should be made available to the participants.