17 January 2011

HIA, ethics, private sector consulting and clients

This is a post I put up on the HIA community wiki website over two years ago. It still has relevance and I have been debating about putting it up on the HIA blog as a much better place for discussion. In the UK there was/is concern and potentially continuing concern among some HIA practitioners about the growing role of large private sector environmental consultancies moving into the HIA field.

The main thrust of the concern is that private sector consultancies do not necessarily have the public health skills and/or public health ethos to do good HIAs and may therefore further their clients interests at the expense of affected communities, in particular, and other stakeholders in general.

This concern can and should be leveled at all practitioners and is something that all practitioners must think about on an ongoing basis whether they are private, public or not-for-profit sector HIA consultants and researchers. There are personal agendas, organisational agendas and politics that impinge on HIA practitioners working in all sectors and professions.

The specific concern about private sector consultancies was I thought then based on a mistaken premise that consultancies do not work by any set of organisational or professional ethics. Unless the argument is that public health has a very special set of ethics which environmental, engineering and planning professionals do not have, cannot share and are unable to foster in themselves and their profession?

Given that private sector consultancies are and will increasingly move into public health consultancy the more urgent question I feel is how to ensure that public health values fit alongside environmental, engineering and other professional values and ethos' such that they complement and do not work in tension with each other.

Not proactively engaging with them will simply create two (or more)  parallel and potentially opposing strands of thinking and doing HIA. More significantly it disrespects the environmental and planning professionals as professional communities who have and continue to grapple with ethical dillemmas that are faced in their areas of work.

Personally, I constantly grapple with ethical dilemmas - both in my personal and professional life - and even over the last year I have had quite a few. These ethical dilemmas have ranged from whether or not to formally critique a fellow HIA practitioners work to whether or not to consider writing a proposal for a HIA of a proposed development because the nature of the development raised conflicts with certain values I held.

For me, ethical dilemmas don't go away because I have a set of implicit/explicit ethical principles; they just bring into sharp relief issues that I need to consider carefully before proceeding. Ultimately, I and we are still the ones who have to make the decision, ethical principles are guides but they can't make decisions for us. Neither are there one set of ethical principles that can work in all contexts; sometimes different ethical principles are at odds with each other and this conflict can only be resolved by making a personal choice to go one way or another. In these situations it is the process of thinking through and making a choice after due reflection and consideration that is the critical step.

So how do we go about fostering a public health ethos in the private sector?

First, by recognising that they already have an ethos that they work by that has been developed from the profession that they are in and upheld by their professional institutes and associations. Just as HIA and public health ethics is developed in public health education and training and upheld by public health colleges, institutes and associations (even if we don't have HIA institutions).

Second, by developing links between these institutions to foster collaborative working and the development of a set of widely held and agreed upon professional ethical principles of HIA practice. For example the Health Good Practice Principles of the International Association for Impact Assessment.

Third, by more collaborative working, thinking and reflection across the not-for-profit, public and private sector HIA practitioners about these kinds of issues.

Do my arguments make sense, have I missed anything crucial or have I got it completely wrong?

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