In February 2013, the Research & Ethics team at Public Health Ontario (PHO) launched an integrated approach for ethics review to help ensure that all evidence-generating public health initiatives conducted by PHO are carried out in a manner that is consistent with PHO’s conceptual framework, the TCPS 2 (2014) Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans as well as other relevant regulations, policies and guidelines. The innovative model for ethics review applies a proportionate approach, so that as risk to participants increases so does the level of review. Several novel mechanisms have been developed to support PHO’s approach and to streamline the review process.
PHO has developed a framework to guide the ethical conduct of evidence-generating public health initiatives. The framework interprets the TCPS 2 (2014) through a public health lens and provides ten questions to facilitate the systematic examination of issues, including appropriate consideration of the interests of all stakeholders. The questions emphasize the interrelatedness of the welfare of individuals and communities and the positive obligation to promote equity and reciprocity. The framework is the foundation for PHO's integrated approach for ethics review, where all evidence-generating initiatives receive ethical scrutiny, proportionate to level of risk. Level of risk is determined using an ethics risk screening process, which uses an innovative Risk Screening Tool (RST) developed by PHO.
This framework has been developed by a working group of public health and ethics professionals and scholars in consultation with individuals representing a wide range of public health roles. The framework was released broadly as a discussion paper in June 2011, which generated tremendous feedback from public health practitioners and academics across Ontario, Canada and the U.S. This feedback was used to inform the current version.
Risk Screening Tool
The Risk Screening Tool (RST) is a key component of PHO’s integrated approach for ethics review, where all evidence-generating initiatives receive ethical scrutiny proportionate to risk. The RST is a 20-item, self-scoring checklist that helps facilitate risk assessment for public health evidence-generating initiatives.
For more information about PHO’s framework and ethics risk screening process, including the Risk Screening Tool, please see the RST web page.