The following material was prepared by Claire A. Stiles, PhD., Professor,
Eckerd College. Dr. Stiles is past Chairman of the Ethics Committe of the American College Health Association.
It is the intent of The Healthier People Network to encourage the articulation of ethical guidelines and the evolution
of professional standards that will allow the development and employment of a valuable, emerging methodology for the best
interest of citizen and community alike. At this time there is no common agency to assess the scientific integrity of any
given health risk appraisal or the competence and performance of a provider of health risk appraisal services. It is hoped
that the quality of health risk appraisals, professional practice, and supporting law will improve as a result of the articulation
and codification of ethical standards presented here. Recognizing that the science of health promotion and risk appraisal,
professional standards and regulations, and legal statutes and case law are constantly evolving, HPN considers this chapter
a work in process.The Rights of Health Risk Appraisal Participants The resolution of ethical and professional issues begins
with the primary beneficiary of the activity--the individual Participant who is invited to take a health risk appraisal. Because
the general goal of HPN is the reduction of preventable morbidity and mortality, the essence of which are individual events,
the health and welfare of the individual are considered the paramount value. Therefore, the administration of a health risk
appraisal is to be accomplished within this broader frame of reference.
The individual Participant has the following inherent rights:
1. The right to privacy. The act of participating in an HRA process allows for an invasion of the individual's physical
and psychological integrity. Therefore, the Participant has the right to control this private information about him or herself
and to expect that privacy will be maintained.2. The right to receive information necessary to give informed consent
before completion of the questionnaire or before agreement to allow inclusion of personal HRA data in a research study (see
section on Informed Consent).
3. The right to refuse to participate in the health risk appraisal program, or to withdraw or cancel participation
at any time, without fear of reprisal. Voluntary participation, agreed to without reservation, also serves the interest of
reliable and valid measurement.
4. The right to expect that all communications will be treated as confidential. Information offered on the health
risk appraisal questionnaire and related laboratory tests or other physical measures are to be held in confidence by the health
risk appraisal User. The User is merely the temporary custodian of the data on the individual Participant (see section on
Managing Aggregate Data).
5. The right to expect courteous treatment without coercion during the course of the HRA administration and the report
feedback sessions.
6. The right to obtain complete and current information concerning his or her health risks in terms the Participant
can reasonably be expected to understand.
To safeguard the rights of Participants, while effectively fulfilling the primary purpose for appraising health risks,
for example, providing information to Participants about their potential future health status, HPN proposes guidelines and
professional standards.
Material for the sections dealing with ethical principles is derived from an earlier
chapter presented in HEALTHIER PEOPLE, Version 4.0 for which we are indebted to Mark Sciegaj.
For a copy of a complete statement of ethical issues send an e-mail request to hrahpn@bellsouth.net
