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Causal Inference

The Ethics of Causal Claims Douglas Weed* Douglas Weed

This paper examines the ethical responsibilities of epidemiologists when the issue is causation, i.e., its determination rather than the application of causal knowledge in public health or the ethics of carrying out studies.  While the ethics of applying causal knowledge has received considerable attention in past discussions of the policy-making roles of epidemiologists and environmental justice, the ethics of causal claims has received little attention.  This paper examines the ways ethics is used to explore professional issues in general and causal claims in particular.  A review of recent ethics guidelines provides little or no guidance on causal claims themselves.  One remedy can be found in the topic of obligation, a central ethical concept with close ties to responsibility.  With regard to causal claims, our obligation extends beyond the abstract pursuit of knowledge to the need to use the best method for assessing causation—the systematic narrative review and others—as well as an obligation to commit any causal claim to peer review and publication.  This is especially important when the claim is contrary to the current consensus.  Discussed are examples in current practice where causal claims have appeared that have broad public health and policy implications and yet had not passed peer review nor appeared in print.  Practical recommendations for education and practice are discussed.