Demystifying the public interest: an ethico-legal conceptualisation and decision-making toolkit for healthcare professionals

Abstract

‘Public interest’ is an ambiguous yet powerful concept. In specific instances, it can lawfully justify disclosure of confidential information to others, as per the common law. However, to date, we lack a robust and defensible conceptualisation of the public interest and a means for assessing the validity and justifiability of claims that appeal to it. Without a solid conceptual understanding of the public interest or a means to assess the validity of appeals to it in specific instances, how can any decision-maker robustly defend their situation-specific appeal to it? This is the problem that my thesis addresses. It does so by providing, a) a robust and defensible conceptualisation of the public interest, and b) an ethico-legal framework to guide healthcare professionals through their public interest determinations. I employ a novel research methodology to gain a better substantive and procedural understanding of the public interest within law. I undertake a comparative analysis of appeals to the public interest within and between three related areas of law (medical, family, and criminal law). However, as my legal analysis shows, law only provides a ‘thin’ conceptualisation of the public interest. I therefore look beyond law to public interest theory, social science, and bioethics literature to develop my robust conceptualisation of the public interest, which I set out as comprising four constituent elements. As part of my conceptualisation, I distinguish between what ‘is’ and what is ‘in’ the public interest. My ethico-legal framework reflects this distinction. It consists of two parts that guide decision-makers step-by-step through each appeal to the public interest and utilises principles-based approaches to decision-making. By developing a robust conceptualisation and decision-making framework, this thesis offers greater clarity to the substances of, and process relating to, the public interest within the UK healthcare context. The contributions offered have wider implications beyond healthcare, and can be used as a starting point to interrogate and/or further build our understanding of, and approaches to, public interest as appealed to in law more generally.