CHES Area VIII: Ethics and Professionalism in Health Education

Every competency tested on the CHES and MCHES exam operates within a framework of ethical obligations. You can master needs assessment, program planning, evaluation, and communication, but if you do not practice with integrity, those skills lose their meaning. Area VIII addresses the ethical principles and professional standards that form the foundation of responsible health education practice. It is the area that ensures everything else is done right.

Ethics in health education is not abstract philosophy. It involves concrete decisions about confidentiality, informed consent, cultural sensitivity, professional boundaries, and accountability. These decisions arise daily in practice, and the certification exam tests your ability to navigate them thoughtfully.

To see how Area VIII connects with the other competency domains, review the overview of all eight Areas of Responsibility.

What Area VIII Covers

Area VIII focuses on the ethical and professional responsibilities of certified health education specialists. The competencies include applying the profession's code of ethics, demonstrating cultural competence and humility, maintaining professional boundaries, protecting participant rights through informed consent and confidentiality, pursuing continuing education, and using ethical decision-making frameworks when faced with complex situations.

This area applies equally to CHES and MCHES candidates, though MCHES-level questions may involve more nuanced ethical dilemmas, particularly those related to leadership, supervision, and organizational ethics. At both levels, the exam expects you to recognize ethical issues and select responses that align with professional standards.

Key Concepts in Area VIII

The Code of Ethics for Health Education Specialists

The Code of Ethics established by the health education profession outlines the fundamental principles that guide practice. These principles address responsibilities to the public, to the profession, to employers, to the delivery of health education, to research, and to professional preparation. The code serves as both a guide for daily practice and a standard against which professional conduct can be measured.

You do not need to memorize the code word for word, but you should understand its major themes. The code emphasizes honesty, respect for autonomy, commitment to social justice, and accountability. When an exam question presents an ethical dilemma, the correct answer will typically align with one or more of these principles.

Cultural Competence and Humility

Cultural competence is the ability to work effectively with individuals and communities from diverse cultural backgrounds. It involves understanding how culture influences health beliefs, behaviors, and access to services, and adjusting your practice accordingly. Cultural competence is not a destination but an ongoing process of learning and adaptation.

Cultural humility builds on competence by emphasizing self-reflection, recognition of power dynamics, and a willingness to learn from the communities you serve rather than assuming you already understand their needs. Health educators who practice cultural humility approach cross-cultural interactions with openness and a genuine commitment to equity.

Pro Tip: Exam questions about cultural competence often test whether you can recognize the difference between a culturally appropriate response and one that imposes the health educator's own assumptions on a community. Look for answer choices that center the perspectives and preferences of the population being served.

Professional Boundaries and Scope of Practice

Professional boundaries define the limits of the health educator's role. Understanding scope of practice means recognizing what you are qualified to do and what falls outside your expertise. For example, a health educator can facilitate a support group for individuals managing chronic conditions, but diagnosing or treating those conditions is outside the scope of practice.

Boundary violations can compromise both the health educator's credibility and the well-being of participants. Maintaining appropriate boundaries also involves managing dual relationships, such as when a health educator serves both as a program facilitator and as a personal acquaintance of a participant, and recognizing when a referral to another professional is the most ethical course of action.

Informed Consent and Confidentiality

Informed consent requires that individuals understand the purpose, procedures, risks, and benefits of a program or research study before agreeing to participate. It must be voluntary, and participants must have the right to withdraw at any time without penalty. Health educators are responsible for ensuring that consent processes are clear, culturally appropriate, and documented.

Confidentiality involves protecting the personal information of program participants and research subjects. Health educators must understand the legal and ethical requirements for data protection, including when confidentiality may be legally required to be broken, such as in cases involving mandatory reporting of abuse or imminent harm.

Continuing Education and Professional Growth

Certification is not the end of professional development. Continuing education is both an ethical obligation and a practical necessity. The health education field evolves continuously as new evidence emerges, populations change, and technologies advance. Certified professionals are expected to maintain and expand their competencies throughout their careers.

NCHEC requires certified health education specialists to complete continuing education credits to maintain their CHES or MCHES credential. Beyond meeting minimum requirements, health educators should actively seek opportunities to learn new skills, stay current with research, and engage with professional organizations. For a detailed look at the recertification process and continuing education requirements, see the guide on CHES continuing education and recertification.

Ethical Decision-Making Frameworks

Not every ethical situation has a clear right answer. Ethical decision-making frameworks provide structured approaches for analyzing complex dilemmas. A typical framework involves identifying the ethical issue, gathering relevant facts, considering the perspectives of all stakeholders, evaluating options against ethical principles, making a decision, and reflecting on the outcome.

Health educators should be familiar with at least one ethical decision-making model and be able to apply it in practice. The exam may present scenarios where multiple courses of action seem reasonable, and the correct answer will be the one that reflects the most systematic and principled approach.

Exam Application

Area VIII questions on the CHES exam frequently present ethical dilemmas and ask you to identify the most appropriate professional response. You might be asked what to do when a participant discloses information that raises a mandatory reporting obligation, how to handle a situation where a funder pressures you to misrepresent program results, or how to respond when a colleague engages in conduct that violates the code of ethics.

These questions test your judgment, not just your recall. The exam rewards candidates who can identify the ethical principle at stake, consider the consequences of different actions, and select the response that best upholds professional standards. Avoid answer choices that prioritize convenience, personal relationships, or organizational pressure over ethical obligations.

Pro Tip: When facing an ethics question on the exam, eliminate answer choices that involve deception, coercion, or violations of participant rights. The remaining options can then be evaluated based on which one most clearly aligns with the code of ethics and demonstrates respect for the autonomy and well-being of the individuals involved.

Study Strategies

Read the Code of Ethics for health education specialists carefully. You do not need to memorize every article, but you should be able to recognize which principle applies in a given scenario. Create a summary document that lists each major section of the code with a brief example of how it might be applied.

Practice with ethical scenario questions, which are among the most common question types in Area VIII. For each practice question, identify the ethical principle being tested and explain why the correct answer is better than the alternatives. This analytical approach builds the reasoning skills you need on exam day.

Review the concepts of cultural competence and humility alongside the communication competencies from Area VII. Many ethical issues in health education involve cross-cultural interactions, and studying these areas together strengthens your ability to recognize culturally grounded ethical dilemmas.

For a comprehensive study timeline that helps you balance your preparation across all eight areas, refer to the CHES study plan guide.

Practicing With Integrity

Ethics is not a separate competency to be studied in isolation. It is the thread that runs through every aspect of health education practice. How you assess needs, plan programs, implement interventions, evaluate outcomes, manage resources, share information, and communicate with the public should all be guided by a commitment to honesty, equity, and respect for the people you serve.

Mastering Area VIII prepares you for more than the certification exam. It prepares you to be the kind of professional that communities can trust, colleagues can rely on, and the field can be proud of. In a profession dedicated to improving the health and well-being of others, practicing with integrity is not optional. It is the standard.

This content is not affiliated with or endorsed by NCHEC. CHES and MCHES are registered trademarks of NCHEC.