Ethical insights into toxic alcohol consumption in Iran: a call for a public health approach

Abstract

Despite the legal prohibition of alcohol in Iran, consumption of non-standard and often toxic alcoholic beverages continues to present a significant public health challenge. Methanol poisoning and associated mortality underscore the urgent need to address alcohol-related harms through ethical and population-centered strategies. This analysis employs the three core goals of contemporary public health—autonomy, well-being, and equality—integrating both duty-based and outcome-oriented ethical reasoning to evaluate current responses and guide interventions. A public health approach is necessary to address ethical issues such as disproportionate impact on young adults and socioeconomically vulnerable groups. A public health centered approach that emphasizes prevention, protection, and health promotion provides opportunities to reduce harm, improve health outcomes, and empower individuals even within restrictive legal and cultural environments. Lessons from national experiences in harm reduction and public health interventions, such as programs for substance addiction and sexually transmitted disease control, particularly HIV control, demonstrate that effective and ethically grounded strategies are achievable even when such certain behaviors such as sex work or alcohol consumption are legally sanctioned or even criminalized. These experiences highlight the moral responsibility of public health authorities to protect vulnerable populations while promoting collective well-being through inclusive, evidence-based, and context-sensitive measures.