Identify and discuss ethical issues that pertain to public health.

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Professional ethics are concerned with the ethical dimensions of professionalism and the moral trust that society bestows on public health professionals to act for the common welfare. This form of ethical discourse stresses the distinct history and traditions of the profession, seeking to create a culture of professionalism among public health students and practitioners. It instills in professionals a sense of public duty and trust.

Professional ethics are role oriented, helping practitioners to act in virtuous ways as they undertake their functions. Currently, several agencies are developing a Code of Public Health Ethics. An example is located at www.publichealthlaw.net/reader. Public health ethics are concerned not so much with the character of professionals as with the ethical dimensions of the public health enterprise itself.

As you have seen in the first two modules, the field of public health is highly complex. What is the meaning of pivotally important abstract concepts that are common in public health: population, community, risk, harm, and benefit? How should society decide when it is necessary and appropriate to intervene to protect the public’s health? Are factors such as risk, effectiveness, cost, burdens, and fairness the best ways to evaluate public health interventions? How does the population perspective differ from the individual perspective? To what extent should social justice be an animating value in public health? Practitioners use various forms of reasoning in analyzing these problems, notably ethics, law, and human rights. Each form of reasoning has its own benefits and disadvantages. While each form of reasoning is distinct, all the forms overlap in important ways. One thing is certainly clear, there are no “correct” answers in public health. However, careful examination of principles and values taken from each of these fields can clarify thinking and, ultimately, lead to more effective and just policies and practices in public health.

In Module 3, we will look more closely at public health ethics and apply them to your work setting.

Identify and discuss ethical issues that pertain to public health. Identify applicable ethical theories and principles. Discuss the role of ethical theories and principles in public health.

Discuss the application of the following ethical theories/principles to public health. Provide recent examples within the field of public health which are consistent or inconsistent with these principles:

  • Utilitarianism
  • Distributive Justice
  • Paternalism

Selgelid (2009) wrote:

While public health ethicists often claim that the least restrictive alternative should be used to achieve the public health goal in question, I argue that a plausible but under-recognized idea is that the least restrictive alternative might sometimes involve improvement of global health via redistributive taxation—i.e., rather than coercive social distancing measures.

What did he mean by this? Provide arguments for and against his position.

Assignment Expectations:

Length: Assignment should be from 3 to 4 pages (750 to 1000 words) in length.

Assessment and Grading: Your paper will be assessed based on the performance assessment grading rubric that is linked within the course. Review it before you begin working on the assignment.



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Ethical Theories and Principles Categories Generally, ethical principles fall into one of two theoretical categories ◼ ◼ Utilitarianism Deontology Utilitarianism Described as the practical, pragmatic position, that provides “the greatest good for the greatest number” Assesses the moral worth of acts according to their extrinsic features, particularly their outcomes and consequences The morally justifiable act is that which produces the greatest amount of value over disvalue Supports a range of ethical principles, including non-malfeasance and beneficence and methods of moral assessment such as risk-benefit analysis (Proportionality) Non-malfeasance Principle that prohibits the infliction of harm, injury or death upon others This principle is related to the maxim "above all, do no harm“ Beneficence Principle that refers to the obligation to seek the well-being or benefit of others Requires acting positively to benefit others Proportionality Obligation to balance the risks and benefits associated with a course of action Deontology Theory that examines behavior based on consideration of morally right or wrong actions Focus is on the degree to which an action or course of action conforms to moral “law” Behavior must be consistent and have universal application Autonomy and Distributive Justice are principles grounded in the Deontology theory Autonomy Right to self-determination Right to make decisions and take action relating to ones body/health Obligates others to act according to such right Requires others to conduct themselves consistent with autonomous rights, and avoid any conduct that would prevent autonomous decision making or taking autonomous action Respect for Persons Moral principle based on the maxim that persons should never be treated as a means, rather as an end This principle requires justification for infringement upon life and liberty of others This principle supports moral rules such as privacy and confidentiality Distributive Justice General moral concept that requires persons be given what they are due Benefits might be distributed based on equality, need, effort, merit or contribution to society Distributive Justice is especially important in decisions about the fair allocation of health care resources Other Principles Veracity – Obligation to tell the truth Fidelity – Obligation to remain loyal and keep promises Paternalism – Obligation to secure the best interests of others, even if against their wishes Read Chapter 7 of the following text: Wing, K. R., & Gilbert, B. (2007). The law and the public's health. Chicago, IL: Health Administration Press. Ethical Theories and Principles. (2011). Baum, N., Gollust, S., Goold, S., & Jacobson, P. (2007). Looking ahead: Addressing ethical challenges in public health practice:1. The Journal of Law, Medicine & Ethics, 35(4), 657-667. Burris, S., Wagenaar, A. C., Swanson, J., Ibrahim, J. K., Wood, J., & Mello, M. M. (2010). Making the case for laws that improve health: A framework for public health law research. The Milbank Quarterly 88(2) 169–210. Cassatly, M. G. (2012). The four critical drivers of healthcare reform. The Journal of Medical Practice Management: MPM, 28(3), 162-3. Clemans-Cope, L., Kenney, G. M., Buettgens, M., Carroll, C., & Blavin, F. (2012). The Affordable Care Act's coverage expansions will reduce differences in uninsurance rates by race and ethnicity. Health Affairs, 31(5), 920-30. Selgelid, M. J. (2009). A moderate pluralist approach to public health policy and ethics. Public Health Ethics, 2(2), 195-205. Available via EBSCO. Optional Reading Furler, J. S., & Palmer, V. J. (2010). The ethics of everyday practice in primary medical care: Responding to social health inequities. Philosophy, Ethics & Humanities in Medicine, 5(6). Gostin, L. O., & Powers, M. (2006). What does social justice require for the public's health? Public health ethics and policy imperatives. Health Affairs, 25(4), 1053. Krebs, J. (2008). The importance of public-health ethics. Bulletin of the World Health Organization, 86(8), 579. Available via EBSCO host. Privacy Policy | Contact
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Running Head: ETHICAL ISSUES IN PUBLIC HEALTH

Ethical Issues in Public Health
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ETHICAL ISSUES IN PUBLIC HEALTH
Public health can be defined as what a society does to ensure people live in healthy
conditions. Public health focuses mainly on the health of the entire population and includes some
activities such as health promotion, prevention of diseases and population surveillance. Public
health is made up of ethics and in relation to public health ethics, there are various ethical issues
that arise in the public health sector. The following are some of the ethical issues experienced in
the public health sector:
1. Appropriate use of public health authority or power. Practitioners in the public health
sector have the power to limit an individual’s freedom and privacy or to alter a business
that is economically important to a community. Medical directors struggle to balance the
public health benefits with economic benefits or an individual’s finance benefits when
attempting to make certain decisions. For example, a public health officer unable to
determine whether to close a contaminated public beach that is an important tourist
attraction in the area ( Baum, N. M, & Jacobson, P. D. 2007).
2. Decision making on resource allocation. The need to allocate limited resources,
individual effort, and scarce products requires officials to make difficult decisions
especially between competi...


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