WorldWideScience

Sample records for public health ethical

  1. Feminism and public health ethics.

    Science.gov (United States)

    Rogers, W A

    2006-06-01

    This paper sketches an account of public health ethics drawing upon established scholarship in feminist ethics. Health inequities are one of the central problems in public health ethics; a feminist approach leads us to examine not only the connections between gender, disadvantage, and health, but also the distribution of power in the processes of public health, from policy making through to programme delivery. The complexity of public health demands investigation using multiple perspectives and an attention to detail that is capable of identifying the health issues that are important to women, and investigating ways to address these issues. Finally, a feminist account of public health ethics embraces rather than avoids the inescapable political dimensions of public health.

  2. Ethical analysis in public health.

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    Roberts, Marc J; Reich, Michael R

    2002-03-23

    Public-health regularly encounters serious ethical dilemmas, such as rationing scarce resources, influencing individuals to change their behaviour, and limiting freedom to diminish disease transmission. Yet unlike medical ethics, there is no agreed-upon framework for analysing these difficulties. We offer such a framework. It distinguishes three philosophical views, often invoked in public-health discourse: positions based on outcomes (utilitarianism), positions focused on rights and opportunities (liberalism), and views that emphasise character and virtue (communitarianism). We explore critical variations within each approach, and identify practical problems that arise in addressing the ethical dimensions of health policy. We conclude by examining challenges posed by the feminist argument of ethics-of-care and by postmodern views about the nature of ethics. Health professionals need enhanced skills in applied philosophy to improve the coherence, transparency, and quality of public deliberations over ethical issues inherent in health policy.

  3. Personalism for public health ethics

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2010-06-01

    Full Text Available In public health ethics, as in bioethics, utilitarian approaches usually prevail, followed by Kantian and communitarian foundations. If one considers the nature and core functions of public health, which are focused on a population perspective, utilitarianism seems still more applicable to public health ethics. Nevertheless, faulting additional protections towards the human person, utilitarianism doesn't offer appropriate solutions when conflicts among values do arise. Further criteria must be applied to protect the fundamental principles of respect for human life. Personalism offers similar advantages to utilitarianism but warrants more protection to the human person. We suggest a possible adaptation of personalism in the specific field of public health by means of four principles: absolute respect for life or principle of inviolability; subsidiarity and the "minimum" mandatory principle; solidarity; justice and non discrimination.

  4. Public health ethics: informing better public health practice.

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    Carter, Stacy M; Kerridge, Ian; Sainsbury, Peter; Letts, Julie K

    2012-01-01

    Public health ethics has emerged and grown as an independent discipline over the last decade. It involves using ethical theory and empirical analyses to determine and justify the right thing to do in public health. In this paper, we distinguish public health ethics from clinical ethics, research ethics, public health law and politics. We then discuss issues in public health ethics including: how to weigh up the benefits, harms and costs of intervening; how to ensure that public health interventions produce fair outcomes; the potential for public health to undermine or promote the rights of citizens; and the significance of being transparent and inclusive in public health interventions. We conclude that the explicit and systematic consideration of ethical issues will, and should, become central to every public health worker's daily practice.

  5. Liberalism and Public Health Ethics.

    Science.gov (United States)

    Rajczi, Alex

    2016-02-01

    Many public health dilemmas involve a tension between the promotion of health and the rights of individuals. This article suggests that we should resolve the tension using our familiar liberal principles of government. The article considers the common objections that (i) liberalism is incompatible with standard public health interventions such as anti-smoking measures or intervention in food markets; (2) there are special reasons for hard paternalism in public health; and (3) liberalism is incompatible with proper protection of the community good. The article argues that we should examine these critiques in a larger methodological framework by first acknowledging that the right theory of public health ethics is the one we arrive at in reflective equilibrium. Once we examine the arguments for and against liberalism in that light, we can see the weaknesses in the objections and the strength of the case for liberalism in public health.

  6. Public health nursing, ethics and human rights.

    Science.gov (United States)

    Ivanov, Luba L; Oden, Tami L

    2013-05-01

    Public health nursing has a code of ethics that guides practice. This includes the American Nurses Association Code of Ethics for Nurses, Principles of the Ethical Practice of Public Health, and the Scope and Standards of Public Health Nursing. Human rights and Rights-based care in public health nursing practice are relatively new. They reflect human rights principles as outlined in the Universal Declaration of Human Rights and applied to public health practice. As our health care system is restructured and there are new advances in technology and genetics, a focus on providing care that is ethical and respects human rights is needed. Public health nurses can be in the forefront of providing care that reflects an ethical base and a rights-based approach to practice with populations.

  7. [Public health ethics and reproduction].

    Science.gov (United States)

    Alexandrova-Yankulovska, S; Bozhinov, P; Bojinova, S

    2014-01-01

    Medical progress has enabled achievements that were not even thinkable earlier but at the same time society and public health have had to face new challenges. What are we ready to accept in the area of human reproduction? This paper aims at ethical analysis of Bulgarian laws on reproduction. The abortion debate nowadays has got new dimiension focusing not that much on its moral acceptability but rather on the acceptable indications for its performance. Is it ethical to perform abortion in case of undesired gender of the embryo or genetic malformations? Lots of moral issues mark the area of assisted reproduction which is due to the separation of the reproductive functions (ova, sperm and embryo donation, surrogacy), fragmentation of motherhood and fatherhood, differentiation of biological and social parenthood. Defining limits of acceptable interference or non-interference in human reproduction will never be easy, but dynamics of moral judgment shouldn't bother us. The rigidity of moral norms is what should be alarming because it threatens procreative autonomy.

  8. Considering virtue: public health and clinical ethics.

    Science.gov (United States)

    Meagher, Karen M

    2011-10-01

    As bioethicists increasingly turn their attention to the profession of public health, many candidate frameworks have been proposed, often with an eye toward articulating the values and foundational concepts that distinguish this practice from curative clinical medicine. First, I will argue that while these suggestions for a distinct ethics of public health are promising, they arise from problems within contemporary bioethics that must be taken into account. Without such cognizance of the impetus for public health ethics, we risk developing a set of ethical resources meant exclusively for public health professionals, thereby neglecting implications for curative medical ethics and the practice of bioethics more broadly. Second, I will present reasons for thinking some of the critiques of dominant contemporary bioethics can be met by a virtue ethics approach. I present a virtue ethics response to criticisms that concern (1) increased rigor in bioethics discourse; (2) the ability of normative theory to accommodate context; and (3) explicit attention to the nature of ethical conflict. I conclude that a virtue ethics approach is a viable avenue for further inquiry, one that leads us away from developing ethics of public health in a vacuum and has the potential for overcoming certain pitfalls of contemporary bioethics discourse. © 2011 Blackwell Publishing Ltd.

  9. A tale of two fields: public health ethics.

    Science.gov (United States)

    Klugman, Craig

    2008-01-01

    Over the last decade, public health and bioethics have been courting each other, trying to figure out a way to inform and assist one another. Ethics in public health began in epidemiology and public health in ethics began in health law. Attempts have been made to create both an ethics of and in public health. Although many edited volumes and even model curriculums have been created for the teaching of public health ethics, most efforts are mired in medical ethics and do not take the unique population perspective of public health. Several challenges to the development and teaching of public health ethics remain, including the issue of ethics being a required public health competency and the questions: what should be in a public health ethics curriculum, where will instructors be trained and how will such faculty be paid? A true public health ethics will help professionals address issues of values, critical thinking and decision making.

  10. Ethics in Public Health Research

    Science.gov (United States)

    Curtis, Valerie A.; Garbrah-Aidoo, Nana; Scott, Beth

    2007-01-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public–Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships. PMID:17329646

  11. Public Health, Ethics, and Autonomous Vehicles.

    Science.gov (United States)

    Fleetwood, Janet

    2017-04-01

    With the potential to save nearly 30 000 lives per year in the United States, autonomous vehicles portend the most significant advance in auto safety history by shifting the focus from minimization of postcrash injury to collision prevention. I have delineated the important public health implications of autonomous vehicles and provided a brief analysis of a critically important ethical issue inherent in autonomous vehicle design. The broad expertise, ethical principles, and values of public health should be brought to bear on a wide range of issues pertaining to autonomous vehicles.

  12. [Ethical dilemmas in public health care organizations].

    Science.gov (United States)

    Pereda Vicandi, M

    2014-01-01

    Today you can ask if you can apply ethics to organizations because much of the greater overall impact decisions are not made by private individuals, are decided by organizations. Any organization is legitimate because it satisfies a need of society and this legitimacy depends if the organization does with quality. To offer a good service, quality service, organizations know they need to do well, but seem to forget that should do well not only instrumental level, must also make good on the ethical level. Public health care organizations claim to promote attitudes and actions based on ethics, level of their internal functioning and level of achievement of its goals, but increased awareness and analysis of its inner workings can question it. Such entities, for its structure and procedures, may make it difficult for ethical standards actually govern its operation, also can have negative ethical consequences at the population level. A healthcare organization must not be organized, either structurally or functionally, like any other organization that offers services. In addition, members of the organization can not simply be passive actors. It is necessary that operators and users have more pro-ethical behaviors. Operators from the professionalism and users from liability. Copyright © 2014 SECA. Published by Elsevier Espana. All rights reserved.

  13. Public Health Ethics Related Training for Public Health Workforce: An Emerging Need in the United States

    Directory of Open Access Journals (Sweden)

    A Kanekar

    2012-04-01

    Full Text Available Background: Ethics is a discipline, which primarily deals with what is moral and immoral behavior. Public Health Ethics is translation of ethical theories and concepts into practice to address complex multidimensional public health problems. The primary purpose of this paper was to conduct a narrative literature review-addressing role of ethics in developing curriculum in programs and schools of public health, ethics-related instruction in schools and programs of public health and the role of ethics in developing a competent public health workforce. Methods: An open search of various health databases including Google scholar and Ebscohost yielded 15 articles related to use of ethics in public health practice or public health training and the salient features were reported.  Results: Results indicated a variable amount of ethics' related training in schools and programs of public health along with public health practitioner training across the nation. Bioethics, medical ethics and public health ethics were found to be subspecialties' needing separate ethical frameworks to guide decision making.Conclusions: Ethics based curricular and non-curricular training for emerging public health professionals from schools and programs of public health in the United States is extremely essential.  In the current age of public health challenges faced in the United States and globally, to have an ethically untrained public health force is arguably, immoral and unethical and jeopardizes population health.  There is an urgent need to develop innovative ethic based curriculums in academia as well as finding effective means to translate these curricular competencies into public health practice.

  14. Ethics and Public Health: Forging a Strong Relationship

    Science.gov (United States)

    Callahan, Daniel; Jennings, Bruce

    2002-01-01

    The field of bioethics arose in the late 1960s in response to the emerging ethical dilemmas of that era. The field for many years focused in general on the dilemmas generated by high-technology medicine rather than on issues of population health and the ethical problems of public health programs and regulations. The time has come to more fully integrate the ethical problems of public health into the field of public health and, at the same time, into the field of bioethics. Public health raises a number of moral problems that extend beyond the earlier boundaries of bioethics and require their own form of ethical analysis. PMID:11818284

  15. Putting public health ethics into practice: A systematic framework

    Directory of Open Access Journals (Sweden)

    Georg eMarckmann

    2015-02-01

    Full Text Available It is widely acknowledged that public health practice raises ethical issues that require a different approach than traditional biomedical ethics. Several frameworks for public health ethics have been proposed, however, none of them provides a practice-oriented combination of the two necessary components: (1 A set of normative criteria based on an explicit ethical justification and (2 a structured methodological approach for applying the resulting normative criteria to concrete public health issues. Building on prior work in the field and integrating valuable elements of other approaches to public health ethics, we present a systematic ethical framework that shall guide professionals in planning, conducting, and evaluating public health interventions.Based on a coherentist model of ethical justification, the proposed framework contains (1 an explicit normative foundation with five substantive criteria and seven procedural conditions to guarantee a fair decision process, and (2 a six-step methodological approach for applying the criteria and conditions to the practice of public health and health policy. The framework explicitly ties together ethical analysis and empirical evidence, thus striving for evidence-based public health ethics. It shall provide normative guidance to those who analyze the ethical implications of public health practice including academic ethicists, health policy makers, health technology assessment bodies, and public health professionals.It will enable those who implement a public health intervention and those affected by it (i.e. the target population to critically assess whether and how the required ethical considerations have been taken into account. Thereby, the framework can contribute to assuring the quality of ethical analysis in public health. Whether the presented framework will be able to achieve its goals has to be determined by evaluating its practical application.

  16. Public health ethics theory: review and path to convergence.

    Science.gov (United States)

    Lee, Lisa M

    2012-01-01

    Public health ethics is a nascent field, emerging over the past decade as an applied field merging concepts of clinical and research ethics. Because the "patient" in public health is the population rather than the individual, existing principles might be weighted differently, or there might be different ethical principles to consider. This paper reviewed the evolution of public health ethics, the use of bioethics as its model, and the proposed frameworks for public health ethics through 2010. Review of 13 major public health ethics frameworks published over the past 15 years yields a wide variety of theoretical approaches, some similar foundational values, and a few similar operating principles. Coming to a consensus on the reach, purpose, and ends of public health is necessary if we are to agree on what ethical underpinnings drive us, what foundational values bring us to these underpinnings, and what operating principles practitioners must implement to make ethical decisions. If public health is distinct enough from clinical medicine to warrant its own set of ethical and philosophical underpinnings, then a decision must be made as to whether a single approach is warranted or we can tolerate a variety of equal but different perspectives. © 2012 American Society of Law, Medicine & Ethics, Inc.

  17. Virtue ethics and public health: a practice-based analysis.

    Science.gov (United States)

    Rogers, Wendy A

    2004-01-01

    Public health plays an important, albeit often unnoticed, role in protecting and promoting the health of populations. The activities of public health are complex, performed by multiple professionals, and range from the innocuous to the intrusive. Ethical analyses in public health reflect some of this complexity and fragmentation, with no one approach able to capture the full range of ethical considerations raised by public health activities. There are however, good reasons why we should pursue such analyses. Providing a robust ethical framework for public health may promote the identity and function of public health, address some of the shortcomings of utilitarianism, and help to combat the threat that public health faces through lack of political will in many parts of the world. In this paper I argue that Alasdair MacIntyre's account of practices and virtues can make a valuable contribution to public health ethics. The first part of the paper argues that public health may properly be described as the type of practice that provides an arena for the exercise of virtues. This is followed by an analysis of the three virtues of honesty, courage and justice in public health practice. Using virtue theory captures morally important elements of public health and helps to maintain awareness of significant moral values in the practice of public health. Such awareness is crucial in maintaining and defending the integrity of public health.

  18. [Economics and ethics in public health?].

    Science.gov (United States)

    Blum, R

    1999-01-01

    The topic suggests a conflict between ethics and economy in medical care. It is often argued that today's welfare state in affluent societies with their social insurance systems makes it easier for the doctor to translate ethical demands into reality without being hampered by economic restrictions. Both doctors and patients took advantage of this system of medical care by mingling social guarantees for health with the doctor's income. Hence, medical expenses expanded rapidly, additionally promoted by technical progress in medicine. This entailed a proportionate increase in medical expenses in relation to personal income, especially wage income. Budgets of state authorities were streamlined or deficits became larger. This state of affairs was promoted further by mechanisms of distribution of national income in accordance with the slogan "less state, more market". While national income continued to grow, although at a slower rate, the number of jobless persons grew continually and thus also the social expenses, this was not due, as is usually assumed and pretended, to an economic crisis. Society and economy are facing a crisis of distribution of national income under conditions of technical progress as a job killer, making economic production more productive and efficient. Not taking into account the new challenge of social market economy--the German innovation in market economy creating the economic miracle after World War II--reforms of the system of medical care took place and are still continuing along market principles, particularly the latest German reform law leading to individual contracts between patients and their doctors in respect of cost charging. However, marketing principles promote economy in medicine, but they do not promote medical ethics. Further German guidelines for medical care should take stock of past experiences. There will be more competition in the "growing market of medical care" (private and public) and this will need--as economic

  19. [Utilitarianism or communitarianism as the foundation of public health ethics?].

    Science.gov (United States)

    Rauprich, O

    2008-02-01

    The goal of public health is to maximise health, and to promote the common good. These two assumptions frequently give rise to claims that public health is founded on utilitarian or communitarian ethics, respectively. In this paper, these claims are critically examined and rejected. It is neither plausible to assume utilitarian goals in public health nor to propose a utilitarian account of public health ethics. The idea of public health as health-related utilitarianism rests on a misconception of utilitarian ethics. Once this misconception is realised, the seeming appeal of public health to utilitarianism quickly fades. Communitarianism, in turn, fails to serve as a comprehensive and systematic ethical account. Some moderate appeals to more communal spirit for public health are well taken, although not exclusive communitarian. Other more extreme proposals of communitarians, e.g. to exercise public-health police power and public-health paternalism, are to be taken with great care. Thus, it is concluded that there is a need for an ethical foundation of public health different from both utilitarianism and communitarianism.

  20. Theoretical Models and Operational Frameworks in Public Health Ethics

    Science.gov (United States)

    Petrini, Carlo

    2010-01-01

    The article is divided into three sections: (i) an overview of the main ethical models in public health (theoretical foundations); (ii) a summary of several published frameworks for public health ethics (practical frameworks); and (iii) a few general remarks. Rather than maintaining the superiority of one position over the others, the main aim of the article is to summarize the basic approaches proposed thus far concerning the development of public health ethics by describing and comparing the various ideas in the literature. With this in mind, an extensive list of references is provided. PMID:20195441

  1. Theoretical Models and Operational Frameworks in Public Health Ethics

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2010-01-01

    Full Text Available The article is divided into three sections: (i an overview of the main ethical models in public health (theoretical foundations; (ii a summary of several published frameworks for public health ethics (practical frameworks; and (iii a few general remarks. Rather than maintaining the superiority of one position over the others, the main aim of the article is to summarize the basic approaches proposed thus far concerning the development of public health ethics by describing and comparing the various ideas in the literature. With this in mind, an extensive list of references is provided.

  2. Public health accreditation and metrics for ethics: a case study on environmental health and community engagement.

    Science.gov (United States)

    Bernheim, Ruth Gaare; Stefanak, Matthew; Brandenburg, Terry; Pannone, Aaron; Melnick, Alan

    2013-01-01

    As public health departments around the country undergo accreditation using the Public Health Accreditation Board standards, the process provides a new opportunity to integrate ethics metrics into day-to-day public health practice. While the accreditation standards do not explicitly address ethics, ethical tools and considerations can enrich the accreditation process by helping health departments and their communities understand what ethical principles underlie the accreditation standards and how to use metrics based on these ethical principles to support decision making in public health practice. We provide a crosswalk between a public health essential service, Public Health Accreditation Board community engagement domain standards, and the relevant ethical principles in the Public Health Code of Ethics (Code). A case study illustrates how the accreditation standards and the ethical principles in the Code together can enhance the practice of engaging the community in decision making in the local health department.

  3. [Specialist and lay ethical expertise in public health: issues and challenges for discourse ethics].

    Science.gov (United States)

    Massé, Raymond

    2012-01-01

    In recent decades, both public health professionals and the populations targeted by prevention and health promotion programs have shown an increasing interest in ethical issues since some interventions have been seen as impinging on fundamental rights and values. Insofar as bioethics is not adapted to population interventions and community health issues, a specific expertise in public health ethics is now required. However, ethical expertise in this area faces many challenges. The purpose of this paper is to examine four of these challenges. The first three challenges concern professional or specialist expertise. The paper suggests that expertise in public health ethics should go beyond the search for greater sophistication in defining ethical principles. Experts in public health ethics also need to identify appropriate strategies to include public health professionals in ethical analysis and to adopt a critical and reflexive approach to the status of moral experts and moral expertise. However, the main challenge is to identify appropriate ways of reconciling lay and specialist ethical expertise. The paper argues that secular morality and common morality represent two key sources of lay ethics expertise and that the fundamental values that inform discourse ethics should be derived from both forms of expertise.

  4. Ethical Issues in Public Health Practice in Michigan

    Science.gov (United States)

    Gollust, Sarah E.; Goold, Susan D.; Jacobson, Peter D.

    2009-01-01

    Objectives. We sought to ascertain the types of ethical challenges public health practitioners face in practice and to identify approaches used to resolve such challenges. Methods. We conducted 45 semistructured interviews with public health practitioners across a range of occupations (e.g., health officers, medical directors, sanitarians, nurses) at 13 health departments in Michigan. Results. Through qualitative analysis, we identified 5 broad categories of ethical issues common across occupations and locations: (1) determining appropriate use of public health authority, (2) making decisions related to resource allocation, (3) negotiating political interference in public health practice, (4) ensuring standards of quality of care, and (5) questioning the role or scope of public health. Participants cited a variety of values guiding their decision-making that did not coalesce around core values often associated with public health, such as social justice or utilitarianism. Public health practitioners relied on consultations with colleagues to resolve challenges, infrequently using frameworks for decision-making. Conclusions. Public health practitioners showed a nuanced understanding of ethical issues and navigated ethical challenges with minimal formal assistance. Decision-making guides that are empirically informed and tailored for practitioners might have some value. PMID:19059850

  5. Nonhuman Animals, Public Health, and Ethics: A First Step, But….

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    Akhtar, Aysha

    2017-01-01

    In December 2015, the Johns Hopkins Bloomberg School of Public Health held the first-ever summit on the intersection between nonhuman animal ethics and human health. The conference covered a variety of issues where animal health intersects with human health, including the wildlife trade, animal agriculture, and animal experimentation. This article provides a brief overview and critique of the summit.

  6. Globalization of public health law and ethics.

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    Sohn, Myongsei

    2012-09-01

    The Constitution of the World Health Organization (1946) states that the "enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social position." The international legal framework for this right was laid by the Universal Declaration of Human Rights (1948) and reaffirmed in the International Covenant on Economic, Social, and Cultural Rights (1966) and the Declaration of Alma-Ata (1978). In recent years, the framework has been developed on 10 key elements: national and international human rights, laws, norms, and standards; resource constraints and progressive realization; obligations of immediate effect; freedoms and entitlements; available, accessible, acceptable, and good quality; respect, protect, and fulfill; non-discrimination, equality, and vulnerability; active and informed participation; international assistance and cooperation; and monitoring and accountability. Whereas public health law plays an essential role in the protection and promotion of the right to health, the emergence of SARS (2003) highlighted the urgent need to reform national public health laws and international obligations relating to public health in order to meet the new realities of a globalized world, leading to the WHO Framework Convention on Tobacco Control (2003) and the revision of the WHO International Health Regulations (2005). The Asian Institute for Bioethics and Health Law, in conjunction with the Republic of Korea's Ministry of Health and Welfare and the WHO International Digest of Health Legislation, conducted a comparative legal analysis of national public health laws in various countries through a project entitled Domestic Profiles of Public/Population Health Legislation (2006), which underscored the importance of recognizing the political and social contexts of distinct legal cultures, including Western, Asian, Islamic, and African.

  7. Ethics approval: a challenge for public health researchers in India.

    Science.gov (United States)

    Nagaraja, Sharath Burugina; Menezes, Ritesh G; Zachariah, Rony; Wilson, Nevin

    2015-01-01

    There is increasing impetus, interest and opportunity for people working in public health programmes in India to carry out operational research (OR) around relevant programme issues and then publish that in peer-reviewed publications. These published researches are valuable in analysing, documenting and advocating for locally generated evidence to inform policy and practice. Ethics review and approval is an essential step in the process of OR but is often viewed as a barrier rather than a prerequisite of good practice in OR. Journals and peer reviewers are also increasingly requiring approvals from local institutional ethics committees (IECs).

  8. Ethics, big data and computing in epidemiology and public health.

    Science.gov (United States)

    Salerno, Jennifer; Knoppers, Bartha M; Lee, Lisa M; Hlaing, WayWay M; Goodman, Kenneth W

    2017-05-01

    This article reflects on the activities of the Ethics Committee of the American College of Epidemiology (ACE). Members of the Ethics Committee identified an opportunity to elaborate on knowledge gained since the inception of the original Ethics Guidelines published by the ACE Ethics and Standards of Practice Committee in 2000. The ACE Ethics Committee presented a symposium session at the 2016 Epidemiology Congress of the Americas in Miami on the evolving complexities of ethics and epidemiology as it pertains to "big data." This article presents a summary and further discussion of that symposium session. Three topic areas were presented: the policy implications of big data and computing, the fallacy of "secondary" data sources, and the duty of citizens to contribute to big data. A balanced perspective is needed that provides safeguards for individuals but also furthers research to improve population health. Our in-depth review offers next steps for teaching of ethics and epidemiology, as well as for epidemiological research, public health practice, and health policy. To address contemporary topics in the area of ethics and epidemiology, the Ethics Committee hosted a symposium session on the timely topic of big data. Technological advancements in clinical medicine and genetic epidemiology research coupled with rapid advancements in data networks, storage, and computation at a lower cost are resulting in the growth of huge data repositories. Big data increases concerns about data integrity; informed consent; protection of individual privacy, confidentiality, and harm; data reidentification; and the reporting of faulty inferences. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Paternalism, Public Health Ethics, and Equality

    DEFF Research Database (Denmark)

    Midtgaard, Søren Flinch

    2015-01-01

    People’s lifestyles or their health choices importantly affect their general health. Furthermore, there is a social gradient in these choices such that people in relatively disadvantaged social positions tend to make worse choices with regard to their health than people in more advantaged positions....... The consequence is deep inequalities in health. The state, to the extent it is part of its role to prevent harm and to reduce inequality, appears obliged to try to influence people’s health choices in the interest of their own health and general well-being. However, the state acting to prevent people from harming...... to government efforts to change lifestyles, partly with the aim of reducing inequalities in health, we need a clear notion of paternalism. The latter may, roughly, be seen as follows: A acts paternalistically in relation to B, if, and only if, (a) A restricts B’s liberty; (b) A does so against B’s will; (c...

  10. Public health ethics and more-than-human solidarity.

    Science.gov (United States)

    Rock, Melanie J; Degeling, Chris

    2015-03-01

    This article contributes to the literature on One Health and public health ethics by expanding the principle of solidarity. We conceptualise solidarity to encompass not only practices intended to assist other people, but also practices intended to assist non-human others, including animals, plants, or places. To illustrate how manifestations of humanist and more-than-human solidarity may selectively complement one another, or collide, recent responses to Hendra virus in Australia and Rabies virus in Canada serve as case examples. Given that caring relationships are foundational to health promotion, people's efforts to care for non-human others are highly relevant to public health, even when these efforts conflict with edicts issued in the name of public health. In its most optimistic explication, One Health aims to attain optimal health for humans, non-human animals and their shared environments. As a field, public health ethics needs to move beyond an exclusive preoccupation with humans, so as to account for moral complexity arising from people's diverse connections with places, plants, and non-human animals.

  11. Procedures for the ethical review of public health surveillance protocols

    Directory of Open Access Journals (Sweden)

    Carlo Petrini

    2014-03-01

    Full Text Available The present commentary is based on the following considerations: 1 for the purposes of authorisation, a distinction is drawn between "research" and "intervention". The procedures for authorising the former are more complex, the relevant controls are stricter and approval has to be granted by a Research Ethics Committee (REC; 2 although the debate is still open, it is barely credible to claim that public health surveillance is not a form of research. It should, therefore, be subject to rigorous ethical assessment; 3 when addressing specifically the issue of surveillance, it would be appropriate to shift the focus of attention from the type of procedure (research/intervention to the risk implied in that procedure; 4 much emphasis has hitherto been placed on the risks that public health surveillance may imply for the protection of personal data; 5 the emphasis on the protection of personal data is frequently excessive and the risks should be examined in a broader context.

  12. Ethical issues in public health promotion

    African Journals Online (AJOL)

    2014-05-30

    May 30, 2014 ... related behaviour, e.g. stop smoking, exercise more, eat healthy food, practise safe ... from certain kinds of behaviour; and (iv) direct instrumental power,. e.g. through .... Intentionally overwhelming a person with excessive information to ... despite the fact that we know they are bad for people's health. There.

  13. [Problems and ethical challenges in public health communication].

    Science.gov (United States)

    Loss, J; Nagel, E

    2009-05-01

    Health communication, e.g., mass media campaigns, patient information leaflets or websites, plays an important role in public health. It contributes to citizen empowerment and helps them make informed decisions in health matters. However, public health communication can lead to adverse effects on both individual and societal level, e.g., by inaccurate or partial information, discriminatory messages, scandalizing coverage or inadequate tailoring to relevant target groups. It seems important to suggest ethical criteria for health information, e.g., (1) accuracy, completeness and balance, (2) transparency, (3) participation of the target group, (4) respect for human dignity, (5) social justice and equity, (6) appropriateness. Thoughtfulness is important in order not to stigmatize population subgroups. In addition, it is laborious to comprehensively and correctly present benefits and risks of a certain health behavior. Marketing principles guide how to 'sell' a certain health behavior, but health campaigns should not manipulate target persons for the sake of a population health aim. It remains unclear, however, how the different providers of health information can be held ethically responsible.

  14. Food and beverage policies and public health ethics.

    Science.gov (United States)

    Resnik, David B

    2015-06-01

    Government food and beverage policies can play an important role in promoting public health. Few people would question this assumption. Difficult questions can arise, however, when policymakers, public health officials, citizens, and businesses deliberate about food and beverage policies, because competing values may be at stake, such as public health, individual autonomy, personal responsibility, economic prosperity, and fairness. An ethically justified policy strikes a reasonable among competing values by meeting the following criteria: (1) the policy serves important social goal(s); (2) the policy is likely to be effective at achieving those goal(s); (3) less burdensome options are not likely to be effective at achieving the goals; (4) the policy is fair.

  15. Public health ethics: key concepts and issues in policy and practice

    National Research Council Canada - National Science Library

    Dawson, Angus

    2011-01-01

    .... Topics covered include the nature of public health ethics, the concepts of disease and prevention, risk and precaution, health inequalities and justice, screening, vaccination and disease control...

  16. Integrating Public Health and Deliberative Public Bioethics: Lessons from the Human Genome Project Ethical, Legal, and Social Implications Program.

    Science.gov (United States)

    Meagher, Karen M; Lee, Lisa M

    2016-01-01

    Public health policy works best when grounded in firm public health standards of evidence and widely shared social values. In this article, we argue for incorporating a specific method of ethical deliberation--deliberative public bioethics--into public health. We describe how deliberative public bioethics is a method of engagement that can be helpful in public health. Although medical, research, and public health ethics can be considered some of what bioethics addresses, deliberative public bioethics offers both a how and where. Using the Human Genome Project Ethical, Legal, and Social Implications program as an example of effective incorporation of deliberative processes to integrate ethics into public health policy, we examine how deliberative public bioethics can integrate both public health and bioethics perspectives into three areas of public health practice: research, education, and health policy. We then offer recommendations for future collaborations that integrate deliberative methods into public health policy and practice.

  17. A critical intersection: human rights, public health nursing, and nursing ethics.

    Science.gov (United States)

    Easley, Cheryl E; Allen, Carol Easley

    2007-01-01

    Public health nurses must make moral decisions regarding practice in complex situations fraught with competing moral claims. While nurses often frame practice decisions within the context of ethical theory, consideration of human rights perspectives is more recent. Basic concepts of nursing and public health ethics and of human rights, in relationship to public health, will be discussed and related to the practice of public health nursing. Intersections of human rights, ethics, and public health nursing practice will be discussed in light of the assertion of health as a human right and described using the issues of HIV/AIDS and genetics/genomics.

  18. Legislating morality progressively - the contraceptive coverage mandate, religious freedom, and public health policy and ethics

    National Research Council Canada - National Science Library

    DeBoer, Michael J

    2015-01-01

    .... The Supreme Court's Ruling D. Other Challenges IV. ANALYSIS UNDER A PUBLIC HEALTH POLICY AND ETHICS FRAMEWORK A. The ACA, the Mandate, Public Health, and Social Justice B. A Brief Overview of t...

  19. Monitoring 'monitoring' and evaluating 'evaluation': an ethical framework for monitoring and evaluation in public health.

    Science.gov (United States)

    Gopichandran, Vijayaprasad; Indira Krishna, Anil Kumar

    2013-01-01

    Monitoring and evaluation (M&E) is an essential part of public health programmes. Since M&E is the backbone of public health programmes, ethical considerations are important in their conduct. Some of the key ethical considerations are avoiding conflicts of interest, maintaining independence of judgement, maintaining fairness, transparency, full disclosure, privacy and confidentiality, respect, responsibility, accountability, empowerment and sustainability. There are several ethical frameworks in public health, but none focusing on the monitoring and evaluation process. There is a need to institutionalise the ethical review of M&E proposals. A theoretical framework for ethical considerations is proposed in this paper. This proposed theoretical framework can act as the blueprint for building the capacity of ethics committees to review M&E proposals. A case study is discussed in this context. After thorough field testing, this practical and field-based ethical framework can be widely used by donor agencies, M&E teams, institutional review boards and ethics committees.

  20. What makes public health studies ethical? Dissolving the boundary between research and practice.

    Science.gov (United States)

    Willison, Donald J; Ondrusek, Nancy; Dawson, Angus; Emerson, Claudia; Ferris, Lorraine E; Saginur, Raphael; Sampson, Heather; Upshur, Ross

    2014-08-08

    The generation of evidence is integral to the work of public health and health service providers. Traditionally, ethics has been addressed differently in research projects, compared with other forms of evidence generation, such as quality improvement, program evaluation, and surveillance, with review of non-research activities falling outside the purview of the research ethics board. However, the boundaries between research and these other evaluative activities are not distinct. Efforts to delineate a boundary - whether on grounds of primary purpose, temporality, underlying legal authority, departure from usual practice, or direct benefits to participants - have been unsatisfactory.Public Health Ontario has eschewed this distinction between research and other evaluative activities, choosing to adopt a common framework and process to guide ethical reflection on all public health evaluative projects throughout their lifecycle - from initial planning through to knowledge exchange. The Public Health Ontario framework was developed by a working group of public health and ethics professionals and scholars, in consultation with individuals representing a wide range of public health roles. The first part of the framework interprets the existing Canadian research ethics policy statement (commonly known as the TCPS 2) through a public health lens. The second part consists of ten questions that guide the investigator in the application of the core ethical principles to public health initiatives.The framework is intended for use by those designing and executing public health evaluations, as well as those charged with ethics review of projects. The goal is to move toward a culture of ethical integrity among investigators, reviewers and decision-makers, rather than mere compliance with rules. The framework is consonant with the perspective of the learning organization and is generalizable to other public health organizations, to health services organizations, and beyond. Public

  1. Right Relation and Right Recognition in Public Health Ethics: Thinking Through the Republic of Health.

    Science.gov (United States)

    Jennings, Bruce

    2016-07-01

    The further development of public health ethics will be assisted by a more direct engagement with political theory. In this way, the moral vocabulary of the liberal tradition should be supplemented-but not supplanted-by different conceptual and normative resources available from other traditions of political and social thought. This article discusses four lines of further development that the normative conceptual discourse of public health ethics might take. (i) The relational turn. The implications for public health ethics of the new 'ecological' or 'relational' interpretation that is emerging for concepts such as agency, self-identity, autonomy, liberty and justice. (ii) Governing the health commons. The framework of collective action problems is giving way to notions of democratic governance and management of common resources. (iii) The concept of membership. Membership is specified by the notions of equal respect and parity of voice and agency. (iv) The concept of mutuality. Mutuality is specified by the notions of interdependent concern and care.

  2. Ethical considerations in biobanks: how a public health ethics perspective sheds new light on old controversies.

    Science.gov (United States)

    Virani, Alice Hawkins; Longstaff, Holly

    2015-06-01

    Biobanks, collections of biospecimens with or without linked medical data, have increased dramatically in number in the last two decades. Their potential power to identify the underlying mechanisms of both rare and common disease has catalyzed their proliferation in the academic, medical, and private sectors. Despite demonstrated public support of biobanks, some within the academic, governmental, and public realms have also expressed cautions associated with the ethical, legal, and social (ELSI) implications of biobanks. These issues include concerns related to the privacy and confidentiality of data; return of results and incidental findings to participants; data sharing and secondary use of samples; informed consent mechanisms; ownership of specimens; and benefit sharing (i.e., the distribution of financial or other assets that result from the research). Such apprehensions become amplified as more researchers seek to pursue national and cross-border collaborations between biobanks. This paper provides an overview of two of the most contentious topics in biobank literature - informed consent and return of individual research results or incidental findings - and explores how a public health ethics lens may help to shed new light on how these issues may be best approached and managed. Doing so also demonstrates the important role that genetic counselors can play in the ongoing discussion of ethically appropriate biobank recruitment and management strategies, as well as identifies important areas of ongoing empirical research on these unresolved topics.

  3. [A framework for evaluating ethical issues of public health initiatives: practical aspects and theoretical implications].

    Science.gov (United States)

    Petrini, Carlo

    2015-01-01

    The "Framework for the Ethical Conduct of Public Health Initiatives", developed by Public Health Ontario, is a practical guide for assessing the ethical implications of evidence-generating public health initiatives, whether research or non-research activities, involving people, their biological materials or their personal information. The Framework is useful not only to those responsible for determining the ethical acceptability of an initiative, but also to investigators planning new public health initiatives. It is informed by a theoretical approach that draws on widely shared bioethical principles. Two considerations emerge from both the theoretical framework and its practical application: the line between practice and research is often blurred; public health ethics and biomedical research ethics are based on the same common heritage of values.

  4. Public Health Ethics, Legitimacy, and the Challenges of Industrial Wind Turbines: The Case of Ontario, Canada

    Science.gov (United States)

    Shain, Martin

    2011-01-01

    While industrial wind turbines (IWTs) clearly raise issues concerning threats to the health of a few in contrast to claimed health benefits to many, the trade-off has not been fully considered in a public health framework. This article reviews public health ethics justifications for the licensing and installation of IWTs. It concludes that the…

  5. Paradigm shifts in disability and health: toward more ethical public health research.

    Science.gov (United States)

    McDonald, Katherine E; Raymaker, Dora M

    2013-12-01

    Disability is often considered a health outcome disproportionately experienced by minority groups. It is also possible to view people with disabilities as a minority group that itself experiences health disparities. Calls to reduce these disparities necessitate the inclusion of people with developmental disabilities in research, although resulting ethical issues can thwart scientific progress. Using disability rights principles can help address ethical challenges and promote safe, respectful public health research. Examples include applying human rights frameworks, providing accommodations, attending to power, countering legacies of deficits-based models of disability, and transforming access to science more broadly. Collectively, these strategies can encourage broader engagement in safe, respectful, inclusive public health research aimed at promoting the health and well-being of people with developmental disabilities.

  6. Publication ethics from the perspective of PhD students of health sciences: a limited experience.

    Science.gov (United States)

    Arda, Berna

    2012-06-01

    Publication ethics, an important subtopic of science ethics, deals with determination of the misconducts of science in performing research or in the dissemination of ideas, data and products. Science, the main features of which are secure, reliable and ethically obtained data, plays a major role in shaping the society. As long as science maintains its quality by being based on reliable and ethically obtained data, it will be possible to maintain its role in shaping the society. This article is devoted to the presentation of opinions of PhD candidate students in health sciences in Ankara concerning publication ethics. The data obtained from 143 PhD students from the fields of medicine, dentistry, pharmacy and veterinary reveal limited but unique experiences. It also shows that plagiarism is one of the worst issues in the publication ethics from the perspective of these young academics.

  7. Teaching ethics in a masters program in public health in Lithuania.

    Science.gov (United States)

    Jakusovaite, Irayda; Bankauskaite, Vaida

    2007-07-01

    This article aims to present 10 years of experience of teaching ethics in a Masters Program in Public Health in Lithuania, and to discuss the content, skills, teaching approach and tools of this programme. In addition, the article analyses the links between ethics and law, identifies the challenges of the teaching process and suggests future teaching strategies. The important role of teaching ethics in countries that are in transition owing to a radically changing value system is emphasised.

  8. Assessing the legal and ethical preparedness of master of public health graduates.

    Science.gov (United States)

    Agee, Brian; Gimbel, Ronald W

    2009-08-01

    We explored the relationship between the preparedness of master of public health (MPH) graduates in public health law and ethics and their completion of courses in these areas. We reviewed accredited public health schools and programs to assess the supply of required and elective courses in law and ethics. In addition, we conducted an Internet-based scenario survey of MPH graduates. Survey results were analyzed, and relationships between scenario responses and completion of law and ethics courses were assessed. Of the 93 programs and schools reviewed, 14% required a course in ethics and 16% required a course in law. The majority (range = 55%-76%) of the survey respondents indicated being "prepared" or "very prepared" for each of the 9 public health scenarios. There were no significant relationships between scenario responses and completion of an ethics course. Responses to 2 scenarios (one involving food code violations and one involving a prison population) were significantly related to participants' completion of a course in law. Few public health schools and programs require graduate courses in ethics and law. Most MPH graduates report being prepared to address public health challenges. Additional research is necessary to improve techniques for measuring preparedness.

  9. Health care rationing and the ethics of publicity

    Science.gov (United States)

    Winslow, Gerald R.

    1995-10-01

    The need to set reasonable limits on expenditures for health care has led to increased discussion of rationing. Given the fact that no single vision of justice will dominate the allocation of health care, it is becoming increasingly important to establish open, democratic procedures for setting limits. Public awareness of the need for limits and public participation in establishing the limits is essential to the development of a just health care system.

  10. A Synergistic Approach to Human Rights and Public Health Ethics: Effective or a Source of Conflict?

    Directory of Open Access Journals (Sweden)

    Steinmetz-Wood, Madeleine

    2014-12-01

    Full Text Available Concerns over the growing disparities in health and wealth between members of society incited Stephanie Nixon and Lisa Forman, in their 2008 article Exploring synergies between human rights and public health ethics: A whole greater than the sum of its parts, to propose that the principles of human rights and public health ethics should be used in combination to develop norms for health action. This commentary reflects on the benefits as well as the difficulties that could arise from taking such an approach.

  11. Editorial: Ethics in public health: Bloomberg's battle and beyond

    NARCIS (Netherlands)

    Verweij, M.F.; Dawson, A.

    2013-01-01

    The growing prevalence of obesity and related conditions such as Type II diabetes is held by many to be a major public health problem in developed countries, and increasingly in developing countries as well (Popkin et al., 2012). If we wish to tackle this problem, it will be a major task.

  12. Ethics in public health research: privacy and public health at risk: public health confidentiality in the digital age.

    Science.gov (United States)

    Myers, Julie; Frieden, Thomas R; Bherwani, Kamal M; Henning, Kelly J

    2008-05-01

    Public health agencies increasingly use electronic means to acquire, use, maintain, and store personal health information. Electronic data formats can improve performance of core public health functions, but potentially threaten privacy because they can be easily duplicated and transmitted to unauthorized people. Although such security breaches do occur, electronic data can be better secured than paper records, because authentication, authorization, auditing, and accountability can be facilitated. Public health professionals should collaborate with law and information technology colleagues to assess possible threats, implement updated policies, train staff, and develop preventive engineering measures to protect information. Tightened physical and electronic controls can prevent misuse of data, minimize the risk of security breaches, and help maintain the reputation and integrity of public health agencies.

  13. Information-sharing ethical dilemmas and decision-making for public health nurses in Japan.

    Science.gov (United States)

    Suzuki, Chisato; Ota, Katsumasa; Matsuda, Masami

    2015-08-01

    Information sharing is one of the most important means of public health nurses collaborating with other healthcare professionals and community members. There are complicated ethical issues in the process. To describe the ethical dilemmas associated with client information sharing that Japanese public health nurses experience in daily practice and to clarify their decision-making process to resolve these dilemmas. Data were collected using a three-phase consensus method consisting of semi-structured interviews, self-administered questionnaires and a group interview. We surveyed administrative public health nurses in Shizuoka Prefecture, Japan. The semi-structured interviews were carried out with 12 administrative public health nurses, and the self-administered questionnaires were sent to all 899 administrative public health nurses. The group interview was carried out with eight administrative public health nurses. Ethical approval was granted by the ethics committee of the School of Health Sciences, Nagoya University, Japan (8-158, 9-130). Information-sharing ethical dilemmas occurred most often when clients' decisions did not coincide with the nurses' own professional assessments, particularly when they faced clinical issues that were inherently ambiguous. In their decision-making processes, nurses prioritised 'protection of health and life'. These findings suggest that, above all, they sought to address urgent risks to clients' lives while upholding the principle of client autonomy as much as possible. In such cases, the nurses made decisions regarding whether to share information about the client depending on the individual situation. Public health nurses should protect the client's health while taking into consideration their relationship with the client. © The Author(s) 2014.

  14. 'Faced' with responsibility: Levinasian ethics and the challenges of responsibility in Norwegian public health nursing.

    Science.gov (United States)

    Clancy, Anne; Svensson, Tommy

    2007-07-01

    This paper is concerned with aspects of responsibility in Norwegian public health nursing. Public health nursing is an expansive profession with diffuse boundaries. The Norwegian public health nurse does not perform 'hands on' nursing, but focuses on the prevention of illness, injury, or disability, and the promotion of health. What is the essence of ethical responsibility in public health nursing? The aim of this article is to explore the phenomenon based on the ethics of responsibility as reflected upon by the philosopher Emanuel Levinas (1906-1995). From an ethical point of view, responsibility is about our duty towards the Other, a duty we have not always chosen, are prepared for, or can fully explain; but it is nevertheless a demand we have to live with. Interviews with five experienced Norwegian nurses provide the empirical base for reflection and interpretation. The nurses share stories from their practice. In interpreting the nurses' stories, the following themes emerge: personal responsibility; boundaries; temporality; worry, fear, and uncertainty; and a sense of satisfaction. As the themes are developed further, it becomes apparent that, despite their diversity, they are all interrelated aspects of ethical responsibility. Responsibility for the Other cannot be avoided, ignored, or transferred. The nurses' responsibility is personal and infinite. Levinasian ethics can help nurses understand the importance of accepting that being a responsive carer can involve not only contentment in the predictable, but also the fear, worry, and uncertainty of the unpredictable.

  15. Ethics in public health research: masters of marketing: bringing private sector skills to public health partnerships.

    Science.gov (United States)

    Curtis, Valerie A; Garbrah-Aidoo, Nana; Scott, Beth

    2007-04-01

    Skill in marketing is a scarce resource in public health, especially in developing countries. The Global Public-Private Partnership for Handwashing with Soap set out to tap the consumer marketing skills of industry for national handwashing programs. Lessons learned from commercial marketers included how to (1) understand consumer motivation, (2) employ 1 single unifying idea, (3) plan for effective reach, and (4) ensure effectiveness before national launch. After the first marketing program, 71% of Ghanaian mothers knew the television ad and the reported rates of handwashing with soap increased. Conditions for the expansion of such partnerships include a wider appreciation of what consumer marketing is, what it can do for public health, and the potential benefits to industry. Although there are practical and philosophical difficulties, there are many opportunities for such partnerships.

  16. Readiness of ethics review systems for a changing public health landscape in the WHO African Region.

    Science.gov (United States)

    Motari, Marion; Ota, Martin Okechukwu; Kirigia, Joses Muthuri

    2015-12-02

    The increasing emphasis on research, development and innovation for health in providing solutions to the high burden of diseases in the African Region has warranted a proliferation of studies including clinical trials. This changing public health landscape requires that countries develop adequate ethics review capacities to protect and minimize risks to study participants. Therefore, this study assessed the readiness of national ethics committees to respond to challenges posed by a globalized biomedical research system which is constantly challenged by new public health threats, rapid scientific and technological advancements affecting biomedical research and development, delivery and manufacture of vaccines and therapies, and health technology transfer. This is a descriptive study, which used a questionnaire structured to elicit information on the existence of relevant national legal frameworks, mechanisms for ethical review; as well as capacity requirements for national ethics committees. The questionnaire was available in English and French and was sent to 41 of the then 46 Member States of the WHO African Region, excluding the five Lusophone Member States. Information was gathered from senior officials in ministries of health, who by virtue of their offices were considered to have expert knowledge of research ethics review systems in their respective countries. Thirty three of the 41 countries (80.5 %) responded. Thirty (90.9 %) of respondent countries had a national ethics review committee (NEC); 79 % of which were established by law. Twenty-five (83.3 %) NECs had secretarial and administrative support. Over 50 % of countries with NECs indicated a need for capacity strengthening through periodic training on international guidelines for health research (including clinical trials) ethics; and allocation of funds for administrative and secretariat support. Despite the existing training initiatives, the Region still experiences a shortage of professionals

  17. CURRENT PERSPECTIVES OF POTTER'S GLOBAL BIOETHICS AS A BRIDGE BETWEEN CLINICAL (PERSONALIZED) AND PUBLIC HEALTH ETHICS.

    Science.gov (United States)

    Turina, Iva Sorta-Bilajac; Brkljacić, Morana; Grgas-Bile, Cecilija; Gajski, Domagoj; Racz, Aleksandar; Cengić, Tomislav

    2015-12-01

    In the context of modern scientific and technological developments in biomedicine and health care, and the potential consequences of their application on humans and the environment, Potter's global bioethics concept resurfaces. By actualizing Potter's original thoughts on individual bioethical issues, the universality of two of his books, which today represent the backbone of the world bioethical literature, "Bioethics--Bridge to the Future" and "Global Bioethics: Building on the Leopold Legacy", is emphasized. Potter's global bioethics today can legitimately be viewed as a bridge between clinical personalized ethics on the one hand and ethics of public health on the other.

  18. The ethics of health service delivery: a challenge to public health leadership.

    Science.gov (United States)

    DeLuca, D M

    1989-01-01

    The ethical distribution of health care is a central issue now that AIDS has started to be a drain on health care resources. If the worst predictions are true, the next half century will be capitalized by a great stress of the health care delivery system in the Pacific. The critical challenges that face the current leadership are: sustaining commitment to all levels of administration to reduce social and health inequities; making sound decisions on policies, priorities and goals that are based on valid information; strengthen health infrastructure, based on the principle of primary health care, including appropriate distribution of staffing, skills, technology and resources. The goals of the Pacific Health Promotion and Development center must not focus exclusively on AIDs. Hepatitis B control measures, hypertension and diabetes, primary care in remote areas, and rehabilitation initiatives must be kept in place. Humanitarian interests for AIDs patients must be balanced with the pragmatic reality of saving children's hearing, or extending useful lives. The attributes of respect, accountability, leadership, judgement, fairness, integrity and honesty controlled by principles of social justice must be part of the administrative decision making process. The 2 major issues facing public health professional are: (1) the financial considerations involved with increasingly expensive technology, services and research, contrasted against the need to prioritize their use and development; (2) pragmatic and ideological needs must be balanced to maximize preventative and curative services and make them available to those who can benefit from them.

  19. Top 10 health care ethics challenges facing the public: views of Toronto bioethicists

    Directory of Open Access Journals (Sweden)

    Bell Jennifer

    2005-06-01

    Full Text Available Abstract Background There are numerous ethical challenges that can impact patients and families in the health care setting. This paper reports on the results of a study conducted with a panel of clinical bioethicists in Toronto, Ontario, Canada, the purpose of which was to identify the top ethical challenges facing patients and their families in health care. A modified Delphi study was conducted with twelve clinical bioethicist members of the Clinical Ethics Group of the University of Toronto Joint Centre for Bioethics. The panel was asked the question, what do you think are the top ten ethical challenges that Canadians may face in health care? The panel was asked to rank the top ten ethical challenges throughout the Delphi process and consensus was reached after three rounds. Discussion The top challenge ranked by the group was disagreement between patients/families and health care professionals about treatment decisions. The second highest ranked challenge was waiting lists. The third ranked challenge was access to needed resources for the aged, chronically ill, and mentally ill. Summary Although many of the challenges listed by the panel have received significant public attention, there has been very little attention paid to the top ranked challenge. We propose several steps that can be taken to help address this key challenge.

  20. Ethical budgets: a critical success factor in implementing new public management accountability in health care.

    Science.gov (United States)

    Bosa, Iris M

    2010-05-01

    New public management accountability is increasingly being introduced into health-care systems throughout the world - albeit with mixed success. This paper examines the successful introduction of new management accounting systems among general practitioners (GPs) as an aspect of reform in the Italian health-care system. In particular, the study examines the critical role played by the novel concept of an 'ethical budget' in engaging the willing cooperation of the medical profession in implementing change. Utilizing a qualitative research design, with in-depth interviews with GPs, hospital doctors and managers, along with archival analysis, the present study finds that management accounting can be successfully implemented among medical professionals provided there is alignment between the management imperative and the ethical framework in which doctors practise their profession. The concept of an 'ethical budget' has been shown to be an innovative and effective tool in achieving this alignment.

  1. Coupled Ethical-Epistemic Analysis of Public Health Research and Practice: Categorizing Variables to Improve Population Health and Equity.

    Science.gov (United States)

    Katikireddi, S Vittal; Valles, Sean A

    2015-01-01

    The categorization of variables can stigmatize populations, which is ethically problematic and threatens the central purpose of public health: to improve population health and reduce health inequities. How social variables (e.g., behavioral risks for HIV) are categorized can reinforce stigma and cause unintended harms to the populations practitioners and researchers strive to serve. Although debates about the validity or ethical consequences of epidemiological variables are familiar for specific variables (e.g., ethnicity), these issues apply more widely. We argue that these tensions and debates regarding epidemiological variables should be analyzed simultaneously as ethical and epistemic challenges. We describe a framework derived from the philosophy of science that may be usefully applied to public health, and we illustrate its application.

  2. Ethical challenges in cluster randomized controlled trials: experiences from public health interventions in Africa and Asia.

    Science.gov (United States)

    Osrin, David; Azad, Kishwar; Fernandez, Armida; Manandhar, Dharma S; Mwansambo, Charles W; Tripathy, Prasanta; Costello, Anthony M

    2009-10-01

    Public health interventions usually operate at the level of groups rather than individuals, and cluster randomized controlled trials (RCTs) are one means of evaluating their effectiveness. Using examples from six such trials in Bangladesh, India, Malawi and Nepal, we discuss our experience of the ethical issues that arise in their conduct. We set cluster RCTs in the broader context of public health research, highlighting debates about the need to reconcile individual autonomy with the common good and about the ethics of public health research in low-income settings in general. After a brief introduction to cluster RCTs, we discuss particular challenges we have faced. These include the nature of - and responsibility for - group consent, and the need for consent by individuals within groups to intervention and data collection. We discuss the timing of consent in relation to the implementation of public health strategies, and the problem of securing ethical review and approval in a complex domain. Finally, we consider the debate about benefits to control groups and the standard of care that they should receive, and the issue of post-trial adoption of the intervention under test.

  3. Exploring synergies between human rights and public health ethics: A whole greater than the sum of its parts

    Directory of Open Access Journals (Sweden)

    Nixon Stephanie

    2008-01-01

    Full Text Available Abstract Background The fields of human rights and public health ethics are each concerned with promoting health and elucidating norms for action. To date, however, little has been written about the contribution that these two justificatory frameworks can make together. This article explores how a combined approach may make a more comprehensive contribution to resolving normative health issues and to advancing a normative framework for global health action than either approach made alone. We explore this synergy by first providing overviews of public health ethics and of international human rights law relevant to health and, second, by articulating complementarities between human rights and public health ethics. Discussion We argue that public health ethics can contribute to human rights by: (a reinforcing the normative claims of international human rights law, (b strengthening advocacy for human rights, and (c bridging the divide between public health practitioners and human rights advocates in certain contemporary health domains. We then discuss how human rights can contribute to public health ethics by contributing to discourses on the determinants of health through: (a definitions of the right to health and the notion of the indivisibility of rights, (b emphasis on the duties of states to progressively realize the health of citizens, and (c recognition of the protection of human rights as itself a determinant of health. We also discuss the role that human rights can play for the emergent field of public health ethics by refocusing attention on the health and illness on marginalized individuals and populations. Summary Actors within the fields of public health, ethics and human rights can gain analytic tools by embracing the untapped potential for collaboration inherent in such a combined approach.

  4. Procedures for the ethical review of public health surveillance protocols. Commentary.

    Science.gov (United States)

    Petrini, Carlo

    2014-01-01

    The present commentary is based on the following considerations: 1) for the purposes of authorisation, a distinction is drawn between "research" and "intervention". The procedures for authorising the former are more complex, the relevant controls are stricter and approval has to be granted by a Research Ethics Committee (REC); 2) although the debate is still open, it is barely credible to claim that public health surveillance is not a form of research. It should, therefore, be subject to rigorous ethical assessment; 3) when addressing specifically the issue of surveillance, it would be appropriate to shift the focus of attention from the type of procedure (research/intervention) to the risk implied in that procedure; 4) much emphasis has hitherto been placed on the risks that public health surveillance may imply for the protection of personal data; 5) the emphasis on the protection of personal data is frequently excessive and the risks should be examined in a broader context.

  5. Congenital rubella syndrome: seeking damages to be born. Ethical, medical and public health considerations.

    Science.gov (United States)

    Verghini, Emanuele; Di Pietro, Maria Luisa; Virdis, Andrea; De Luca, Daniele

    2011-12-01

    A case of congenital rubella syndrome has been the reason to seek damages but a Civil Court of Rome sentenced against this and in favor of sued doctors. We discussed the high level of social attention and the feeling present in our western culture behind the request for damages. Legal considerations above the Italian abortion Law is provided to understand the framework of the court decision. Ethical, medical, and public health issues are commented and compared with the Perruche's case.

  6. The conflict between the ethics of th individual and the ethics governing public health: practical sustainability of health care in jeopardy?

    Science.gov (United States)

    Smith, Saxon Donald

    2007-12-01

    The "health rights movement" has reconstructed the clinical relationship between health care workers and patients by simultaneously demanding more from traditional medical care and challenging the perceived power differential between doctors and patients by rejecting the paternalistic medical model in favour of an individual patients' rights model. However, the growth in individual expectations of a right to health care creates a potential conflict with the ethics that prioritise public health and guide the rationing of its limited financial and human capital resources. This, in turn, creates a practical dilemma which requires public health institutions to become service orientated while sacrificing their integral role in training and educating the medical workforce and potentially compromising the practical sustainable delivery of public health in Australia. However, the law can play a role in resolving this conflict through legislation, regulations, codes, administrative law and common law in an effort to ensure the quality and future sustainability of public health in Australia.

  7. Public policy and medical tourism: ethical implications for the Egyptian health care system.

    Science.gov (United States)

    Haley, Bob

    2011-01-01

    Egypt's medical tourism industry has been experiencing tremendous growth. However, Egypt continues to lack the necessary investment in its public health system to effectively care for its population. Current policy and the emergence of medical tourism have led to unequal health care access, resulting in high a prevalence of infectious diseases and lack of resources for its most vulnerable populations. As a new Egyptian government emerges, it is important for policymakers to understand the critical issues and ethical concerns of existing health policy. This understanding may be used to propose new policy that more effectively allocates to care for Egypt's population.

  8. A brief introduction to public health ethics%公共卫生伦理学简论

    Institute of Scientific and Technical Information of China (English)

    张琳; 李国红; 郑志杰

    2012-01-01

    This article reviewed the basic concepts and principles of public health ethics, and conceptual frameworks for ethical reasoning in public health research and practice. Several important cases in public health ethics have also been highlighted. Attention to ethical issues will help facilitate the effective planning, implementation, and growth of a variety of public health programs.%试图阐述公共卫生伦理学的基本概念、基本原则和概念框架,并通过例举多个公共卫生伦理的具体案例来阐明如何利用道德推理来解决公共卫生研究和实践中出现的伦理冲突,制定有效的公共卫生政策和措施.

  9. Ethical aspects of public health legislation: the Mental Health Care Bill, 2011.

    Science.gov (United States)

    Thippeswamy, Harish; Goswami, Kausik; Chaturvedi, Santosh

    2012-01-01

    A legal framework is essential to promote and safeguard the interests of persons with mental illness. Since the Indian Lunacy Act, 1912, mental health legislation has come a long way. Currently efforts are underway to modify the existing Mental Health Act taking into account the resolutions under the UN Convention on the Rights of Persons with Disabilities. The proposed Mental Health Care Bill, 2011 incorporates promising modifications, like "caregiver", "nominated representative", "consent", "support" for decision making, and "advance directive" for persons with mental illness in its rubric, which seems potentially beneficial to the patients. The proposed new bill should facilitate and strengthen a mental health policy which provides acceptable, accessible, and equitable mental health care. A law becomes meaningful when it is realistic, implementable and ethical in provisions. In this comment, we take a critical look at the proposed 'The Mental Health Care Bill, 2011' through the lens of ethical principles.

  10. Ethics in Online Publications.

    Science.gov (United States)

    Vervaart, Peter

    2014-10-01

    Journals have been publishing the results of scientific investigations since the founding of Philosophical Transactions in 1665. Since then we have witnessed a massive expansion in the number of journals to the point that there are now approximately 28,000 active, peer reviewed journals collectively publishing more than 1.8 million articles per year. Before the mid-1990s, these journals were only available on paper but by the end of the 20th century, most journals had moved to online platforms. Online publication has also served as the impetus for the move to 'open-access' to the information contained in journals. The fact that a publication is 'on-line' and 'open-access' does not negate the responsibility of the author and the publisher to publish in an ethical way. [1] The document produced by the IFCC Ethics Task Force (TF-E) on publication ethics states that 'Ethics in Science at its broadest level encompasses research ethics, medical ethics, publication ethics, conflicts of interest, ethical responsibilities as educator, plus many other areas.' Thus publication ethics is a continuum from the first step of research design through to the information being read by the reader. In general terms 'publication ethics' includes the ethical behaviour of the authors in writing and submitting a scientific manuscript to a publisher for the purpose of publication, thus any discussion of publication ethics must include the role of the authors, referees, publisher and reader and the issues of authorship (and the use of 'ghosts'), plagiarism, duplicate publication (including in different languages), image manipulation (particularly in the era of digitisation), and conflict of interest [2]. To aid the authors, and others involved in the process of publication, a number of resources are now available particularly those from the Committee on Publication Ethics (COPE) [3] and the World Association of Medical Editors (WAME) [4]. More recently the issue of 'publisher ethics' has

  11. The ethical introduction of genome-based information and technologies into public health.

    Science.gov (United States)

    Howard, H C; Swinnen, E; Douw, K; Vondeling, H; Cassiman, J-J; Cambon-Thomsen, A; Borry, P

    2013-01-01

    With the human genome project running from 1989 until its completion in 2003, and the incredible advances in sequencing technology and in bioinformatics during the last decade, there has been a shift towards an increase focus on studying common complex disorders which develop due to the interplay of many different genes as well as environmental factors. Although some susceptibility genes have been identified in some populations for disorders such as cancer, diabetes and cardiovascular diseases, the integration of this information into the health care system has proven to be much more problematic than for single gene disorders. Furthermore, with the 1000$ genome supposedly just around the corner, and whole genome sequencing gradually being integrated into research protocols as well as in the clinical context, there is a strong push for the uptake of additional genomic testing. Indeed, the advent of public health genomics, wherein genomics would be integrated in all aspects of health care and public health, should be taken seriously. Although laudable, these advances also bring with them a slew of ethical and social issues that challenge the normative frameworks used in clinical genetics until now. With this in mind, we highlight herein 5 principles that are used as a primer to discuss the ethical introduction of genome-based information and genome-based technologies into public health.

  12. [Grounding public health policies in ethics and economic efficiency. SESPAS report 2010].

    Science.gov (United States)

    Ramiro Avilés, Miguel A; Lobo, Félix

    2010-12-01

    In recent times, various voices in Spain have questioned public health policies as an assault to personal freedom. The present article aims to respond to these voices with ethical and economic arguments. The scope and characteristics of this current of opinion are described. Then, starting with John Stuart Mill, the ethical principles of non-maleficence, beneficence, personal autonomy and justice, as well as related concepts taken from economic efficiency, such as externalities, monopoly, incomplete and asymmetric information, agency relationship, public goods and adverse selection, are discussed. A short mention is made of equity in economics, the welfare state and public health systems. The justification for paternalist actions by the state, as well as limits to these actions, are briefly discussed. Respect for individual freedom does not exclude the implementation of public health actions but rather demands the adoption of such policies. If these actions comply with certain conditions, they do not limit individual freedom but rather serve to protect it. Copyright © 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. Ethical issues in publication.

    Science.gov (United States)

    Hamblet, J L

    1996-04-01

    Nurses usually publish to disseminate pertinent information and research findings. Their articles and textbooks promote quality patient care and sound professional practice. Nurses may also publish to meet requirements for academic promotion and professional advancement. Ethical issues play a part in any phase of writing for publication. Veracity, justice, beneficence, and nonmaleficence are four of the ethical principles that pertain to aspects of authorship, peer review, and research in publication.

  14. [Ethical and philosophical dimensions of decision-making in public health].

    Science.gov (United States)

    Grémy, F

    2008-01-01

    Decisions in public health, or in individual health care, are taken by people (individuals or collective) for other people (individuals or collective). Human values, that is to say what is connected to Ethics, should be to the fore, de jure. Too often, under the pretext that they refer to subjectivity, they appear only after very many technical considerations. The latter, in a scientist society, are supposed to deserve a claim to objectivity, this being of course illusory. The author, placing himself in the line of Levinas, Ricoeur, and also of Kant, for whom the "What must I do?" is the most fundamental question any human being has to face, develops four reasons which plead for the pre-eminence of ethics as the foundation of decisions in a policy for public health. 1) He reminds us the intangible values, which are on one side uniqueness and universality of mankind, and on the other side the singularity of the human person. 2) He insists on the ethical wreck which threatens the whole health- and healthcare systems. 3) He sets out some results of modern neurophysiological research (AR Damasio's work), joining an intuition of Aristoteles: the decision making process implies two phases: deliberation the aim of which is to list the different possible actions to undertake, then the choice between those actions. Damasio shows that the lack of emotions inhibits the choice, especially when decision implies human values. 4) Finally, he insists, after E. Morin, on the practical and theoretical difficulties in taking a "good" decision, and on what Morin calls "ecology of action". The results of a decision may completely escape from the decision-makers aims, very often for unexpected social and psychological reasons.

  15. [Contagion - some notes on the epistemology and the ethics of public health].

    Science.gov (United States)

    Marques, Manuel Silvério; Ferreira, Carlos Miguel

    2010-01-01

    European Medical thought on epidemics - ranging from the opposition clean/dirty, pollution, malaria, pestilential seeds to 19th century microbiology - has always been ruled by figures such as the miasma, the repulsive, the excrement, the filth, the corrupt, the contagion. Theoretically framed, in general, by Foucault's ideas, this research focuses on some aspects of the historical epistemology and ethics of Public Health. Based on the history of Tuberculosis (TB) management in Portugal and, more briefly, on the flu pandemics, we thematize aspects of Biopolitics, namely, the disciplinary power and the processes of indifferentiation and reification. We will focus on the disjunction between contamination and transmission, on the systems of inclusion and exclusion and on the differences between uncertainty, risk, danger, precaution and prevention, aiming to contribute to the public debate on an ethic of precaution. It will be attested that the praxis of Public Health inevitably calls together, at various levels, the old categories of medical ethos, among which are the catharsis, the crisis, and the kairos.

  16. Through the quarantine looking glass: drug-resistant tuberculosis and public health governance, law, and ethics.

    Science.gov (United States)

    Fidler, David P; Gostin, Lawrence O; Markel, Howard

    2007-01-01

    The incident in May-June 2007 involving a U.S. citizen traveling internationally while infected with drug-resistant tuberculosis involved the U.S. federal government's application of its quarantine and isolation powers. The incident and the isolation order raised numerous important issues for public health governance, law, and ethics. This article explores many of these issues by examining how the exercise of quarantine powers provides a powerful lens through which to understand how societies respond to and attempt to govern threats posed by dangerous, contagious pathogens. The article considers historical aspects of governmental power to quarantine and isolate individuals and groups; analyzes the current state of quarantine and isolation law in the United States in light of the recent incident with drug-resistant tuberculosis; and explores global aspects of public health governance and law highlighted by this incident.

  17. Engaging Ethical Issues Associated with Research and Public Health Interventions During Humanitarian Crises: Review of a Dialogic Workshop

    Directory of Open Access Journals (Sweden)

    Dave, Anushree

    2016-01-01

    Full Text Available On November 7th, 2014 the Humanitarian Health Ethics Workshop was held at McGill University, in Montreal. Co-hosted by the Montreal Health Equity Research Consortium and the Humanitarian Health Ethics Network, the event included six presentations and extensive discussion amongst participants, including researchers from Canada, Haiti, India, Switzerland and the US. Participants had training in disciplines including anthropology, bioethics, medicine, occupational therapy, philosophy, physical therapy, political science, public administration and public health. The objective of the workshop was to create a forum for discussion amongst scholars and practitioners interested in the ethics of healthcare delivery, research and public health interventions during humanitarian crises. This review is a summary of the presentations given, key themes that emerged during the day’s discussions, and avenues for future research that were identified.

  18. Critical reflections on evidence, ethics and effectiveness in the management of tuberculosis: public health and global perspectives

    Directory of Open Access Journals (Sweden)

    Upshur Ross EG

    2004-03-01

    Full Text Available Abstract Background Tuberculosis is a major cause of morbidity and mortality globally. Recent scholarly attention to public health ethics provides an opportunity to analyze several ethical issues raised by the global tuberculosis pandemic. Discussion Recently articulated frameworks for public health ethics emphasize the importance of effectiveness in the justification of public health action. This paper critically reviews the relationship between these frameworks and the published evidence of effectiveness of tuberculosis interventions, with a specific focus on the controversies engendered by the endorsement of programs of service delivery that emphasize direct observation of therapy. The role of global economic inequities in perpetuating the tuberculosis pandemic is also discussed. Summary Tuberculosis is a complex but well understood disease that raises important ethical challenges for emerging frameworks in public health ethics. The exact role of effectiveness as a criterion for judging the ethics of interventions needs greater discussion and analysis. Emerging frameworks are silent about the economic conditions contributing to the global burden of illness associated with tuberculosis and this requires remediation.

  19. Ethics and Scientific Publication

    Science.gov (United States)

    Benos, Dale J.; Fabres, Jorge; Farmer, John; Gutierrez, Jessica P.; Hennessy, Kristin; Kosek, David; Lee, Joo Hyoung; Olteanu, Dragos; Russell, Tara; Wang, Kai

    2005-01-01

    This article summarizes the major categories of ethical violations encountered during submission, review, and publication of scientific articles. We discuss data fabrication and falsification, plagiarism, redundant and duplicate publication, conflict of interest, authorship, animal and human welfare, and reviewer responsibility. In each section,…

  20. Ethics and Scientific Publication

    Science.gov (United States)

    Benos, Dale J.; Fabres, Jorge; Farmer, John; Gutierrez, Jessica P.; Hennessy, Kristin; Kosek, David; Lee, Joo Hyoung; Olteanu, Dragos; Russell, Tara; Wang, Kai

    2005-01-01

    This article summarizes the major categories of ethical violations encountered during submission, review, and publication of scientific articles. We discuss data fabrication and falsification, plagiarism, redundant and duplicate publication, conflict of interest, authorship, animal and human welfare, and reviewer responsibility. In each section,…

  1. Application of Ethical Principles to Research using Public Health Data in The Global South: Perspectives from Africa.

    Science.gov (United States)

    Anane-Sarpong, Evelyn; Wangmo, Tenzin; Sankoh, Osman; Tanner, Marcel; Elger, Bernice Simone

    2016-12-22

    Existing ethics guidelines, influential literature and policies on ethical research generally focus on real-time data collection from humans. They enforce individual rights and liberties, thereby lowering need for aggregate protections. Although dependable, emerging public health research paradigms like research using public health data (RUPD) raise new challenges to their application. Unlike traditional research, RUPD is population-based, aligned to public health activities, and often reliant on pre-collected longitudinal data. These characteristics, when considered in relation to the generally lower protective ethico-legal frameworks of the Global South, including Africa, highlight ethical gaps. Health and demographic surveillance systems are examples of public health programs that accommodate RUPD in these contexts. We set out to explore the perspectives of professionals with a working knowledge of these systems to determine practical ways of appropriating the foundational principles of health research to advance the ever growing opportunities in RUPD. We present their perspectives and in relation to the literature and our ethical analysis, make context relevant recommendations. We further argue for the development of a framework founded on the discussions and recommendations as a minimum base for achieving optimal ethics for optimal RUPD in the Global South.

  2. [Current legislation in public health--an example for post-modern social ethics?].

    Science.gov (United States)

    Rothfuss, J; Adam, H

    1996-10-01

    Social ethics of affirmative postmodernists are discussed in relation to recent German health care legislation. It could be shown that: 1. the health care legislation 1989 and 1993 only partially fulfills the postmodern call for "cultivation of individual responsibility", 2. both laws largely fail to enforce the principle of subsidiarity, and 3. postmodernist thinking is weak on the question of global strategies but strong In the area of individualism and subjectivity. We conclude that postmodern social ethics are useful to compensate areas largely neglected by recent German health care legislation, rather than that the legislation is an example of postmodern social ethics.

  3. Ethics, privacy and the legal framework governing medical data: opportunities or threats for biomedical and public health research?

    Science.gov (United States)

    Coppieters, Yves; Levêque, Alain

    2013-06-21

    Privacy is an important concern in any research programme that deals with personal medical data. In recent years, ethics and privacy have become key considerations when conducting any form of scientific research that involves personal data. These issues are now addressed in healthcare professional training programmes. Indeed, ethics, legal frameworks and privacy are often the subject of much confusion in discussions among healthcare professionals. They tend to group these different concepts under the same heading and delegate responsibility for "ethical" approval of their research programmes to ethics committees. Public health researchers therefore need to ask questions about how changes to legal frameworks and ethical codes governing privacy in the use of personal medical data are to be applied in practice. What types of data do these laws and codes cover? Who is involved? What restrictions and requirements apply to any research programme that involves medical data?

  4. Ethics in publication

    NARCIS (Netherlands)

    Wallace, M.B.; Siersema, P.D.

    2015-01-01

    Publication of scientific manuscripts remains our core method of sharing knowledge and advanced scientific inquiry. Pressures to publish for reasons other than pure discovery have the potential to corrupt this process. The core principles of scientific ethics outlined above provide guidance on how t

  5. Research Content and Ethical Thinking of Public Health Ethics%公共卫生伦理学的研究内容及伦理思考∗

    Institute of Scientific and Technical Information of China (English)

    鲁琳; 胡晓燕

    2016-01-01

    This article outlines the arising, the research content, the related ethical issues and the future de-velopment of public health ethics. The related ethical issues contains the ethical issues of disease prevention and control, the ethical issues in group unit, the ethical issues in public health policy-making, the ethical issues un-der the influence of biological science, and ethics review issues related with the thinking methoods namely moderate diversity, avoiding the socialism and in a relationship. The last, the article points out the human subjects in bio-medical researches.%通过概述公共卫生伦理学的兴起,论述了公共卫生伦理学的研究内容及相关伦理问题,即疾病防治中的伦理问题,以群体为单位的伦理问题,公共卫生政策制定中的伦理问题,生物科学影响下的伦理问题,涉及人的生物医学研究的伦理审查问题。并分析了公共卫生伦理学的思考方式,即适度多元化,避免主义化及外在关系中的思考方式,最后指出了公共卫生伦理学未来的发展状况。

  6. Ethics in Public Administration

    Directory of Open Access Journals (Sweden)

    MSc. Arjeta Hallunovi

    2014-06-01

    Full Text Available The goal of this study is to deal with some ethical causes in the public administration, that aim the avoidance of negative phenomenon’s as theft, corruption, etc. In this direction, the debates about ethics are becoming more and more a global tendency, as an implement through which would be found the way to get out of the crisis. The success in the reforms of the public administrations in major part depends, on the public functionaries and their willingness to make fundamental changes in the way they work. In this direction, the State should strengthen and modernize the public service, should realize an employment system, which should reflect more the merits on its service. For this reason, the government’s attempts should be concentrated on the construction of a positive image for the state and its administration as professional objective, which is oriented to the services. Being aware for the practical restrictions of this study, we firstly chose to concentrate on the local public administrations ethics. The study will be focused on the practical comparative analysis of the city of Shkodra and Durres by the realization of a questionnaire by each of these municipalities and the Agency of Legalization and Urbanization of Informal Zones (ALUIZNI in Shkodra.

  7. A Research Agenda for Humanitarian Health Ethics

    Science.gov (United States)

    Hunt, Matthew; Schwartz, Lisa; Pringle, John; Boulanger, Renaud; Nouvet, Elysée; O'Mathúna, Dónal; Arya, Neil; Bernard, Carrie; Beukeboom, Carolyn; Calain, Philippe; de Laat, Sonya; Eckenwiler, Lisa; Elit, Laurie; Fraser, Veronique; Gillespie, Leigh-Anne; Johnson, Kirsten; Meagher, Rachel; Nixon, Stephanie; Olivier, Catherine; Pakes, Barry; Redwood-Campbell, Lynda; Reis, Andreas; Renaldi, Teuku; Singh, Jerome; Smith, Maxwell; Von Schreeb, Johan

    2014-01-01

    This paper maps key research questions for humanitarian health ethics: the ethical dimensions of healthcare provision and public health activities during international responses to situations of humanitarian crisis. Development of this research agenda was initiated at the Humanitarian Health Ethics Forum (HHE Forum) convened in Hamilton, Canada in November 2012. The HHE Forum identified priority avenues for advancing policy and practice for ethics in humanitarian health action. The main topic areas examined were: experiences and perceptions of humanitarian health ethics; training and professional development initiatives for humanitarian health ethics; ethics support for humanitarian health workers; impact of policies and project structures on humanitarian health ethics; and theoretical frameworks and ethics lenses. Key research questions for each topic area are presented, as well as proposed strategies for advancing this research agenda. Pursuing the research agenda will help strengthen the ethical foundations of humanitarian health action. PMID:25687273

  8. Ethical issues raised by thyroid cancer overdiagnosis: A matter for public health?

    Science.gov (United States)

    Rogers, Wendy A; Craig, Wendy L; Entwistle, Vikki A

    2017-10-01

    Current practices of identifying and treating small indolent thyroid cancers constitute an important but in some ways unusual form of overdiagnosis. Overdiagnosis refers to diagnoses that generally harm rather than benefit patients, primarily because the diagnosed condition is not a harmful form of disease. Patients who are overdiagnosed with thyroid cancer are harmed by the psycho-social impact of a cancer diagnosis, as well as treatment interventions such partial or total thyroidectomy, lifelong thyroid replacement hormone, monitoring, surgical complications and other side effects. These harms seem to outweigh any putative benefit of knowing about a cancer that would not have caused problems if left undiscovered. In addition to harms to patients, thyroid cancer overdiagnosis leads to significant opportunity costs at a societal level, due to costs of diagnosis and treatment. Unlike many other overdiagnosed cancers, accurate risk stratification is possible with thyroid cancer. At the individual patient level, use of this risk information might support informed choice and/or shared decision-making, as mandated by clinical ethics frameworks. And this approach might, to some extent, help to reduce rates of diagnosis and intervention. In practice, however, it is unlikely to stem the rising incidence and associated harms and costs of overdiagnosed thyroid cancer, especially in situations where health professionals have conflicts of interest. We argue in this article that thyroid cancer overdiagnosis may be usefully understood as a public health problem, and that some public health approaches will be readily justifiable and are more likely to be effective in minimising its harms. © 2017 John Wiley & Sons Ltd.

  9. Public health ethics and a status for pets as person-things : revisiting the place of animals in urbanized societies.

    Science.gov (United States)

    Rock, Melanie; Degeling, Chris

    2013-12-01

    Within the field of medical ethics, discussions related to public health have mainly concentrated on issues that are closely tied to research and practice involving technologies and professional services, including vaccination, screening, and insurance coverage. Broader determinants of population health have received less attention, although this situation is rapidly changing. Against this backdrop, our specific contribution to the literature on ethics and law vis-à-vis promoting population health is to open up the ubiquitous presence of pets within cities and towns for further discussion. An expanding body of research suggests that pet animals are deeply relevant to people's health (negatively and positively). Pet bylaws adopted by town and city councils have largely escaped notice, yet they are meaningful to consider in relation to everyday practices, social norms, and cultural values, and thus in relation to population health. Nevertheless, not least because they pivot on defining pets as private property belonging to individual people, pet bylaws raise emotionally charged ethical issues that have yet to be tackled in any of the health research on pet ownership. The literature in moral philosophy on animals is vast, and we do not claim to advance this field here. Rather, we pragmatically seek to reconcile philosophical objections to pet ownership with both animal welfare and public health. In doing so, we foreground theorizations of personhood and property from sociocultural anthropology.

  10. Scientific Publication Ethics

    Directory of Open Access Journals (Sweden)

    Osman İnci

    2015-06-01

    Full Text Available Science based on consciousness of responsibility and principles of trust puts academics under an obligation to act according to the values and principles, ethical attitudes and standards of behaviour. A quest for perfectness, to observe truth and show respect for the dignity and value of each individual should be a fundamental principle. In this context, academic freedom and autonomy, academic integrity,  responsibility and accountabily, respect for others, the protection of the fundamental rights and competence are among the core values of academic merit. Science is not possible without ethics. Protection of academic value is essential for an academic publication. It is also fundamental that academics should not behave contrary to the ethics values. It is assumed that academic studies are conducted honestly, based on true foundations, that the research data are collected according to the correct methods, accurate statistics are used and results are reported accordingly. It is also assumed that professional standards are carried out in software presentation and share of results. The exceptional methods in academical publications should be classified as those carried out intentionally, aiming to mislead the related studies and the others to be distinguished from the ones carried out by some ignorances and various innocent facts. The most serious infraction of the ethical rules and standards is the ‘academic misappropriation’. Among all, the most crucial one is the academic plagiarism, which is transferring the production of some other person under one’s own name or stealing away the work of other persons. Creating some not-existing data and results, and fabrication is inventing some information just by sitting at the table. Changing the datas and results without scientific reasoning, and falsification is accepted as another and the third kind of misappropriation (FTP. Their most important difference from the other kinds is

  11. Tuskegee University experience challenges conventional wisdom: is integrative bioethics practice the new ethics for the public's health?

    Science.gov (United States)

    Sodeke, Stephen Olufemi

    2012-11-01

    The Tuskegee University National Center for Bioethics in Research and Health Care was established in 1999 in partial response to the Presidential Apology for the United States Public Health Service's Study of Untreated Syphilis in the Negro Male conducted in Macon County, Alabama, from 1932 to 1972. The Center's mission of promoting equity and justice in health and health care for African Americans and other underserved populations employs an integrative bioethics approach informed by moral vision. Etymological and historical analyses are used to delineate the meaning and evolution of bioethics and to provide a basis for Tuskegee's integrative bioethics niche. Unlike mainstream bioethics, integrative bioethics practice is holistic in orientation, and more robust for understanding the epistemic realities of minority life, health disparities, and population health. The conclusion is that integrative bioethics is relevant to the survival of all people, not just a privileged few; it could be the new ethics for the public's health.

  12. Ethical models underpinning responses to threats to public health: a comparison of approaches to communicable disease control in Europe.

    Science.gov (United States)

    Gainotti, Sabina; Moran, Nicola; Petrini, Carlo; Shickle, Darren

    2008-11-01

    Increases in international travel and migratory flows have enabled infectious diseases to emerge and spread more rapidly than ever before. Hence, it is increasingly easy for local infectious diseases to become global infectious diseases (GIDs). National governments must be able to react quickly and effectively to GIDs, whether naturally occurring or intentionally instigated by bioterrorism. According to the World Health Organisation, global partnerships are necessary to gather the most up-to-date information and to mobilize resources to tackle GIDs when necessary. Communicable disease control also depends upon national public health laws and policies. The containment of an infectious disease typically involves detection, notification, quarantine and isolation of actual or suspected cases; the protection and monitoring of those not infected; and possibly even treatment. Some measures are clearly contentious and raise conflicts between individual and societal interests. In Europe national policies against infectious diseases are very heterogeneous. Some countries have a more communitarian approach to public health ethics, in which the interests of individual and society are more closely intertwined and interdependent, while others take a more liberal approach and give priority to individual freedoms in communicable disease control. This paper provides an overview of the different policies around communicable disease control that exist across a select number of countries across Europe. It then proposes ethical arguments to be considered in the making of public health laws, mostly concerning their effectiveness for public health protection.

  13. "The way the country has been carved up by researchers": ethics and power in north-south public health research.

    Science.gov (United States)

    Walsh, Aisling; Brugha, Ruairi; Byrne, Elaine

    2016-12-12

    Despite the recognition of power as being central to health research collaborations between high income countries and low and middle income countries, there has been insufficient detailed analysis of power within these partnerships. The politics of research in the global south is often considered outside of the remit of research ethics. This article reports on an analysis of power in north-south public health research, using Zambia as a case study. Primary data were collected in 2011/2012, through 53 in-depth interviews with: Zambian researchers (n = 20), Zambian national stakeholders (n = 8) and northern researchers who had been involved in public health research collaborations involving Zambia and the global north (n = 25). Thematic analysis, utilising a situated ethics perspective, was undertaken using Nvivo 10. Most interviewees perceived roles and relationships to be inequitable with power remaining with the north. Concepts from Bourdieu's theory of Power and Practice highlight new aspects of research ethics: Northern and southern researchers perceive that different habituses exist, north and south - habituses of domination (northern) and subordination (Zambian) in relation to researcher relationships. Bourdieu's hysteresis effect provides a possible explanation for why power differentials continue to exist. In some cases, new opportunities have arisen for Zambian researchers; however, they may not immediately recognise and grasp them. Bourdieu's concept of Capitals offers an explanation of how diverse resources are used to explain these power imbalances, where northern researchers are often in possession of more economic, symbolic and social capital; while Zambian researchers possess more cultural capital. Inequities and power imbalances need to be recognised and addressed in research partnerships. A situated ethics approach is central in understanding this relationship in north-south public health research.

  14. Ethics, Politics, and Religion in Public Health Care: A Manifesto for Health Care Chaplains in Canada.

    Science.gov (United States)

    Lasair, Simon

    2016-03-01

    Health care chaplaincy positions in Canada are significantly threatened due to widespread health care cutbacks. Yet the current time also presents a significant opportunity for spiritual care providers. This article argues that religion and spirituality in Canada are undergoing significant changes. The question for Canadian health care chaplains is, then: how well equipped are they to understand these changes in health care settings and to engage them? This article attempts to go part way toward an answer.

  15. Critical role of ethics in clinical management and public health response to the West Africa Ebola epidemic

    Directory of Open Access Journals (Sweden)

    Folayan MO

    2016-05-01

    Full Text Available Morenike O Folayan1,2 Bridget G Haire3 Brandon Brown4 1Institute of Public Health, 2Department of Child Dental Health, Obafemi Awolowo University, Ile-Ife, Nigeria; 3Kirby Institute for Infection and Immunity in Society, University of New South Wales, Sydney, NSW, Australia; 4Center for Healthy Communities, Department of Social Medicine and Population Health, University of California Riverside School of Medicine, Riverside, CA, USA Abstract: The devastation caused by the Ebola virus disease (EVD outbreak in West Africa has brought to the fore a number of important ethical debates about how best to respond to a health crisis. These debates include issues related to prevention and containment, management of the health care workforce, clinical care, and research design, all of which are situated within the overarching moral problem of severe transnational disadvantage, which has very real and specific impacts upon the ability of citizens of EVD-affected countries to respond to a disease outbreak. Ethical issues related to prevention and containment include the appropriateness and scope of quarantine and isolation within and outside affected countries. The possibility of infection in health care workers impelled consideration of whether there is an obligation to provide health services where personal protection equipment is inadequate, alongside the issue of whether the health care workforce should have special access to experimental treatment and care interventions under development. In clinical care, ethical issues include the standards of care owed to people who comply with quarantine and isolation restrictions. Ethical issues in research include appropriate study design related to experimental vaccines and treatment interventions, and the sharing of data and biospecimens between research groups. The compassionate use of experimental drugs intersects both with research ethics and clinical care. The role of developed countries also came under

  16. Adding justice to the clinical and public health ethics arguments for mandatory seasonal influenza immunisation for healthcare workers.

    Science.gov (United States)

    Lee, Lisa M

    2015-08-01

    Ethical considerations from both the clinical and public health perspectives have been used to examine whether it is ethically permissible to mandate the seasonal influenza vaccine for healthcare workers (HCWs). Both frameworks have resulted in arguments for and against the requirement. Neither perspective resolves the question fully. By adding components of justice to the argument, I seek to provide a more fulsome ethical defence for requiring seasonal influenza immunisation for HCWs. Two critical components of a just society support requiring vaccination: fairness of opportunity and the obligation to follow democratically formulated rules. The fairness of opportunity is informed by Rawls' two principles of justice. The obligation to follow democratically formulated rules allows us to focus simultaneously on freedom, plurality and solidarity. Justice requires equitable participation in and benefit from cooperative schemes to gain or profit socially as individuals and as a community. And to be just, HCW immunisation exemptions should be limited to medical contraindications only. In addition to the HCWs fiduciary duty to do what is best for the patient and the public health duty to protect the community with effective and minimally intrusive interventions, HCWs are members of a just society in which all members have an obligation to participate equitably in order to partake in the benefits of membership. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  17. Health branding ethics

    DEFF Research Database (Denmark)

    Anker, Thomas Boysen; Sandøe, Peter; Kamin, Tanja

    2011-01-01

    Commercial food health branding is a challenging branch of marketing because it might, at the same time, promote healthy living and be commercially viable. However, the power to influence individuals’ health behavior and overall health status makes it crucial for marketing professionals to take...... into account the ethical dimensions of health branding: this article presents a conceptual analysis of potential ethical problems in health branding. The analysis focuses on ethical concerns related to the application of three health brand elements (functional claims, process claims, and health symbols......) as well as a number of general concerns that apply to health branding as such. Being a pioneering analysis, this article advances the academic understanding of health branding and provides practitioners with knowledge of important concerns to take into account when marketing health brands....

  18. Public health surveillance data: legal, policy, ethical, regulatory, and practical issues.

    Science.gov (United States)

    Bernstein, Amy B; Sweeney, Marie Haring

    2012-07-27

    In the United States, data systems are created by the ongoing, systematic collection of health, demographic, and other information through federally funded national surveys, vital statistics, public and private administrative and claims data, regulatory data, and medical records data. Certain data systems are designed to support public health surveillance and have used well-defined protocols and standard analytic methods for assessing specific health outcomes, exposures, or other endpoints. However, other data systems have been designed for a different purpose but can be used by public health programs for surveillance. Several public health surveillance programs rely substantially on others' data systems. An example of data used for surveillance purposes but collected for another reason is vital statistics data. CDC's National Center for Health Statistics (NCHS) purchases, aggregates, and disseminates vital statistics (birth and death rates) that are collected at the state level. These data are used to understand disease burden, monitor trends, and guide public health action. Administrative data also can be used for surveillance purposes (e.g., Medicare and Social Security Disability data that have been linked to survey data to monitor changes in health and health-care use over time).

  19. A situated practice of ethics for participatory visual and digital methods in public health research and practice: a focus on digital storytelling.

    Science.gov (United States)

    Gubrium, Aline C; Hill, Amy L; Flicker, Sarah

    2014-09-01

    This article explores ethical considerations related to participatory visual and digital methods for public health research and practice, through the lens of an approach known as "digital storytelling." We begin by briefly describing the digital storytelling process and its applications to public health research and practice. Next, we explore 6 common challenges: fuzzy boundaries, recruitment and consent to participate, power of shaping, representation and harm, confidentiality, and release of materials. We discuss their complexities and offer some considerations for ethical practice. We hope this article serves as a catalyst for expanded dialogue about the need for high standards of integrity and a situated practice of ethics wherein researchers and practitioners reflexively consider ethical decision-making as part of the ongoing work of public health.

  20. Testing public health ethics: why the CDC's HIV screening recommendations may violate the least infringement principle.

    Science.gov (United States)

    Pierce, Matthew W; Maman, Suzanne; Groves, Allison K; King, Elizabeth J; Wyckoff, Sarah C

    2011-01-01

    The CDC's HIV screening recommendations for health care settings advocate abandoning two important autonomy protections: (1) pretest counseling and (2) the requirement that providers obtain affirmative agreement from patients prior to testing. The recommendations may violate the least infringement principle because there is insufficient evidence to conclude that abandoning pretest counseling or affirmative agreement requirements will further the CDC's stated public health goals.

  1. A new ethical landscape of prenatal testing: individualizing choice to serve autonomy and promote public health: a radical proposal.

    Science.gov (United States)

    Munthe, Christian

    2015-01-01

    A new landscape of prenatal testing (PNT) is presently developing, including new techniques for risk-reducing, non-invasive sampling of foetal DNA and drastically enhanced possibilities of what may be rapidly and precisely analysed, surrounded by a growing commercial genetic testing industry and a general trend of individualization in healthcare policies. This article applies a set of established ethical notions from past debates on PNT for analysing PNT screening-programmes in this new situation. While some basic challenges of PNT stay untouched, the new development supports a radical individualization of how PNT screening is organized. This reformation is, at the same time, difficult to reconcile with responsible spending of resources in a publicly funded healthcare context. Thus, while the ethical imperative of individualization holds and applies to PNT, the new landscape of PNT provides reasons to start rolling back the type of mass-screening programmes currently established in many countries. Instead, more limited offers are suggested, based on considerations of severity of conditions and optimized to simultaneously serve reproductive autonomy and public health within an acceptable frame of priorities. The new landscape of PNT furthermore underscores the ethical importance of supporting and including people with disabilities. For the very same reason, no ban on what may be analysed using PNT in the new landscape should be applied, although private offers must, of course, conform to strict requirements of respecting reproductive autonomy and what that means in terms of counselling.

  2. [Ethical dilemmas in health].

    Science.gov (United States)

    Boléo-Tomé, J

    2009-01-01

    It is difficult to speak of ethic dilemmas in a society that has relativism as the oficial philosophical and political doctrine, i.e., stable values and behavior references, are denied, both in health care and in any other area of human knowledge. In the field of medical sciences it is even pretended to pass from the observational methodology to a field of manipulation and manipulability. It is the very Ethic that is presented as a dilemma. In these conditions one needs to know the lines of thought that are defended, to replace and make disappear the stable ethic references: ecletism, historicism, scientificism, pragmatism, and nihilism itself, that lead to the 'new ethic paradigm', that has created by itself a pseudo-spirituality. The truth is we are adrift in the 'Ethic of Convenience' which changes according to the majorities. In this setting the way to go is to rediscover the abandoned ethic values: only with an objective ethic, with sound references and foundations, it is possible to re-establish and perfect the patient-physician relationship, for a better social health. And this begins with the ethic problem of human life.

  3. Informing the gestalt: an ethical framework for allocating scarce federal public health and medical resources to states during disasters.

    Science.gov (United States)

    Knebel, Ann R; Sharpe, Virginia A; Danis, Marion; Toomey, Lauren M; Knickerbocker, Deborah K

    2014-02-01

    During catastrophic disasters, government leaders must decide how to efficiently and effectively allocate scarce public health and medical resources. The literature about triage decision making at the individual patient level is substantial, and the National Response Framework provides guidance about the distribution of responsibilities between federal and state governments. However, little has been written about the decision-making process of federal leaders in disaster situations when resources are not sufficient to meet the needs of several states simultaneously. We offer an ethical framework and logic model for decision making in such circumstances. We adapted medical triage and the federalism principle to the decision-making process for allocating scarce federal public health and medical resources. We believe that the logic model provides a values-based framework that can inform the gestalt during the iterative decision process used by federal leaders as they allocate scarce resources to states during catastrophic disasters.

  4. Ethical, Legal and Social Issues related to the health data-warehouses: re-using health data in the research and public health research.

    Science.gov (United States)

    Lamas, Eugenia; Barh, Anne; Brown, Dario; Jaulent, Marie-Christine

    2015-01-01

    Research derived from the application of information and communication technologies in medicine operates in a context involving the globalization of collecting, sharing, storage, transfer and re-use of personal health data. Health data computerization within Clinical Information Systems (as Electronic Healthcare Records) should allow the re-use of health data for clinical research and public health purposes. One of the objects allowing the integration of healthcare and research information systems is the health data-warehouse (DWH). However, ethical-legal frameworks in force are not adapted to these DWHs because they were not conceived for re-using data in a different context than the one of their acquisition. For that matter, access modalities to data-warehouses must ensure the respect of patients' rights: information to the patient, as well as confidentiality and security. Through a bibliography research, some Ethical, legal and Social Issues (ELSI) have been identified: Patients' rights Modalities of implementation of the DWs; Solidarity and common good; Transparency and Trust. Comparative analysis between the Directive 95/46/CE and the "Proposal for regulation on protection of individuals with regard to the processing of personal data" shows that this regulation pretends allowing the re-use of key-coded data when aimed at a scientific purpose. However, since this new regulation does not align with the ethical and legal requirements at an operational level, a Code of practice on secondary use of Medical Data in scientific Research Projects has been developed at the European Level. This Code provides guidance for Innovative Medicine Initiative (IMI) and will help to propose practical solutions to overcome the issue of the re-use of data for research purposes.

  5. Ethical aspects in public relations

    Directory of Open Access Journals (Sweden)

    Voza Danijela

    2009-01-01

    Full Text Available The basic aim of this paper is to explore public relations practitioners' different perceptions of professional ethics depending on gender, age, educational level and years of experience. Analysis of professional ethics in Serbian public relations, has gained the ability to introduce all relevant aspects that should act in order to reach the positive developments and improve the existing situation in the field of ethics in public relations. The conclusion may be derived from this research is that business ethics in public relations in Serbia is at a high level. However, we must accept these results with caution, because very critical and sensitive issues of ethics lead to the interviewees to give fulsome answers that prove and practical examples. In order to obtain relevant results in future studies need to be, above all, changed the manner of conducting the survey. So, you need a personal approach with full respect for the respondents of anonymity. Business ethics in Serbia deserves much more attention and through education and research, as well as direct examples of business practice. .

  6. Evaluation of newspaper articles about complementary alternative medicine in terms of journalism, public health and medical ethics

    Directory of Open Access Journals (Sweden)

    Gamze Polat

    2014-04-01

    Full Text Available The study was conducted to determine how the three best-selling daily newspapers in Turkey (Posta, Hurriyet, Sabah gave news about CAM both from a quantitative-qualitative aspect and to evaluate them in terms of ethics, public health. (January 1-June 30, 2013. Quantitative-qualitative analysis was performed, 585 articles on CAM were published. As a source of the news, medical doctors took the first place(33.7%. It was seen that 69.6% of them recommended readers to make use of CAM practices and that articles tempting people into CAM took the second place(27.1%. Of the articles, 58.5% were on herbal treatment. Articles on diseases were mostly on nutrition–diet(15.9%. Newspapers were support to CAM-related news(56.3%. The media deal with all kinds of information on the agenda because they consider them as newsworthy, and thus the public is misinformed and misled on such an important issue as health, medical ethics. CAM should be subjected to scientific studies.

  7. Corporate Funding for Schools of Public Health: Confronting the Ethical and Economic Challenges.

    Science.gov (United States)

    Bayer, Ronald; Sampat, Bhaven N

    2016-04-01

    We discuss the public and private sponsoring of university research and the issues it raises in a context of diminished federal funding. We consider research funding at schools of public health and why these schools have historically had weaker links to industry than have other academic units. We argue that the possibility of enhanced links with industry at schools of public health may raise specific concerns beyond those facing universities generally. Six issues should be considered before entering into these relationships: (1) the effects on research orientation, (2) unacceptability of some funders, (3) potential threats to objectivity and academic freedom, (4) effects on academic standards, (5) the effects on dissemination of knowledge, and (6) reputational risks.

  8. The ethics of sharing preliminary research findings during public health emergencies: a case study from the 2009 influenza pandemic.

    Science.gov (United States)

    Crowcroft, N S; Rosella, L C; Pakes, B N

    2014-06-19

    During the 2009 A(H1N1) influenza pandemic, a suite of studies conducted in Canada showed an unexpected finding, that patients with medically attended laboratory-confirmed pandemic influenza were more likely to have received seasonal influenza vaccination than test-negative control patients. Different bodies, including scientific journals and government scientific advisory committees, reviewed the evidence simultaneously to determine its scientific validity and implications. Decision-making was complicated when the findings made their way into the media. The normal trajectory of non-urgent research includes peer-review publication after which decision-makers can process the information taking into account other evidence and logistic considerations. In the situation that arose, however, the congruence of an unexpected finding and the simultaneous review of the evidence both within and outside the traditional peer-review sphere raised several interesting issues about how to deal with emerging evidence during a public health emergency. These events are used in this article to aid discussion of the complex interrelationship between researchers, public health decision-makers and scientific journals, the trade-offs between sharing information early and maintaining the peer-review quality assurance process, and to emphasise the need for critical reflection on the practical and ethical norms that govern the way in which research is evaluated, published and communicated in public health emergencies.

  9. Ethical dilemmas in journal publication.

    Science.gov (United States)

    Babalola, Olubukola; Grant-Kels, Jane M; Parish, Lawrence Charles

    2012-01-01

    Physicians often face tremendous pressures and incentives to publish, sometimes leading to a compromise of ethical standards, either consciously or unconsciously. From the vantage of ethical authorship, we discuss what constitutes authorship; avoidance of ghost authorship; plagiarism, as well as self-plagiarism and duplicate publication; falsification; and fabrication. Editors also face ethical challenges, including how best to manage peer-review bias, to address reviewer tardiness, and to locate reviewers with appropriate expertise and professionalism. Editors need to deal with authors who fragment their work into multiple publications to enhance their curriculum vitae ("salami factor"), as well as to manage the financial benefits of advertising and to avoid conflicts of interest for the journal. Both authors and editors should be straightforward and principled throughout the publication process. Copyright © 2012 Elsevier Inc. All rights reserved.

  10. Ethics committees as corporate and public policy advocates.

    Science.gov (United States)

    Cohen, C B

    1990-01-01

    The "Ethics committees" column in this issue of the Hastings Center Report features an introduction by Cynthia B. Cohen and four brief commentaries on the roles hospital ethics committees may play in the making of institutional and public health care policy in the 1990s. The pros and cons of a broader, more public role for ethics committees in reconciling the business and patient care aspects of health care delivery are debated by Cohen in this commentary, and by Philip Boyle in "Business ethics in ethics committees?"

  11. Ethics problems and theories in public relations

    OpenAIRE

    Grunig, James E.

    2015-01-01

    Public relations professionals encounter ethical problems as individuals who make decisions about their professional lives. They also serve as ethical counselors to organizations, a role in which they help organizations behave in ethical, responsible, and sustainable ways. This introduction defines ethics and social responsibility and discusses the possibilities and obstacles that public relations professionals face in the role of ethical counselor. Seven research problems in public relations...

  12. [Ethical problems in health surveillance].

    Science.gov (United States)

    Toffoletto, F; Briatico Vangosa, G; Panizza, C

    2000-01-01

    Surveillance of workers' health in the field of occupational medicine poses substantial ethical problems in view of occupational medicine's complex responsibilities towards workers and employers, preventive and protection services, workers' representatives, public healthcare and preventive medicine facilities, controlling agencies and judicial authorities. Potentially conflicting rights and duties often come into play in this sector. In the last few years various international and national bodies have drawn up codes of ethics or guidelines for the conduct of physicians in occupational medicine, three of which are of particular importance: 1) The International Ethical Code of the International Commission on Occupational Health (ICOH, 1992); 2) The Code of Conduct of the National Association of Company Doctors (ANMA, 1997); 3) The Technical and Ethical Guidelines for workers' health (ILO, 1998). The chief purpose of all these documents is to safeguard the health of workers and to guarantee the safety of the workplace by defining programmes of health supervision to match specific risks. The methods should be non-invasive and should allow for a check or efficiency. The physician is expected to have a high degree of professionalism and up-to-date skills; to be independent and impartial; to be reserved and capable of inter-disciplinary co-operation. On the basis of the above documents, a number of problematic aspects may be appraised concerning the relationship between the occupational health physician responsible for the surveillance activities of the local health authority and the relative company physician. The documents stress the importance of keeping up to date and of quality, fields in which the dominant role played by Scientific Societies is underlined. Finally it is recommended that health supervision be arranged in such a manner as to foster the professionalism and responsibility of the physician in charge rather than the formal implementation of health

  13. Teaching Ethics across the Public Relations Curriculum.

    Science.gov (United States)

    Hutchison, Liese L.

    2002-01-01

    Suggests ways of incorporating ethics across the undergraduate public relations curriculum. Reviews current coverage of ethics in public relations principles, writing, cases, and textbooks. Suggests other methods that teachers can use to incorporate ethical pedagogical tools in all public relations courses in an effort to develop students' ethical…

  14. The Economic Crisis and Its Ethical Relevance for Public Health in Europe - an Analysis in the Perspective of the Capability Approach.

    Science.gov (United States)

    Brall, Caroline; Schröder-Bäck, Peter; Brand, Helmut

    2016-03-01

    Policy responses to the economic crisis have manifest consequences to European population health and health systems. The aim of this article is to assess, by using the capability approach advanced by Sen, the ethical dimension of trade-offs made in health policy due to austerity measures. From a capability approach point of view, austerity measures such as reducing resources for health care, further deregulating the health care market or moving towards privatisation are ethically challenging since they limit opportunities and capabilities for individuals of a population. Public policies should thus aim to guarantee sufficient capabilities (options to access health care and possibilities to make healthy choices) for its populations. Prioritising those in need is a notion the capability approach particularly focuses on in its goal of supporting those with the least capabilities.

  15. Ethics Simulations as Preparation for Public Discourse

    Science.gov (United States)

    Hamilton, James P.; Mueller, Alfred G.

    2010-01-01

    Courses: Fundamentals of public speaking, basic hybrid course, introduction to communication, introduction to journalism, introduction to advertising, and any other course that includes components of communication ethics. Objective: Students will understand the fundamental elements of communication ethics.

  16. Ethics Simulations as Preparation for Public Discourse

    Science.gov (United States)

    Hamilton, James P.; Mueller, Alfred G.

    2010-01-01

    Courses: Fundamentals of public speaking, basic hybrid course, introduction to communication, introduction to journalism, introduction to advertising, and any other course that includes components of communication ethics. Objective: Students will understand the fundamental elements of communication ethics.

  17. Ethics, equality and evidence in health promotion

    DEFF Research Database (Denmark)

    Vallgårda, Signild

    2014-01-01

    Abstract Aim: The Danish National Board of Health has expressed its commitment to social equality in health, evidence-informed health promotion and public health ethics, and has issued guidelines for municipalities on health promotion, in Danish named prevention packages.The aim of this article...... is to analyse whether the Board of Health adheres to ideals of equality, evidence and ethics in these guidelines. Methods: An analysis to detect statements about equity, evidence and ethics in 10 health promotion packages directed at municipalities with the aim of guiding the municipalities towards evidence......-informed disease prevention and health promotion. Results: Despite declared intentions of prioritizing social equality in health, these intentions are largely absent from most of the packages.When health inequalities are mentioned, focus is on the disadvantaged or the marginalized. Several interventions...

  18. Ethics in Public Administration: Evidence from Slovenia

    OpenAIRE

    Nedelko, Zlatko; Vojko POTOCAN

    2013-01-01

    The main purpose of this paper is to examine how employees’ personal ethics, expressed through their personal values and attitudes toward social and environmental issues, are associated with the ethics of organizations in public administration. The authors introduce their own theoretical model that examines the relations between employees’ personal ethics – expressed through employees’ personal values and attitudes toward natural and social environments – and the ethics of public administrati...

  19. Ethical and Social Issues in Health Research Involving Incarcerated People.

    Science.gov (United States)

    Coughlin, Steven S; Lewis, Sharon R; Smith, Selina A

    2016-01-01

    The use of inmates in research in the U.S. was restricted by the recommendations of the National Commission and by federal regulations and guidelines that followed. By the 1980s, many health care officials became concerned about the exclusion of inmates from experimental treatments for human immunodeficiency virus infection (HIV). These developments in ethics occurred in the context of racial/ethnic disparities in health. In this article, ethical considerations in clinical and public health research on HIV in prison and jail settings are considered. Ethical considerations in mental health research are summarized as well as issues pertaining to research involving female inmates. Issues related to oversight of research involving incarcerated people are considered along with the ethics of public health research. The ethics of research involving incarcerated people extends beyond traditional issues in human subjects ethics to include issues within the domains of bioethics and public health ethics.

  20. Questioning the concept of risk in ethical guidelines for research in the humanities and social sciences in Public Health.

    Science.gov (United States)

    Bosi, Maria Lúcia Magalhães

    2015-09-01

    This article discusses the use of the concept of risk in ethical guidelines directed to research in the humanities and social sciences (CHS), suggesting an alternative to that concept. In Public Health field (PH), risk assumes a peculiar semantics, closely linked to the idea of calculation and predictability, according to the disciplinary bases that support it. This circumstance makes incongruous its use in initiatives justified precisely by strong distinctions between biomedical and social research, as ilustrated by specific guidelines for CHS, especially to the qualitative approach. The authors do not seek to redefine risk, operating a conceptual transit, but to sustain an effective conceptual distance within these specific guidelines, keeping congruence with the objectives pursued by its construction. Taking risk in the quantitative sense, still hegemonic in PH, overlooks important dimensions, reifying the use of this concept in situations where uncertainty, unpredictability, intersubjectivity inherent to the processes beyond the calculation and measurement, as in the case of a significant portion of the research in CHS. Alternatively, it is suggested to replace the expression level of risk, as also appears in Brazilian resolutions.

  1. Access to nutritious food, socioeconomic individualism and public health ethics in the USA: a common good approach.

    Science.gov (United States)

    Azétsop, Jacquineau; Joy, Tisha R

    2013-10-29

    Good nutrition plays an important role in the optimal growth, development, health and well-being of individuals in all stages of life. Healthy eating can reduce the risk of chronic diseases, such as heart disease, stroke, diabetes and some types of cancer. However, the capitalist mindset that shapes the food environment has led to the commoditization of food. Food is not just a marketable commodity like any other commodity. Food is different from other commodities on the market in that it is explicitly and intrinsically linked to our human existence. While possessing another commodity allows for social benefits, food ensures survival. Millions of people in United States of America are either malnourished or food insecure. The purpose of this paper is to present a critique of the current food system using four meanings of the common good--as a framework, rhetorical device, ethical concept and practical tool for social justice. The first section of this paper provides a general overview of the notion of the common good. The second section outlines how each of the four meanings of the common good helps us understand public practices, social policies and market values that shape the distal causal factors of nutritious food inaccessibility. We then outline policy and empowerment initiatives for nutritious food access.

  2. Public consultation in ethics: an experiment in representative ethics.

    Science.gov (United States)

    Burgess, Michael M

    2004-01-01

    Genome Canada has funded a research project to evaluate the usefulness of different forms of ethical analysis for assessing the moral weight of public opinion in the governance of genomics. This paper will describe a role of public consultation for ethical analysis and a contribution of ethical analysis to public consultation and the governance of genomics/biotechnology. Public consultation increases the robustness of ethical analysis with a more diverse set of moral experiences. Consultation must be carefully and respectfully designed to generate sufficiently diverse and rich accounts of moral experiences. Since dominant groups tend to define ethical or policy issues in a manner that excludes some interests or perspectives, it is important to identify the range of interests that diverse publics hold before defining the issue and scope of the discussion and the premature foreclosure of ethical dialogue. Consequently, a significant contribution of ethical dialogue strengthened by social analysis is to consider the context and non-policy use of power to govern genomics and to sustain social debate on enduring ethical issues.

  3. Ethics of reviewing scientific publications.

    Science.gov (United States)

    Napolitani, Federica; Petrini, Carlo; Garattini, Silvio

    2017-05-01

    The approval or rejection of scientific publications can have important consequences for scientific knowledge, so considerable responsibility lies on those who have to assess or review them. Today it seems that the peer review process, far from being considered an outdated system to be abandoned, is experiencing a new upturn. This article proposes criteria for the conduct of reviewers and of those who select them. While commenting on new emerging models, it provides practical recommendations for improving the peer-review system, like strengthening the role of guidelines and training and supporting reviewers. The process of peer review is changing, it is getting more open and collaborative, but those same ethical principles which guided it from its very origin should remain untouched and be firmly consolidated. The paper highlights how the ethics of reviewing scientific publications is needed now more than ever, in particular with regard to competence, conflict of interest, willingness to discuss decisions, complete transparency and integrity. Copyright © 2016 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.

  4. Public Figures, Professional Ethics, and the Media.

    Science.gov (United States)

    Fowler, David R

    2016-08-01

    Death certificates and autopsy reports contain personal identifying information and clinical information protected under the Health Insurance Portability and Accountability Act (HIPAA) of 1996. These documents are used, for example, by the families of the deceased for settling estates, bereavement and closure, and genetic counseling of relatives. Insurance companies, public health and law enforcement officials, and the legal community also have legitimate claims to this information. Critical ethical questions have not yet been settled about whether and when this information should be public and under which circumstances making this kind of information public incurs benefits, harms, or both. Additional considerations include which organizations-the media, academic institutions, or government agencies, for example-are best suited to interpret these questions and respond to them. © 2016 American Medical Association. All Rights Reserved.

  5. Ethical considerations in community oral health.

    Science.gov (United States)

    Naidoo, Sudeshni

    2015-05-01

    As the public's oral health care needs increase in complexity, there is renewed attention to the ethical dimensions of community oral health decision making and the development of public health ethics in teaching and research in dentistry. Despite their reduction globally, oral diseases persist with a particular distribution pattern that is a reflection of the increasingly widespread inequality in access to community oral health preventive and dental care. This is due to differences in the appropriateness, availability, accessibility, and acceptability of oral health education and the care provided. This article provides an overview of community oral health from an ethical perspective, including the importance of equity, human rights, and social justice in providing oral health care to the underserved. The need for a paradigm shift from highly technical and individualistic dental training curricula is discussed, together with the need to instill a holistic approach to ethical and social responsibility in new dental graduates. It concludes with some possible strategies, using the overarching principles of ethics and bioethics that are applicable to practice among vulnerable populations.

  6. Health Ethics Education for Health Administration Chaplains

    Science.gov (United States)

    Porter, Russell; Broussard, Amelia; Duckett, Todd

    2008-01-01

    It is imperative for divinity and health administration programs to improve their level of ethics education for their graduates who work as health administration chaplains. With an initial presentation of the variation of ethical dilemmas presented in health care facilities covering social, organizational, and patient levels, we indicate the need…

  7. ETHICAL DILEMMAS IN THE PUBLIC SECTOR

    Directory of Open Access Journals (Sweden)

    Silvia PUIU

    2015-06-01

    Full Text Available The article offers an insight on the ethical dilemmas specific to a public sector and brings some suggestions for coping with these. Ethics management is a complex system that deals also with ethical dilemmas. The instruments and tools of ethics management are helpful in dealing with these issues. There are a lot of cases in which public employees do not know what to do or how to react in a certain situation, so, a debate on this subject is very useful for people working in public institutions.

  8. Publication ethics: whose problem is it?

    Directory of Open Access Journals (Sweden)

    Elizabeth Wager

    2012-11-01

    Full Text Available Discussions about publication ethics often focus on misconduct by authors, such as data fabrication and plagiarism. However, this article focuses on the roles of editors, publishers, academic societies and research institutions. All these players have ethical responsibilities and should carefully consider the effects of their policies and actions. If people believe that publication ethics is ‘somebody else's problem’, little progress will be made and problems will persist.

  9. Publication ethics: whose problem is it?

    Science.gov (United States)

    Wager, Elizabeth

    2014-01-01

    Discussions about publication ethics often focus on misconduct by authors such as data fabrication and plagiarism. However, the roles of editors, publishers, academic societies, and research institutions should not be ignored. All these players have ethical responsibilities and should carefully consider the effects of their policies and actions. If people believe that publication ethics is 'somebody else's problem', little progress will be made and problems will persist.

  10. Publication ethics: whose problem is it?

    OpenAIRE

    Wager, Elizabeth

    2012-01-01

    Discussions about publication ethics often focus on misconduct by authors, such as data fabrication and plagiarism. However, this article focuses on the roles of editors, publishers, academic societies and research institutions. All these players have ethical responsibilities and should carefully consider the effects of their policies and actions. If people believe that publication ethics is ‘somebody else's problem’, little progress will be made and problems will persist.

  11. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she ad

  12. Public health

    NARCIS (Netherlands)

    Berg, van den A.E.

    2007-01-01

    Agnes van den Berg wrote an essay about human health and nature, establishing that subject as an important policy argument in developing (urban) nature in the Netherlands. She studied the public balance of fear and fascination for nature, summarising benefits on human health. In this chapter, she

  13. A Scoping Study on the Ethics of Health Systems Research.

    Science.gov (United States)

    Bachani, Abdulgafoor M; Rattani, Abbas; Hyder, Adnan A

    2016-12-01

    Currently, health systems research (HSR) is reviewed by the same ethical standards as clinical research, which has recently been argued in the literature to be an inappropriate standard of evaluation. The issues unique to HSR warrant a different review by research ethics committees (RECs), as it does not impose the same risks to study participants as other types of clinical or public health research. However, there are limited tools and supporting documents that clarify the ethical considerations. Therefore, there is a need for additional reflection around ethical review of HSR and their consideration by RECs. The purpose of this paper is to review, understand, and synthesize the current state of literature and practice to inform these deliberations and the larger discourse on ethics review guidelines for HSR. This paper presents a review of the literature on ethics of HSR in the biomedical, public health, and implementation research to identify ethical considerations specific to HSR; and to identify examples of commonly available guidance and/or tools for the ethical review of HSR studies. Fifteen articles were identified on HSR ethics issues, and forty-two international academic institutions were contacted (of the responses (n=29), no institution had special ethical guidelines for reviewing HSR) about their HSR ethics review guidelines. There appears to be a clear gap in the current health research ethics discourse around health systems research ethics. This review serves as a first step (to better understand the current status) towards a larger dialogue on the topic.

  14. Ethics in Public Administration: Evidence from Slovenia

    Directory of Open Access Journals (Sweden)

    Zlatko NEDELKO

    2013-12-01

    Full Text Available The main purpose of this paper is to examine how employees’ personal ethics, expressed through their personal values and attitudes toward social and environmental issues, are associated with the ethics of organizations in public administration. The authors introduce their own theoretical model that examines the relations between employees’ personal ethics – expressed through employees’ personal values and attitudes toward natural and social environments – and the ethics of public administration. The reported study examined these relations and tested a proposed model based on the answers of 212 employees from public administration organizations in Slovenia. Employees’ attitudes toward natural and social environments and the ethics of their organizations were measured using a questionnaire designed to measure aspects of ethics whereas personal values were measured using the Schwartz value survey. The results demonstrated that employees’ self-enhancing values significantly influence their attitudes toward the natural environment. Employees’ self-transcendence and self-enhancement values significantly influence their attitudes toward the social environment and the ethics of organizations. In addition, research results about the mediation effect of employees’ attitudes toward natural and social environments on the association between the employees’ personal values and their perception of the ethics of public administration organizations reveals that employees’ social attitudes have a significant impact on the ethics of public administration while the impact of self-transcending and self-enhancing values becomes insignificant. Based on results of testing our model we can conclude that the employee’s attitudes toward to the social environment represent a significantly more powerful predictor of ethics in public administration organizations than the employees’ personal values. These results present a solid basis for further

  15. Public Relations Ethics in Information Management

    Directory of Open Access Journals (Sweden)

    Hrvoje Jakopović

    2013-06-01

    Full Text Available Public relations is involved in all communication between an organization and the public. In the contemporary world, PR practitioners have become the facilitators of information. Information and communication technology (ICT have imposed new rules in the field of public relations. Communication strategy and information management have become crucial parts of modern public relations. People change their habits with regard to the consumption of traditional and new media. The challenges imposed by the development of information and communication technology are also related to understanding the new information society. For that reason information ethics deals with the ethical implications of dissemination, use, development and safety of information. Public relations follow new information and communication trends, and they need to build firm ethical principles for the age of information. The author examines the ethical implications of the framing concept in public relations.

  16. The meaning of ethically charged encounters and their possible influence on professional identity in Norwegian public health nursing: a phenomenological hermeneutic study.

    Science.gov (United States)

    Dahl, Berit Misund; Clancy, Anne; Andrews, Therese

    2014-09-01

    In today's health care, new health reforms focus on market values and demands of efficiency influence health workers' professional practice. Norwegian public health nurses work mainly with healthy populations, but the children, families and young people they meet can be in vulnerable and even dependent situations. Strategies in coping with ethically challenging encounters can be important for the identity of the profession. The aim of the study was to illuminate public health nurses' experiences of being in ethically charged encounters and to reflect upon how these experiences can influence their professional identity. A purposive sample of 23 Norwegian public health nurses with experience ranging from 0.5 to 25 years narrated about their work-related experiences. The interviews were interpreted with a phenomenological hermeneutic method inspired by the philosophy of Paul Ricoeur. Four themes were identified: feeling responsible, being committed, feeling confident and feeling inadequate. These experiences were related to both work and private life and involved an emotional commitment to the well-being of children, young people and families. On the basis of the findings, it can be estimated that PHNs are committed to their work, and defending children's rights is a strong driving force. Responsibility for service users is a deciding factor that can overshadow institutional demands. It seems as if value conflicts mobilised courage which is essential in maintaining moral strength. This is in turn important for a strong professional identity and can have positive implications for the quality of public health nursing work. © 2013 Nordic College of Caring Science.

  17. Investigating Public trust in Expert Knowledge: Narrative, Ethics, and Engagement.

    Science.gov (United States)

    Camporesi, Silvia; Vaccarella, Maria; Davis, Mark

    2017-03-01

    "Public Trust in Expert Knowledge: Narrative, Ethics, and Engagement" examines the social, cultural, and ethical ramifications of changing public trust in the expert biomedical knowledge systems of emergent and complex global societies. This symposium was conceived as an interdisciplinary project, drawing on bioethics, the social sciences, and the medical humanities. We settled on public trust as a topic for our work together because its problematization cuts across our fields and substantive research interests. For us, trust is simultaneously a matter of ethics, social relations, and the cultural organization of meaning. We share a commitment to narrative inquiry across our fields of expertise in the bioethics of transformative health technologies, public communications on health threats, and narrative medicine. The contributions to this symposium have applied, in different ways and with different effects, this interdisciplinary mode of inquiry, supplying new reflections on public trust, expertise, and biomedical knowledge.

  18. Salud pública, genética y ética Public health, genetics and ethics

    Directory of Open Access Journals (Sweden)

    Miguel H Kottow

    2002-10-01

    Full Text Available La investigación genética ha tenido una enorme expansión en recientes décadas, con repercusiones terapéuticas aún inciertas. El análisis bioético tradicional de las complejas prácticas genéticas ha sido insuficiente por sostenerse en la ética de la investigación y en la bioética de corte principialista. Los problemas éticos más importantes de la genética son de orden colectivo y deben ser abordados por una reflexión ético-social cuyo enfoque es más amplio que la agenda interpersonal del principialismo. Temas como exploraciones genéticas, cuestiones patrimoniales, manipulación génica y asignación de recursos, deben todos ser sometidos a un pensamiento inspirado en los requerimientos de la ciudadanía, en el bien común y en la definición del rol del Estado en fiscalizar actividades genéticas y en proteger a la población. El objetivo del estudio es mostrar cómo el amplio campo de la ética y de la genética tiene una mayor relevancia en el campo social que en el clínico. El objetivo del trabajo es señalar que la bioética principialista ha enfatizado los problemas éticos individuales que nacen con la intervención genética, a costa de marginar sus importantes repercusiones sociales.Genetics research has shown enormous developments in recent decades, although as yet with only limited clinical application. Bioethical analysis has been unable to deal with the vast problems of genetics because emphasis has been put on the principlism applied to both clinical and research bioethics. Genetics nevertheless poses its most complex moral dilemmas at the public level, where a social brand of ethics ought to supersede the essentially interpersonal perspective of principlism. A more social understanding of ethics in genetics is required to unravel issues such as research and clinical explorations, ownership and patents, genetic manipulation, and allocation of resources. All these issues require reflection based on the

  19. Health promotion: an ethical analysis.

    Science.gov (United States)

    Carter, Stacy M

    2014-04-01

    Thinking and practising ethically requires reasoning systematically about the right thing to do. Health promotion ethics - a form of applied ethics - includes analysis of health promotion practice and how this can be ethically justified. Existing frameworks can assist in such evaluation. These acknowledge the moral value of delivering benefits. But benefits need to be weighed against burdens, harms or wrongs, and these should be minimised: they include invading privacy, breaking confidentiality, restraining liberty, undermining self-determination or people's own values, or perpetuating injustice. Thinking about the ethics of health promotion also means recognising health promotion as a normative ideal: a vision of the good society. This ideal society values health, sees citizens as active and includes them in decisions that affect them, and makes the state responsible for providing all of its citizens, no matter how advantaged or disadvantaged, with the conditions and resources they need to be healthy. Ethicists writing about health promotion have focused on this relationship between the citizen and the state. Comparing existing frameworks, theories and the expressed values of practitioners themselves, we can see common patterns. All oppose pursuing an instrumental, individualistic, health-at-all-costs vision of health promotion. And all defend the moral significance of just processes: those that engage with citizens in a transparent, inclusive and open way. In recent years, some Australian governments have sought to delegitimise health promotion, defining it as extraneous to the role of the state. Good evidence is not enough to counter this trend, because it is founded in competing visions of a good society. For this reason, the most pressing agenda for health promotion ethics is to engage with communities, in a procedurally just way, about the role and responsibilities of the citizen and the state in promoting and maintaining good health.

  20. Provision of Private Care by Doctors Employed in Public Health Institutions: Ethical Considerations and Implications for Clinical Training.

    Science.gov (United States)

    Benbassat, Jochanan

    2015-06-01

    This paper summarizes the difficulties that may emerge when the same care-provider attends to private and public patients within the same or different clinical settings. First, I argue that blurring the boundaries between public and private care may start a slippery slope leading to "black" under-the-table payments for preferential patient care. Second, I question whether public hospitals that allow their doctors to attend to private patients provide an appropriate learning environment for medical students and residents. Finally, I propose a way to both maintain the advantages of private care and avoid its negative consequences: complete separation between the public and the private health care systems.

  1. Law and ethics in population health.

    Science.gov (United States)

    Gostin, Lawrence O

    2004-02-01

    This paper proposes an action agenda to assure healthier and safer populations. First, create a strong public health infrastructure with sustainable funding and secure foundations--a well-trained workforce, modern data systems, rapid disease surveillance, and laboratory capacity. Second, use law as a tool for the public's health - tax and spend to create incentives for health, alter the informational and built environments to reduce risk behaviours, lower socio-economic disparities to improve health, regulate for the public's welfare, pursue tort litigation to innovate for safety, and deregulate to reduce harm. Third, create a new public health ethic in society that truly values human health--advocate for a renewed commitment to the ideals of community and partnership, and stress citizens' duties to help and protect their fellow human beings.

  2. Towards a public health profession

    DEFF Research Database (Denmark)

    Foldspang, Anders

    2015-01-01

    and disease prevention, health economics and leadership, health sociology, ethics, etc.—unified under the comprehensive public health umbrella. This approach will contribute to the prevention of silo thinking and isolated, particularistic action. Conversely, just thinking in and engaging specialists...

  3. Ethical, Political and Societal Implications of the Open Access Journal Movement in the Era of Economic Crisis, with Emphasis on Public Health Pharmacogenomics.

    Science.gov (United States)

    Bragazzi, Nicola Luigi

    2013-12-01

    Publication of the research outputs is a vital step of the research processes and a gateway between the laboratory and the global society. Open Access is revolutionizing the dissemination of scientific ideas, particularly in the field of public health pharmacogenomics that examines the ways in which pharmacogenomics impacts health systems and services at a societal level, rather than a narrow bench to bedside model of translation science. This manuscript argues that despite some limitations and drawbacks, open access has profound ethical, political and societal implications especially on underdeveloped and developing countries, and that it provides opportunities for science to grow in these resource-limited countries, particularly in the era of a severe economic and financial crisis that is imposing cuts and restrictions to research.

  4. Umbilical cord blood banks. Ethical aspects. Public versus private banks.

    Science.gov (United States)

    Aznar Lucea, Justo

    2012-01-01

    The creation of umbilical cord blood (UCB) banks raises interesting medical, social, economic and ethical issues. This paper reviews the ethical problems specifically. In this respect, it evaluates: a) whether there are advantages to the use of UCB compared to bone marrow, b) whether or not it is ethical to create UCB banks, c) whether their creation is ethically acceptable in terms of their clinical usefulness or d) the use made of them for therapeutic purposes, and finally e) whether their creation is ethically justified from a cost/profitability point of view. We focus primarily on evaluating the ethical controversy between public and private banks, particularly on whether it is ethical to bank autologous blood in private UCB banks, on the basis of its limited possibilities for use by the cord blood donor. We can conclude that, from an ethical point of view, autologous blood banks have limited acceptance among specialised researchers, scientific societies and other public institutions. Therefore, we believe that it is ethically more acceptable to support the creation of public UCB banks for medical and social reasons and, above all, based on the principle of justice and human solidarity. Nevertheless, there is no definitive ethical argument why a couple, according to their autonomy and freedom, cannot bank their child's UCB in a private bank. An equally acceptable solution could be the creation of mixed banks, such as that proposed by the Virgin Health Bank or like the Spanish system where autologous samples can be stored in public banks but with the proviso that if at any time the stored sample is required by any person other than the donor, it would have to be given to them.

  5. Ethics and professionalism in public relations

    Directory of Open Access Journals (Sweden)

    Krstić Ana

    2009-01-01

    Full Text Available The subjects of this paper are ethics and professionalism, topics closely linked in contemporary theory, and especially in practice of public relations, whose significance is increasingly coming to the spotlight of experts from this area. Several definitions, classification, the historical development and principles of theories of ethics most frequently used in ethical decision-making within a business environment, have been presented in the first chapter in the endeavor to ascertain the concept of ethics. The next chapter concerns the duties a public relations expert must pay attention to while carrying out his or her activities. Those are: duty towards oneself, towards the organization, society and profession, within which, in the case of a conflict of interest, the duty towards society (so-called social responsibility, or professional duty, must prevail. The chapter that follows concerns ethical problems in the contemporary practice of public relations: the competence of practitioners, possible conflicts of interest and the very sensitive area of media relations. The chapter on models of ethical decision-making involves concrete experts' advice on decision making which are firmly based on ethical principles. Next section concerns professionalism and professional education in public relations. Recommendations concerning topics which should be included in the university education in this area are also presented. The focus is on the following: the absence of standards that would establish who can work in public relations and under which conditions; the lack of a specified educational minimum and expertise which a practitioner should possess; the need for practitioners to be the members of professional associations, as well as to adhere to a required ethical codex. Some of the most significant world public relations associations are mentioned and at the end, and a review of the state of public relations in Serbia is given.

  6. Moral Objectivity, Jurgen Habermas's Discourse Ethics, and Public Relations.

    Science.gov (United States)

    Leeper, Roy V.

    1996-01-01

    States that while increasing attention is being paid by people in public relations to ethical theory, the predominant ethical perspective is still situational. Analyzes the applicability of the Discourse Ethics theory of Jurgen Habermas to public relations ethics. Concludes that Discourse Ethics holds the potential of a new, more objective…

  7. Insegurança, ética e comunicação em saúde pública Insecurity, ethics and communication in public health

    Directory of Open Access Journals (Sweden)

    Luis David Castiel

    2003-04-01

    Full Text Available São descritos e abordados analiticamente como uma questão pertinente ao âmbito da saúde pública, aspectos da insegurança que atingem as sociedades contemporâneas. São apresentados tópicos que abordam a relação entre profissionais de saúde e instâncias de informação e comunicação pública de conteúdos ligados a riscos à saúde, com exemplos provenientes de questões vinculadas à biotecnologia. Analisa-se a necessidade de desenvolvimento de uma ética global voltada para problemas de saúde pública que envolve desigualdades sociais e vulnerabilidade de parcelas expressivas das populações em escala mundial.Insecurity and some aspects that affect contemporary societies are described. They are approached analytically as a question of public health concern. Some topics are brought into discussion regarding the relationship between health workers and various levels of information and public communication of risks and health issues, using biotechnological problems as examples. Finally, it is pointed out the need to further development global ethics for public health problems related to social inequalities and vulnerabilities of large populations worldwide.

  8. Code of ethics and ethical dilemmas' management in health professions

    Directory of Open Access Journals (Sweden)

    Sofia Triadafyllidou

    2011-10-01

    Full Text Available As the main interest of health professionals is for the well-being of patients/clients, ethical decision making is one of the prominent elements of his/her professionalism. Aim: The present study aims to illustrate the role of ethical judgment and the so-called "moral imagination" in health professions. Method and material: Review of theoretical and research literature, including both classic and recent sources about ethical dilemmas that health professionals may anticipate, as well as the suggested ways to manage these dilemmas. Results: Health professionals often have to act in complicated situations. Review of relevant literature indicates that the professionals' ethical decisions are structured not only through the codes of ethics, but also through other collective practices, such as organizational culture and cultural schemas about the role of health professional. Resorting to schematic thinking may temporarily release the professional from his/her concerns, but in the long run, it may devoid him/her of the sense of satisfaction from work and of the ability to offer clients the optimal care. The development of the so-called "moral imagination" permits the professional to advance from the typical application of the rules to actual ethical judgment. Conclusions: Ethical decision making presupposes not only a thorough knowledge of ethical guidelines, but also the development of the ability to openly reflect upon the ethical dimensions of an issue (moral imagination that allows health professionals to overcome schematic thinking and investigate comprehensive solutions to ethical dilemmas.

  9. The Role of Public Relations in the Institutionalization of Ethics.

    Science.gov (United States)

    Fitzpatrick, Kathy R.

    1996-01-01

    Examines the role and perceived value of public relations in institutional ethics initiatives. Surveys ethics officers in North American institutions. Finds that public relations professionals are not playing key roles in the institutionalization of ethics, and that public relations remains a relatively untapped resource in ethics programs. (PA)

  10. Ethics in Medical Research and Publication

    Directory of Open Access Journals (Sweden)

    Izet Masic

    2014-01-01

    Full Text Available To present the basic principles and standards of Ethics in medical research and publishing, as well as the need for continuing education in the principles and ethics in science and publication in biomedicine. An analysis of relevant materials and documents, sources from the published literature. Investing in education of researches and potential researches, already in the level of medical schools. Educating them on research ethics, what constitutes research misconduct and the seriousness of it repercussion is essential for finding a solution to this problem and ensuring careers are constructed on honesty and integrity.

  11. How often are ethics approval and informed consent reported in publications on health research in Cameroon? A five-year review.

    Science.gov (United States)

    Munung, Nchangwi Syntia; Che, Chi Primus; Ouwe-Missi-Oukem-Boyer, Odile; Tangwa, Godfrey B

    2011-09-01

    We assessed the extent of research ethics approval and informed consent reporting in publications emanating from Cameroon and indexed in PubMed from 2005-2009. In our review of 219 full-length articles, we found that 57.53% reported ethics approval, 70.78% informed consent, and 50.68% both ethics approval and informed consent. Reporting these procedures was more common in randomized clinical trials than in other study designs. Also, 59.52% of the articles on vulnerable populations documented ethics approval and 76.19% documented informed consent. This study also identified some structures for ethics review and recommends some next steps for research on the quality of ethics review in Cameroon.

  12. 公共健康危机治理的伦理构建%Ethics Construction of Public Health Crisis Governance

    Institute of Scientific and Technical Information of China (English)

    高进; 娄成武

    2016-01-01

    Ethics construction of public health crisis governance is the intrinsic requirement of fundamental attributes, the significant guarantee of harmed subj ects,and the due implication of crisis governance policies.Public health crisis governance should uphold such ethical norms as human-oriented value,j ustice and responsibility.On the value orientation,the human rights to live,to know and to choose should be protected.To pursue the justice of rights,opportunities and procedures,the fairness and j ustice of resources distribution,risk undertaking and measure implementation should be guaranteed.The duty-bound responsibility and result responsibility of public health crisis governance should also be clarified. Consequently,the multiple subj ects of public health crisis governance are supposed to insist on human orientation and humanist care,carry the fairness and j ustice through,share reasonably the resources risk,enhance the sense of responsibility, and implement effectively the preventive governance.%构建公共健康危机治理的伦理道德,是公共健康危机根本属性的内在要求,是公共健康危机侵害对象的重要保障,是公共健康危机治理政策的应有之义。公共健康危机治理应该秉持人本、公正与责任等伦理规范。在价值取向上,维护人的生命权、知情权和选择权,追求权利、机会和程序的公正;在资源分配、风险承担和手段实施方面实现公平与正义;同时,明确公共健康危机治理的应当责任和结果责任。因此,公共健康危机治理的多元主体需要坚持以人为本,实现人文价值关怀;贯彻公平正义,合理分担资源风险;强化责任意识,有效防控治理。

  13. Institutionalising of public health.

    Science.gov (United States)

    Karkee, R

    2014-01-01

    Though public health situation in Nepal is under-developed, the public health education and workforce has not been prioritised. Nepal should institutionalise public health education by means of accrediting public health courses, registration of public health graduates in a data bank and increasing job opportunities for public health graduates in various institutions at government sector.

  14. Public Ethics and Urban Space

    Directory of Open Access Journals (Sweden)

    Sergio Brancaccio

    2013-07-01

    Full Text Available Naples as a centre of development and human relations must choose amongst the relational goods: friendship, cultural exchange, mobility, sports, green spaces etc. or goods which reflect “acquired positions”: the size and quality of the houses, monetary wealth, automobiles etc. to go towards a model in modern society where the increase in income is in contrast with the increase in well-being.  Conservation and regeneration of the fabric of the city depend on the cultural orientation which its citizens have attained coming from the great ideals of social justice, liberty and democratic participation; these terms are also related to the choice between free market and “civil economy” which should aim at the common well-being, reserving for ethics the place of a renewed protagonist role.

  15. Health technology assessment implementation: the politics of ethics.

    Science.gov (United States)

    Callahan, Daniel

    2012-01-01

    Using a 2009 American debate on a federal public health recommendation on mammography screening for women under the age of 50 as a case study, it is argued that public acceptance of health technology assessment (HTA) depends on the ethical acceptability of its recommendations. At the same time, that acceptability cannot be separated from the politics and values of the health care system of which it is part. In the United States, those values display a sharp ideological split between a conservative individual-based ethic and a liberal community-oriented ethic. A clash of this kind cannot be solved by invocation of ethical principles when it is those principles themselves that are in conflict. Inevitably HTA acceptance is threatened by this conflict as is the fate of health care reform.

  16. Ethical thinking and discrimination in health care

    Directory of Open Access Journals (Sweden)

    Aleksander Mlinšek

    2012-02-01

    Full Text Available RQ: Personal excellence of nursing focusing on self-transcendence and achievements is crucial for achieving excellence in health care. The question is whether there is unequal treatment of patients despite high ethical standards placed in health care.Purpose: Professional nurses code is a guide in assessing their ethical performance. People are different amongst each other, but have the same rights in the health system, which should be provided by health care services. The need to overcome inequalities has become a cornerstone of excellence in health care.Method: A small quantitative survey of nurses was conducted in one of the departments in a Slovenian hospital. To analyse the results, we used frequency statistics, Spearman's rank correlation test and chi-square test. Results: Providers of health care services are aware of the importance of ethics in its formation. Professional Code is relatively well known; 8.4 % of the respondents were not sure if they clearly define the principles of respect for equality. Discrimination, caused by providers of health care, is of a less extent. Ethical awareness among health care providers does not affect identification with the profession. The education level ofnursing personnel and the perception of discrimination based on religious affiliation influenced one another. Education has no influence on the perception of discrimination based on other circumstances.Organization: Health care organizations should integrate hygieneethical thinking among its strategic goals. Quality is not only quantifying the data. Personal excellence of health care providers, which is difficult to measure, is the basic building block of organizational excellence and patient satisfaction.Originality: There are not many research studies on perceptionsof discrimination in health care. The article raises the sensitive issue that we should talk more about.Limitations: The survey was conducted on a small sample size. Further research

  17. Ethical Newsgathering Values of the Public and Press Photographers.

    Science.gov (United States)

    Hartley, Craig H.

    1983-01-01

    Compares the reactions of photojournalists and the public to hypothetical ethical dilemmas confronting press photographers. Concludes that the two groups disagree significantly in their reactions to 17 of 19 ethical situations. (FL)

  18. Death, democracy and public ethical choice.

    Science.gov (United States)

    Cushman, Reid; Holm, Soren

    1990-07-01

    The Danish Council of Ethics...believed that the brain-death criterion should not be accepted without public education and debate. Following the introduction of a spectrum of educational and related activites, a Gallup poll found that 98% of the survey population was aware of the debate over brain-vs-heart criteria and that 80% favoured the adoption of a supplemental brain-death standard... This raises the fundamental question of decisionmaking in pluralist democratic societies, of the limits of democratic involvement in such choices, and of the role of bodies like the Danish Council of Ethics... It must be part of the mission of a governmental bioethical body to use its peculiar expertise to teach and to lead -- to build a popular consensus out of confusion. But in doing so, such a Commission will be steering a dangerous course....

  19. (Public) Health and Human Rights in Practice.

    Science.gov (United States)

    Annas, George J; Mariner, Wendy K

    2016-02-01

    Public health's reliance on law to define and carry out public activities makes it impossible to define a set of ethical principles unique to public health. Public health ethics must be encompassed within--and consistent with--a broader set of principles that define the power and limits of governmental institutions. These include human rights, health law, and even medical ethics. The human right to health requires governments not only to respect individual human rights and personal freedoms, but also, importantly, to protect people from harm from external sources and third parties, and to fulfill the health needs of the population. Even if human rights are the natural language for public health, not all public health professionals are comfortable with the language of human rights. Some argue that individual human rights--such as autonomy and privacy--unfairly limit the permissible means to achieve the goal of health protection. We argue that public health should welcome and promote the human rights framework. In almost every instance, this will make public health more effective in the long run, because the goals of public health and human rights are the same: to promote human flourishing. Copyright © 2016 by Duke University Press.

  20. Ethical Issues in Health Services: A Report and Annotated Bibliography.

    Science.gov (United States)

    Carmody, James

    This publication identifies, discusses, and lists areas for further research for five ethical issues related to health services: 1) the right to health care; 2) death and euthanasia; 3) human experimentation; 4) genetic engineering; and, 5) abortion. Following a discussion of each issue is a selected annotated bibliography covering the years 1967…

  1. Reporting ethics committee approval in public administration research.

    Science.gov (United States)

    Jordan, Sara R; Gray, Phillip W

    2014-03-01

    While public administration research is thriving because of increased attention to social scientific rigor, lingering problems of methods and ethics remain. This article investigates the reporting of ethics approval within public administration publications. Beginning with an overview of ethics requirements regarding research with human participants, I turn to an examination of human participants protections for public administration research. Next, I present the findings of my analysis of articles published in the top five public administration journals over the period from 2000 to 2012, noting the incidences of ethics approval reporting as well as funding reporting. In explicating the importance of ethics reporting for public administration research, as it relates to replication, reputation, and vulnerable populations, I conclude with recommendations for increasing ethics approval reporting in public administration research.

  2. Twitter and public health.

    Science.gov (United States)

    Bartlett, Catherine; Wurtz, Rebecca

    2015-01-01

    Twitter can serve as a powerful communication modality to both "push" and "pull" public health data; each user is a potential public health sensor and actor. However, in 2012, only 8% of local health departments had Twitter accounts. We outline how Twitter works, describe how to access public tweets for public health surveillance purposes, review the literature on Twitter's current and potential role supporting public health's essential services, summarize Twitter's limitations, and make recommendations for health department use.

  3. On the Four Key Problems to Evaluate the Medical Ethics for Public Health Communication%论大众健康传播医学伦理评价的四个关键问题

    Institute of Scientific and Technical Information of China (English)

    王勇安; 张建耕; 吴洁

    2011-01-01

    Based on the analysis of the properties of the health spread, the author suggested that the public health communication activity should be evaluated because the public health communication activity is either communication activity or the health care activities, and both either comply with communication ethics or more cant go against medical ethics. The medical ethics experts should be the main body of the professional evaluation core team - as a spokesman of the social public - to make the value decide and moral decisions for the motivation and the results of public health communication activity according to four principle or the standard of medical ethics: no hurt, favorable, respect and justice.%在分析健康传播属性的基础上,认为大众健康传播活动既是传播活动,也是医疗保健活动,既要符合传播伦理,更不能违背医学伦理规范,必须进行医学伦理评价.应当由以医学伦理学专家为核心的专业评价队伍作为评价主体——社会公众的代言人,以不伤害、有利、尊重和公正四大医学伦理学原则为标准,对大众健康传播活动的动机和结果进行价值确定和道德决断.

  4. Research Ethics, Governance, Oversight And Public Interest

    Directory of Open Access Journals (Sweden)

    Abu Bakar Suleiman

    2008-12-01

    Full Text Available A better educated public has started to challengethe way decisions are made in medical research activities.Although Institutional and National Guidelines onResearch are in place, there are fears that InstitutionalReview Boards (IRBs and funding agencies are only fairlyactive in scientific and ethical reviews of research proposalsbut not on oversight of projects after their initiation. Theseissues are integral to good research governance andresearchers and custodians of research ethics must ensurethat public interest is not compromised. Medical progress is based on research including humanexperimentation carried out according to guidingprinciples as enunciated in the Declaration of Helsinki(2000, but the quality of compliance with theDeclaration is an important issue. Better choice and appropriate training of members of IRBsto improve the quality of decision making and governanceprocesses are urgently needed. Competency in evaluationof proposals requires not only the appropriate scientificknowledge but also access to relevant preclinical andother data. Unfortunately, the completeness and quality ofsuch data may not be adequate. Public interest demands that injury to trial subjects inclinical trials is minimized if not avoided completely.Unfortunately this is not always possible with trialswhere novel biological modes of action are tested.A more robust evaluation mechanism for projectapproval may minimize but not completely avoid injuryto subjects; thus insurance cover to provide care andcompensation to subjects must be compulsory.The decision to approve or reject a project must bebased on the balance of potential risks and benefits,taking into consideration justifiable distributive risks totarget communities and populations. Economicconsiderations should never be the primary focus,especially when there are real concerns that themigration of early phase clinical trials including vaccinetrials to developing countries is based on the perceivedless

  5. Ethical review of health promotion program evaluation proposals.

    Science.gov (United States)

    Thurston, Wilfreda E; Vollman, Ardene Robinson; Burgess, Michael M

    2003-01-01

    Some policies state that program evaluation falls within the domain of administrative research that does not require review by an ethics review board. We propose that some health promotion program evaluations include at least one element of research and can be distinguished from quality assurance. Although American and Canadian evaluation societies provide important guidelines and standards for evaluation practitioners, processes for accountability to the public are provided by research ethics boards. The field of health promotion is, by its nature, replete with challenges to existing research ethics boards. Given the dearth of published literature on the ethics of health promotion evaluation or practice, the field could benefit from the open debate that reviews of proposals would encourage.

  6. Publication ethics and the ghost management of medical publication.

    Science.gov (United States)

    Sismondo, Sergio; Doucet, Mathieu

    2010-07-01

    It is by now no secret that some scientific articles are ghost authored - that is, written by someone other than the person whose name appears at the top of the article. Ghost authorship, however, is only one sort of ghosting. In this article, we present evidence that pharmaceutical companies engage in the ghost management of the scientific literature, by controlling or shaping several crucial steps in the research, writing, and publication of scientific articles. Ghost management allows the pharmaceutical industry to shape the literature in ways that serve its interests. This article aims to reinforce and expand publication ethics as an important area of concern for bioethics. Since ghost-managed research is primarily undertaken in the interests of marketing, large quantities of medical research violate not just publication norms but also research ethics. Much of this research involves human subjects, and yet is performed not primarily to increase knowledge for broad human benefit, but to disseminate results in the service of profits. Those who sponsor, manage, conduct, and publish such research therefore behave unethically, since they put patients at risk without justification. This leads us to a strong conclusion: if medical journals want to ensure that the research they publish is ethically sound, they should not publish articles that are commercially sponsored.

  7. Ethical issues in providing occupational health services.

    Science.gov (United States)

    Rest, K M

    1994-04-01

    In the rush to capture new segments of the health care market, occupational health services have become an attractive "product line" for some provider groups. However, providers may not appreciate the significant ethical dimensions of delivering occupational health services. The environment of the workplace gives rise to competing goals, interests, and expectations and creates thorny ethical issues for health care providers. It is important that providers develop a framework for recognizing and addressing these ethical issues and the influence of their own and other parties' values on their decision-making processes.

  8. The right to public health.

    Science.gov (United States)

    Wilson, James

    2016-06-01

    Much work in public health ethics is shaped by an 'autonomy first' view, which takes it to be axiomatic that it is difficult to justify state interference in the lives of competent adults unless the behaviours interfered with are compromised in terms of their autonomy, or would wrongfully infringe on the autonomy of others. However, such an approach is difficult to square with much of traditional public heath practice. Recent years have seen running battles between those who assume that an 'autonomy first' approach is basically sound (and so much the worse for public health practice) and those who assume that public health practice is basically sound (and so much the worse for the 'autonomy first' approach). This paper aims to reconcile in a normatively satisfying way what is best about the 'autonomy first' approach with what is best about a standard public health approach. It develops a positive case for state action to promote and protect health as a duty that is owed to each individual. According to this view, the state violates individuals' rights if it fails to take cost-effective and proportionate measures to remove health threats from the environment. It is thus a mistake to approach public health in the way that 'autonomy first' accounts do, as primarily a matter of individual entitlements versus the common good. Too little state intervention in the cause of improving population health can violate individuals' rights, just as too much can.

  9. Ethical Tools to Support Systematic Public Deliberations about the Ethical Aspects of Agricultural Biotechnologies

    NARCIS (Netherlands)

    Beekman, V.; Brom, F.W.A.

    2007-01-01

    This special issue of the Journal of Agricultural and Environmental Ethics presents so-called ethical tools that are developed to support systematic public deliberations about the ethical aspects of agricultural biotechnologies. This paper firstly clarifies the intended connotations of the term ¿eth

  10. Ethical Tools to Support Systematic Public Deliberations about the Ethical Aspects of Agricultural Biotechnologies

    NARCIS (Netherlands)

    Beekman, V.; Brom, F.W.A.

    2007-01-01

    This special issue of the Journal of Agricultural and Environmental Ethics presents so-called ethical tools that are developed to support systematic public deliberations about the ethical aspects of agricultural biotechnologies. This paper firstly clarifies the intended connotations of the term ¿eth

  11. FRAMEWORKS FOR ETHICS IN PUBLIC HEALTH MARCOS CONCEPTUALES PARA LA ÉTICA EN SALUD PÚBLICA MARCOS CONCEPTUAIS PARA A ÉTICA EM SAÚDE PÚBLICA

    Directory of Open Access Journals (Sweden)

    Bruce Jennings

    2003-01-01

    Full Text Available This paper constructs a conceptual framework for the normative study of public health. It argues that to develop discussions of ethics in public health without paying attention to the broader theoretical and ideological context of public health controversies and social conflicts will be of limited value. In defining that context, the author distinguishes three main types of ethical theory-utilitarianism, contractarianism, and communitarianism; and several varieties of political theory -liberal welfarism, liberal egalitarianism, libertarian liberalism, deliberative democracy, civic republicanism, and cultural conservatism. The meanings and interconnections of these theory formations are discussed. Illustrations to particular public health programs and issues are given. The paper also distinguishes four different types of applied ethical discourse in public health-professional ethics, advocacy ethics, applied ethics, and critical ethics. Each of these modes of ethics is important, but the development of work in critical ethics is the most important priority within the normative study of public health at presentEste texto construye un marco conceptual para el estudio normativo de la salud pública. Argumenta que desarrollar discusiones sobre la ética en salud pública será de escasa utilidad si no se presta atención al contexto más amplio, teórico e ideológico, de las controversias en salud pública y a los conflictos sociales. En la definición de ese contexto, el autor distingue tres tipos principales de teorías éticas -utilitarianismo, contractarianismo y comunitarianismo- y diversas variantes de teoría política -liberalismo del bienestar, liberalismo igualitario, liberalismo libertario, democracia deliberativa, republicanismo cívico y conservatismo cultural-. Se discuten los significados e interconexiones de estas formaciones teóricas. Se ilustra su aplicación a programas y temas particulares de salud pública. El artículo tambi

  12. Integrating ethics, health policy and health systems in low- and middle-income countries: case studies from Malaysia and Pakistan.

    Science.gov (United States)

    Hyder, Adnan A; Merritt, Maria; Ali, Joseph; Tran, Nhan T; Subramaniam, Kulanthayan; Akhtar, Tasleem

    2008-08-01

    Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.

  13. Ethical and public policy challenges for pharmacogenomics.

    Science.gov (United States)

    Gershon, Elliot S; Alliey-Rodriguez, Ney; Grennan, Kay

    2014-12-01

    It is timely to consider the ethical and social questions raised by progress in pharmacogenomics, based on the current importance of pharmacogenomics for avoidance of predictable side effects of drugs, and for correct choice of medications in certain cancers. It has been proposed that the entire population be genotyped for drug-metabolizing enzyme polymorphisms, as a measure that would prevent many untoward and dangerous drug reactions. Pharmacologic treatment targeting based on genomics of disease can be expected to increase greatly in the coming years. Policy and ethical issues exist on consent for large-scale genomic pharmacogenomic data collection, public vs corporate ownership of genomic research results, testing efficacy and safety of drugs used for rare genomic indications, and accessibility of treatments based on costly research that is applicable to relatively few patients. In major psychiatric disorders and intellectual deficiency, rare and de novo deletion or duplication of chromosomal segments (copy number variation), in the aggregate, are common causes of increased risk. This implies that the policy problems of pharmacogenomics will be particularly important for the psychiatric disorders.

  14. Training Public Health Advisors.

    Science.gov (United States)

    Meyer, Pamela A; Brusuelas, Kristin M; Baden, Daniel J; Duncan, Heather L

    2015-01-01

    Federal public health advisors provide guidance and assistance to health departments to improve public health program work. The Centers for Disease Control and Prevention (CDC) prepares them with specialized training in administering public health programs. This article describes the evolving training and is based on internal CDC documents and interviews. The first federal public health advisors worked in health departments to assist with controlling syphilis after World War II. Over time, more CDC prevention programs hired them. To meet emerging needs, 3 major changes occurred: the Public Health Prevention Service, a fellowship program, in 1999; the Public Health Associate Program in 2007; and integration of those programs. Key components of the updated training are competency-based training, field experience, supervision, recruitment and retention, and stakeholder support. The enduring strength of the training has been the experience in a public health agency developing practical skills for program implementation and management.

  15. Applying Classical Ethical Theories to Ethical Decision Making in Public Relations: Perrier's Product Recall.

    Science.gov (United States)

    Pratt, Cornelius B.

    1994-01-01

    Links ethical theories to the management of the product recall of the Perrier Group of America. Argues for a nonsituational theory-based eclectic approach to ethics in public relations to enable public relations practitioners, as strategic communication managers, to respond effectively to potentially unethical organizational actions. (SR)

  16. Applying Classical Ethical Theories to Ethical Decision Making in Public Relations: Perrier's Product Recall.

    Science.gov (United States)

    Pratt, Cornelius B.

    1994-01-01

    Links ethical theories to the management of the product recall of the Perrier Group of America. Argues for a nonsituational theory-based eclectic approach to ethics in public relations to enable public relations practitioners, as strategic communication managers, to respond effectively to potentially unethical organizational actions. (SR)

  17. Health and Wellness Policy Ethics

    Directory of Open Access Journals (Sweden)

    Frank J. Cavico

    2013-01-01

    Full Text Available This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace.

  18. Health and Wellness Policy Ethics

    Science.gov (United States)

    Cavico, Frank J.; Mujtaba, Bahaudin G.

    2013-01-01

    This perspective is an ethical brief overview and examination of “wellness” policies in the modern workplace using practical examples and a general application of utilitarianism. Many employers are implementing policies that provide incentives to employees who lead a “healthy” lifestyle. The authors address how these policies could adversely affect “non-healthy” employees. There are a wide variety of ethical issues that impact wellness policies and practices in the workplace. The authors conclude that wellness programs can be ethical, while also providing a general reflective analysis of healthcare challenges in order to reflect on the externalities associated with such policies in the workplace. PMID:24596847

  19. Publication Ethics: Many Facets, Collaboration Required

    Directory of Open Access Journals (Sweden)

    Viroj Wiwanitkit

    2013-05-01

    from the institute with low standard of peer reviewing process, citing the name of some famous scientists into the publication of the institute without previous asking for permission, etc. In order to cope   with those problems, the collaboration between all partners (author, editor, journal, institute, reviewer and reader is needed. Sharing of knowledge, learning together and going together toward the ethical publication is recommended.

  20. Rethinking the ethical approach to health information management through narration: pertinence of Ricœur's 'little ethics'.

    Science.gov (United States)

    Mouton Dorey, Corine

    2016-12-01

    The increased complexity of health information management sows the seeds of inequalities between health care stakeholders involved in the production and use of health information. Patients may thus be more vulnerable to use of their data without their consent and breaches in confidentiality. Health care providers can also be the victims of a health information system that they do not fully master. Yet, despite its possible drawbacks, the management of health information is indispensable for advancing science, medical care and public health. Therefore, the central question addressed by this paper is how to manage health information ethically? This article argues that Paul Ricœur's "little ethics", based on his work on hermeneutics and narrative identity, provides a suitable ethical framework to this end. This ethical theory has the merit of helping to harmonise self-esteem and solicitude amongst patients and healthcare providers, and at the same time provides an ethics of justice in public health. A matrix, derived from Ricœur's ethics, has been developed as a solution to overcoming possible conflicts between privacy interests and the common good in the management of health information.

  1. [Subjectivity, ethics and productivity in post-productive health restructuring].

    Science.gov (United States)

    Gomes, Doris; Ramos, Flávia Regina Souza

    2015-08-01

    The scope of this paper is to analyze the ethical problems generated by the modern stressor pattern of post-transformation productivity in productive restructuring in the health area. It is a qualitative study of the descriptive and exploratory type in which 30 professionals (nurses, doctors and dental surgeons) from a metropolitan region in the South of Brazil were interviewed, all of whom had prior experience in the public and private sectors. The results were analyzed through Discursive Textual Analysis. Capitalization is revealed as a major ethical problem in the series of new issues derived from the productivity-profitability imperative in health, due to the acritical incorporation of ethics that is restricted to the company's interests or to corporate-individual interests. The ethical problem of low professional commitment to the needs of the patient and of the social collective indicates the need to build a new engaged solidarity in order to increase the quality of public healthcare. Productivity targeted at individual and social needs/interests in the area of health requires a new self-managing and collective engagement of the subjects, supported by an institutional and ethical-political effort of group action, cooperation and solidarity.

  2. Discover: What Is Public Health?

    Science.gov (United States)

    ... Series Undergraduate Network Membership Contact Discover What is Public Health? Public health protects and improves the health of individuals, families, communities, and populations, locally and globally. Public health is personal. Public health professionals focus on preventing ...

  3. Mental health research, ethics and multiculturalism.

    Science.gov (United States)

    Bailes, Marion J; Minas, I Harry; Klimidis, Steven

    2006-01-01

    In this paper we examine ethical issues relevant to conducting mental health research with refugees and immigrant communities that have cultural orientations and social organisation that are substantially different to those of the broader Australian community, and we relate these issues to NH&MRC Guidelines. We describe the development and conduct of a mental health research project carried out recently in Melbourne with the Somali community, focusing on ethical principles involved, and relating these to the NH&MRC National Statement on Ethical Conduct in Research Involving Humans, and the NH&MRC document Values and Ethics: Guidelines for Ethical Conduct in Aboriginal and Torres Strait Islander Health Research. The experience of conducting mental health research with the Somali community highlights the fact that the principles of inclusion and benefit enunciated in the NH&MRC document Values and Ethics are particularly pertinent when conducting research with refugees and immigrant communities that are culturally distant to those of the broader Australian community. These principles inform issues of research design and consent, as well as guiding respectful engagement with the participating community and communication of the research findings.

  4. [Physicians' strikes and health services: an ethical perspective].

    Science.gov (United States)

    Goić, A

    1996-07-01

    For the public opinion, medical strikes are a controversial issue; physician's ethical judgments are also different. The present article analyses the requisites to consider legitimate a strike and, based on these, the ethical duties of physicians; the features of medical unionism; the ethical duties of authority; the manipulation of ill people by the strike and the social factors that may cause these conflicts. In a medical strike, universal ethical values based on the Hyppocratic oath and promoted by the profession, are endangered. This article concludes that a medical strike may be explainable due to different reasons, but it is not ethically justifiable beyond any doubt. The health profession that is not prepared to give up strikes as gremial pressure tool, should not choose a profession that takes care of the ill. The best way to avoid medical strike is to prevent them: the society and the authority have the ethical obligation to create work conditions that elude conflicts. To settle disputes between physicians and health institutions, the creation of a permanent arbitral instance agreed by physicians and the authority, i.e. a high level committee integrated by respected individuals and physicians, could be necessary. This committee should send forth veredicts that would be obeyed by the contending parties.

  5. Core competencies for health care ethics consultants: in search of professional status in a post-modern world.

    Science.gov (United States)

    Engelhardt, H Tristram

    2011-09-01

    The American Society for Bioethics and the Humanities (ASBH) issued its Core Competencies for Health Care Ethics Consultation just as it is becoming ever clearer that secular ethics is intractably plural and without foundations in any reality that is not a social-historical construction (ASBH Core Competencies for Health Care Ethics Consultation, 2nd edn. American Society for Bioethics and Humanities, Glenview, IL, 2011). Core Competencies fails to recognize that the ethics of health care ethics consultants is not ethics in the usual sense of a morally canonical ethics. Its ethics is the ethics established at law and in enforceable health care public policy in a particular jurisdiction. Its normativity is a legal normativity, so that the wrongness of violating this ethics is simply the legal penalties involved and the likelihood of their being imposed. That the ethics of ethics consultation is that ethics legally established accounts for the circumstance that the major role of hospital ethics consultants is as quasi-lawyers giving legal advice, aiding in risk management, and engaging in mediation. It also indicates why this collage of roles has succeeded so well. This article shows how moral philosophy as it was reborn in the 13th century West led to the ethics of modernity and then finally to the ethics of hospital ethics consultation. It provides a brief history of the emergence of an ethics that is after morality. Against this background, the significance of Core Competencies must be critically reconsidered.

  6. Ethical issues when using social media for health outside professional relationships.

    Science.gov (United States)

    DeCamp, Matthew

    2015-04-01

    Social media have the potential to revolutionize health and healthcare, but fulfilling this potential requires attention to the ethical issues social media may raise. This article reviews the major ethical issues arising when social media are used for research, public health, mobile health applications, and global health. It focuses on social media use outside fiduciary relationships between healthcare professionals and patients. Emphasis is given to the potential of social media in these contexts, the ethical issues relatively unique to each, and where possible how existing ethical principles and frameworks could help navigate these issues. In some cases social media create the circumstance for particular ethical issues but also facilitate managing them, such as in informed consent for research. In other cases, disagreement exists about whether social media - despite their potential - should be used for certain purposes, such as in public health surveillance (where confidentiality represents a significant ethical concern). In still others, ethical uncertainty exists about how social media will affect ethical issues, such as inequality in global health. As social media technologies continue to develop, identifying and managing the ethical issues they raise will be critical to their success in improving health while preserving fundamental ethical values.

  7. [Ethical problems experienced by nurses in primary health care: integrative literature review].

    Science.gov (United States)

    Nora, Carlise Rigon Dalla; Zoboli, Elma Lourdes Campos Pavone; Vieira, Margarida

    2015-03-01

    The aim of this study is to identify ethical problems experienced by nurses in primary health care and resources for coping based on publications on the subject. An integrative literature review was performed between the months of October and November 2013, using the databases: BDTD, CINAHL, LILACS, MEDLINE, Biblioteca Cochrane, PubMed, RCAAP and SciELO. Articles, dissertations and theses published in Portuguese, English and Spanish were included, totalling 31 studies published from 1992 to 2013. This analysis resulted in four categories: ethical problems in the relationship between team members, ethical problems in the relationship with the user, ethical problems in health services management and resources for coping with ethical problems. Results showed that nurses need to be prepared to face ethical problems, emphasizing the importance of ethics education during the education process before and during professional practice to enhance the development of ethical sensitivity and competence for problem resolution.

  8. ETHICS MANAGEMENT ISSUES IN THE ROMANIAN PUBLIC ADMINISTRATION. THE ETHICAL EVALUATION

    OpenAIRE

    L. GAVRILESCU

    2011-01-01

    The Romanian public administration reform aims, among other, to fight against the corruption, by means very similar to those of the so called ethics management. The present achievements: the laws concerning the codes of conduct and some implementation measures, ranks the Romanian administration system in the early stages of the ethics management development. To gain momentum at institutional level, the ethics management needs some evaluation tools. One of such tools, as this paper proposes, i...

  9. American Public Health Association

    Science.gov (United States)

    ... Published Books Fact Sheets Reports and Issue Briefs Advertising Public Health Buyers Guide Publications Contacts Professional Development ... Steps Challenge doubles its goal Apr 11 2017 Facebook Is your organization an APHA member? As an ...

  10. Lighting and public health.

    NARCIS (Netherlands)

    Ierland, J. van & Schreuder, D.A.

    1969-01-01

    The following topics; are discussed with respect to public health: - the effect of visible and ultraviolet radiation upon man. - vision with respect to lighting. interior lighting. - artificial lighting of work environments. - day light and windows. - recommendations for lighting. public lighting. -

  11. Ethics in Health Care. Syllabus #1006.2.

    Science.gov (United States)

    Fullen, Jim; Coverdale, Edna

    A 12-week course in health care ethics offered by Central Ohio Technical College is described. Following a list of objectives, a week by week outline charts the following topics covered in the course: ethics in health, an introduction to ethics, utilitarianism and egoism (goal-based ethical theories), divine command and social law (duty-based…

  12. Ethics in Health Care. Syllabus #1006.2.

    Science.gov (United States)

    Fullen, Jim; Coverdale, Edna

    A 12-week course in health care ethics offered by Central Ohio Technical College is described. Following a list of objectives, a week by week outline charts the following topics covered in the course: ethics in health, an introduction to ethics, utilitarianism and egoism (goal-based ethical theories), divine command and social law (duty-based…

  13. Lithuanian health care in transitional state: ethical problems

    Directory of Open Access Journals (Sweden)

    Žekas Romualdas

    2005-11-01

    Full Text Available Abstract Background Throughout the economic and political reforms in post-communist countries, significant changes have also occurred in public morality. One of the tasks of the Lithuanian health policy is to create mechanisms for strengthening the significance of ethical considerations in the decision-making processes concerning health care of individuals and groups of individuals, as well as considering the positions of physicians and the health care system itself in a general way. Thus, health care ethics could be analyzed at two levels: the micro level (the ethics of doctor-patient relationships and the macro level (the ethics of health policy-making, which can be realized by applying the principles of equal access, reasonable quality, affordable care and shared responsibilities. To date, the first level remains dominant, but the need arises for our attention to refocus now from the micro level to the patterns of managing and delivering care, managing the health care resources, and conducting business practices. Discussion In attempting to increase the efficiency of health services in Lithuania, a common strategy has been in place for the last fifteen years. Decentralization and privatization have been implemented as part of its policy to achieve greater efficiency. Although decentralization in theory is supposed to improve efficiency, in practice the reform of decentralization has still to be completely implemented in Lithuania. Debates on health policy in Lithuania also include the issue of private versus public health care. Although the approach of private health care is changing in a positive way, it is obvious that reduced access to health services is the most vulnerable aspect. In the Lithuanian Health Program adopted in July 1998, the target of equity was stressed, stating that by 2010, differences in health and health care between various socio-economic groups should be reduced by 25%. Summary The restructuring of health care system

  14. Lithuanian health care in transitional state: ethical problems.

    Science.gov (United States)

    Jakusovaite, Irayda; Darulis, Zilvinas; Zekas, Romualdas

    2005-11-09

    Throughout the economic and political reforms in post-communist countries, significant changes have also occurred in public morality. One of the tasks of the Lithuanian health policy is to create mechanisms for strengthening the significance of ethical considerations in the decision-making processes concerning health care of individuals and groups of individuals, as well as considering the positions of physicians and the health care system itself in a general way. Thus, health care ethics could be analyzed at two levels: the micro level (the ethics of doctor-patient relationships) and the macro level (the ethics of health policy-making, which can be realized by applying the principles of equal access, reasonable quality, affordable care and shared responsibilities). To date, the first level remains dominant, but the need arises for our attention to refocus now from the micro level to the patterns of managing and delivering care, managing the health care resources, and conducting business practices. In attempting to increase the efficiency of health services in Lithuania, a common strategy has been in place for the last fifteen years. Decentralization and privatization have been implemented as part of its policy to achieve greater efficiency. Although decentralization in theory is supposed to improve efficiency, in practice the reform of decentralization has still to be completely implemented in Lithuania. Debates on health policy in Lithuania also include the issue of private versus public health care. Although the approach of private health care is changing in a positive way, it is obvious that reduced access to health services is the most vulnerable aspect. In the Lithuanian Health Program adopted in July 1998, the target of equity was stressed, stating that by 2010, differences in health and health care between various socio-economic groups should be reduced by 25%. The restructuring of health care system in Lithuania should be based on a balance between

  15. Debating Diversity: Ethics and Controversial Public Issues

    Science.gov (United States)

    Darr, Christopher R.

    2016-01-01

    Courses: Ethics, Organizational Communication, Political Communication. Objectives: After completing this unit activity, students should be able to (1) apply multiple ethical perspectives to real-world diversity issues in a debate format, and (2) explain the role of informational and social category diversity in current controversies.

  16. Ethical assessment of national health insurance system of Korea.

    Science.gov (United States)

    Lee, Yuri; Kim, Soyoon; Kim, Ganglip

    2012-09-01

    The current adverse effects of the health insurance system in Korea are considered to be problems that arise from an insufficient reflection of the notion of respecting human rights. The ethical principles most commonly suggested and used in public health are the 4 principles suggested by Beauchamp and Childress in 1994. From the perspective of the community, these 4 principles of medical ethics can be expanded to resolve problems surrounding existing social systems from a socialistic standpoint. This article describes a flexible, easy-to-use model for incorporating the 4 medical ethics principles into the National Health Insurance System (NHIS). First, the principle of respect for autonomy involves respecting the decision-making capacities of autonomous medical consumers and providers and enabling individuals to make reasoned and informed choices. Second is the principle of good practice. The government and medical institutions should act in a way that benefits the health care consumers. The principle of prohibiting bad practice involves avoiding causing health problems. The National Health Insurance Corporation and health care providers should not harm the health care consumers. Finally, the principle of justice is concerned with distributing benefits, risks, and costs fairly-that is, the notion that patients in similar positions should be treated in a similar manner. If these problems are solved, health system quality could be better and more accessible and sustainable. The ethical assessment of the NHIS could be a trial to match the 4 medical ethics principles and the NHIS. It can be applied internationally to relevant policy makers in different settings.

  17. [Equity in health? Health inequalities, ethics, and theories of distributive justice].

    Science.gov (United States)

    Buyx, A M

    2010-01-01

    It is well-documented that the socio-economic status has an important influence on health. In all developed countries, health is closely correlated with income, education, and type of employment, as well as with several other social determinants. While data on this socio-economic health gradient have been available for decades, the moral questions surrounding social health inequalities have only recently been addressed within the field of public health ethics. The present article offers a brief overview of relevant data on social health inequalities and on some explanatory models from epidemiology, social medicine and related disciplines. The main part explores three influential normative accounts addressing the issue of health inequalities. Finally, an agenda for future work in the field of public health ethics and health inequalities is sketched, with particular attention to the German context.

  18. Ethical issues posed by cluster randomized trials in health research

    Directory of Open Access Journals (Sweden)

    Donner Allan

    2011-04-01

    Full Text Available Abstract The cluster randomized trial (CRT is used increasingly in knowledge translation research, quality improvement research, community based intervention studies, public health research, and research in developing countries. However, cluster trials raise difficult ethical issues that challenge researchers, research ethics committees, regulators, and sponsors as they seek to fulfill responsibly their respective roles. Our project will provide a systematic analysis of the ethics of cluster trials. Here we have outlined a series of six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation: 1. Who is a research subject? 2. From whom, how, and when must informed consent be obtained? 3. Does clinical equipoise apply to CRTs? 4. How do we determine if the benefits outweigh the risks of CRTs? 5. How ought vulnerable groups be protected in CRTs? 6. Who are gatekeepers and what are their responsibilities? Subsequent papers in this series will address each of these areas, clarifying the ethical issues at stake and, where possible, arguing for a preferred solution. Our hope is that these papers will serve as the basis for the creation of international ethical guidelines for the design and conduct of cluster randomized trials.

  19. Ethical challenges and how to develop ethics support in primary health care.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2013-02-01

    Ethics support in primary health care has been sparser than in hospitals, the need for ethics support is probably no less. We have, however, limited knowledge about how to develop ethics support that responds to primary health-care workers' needs. In this article, we present a survey with a mixture of closed- and open-ended questions concerning: How frequent and how distressed various types of ethical challenges make the primary health-care workers feel, how important they think it is to deal with these challenges better and what kind of ethics support they want. Five primary health-care institutions participated. Ethical challenges seem to be prominent and common. Most frequently, the participants experienced ethical challenges related to scarce resources and lack of knowledge and skills. Furthermore, ethical challenges related to communication and decision making were common. The participants welcomed ethics support responding to their challenges and being integrated in their daily practices.

  20. [Health system reforms, economic constraints and ethical and legal values].

    Science.gov (United States)

    Caillol, Michel; Le Coz, Pierre; Aubry, Régis; Bréchat, Pierre-Henri

    2010-01-01

    Health system and hospital reforms have led to important and on-going legislative, structural and organizational changes. Is there any logic at work within the health system and hospitals that could call into question the principle of solidarity, the secular values of ethics that govern the texts of law and ethics? In order to respond, we compared our experiences to a review of the professional and scientific literature from 1992 to 2010. Over the course of the past eighteen years, health system organization was subjected to variations and significant tensions. These variations are witnesses to a paradigm shift: although a step towards the regionalization of the health system integrating the choice of public health priorities, consultation and participatory democracy has been implemented, nevertheless the system was then re-oriented towards the trend of returning to centralization on the basis of uniting economics, technical modernization and contracting. This change of doctrine may undermine the social mission of hospitals and the principle of solidarity. Progress, the aging population and financial constraints would force policy-makers to steer the health system towards more centralized control. Hospitals, health professionals and users may feel torn within a system that tends to simplify and minimize what is becoming increasingly complex and global. Benchmarks on values, ethics and law for the hospitals, healthcare professionals and users are questioned. These are important elements to consider when the law on the reform of hospitals, patients, health care and territories and regional health agencies is implemented.

  1. Dimensão ética do cuidado em saúde mental na rede pública de serviços Ethical dimension of mental health care within the public health network

    Directory of Open Access Journals (Sweden)

    Liliane Brandão Carvalho

    2008-08-01

    which were psychologists working in the state public health network. Data was obtained by means of non-directive interviews which were taped and transcribed. Categories were obtained from the discourses based on a hermeneutical approach by means of which an interpretive network was constructed. ANALISYS OF RESULTS: The interpretative network indicated that psychologists recognize their insertion in the field of public health as distinct from the professional field in which they obtained their training and, consequently, as a challenge. The predominant conceptions of care were circumscribed to the technical dimension, although other dimensions, closer to ethical concerns and to those related to respect for the "other" were also identified. CONCLUSIONS: In the daily routine of assistance within the public health network, care is perceived as a technical attitude. It involves control and nullification of alterity, being more closely aligned to the traditional models of biomedicine and clinical psychology. However, other practices were observed that overcome this attitude. These emerging practices assume a new configuration, oriented towards affection, dialogue between professionals and those seeking assistance and an ethical commitment forged within a political and socio-cultural perspective.

  2. Business ethics as a novel issue in health care economics.

    Science.gov (United States)

    Vrbová, H; Holmerová, I; Hrubantová, L

    1997-01-01

    The problems of health care providing and solutions suggested to solve them should be discussed publicly at all appropriate levels in all developed countries. In this contribution, new approaches to understanding the problems of business ethics in health care are mentioned and recommended for discussion. An application of such principles of business ethics as trust, accountability, solidarity, transparency and social responsibility is considered in the four following areas. First, it is the allocation of limited resources in health care. This is the world-wide problem of the end of 20th century, as the development of medical technologies offers a wide range of new diagnostic and therapeutic procedures. In our country this coincides with the on-going, and still incompleted reform of health care. Second, the other area is that of connecting health-care and social problems, important namely for vulnerable groups such as children, the elderly and chronically ill. The third area is concerned with the privatization of health care, the newly emanating structure and function of the health care system and the role of health care provides in society. The last group contains issues concerning attempts to facilitate communication between health care specialists and general public, as well as attempts to support those institutions of the civic democratic society that are oriented toward health, sickness and health care providing.

  3. Public health workforce taxonomy.

    Science.gov (United States)

    Boulton, Matthew L; Beck, Angela J; Coronado, Fátima; Merrill, Jacqueline A; Friedman, Charles P; Stamas, George D; Tyus, Nadra; Sellers, Katie; Moore, Jean; Tilson, Hugh H; Leep, Carolyn J

    2014-11-01

    Thoroughly characterizing and continuously monitoring the public health workforce is necessary for ensuring capacity to deliver public health services. A prerequisite for this is to develop a standardized methodology for classifying public health workers, permitting valid comparisons across agencies and over time, which does not exist for the public health workforce. An expert working group, all of whom are authors on this paper, was convened during 2012-2014 to develop a public health workforce taxonomy. The purpose of the taxonomy is to facilitate the systematic characterization of all public health workers while delineating a set of minimum data elements to be used in workforce surveys. The taxonomy will improve the comparability across surveys, assist with estimating duplicate counting of workers, provide a framework for describing the size and composition of the workforce, and address other challenges to workforce enumeration. The taxonomy consists of 12 axes, with each axis describing a key characteristic of public health workers. Within each axis are multiple categories, and sometimes subcategories, that further define that worker characteristic. The workforce taxonomy axes are occupation, workplace setting, employer, education, licensure, certification, job tasks, program area, public health specialization area, funding source, condition of employment, and demographics. The taxonomy is not intended to serve as a replacement for occupational classifications but rather is a tool for systematically categorizing worker characteristics. The taxonomy will continue to evolve as organizations implement it and recommend ways to improve this tool for more accurate workforce data collection.

  4. Ethics in health care: the practice of defensive medicine

    African Journals Online (AJOL)

    nurses and 100 hospital administrators in the USA found ... Ethics CPD Supplement: Ethics in health care: confidentiality and information technologies. S7 .... Health Care. News. 2003;3(2). 4. Fienberg S. A view on medical malpractice.

  5. Setting an ethical agenda for health promotion.

    Science.gov (United States)

    Mittelmark, Maurice B

    2008-03-01

    The Bangkok Charter for Health Promotion in a Globalized World has sparked lively dialogue. Welcomed by some as a Charter current to the times, there are others who see it as an unneeded and therefore unwelcome challenger to the Ottawa Charter for Health Promotion. Intended or not, the Bangkok Charter seems to signal a shift in discourse, from a social-ecological approach and an emphasis on individual and community capacity-building and empowerment, to an investment approach and an emphasis on globalization, macro-level factors and policy. Positively, the Bangkok Charter proclaims to build on Ottawa, and no one suggests it is meant to replace the Ottawa Charter outright. In concert with that, the dialogue today is not so much about the ascendancy of the one Charter over the other, but about the degree to which the Bangkok Charter remains true to the ethic of the Ottawa Charter. It is welcome that the Ottawa and Bangkok Charters are the subject of brisk dialogue about strategy and tactics in a rapidly changing world, and about the foundational values of health promotion. Regarding the latter, we have unfinished work in constructing an ethic for health promotion, and the present dialogue may inspire us to progress. Though we have the cornerstone of an ethic for health promotion, in the Ottawa Charter and in other principled documents that have followed, we have yet to build sufficiently on the cornerstone; an ethic for practice has yet to be codified, and the same is true for research. Health promotion journals, conferences and organizations can and should do more to facilitate dialogue on ethics in health promotion, and the Internet provides the means for all to participate actively.

  6. Ethical dilemmas in workplace health promotion.

    Science.gov (United States)

    Allegrante, J P; Sloan, R P

    1986-05-01

    In less than a decade, workplace health promotion programs designed to promote employee health and help reduce the high cost of health insurance premiums paid by business and industry have proliferated. Notwithstanding the latent benefits and cost savings that corporate management expects to gain from the investment in such programs, it is argued that workplace health promotion is not without potential misuse and that its goals and methods ought not to be above ethical scrutiny. Drawing on earlier work, we discuss how workplace health promotion may pose ethical problems related to social justice, protection of privacy, and social control. The attendant moral dilemmas for the professional whose responsibility it is to develop and implement such programs are also presented.

  7. The Public Health Practitioner of the Future.

    Science.gov (United States)

    Erwin, Paul Campbell; Brownson, Ross C

    2017-08-01

    The requisite capacities and capabilities of the public health practitioner of the future are being driven by multiple forces of change, including public health agency accreditation, climate change, health in all policies, social media and informatics, demographic transitions, globalized travel, and the repercussions of the Affordable Care Act. We describe five critical capacities and capabilities that public health practitioners can build on to successfully prepare for and respond to these forces of change: systems thinking and systems methods, communication capacities, an entrepreneurial orientation, transformational ethics, and policy analysis and response. Equipping the public health practitioner with the requisite capabilities and capacities will require new content and methods for those in public health academia, as well as a recommitment to lifelong learning on the part of the practitioner, within an increasingly uncertain and polarized political environment.

  8. Pigs in Public Health

    DEFF Research Database (Denmark)

    Svendsen, Mette N.

    2017-01-01

    Animals are rare topics in public health science texts and speech despite the fact that animal bodies and lives are woven into the health of human populations, and vice versa. Years of ethnographic and documentary research – following pigs and their humans in and out of biomedical research – made...... me mindful and watchful of the porous passages between animal and human bodies and environments that do not confine themselves to ‘national health programs’ directed towards a specific (human) population. These unrecognized species encounters and relationships, which exceed the conventional framework...... of public health, made me re-evaluate both what ‘public’ and what ‘health’ means in public health. In this commentary I provide a short personal account of that intellectual journey. I argue that entanglements between species make it urgent that public health scholars investigate the moral, socio...

  9. Ethical sharing of health data in online platforms – which values should be considered?

    DEFF Research Database (Denmark)

    Riso, Brigida; Tupasela, Aaro Mikael; Vears, Danya

    2017-01-01

    , the sensitive and personal nature of health data poses ethical challenges when data is disclosed and shared even if for scientific research purposes. With this in mind, the Science and Values Working Group of the COST Action CHIP ME ‘Citizen's Health through public-private Initiatives: Public health, Market...

  10. Problems and Countermeasures of Patent Ethical Review Mechanism From the Perspective of the Public Health%公共健康视域下专利伦理审查机制的问题与对策

    Institute of Scientific and Technical Information of China (English)

    陈桂荣

    2014-01-01

    危及公共健康的专利的存在,让专利的合理性及合法性颇受质疑,强化伦理审查是提高专利道德合理性及维护公共利益的必然要求。目前我国专利伦理审查面临多重挑战,致使伦理审查流于形式:意识层面上,面临“去伦理化”主张的挑战;立法层面上,立法不完善,缺乏审查依据和标准;实践层面上,审查主体、公众参与及反馈机制不健全。目前可通过厘清观念误区、健全法律体系、引入伦理审查委员会等多种举措来完善专利伦理审查及监督机制。%The patents which do harms to the public health challenged the rationality and legitimacy of patent and it is necessary to strengthen the ethical review of patent to safeguard the public interest requirements.But at present,the ethical review of patent in China is facing multiple challenges,thus the ethical review of patent is just a form.In the level of consciousness,ethical review of patent faces the challenge of“getting-rid-of ethics”;in the level of legislation,laws are far away from perfect and lack of standards of review;and in the level of prac-tice,review subject,public participation and feedback mechanism do not work perfectly.In view of this,it is ur-gent to improve the ethical review and supervision mechanism of patent through a variety of measures.

  11. [Ethics and reproductive health: the issue of HPV vaccination].

    Science.gov (United States)

    Matejić, Bojana; Kesić, Vesna

    2013-01-01

    The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV) has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years), attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years, regardless of the

  12. Ethics and reproductive health: The issue of HPV vaccination

    Directory of Open Access Journals (Sweden)

    Matejić Bojana

    2013-01-01

    Full Text Available The ethics of reproductive health covers a wide field of different issues, from the ethical dimensions of assisted reproduction, life of newborns with disabilities to the never-ending debate on the ethical aspects of abortion. Furthermore, increasing attention is paid to the ethical dimensions of using stem cells taken from human embryos, the creation of cloned embryos of patients for possible self-healing, and the increasingly present issue of reproductive cloning. Development of vaccines against human papillomavirus (HPV has introduced new ethical aspects related to reproductive health and the need for a consensus of clinical and public-healthcare population. Today immunization with HPV vaccine is a measure for the primary prevention of cervical cancer and it provides effective protection against certain types of viruses included in the vaccine. The most often mentioned issues of discussions on ethical concerns about HPV vaccination are the recommended age of girls who should be informed and vaccinated (12-14 years, attitudes and fears of parents concerning discussion with their preadolescent daughters on issues important for their future sexual behavior, dilemma on the vaccination of boys and the role of the chosen pediatrician in providing information on the vaccination. In Serbia, two HPV vaccines have been registered but the vaccination is not compulsory. Up-till-now there has been no researches on the attitudes of physicians and parents about HPV vaccination. Nevertheless, it is very important to initiate education of general and medical public about the fact that the availability of vaccine, even if we disregard all aforementioned dilemmas, does not lead to the neglect of other preventive strategies against cervical cancer, primarily screening. The National Program for Cervical Cancer Prevention involves organized screening, i.e. regular cytological examinations of the cervical smear of all women aged 25-69 years, every three years

  13. The Public Health Impact of the So-Called "Fluad Effect" on the 2014/2015 Influenza Vaccination Campaign in Italy: Ethical Implications for Health-Care Workers and Health Communication Practitioners.

    Science.gov (United States)

    Rosselli, Roberto; Martini, Mariano; Bragazzi, Nicola Luigi; Watad, Abdulla

    2017-01-01

    Seasonal influenza, causing complications, hospitalizations and deaths, generates a serious socio-economic burden, especially among elderly and high-risk subjects, as well as among adult individuals. Despite the availability and active free-of charge offer of influenza vaccines, vaccine coverage rates remain low and far from the target established by the Ministry of Health. Notwithstanding their effectiveness, vaccines are victims of prejudices and false myths, that contribute to the increasing phenomenon of vaccine hesitancy and loss of confidence. Media and, in particular, new media and information and communication technologies (ICTs) play a major role in disseminating health-related information. They are extremely promising devices for delivering health education and promoting disease prevention, including immunization. However, they can also have a negative impact on population's health attitudes and behaviors when channeling wrong, misleading information. During the 2014/2015 influenza vaccination campaign, the report of four deaths allegedly caused by administration of an adjuvanted influenza vaccine, Fluad - the so-called "Fluad case" - received an important media coverage, which contributed to the failure of the vaccination campaign, dramatically reducing the influenza vaccine uptake. In the extant literature, there is a dearth of information concerning the effect of the "Fluad case". The current study aims at quantifying the impact of the "Fluad effect" at the level of the Local Health Unit 3 (LHU3) ASL3 Genovese, Genoa, Italy. Ethical implications for health-care workers and health communication practitioners are also envisaged.

  14. The role of emotions in health professional ethics teaching.

    Science.gov (United States)

    Gillam, Lynn; Delany, Clare; Guillemin, Marilys; Warmington, Sally

    2014-05-01

    In this paper, we put forward the view that emotions have a legitimate and important role in health professional ethics education. This paper draws upon our experience of running a narrative ethics education programme for ethics educators from a range of healthcare disciplines. It describes the way in which emotions may be elicited in narrative ethics teaching and considers the appropriate role of emotions in ethics education for health professionals. We argue there is a need for a pedagogical framework to productively incorporate the role of emotions in health professional ethics teaching. We suggest a theoretical basis for an ethics pedagogy that integrates health professional emotions in both the experience and the analysis of ethical practice, and identify a range of strategies to support the educator to incorporate emotion within their ethics teaching.

  15. How effective is dog culling in controlling zoonotic visceral leishmaniasis? a critical evaluation of the science, politics and ethics behind this public health policy

    Directory of Open Access Journals (Sweden)

    Carlos Henrique Nery Costa

    2011-04-01

    Full Text Available INTRODUCTION: Zoonotic kala-azar, a lethal disease caused by protozoa of the genus Leishmania is considered out of control in parts of the world, particularly in Brazil, where transmission has spread to cities throughout most of the territory and mortality presents an increasing trend. Although a highly debatable measure, the Brazilian government regularly culls seropositive dogs to control the disease. Since control is failing, critical analysis concerning the actions focused on the canine reservoir was conducted. METHODS: In a review of the literature, a historical perspective focusing mainly on comparisons between the successful Chinese and Soviet strategies and the Brazilian approach is presented. In addition, analyses of the principal studies regarding the role of dogs as risk factors to humans and of the main intervention studies regarding the efficacy of the dog killing strategy were undertaken. Brazilian political reaction to a recently published systematic review that concluded that the dog culling program lacked efficiency and its effect on public policy were also reviewed. RESULTS: No firm evidence of the risk conferred by the presence of dogs to humans was verified; on the contrary, a lack of scientific support for the policy of killing dogs was confirmed. A bias for distorting scientific data towards maintaining the policy of culling animals was observed. CONCLUSIONS: Since there is no evidence that dog culling diminishes visceral leishmaniasis transmission, it should be abandoned as a control measure. Ethical considerations have been raised regarding distorting scientific results and the killing of animals despite minimal or absent scientific evidence

  16. Theological ethics, moral philosophy, and public moral discourse.

    Science.gov (United States)

    Jonsen, Albert R

    1994-03-01

    The advent and growth of bioethics in the United States in the late 1960s and early 1970s precipitated an era of public moral discourse, that is, the deliberate attempt to analyze and formulate moral argument for use in public policy. The language for rational discussion of moral matters evolved from the parent disciplines of moral philosophy and theological ethics, as well as from the idioms of a secular, pluralistic world that was searching for policy answers to difficult bioethical questions. This article explores the basis and content of the unique contributions of both theological and philosophical ethics to the development of public moral discourse.

  17. Children's Health Publications

    Science.gov (United States)

    Each title has a brief description and link for downloading the full text. Includes the publications catalog, the Child Health Champion resource guide, student curriculum materials, reports, fact sheets, and booklets/brochures of advice and tools.

  18. Dewey's Ethical Justification for Public Deliberation Democracy

    Science.gov (United States)

    Shook, John

    2013-01-01

    Interpretations of John Dewey's political theory grasp his respect for public deliberation, but typically overlook his ethical justification for democracy. Dewey gave two primary reasons why democracy is superior to other forms of government. First, a public educated in the tools of social intelligence can be more effective at managing their…

  19. Public Relations Ethics and Communitarianism: A Preliminary Investigation.

    Science.gov (United States)

    Leeper, Kathie A.

    1996-01-01

    Presents a preliminary examination of communitarianism and its emphasis on community and responsibility as an ethical base for public relations. Suggests that the emphasis business currently places on quality, social responsibility, and stewardship may fit within a communitarian approach. Argues that a communitarian base to public relations may…

  20. Business ethics in ethics committees?

    Science.gov (United States)

    Boyle, P

    1990-01-01

    The "Ethics committees" column in this issue of the Hastings Center Report features an introduction by Cynthia B. Cohen and four brief commentaries on the roles hospital ethics committees may play in the making of institutional and public health care policy in the 1990s. The pros and cons of a broader, more public role for ethics committees in reconciling the business and patient care aspects of health care delivery are debated by Cohen in "Ethics committees as corporate and public policy advocates," and by Philip Boyle in this article. Boyle is an associate for ethical studies at The Hastings Center.

  1. Aristotle's ethical theory & modern health care.

    Science.gov (United States)

    Majumdar, S K

    1996-01-01

    The Greek physician of antiquity - Hippocrates (460-356 B.C.) is called the Father of Modern Medicine and the Hippocratic Oath to which doctors of modern medicine traditionally and formally express their allegiance, forms the basic foundation of medical ethics. The tradition of Western ethical philosophy began with the ancient Greeks. From Socrates (469-399 B.C.) and his immediate successors, Plato (427-347 B.C.) and Aristotle (384-322 B.C.), there is a clear line of continuity, through Hellenistic period (from the death of Alexander the Great (323 B.C.) to the end of Ptolemic dynasty (30 B.C.) and the Roman annexation of Egypt - broadly post-Aristotelian and medieval thought to the present day. But the society has qualitatively and quantitatively changed since the Industrial Revolution in the late 18th and 19th centuries. Society, today, is just a collection of discrete individuals, each with his or her own purposes and interests. Hence it has become almost imperative to apply the principle of autonomy to issues in the ethics of health care. The aim of this short essay is, therefore, an attempt to explore the relevance, if any, of Aristotelian ethical theory to the modern health care.

  2. GIS and Public Health

    Directory of Open Access Journals (Sweden)

    Stefania Bertazzon

    2014-06-01

    Full Text Available This Special Issue on GIS and public health is the result of a highly selective process, which saw the participation of some 20 expert peer-reviewers and led to the acceptance of one half of the high-quality submissions received over the past year. Many threads link these papers to each other and, indeed, to our original call for papers, but the element that most clearly emerges from these works is the inextricable connection between public health and the environment. Indeed, GIS analysis of public health simply cannot disregard the geospatial dimension of environmental resources and risks. What consistently emerges from these analyses is that current geospatial research can only scratch the surface of the complex interactions of spatial resources, risks, and public health. In today’s world, or at least in the developed world, researchers and practitioners can count on virtually endless data, on inexpensive computational power, and on seamless connectivity. In this research environment, these papers point to the need for improved analytical tools, covering concepts, representation, modeling and reliability. These works are important contributions that help us to identify what advances in geospatial analysis can better address the complex interactions of public health with our physical and cultural environment, and bridge research and practice, so that geospatial analyses can inform public health policy making. [...

  3. Why ethics should be part of health technology assessment.

    Science.gov (United States)

    Hofmann, Bjørn Morten

    2008-01-01

    From the heydays of HTA in the 1970s, it has been argued that ethics should be a part of HTA. Despite more than 30 years with repeated intentions, only few HTA reports include ethical analysis, and there is little agreement on methods for integrating ethics. This poses the question of why it is so important to integrate ethics in HTA? The article analyzes ten arguments for making ethics part of HTA. The validity of the arguments depend on what we mean by "integrating," "ethics," and "HTA." Some of the counterarguments explain why it has taken so long to integrate ethics in HTA and why there are so many ethical approaches. Nevertheless, some of the arguments for making ethics part of HTA appear to be compelling. Health care is a moral endeavor, and the vast potential of technology poses complex moral challenges. A thorough assessment of technology would include reflection on these moral aspects. Ethics provides such a moral reflection. Health technology is a way to improve the life of human individuals. This involves questions of what "the good life" is, and hence ethical issues. Trying to ignore such questions may inflict with the moral foundation of health care: to help people. Additionally, HTA is an evaluation, and as such also a reflection on values. Hence, there is a profound affinity between HTA and ethics. Accordingly, ethics cannot be "integrated" in HTA as ethics is already a constitutive part of HTA. However, ethics can be acknowledged and emphasized.

  4. The Profession of Public Administration: An Ethics Edge in Introductory Textbooks?

    Science.gov (United States)

    Bowman, James S.; Berman, Evan M.; West, Jonathan P.

    2001-01-01

    Examination of the foundations of public service ethics as reflected in 12 textbooks revealed that ethics coverage is modest and is seldom covered in areas in which ethical behavior is crucial. (Contains 57 references.) (JOW)

  5. The stigmatization dilemma in public health policy

    DEFF Research Database (Denmark)

    Ploug, Thomas; Holm, Søren; Gjerris, Mickey

    2015-01-01

    Background Multi-resistant bacteria pose an increasing and significant public health risk. As awareness of the severity of the problem grows, it is likely that it will become the target for a range of public health interventions. Some of these can intentionally or unintentionally lead...... to stigmatization of groups of citizens. Discussion The article describes the phenomenon of stigmatization within the health care area by discussing the concept in relation to AIDS and psychiatric diagnosis. It unfolds the ethical aspects of using stigmatization as a public health instrument to affect unwanted...... behaviours e.g. smoking. Moreover it discusses stigmatization as an unintended albeit expected side effect of public health instruments potentially used to counter the challenge of multi-resistant bacteria with particular reference to the Danish case of the growing problems with Methicillin...

  6. Codes of ethics in occupational health – are they important?

    African Journals Online (AJOL)

    This article addresses the ethical competence of occupational health professionals (OHPs). ... ethical dilemma an occupational physician may have to confront. An occupational ..... RISK WASTE. Waste Treatment & Disposal is our business.

  7. Ethics in studies on children and environmental health

    DEFF Research Database (Denmark)

    Merlo, D F; Knudsen, Lisbeth E.; Matusiewicz, K

    2007-01-01

    Children, because of age-related reasons, are a vulnerable population, and protecting their health is a social, scientific and emotional priority. The increased susceptibility of children and fetuses to environmental (including genotoxic) agents has been widely discussed by the scientific community...... and their parents, physicians and public health researchers, and the society as a whole, with its ethical, regulatory, administrative and political components. The important ethical issues are information of participants and consent to participate. Follow-up and protection of data (samples and information derived...... on children is necessary in both clinical and environmental fields, to provide age-specific relevant data regarding the efficacy and safety of medical treatments, and regarding the assessment of risk from unintended environmental exposure. In this context, the stakeholders are many, including children...

  8. The major medical ethical challenges facing the public and healthcare providers in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Abdulaziz F Alkabba

    2012-01-01

    Full Text Available Background: Despite the relatively high expenditure on healthcare in Saudi Arabia, its health system remains highly centralized in the main cities with its primary focus on secondary and tertiary care rather than primary care. This has led to numerous ethical challenges for the healthcare providers. This article reports the results of a study conducted with a panel of practitioners, and non-clinicians, in Saudi Arabia, in order to identify the top ten ethical challenges for healthcare providers, patients, and their families. Materials and Methods: The study design was a cross-sectional, descriptive, and qualitative one. The participants were asked the question: "What top ten ethical challenges are Saudis likely to face in health care?" The participants were asked to rank the top ten ethical challenges throughout a modified Delphi process, using a ranking Scale. A consensus was reached after three rounds of questions and an experts′ meeting. Results: The major 10 ethical issues, as perceived by the participants in order of their importance, were: (1 Patients′ Rights, (2 Equity of resources, (3 Confidentiality of the patients, (4 Patient Safety, (5 Conflict of Interests, (6 Ethics of privatization, (7 Informed Consent, (8 Dealing with the opposite sex, (9 Beginning and end of life, and (10 Healthcare team ethics. Conclusion: Although many of the challenges listed by the participants have received significant public and specialized attention worldwide, scant attention has been paid to these top challenges in Saudi Arabia. We propose several possible steps to help address these key challenges.

  9. Transparency during public health emergencies: from rhetoric to reality

    OpenAIRE

    2009-01-01

    Effective management of public health emergencies demands open and transparent public communication. The rationale for transparency has public health, strategic and ethical dimensions. Despite this, government authorities often fail to demonstrate transparency. A key step in bridging the gap between the rhetoric and reality is to define and codify transparency to put in place practical mechanisms to encourage open public health communication for emergencies. The authors demonstrate this appro...

  10. Public titles of clinical trials should have ethics review.

    Science.gov (United States)

    Saenz, Carla; Reveiz, Ludovic; Tisdale, John F

    2015-09-01

    A key aspect to guarantee that research with human subjects is ethical is being overlooked. Ethics review committees invest great effort examining the informed consent documents of research protocols to ensure that potential participants can provide consent validly and are not deluded into thinking that the experimental intervention they may sign up for is already known to be therapeutic. However, these efforts to avoid what is called the "therapeutic misconception" might be in vain if the title with which the studies are being introduced to the potential participants escapes ethics review. Research participants might be deceived by clinical trials entitled "novel therapy" when the point of the trial is precisely to find out whether the intervention at stake is therapeutic or not. Providing potential research participants with such misleading information hampers their ability to make informed decisions. The well-established scrutiny that ethics review committees exercise with regard to consent forms is limited if the registration of clinical trials, for which a public title is chosen, constitutes a process that is independent from the ethics review. In this article, we examine this problem, assess recent measures to integrate clinical trial registration with ethics review processes, and provide specific recommendations to solve the problem and ultimately enhance the accountability, transparency, and ethics of research with human subjects.

  11. Ethics Review of Survey Research: A Mandatory Requirement for Publication?

    Science.gov (United States)

    Whicher, Danielle; Wu, Albert W

    2015-12-01

    National regulations governing human subjects research differ with regard to whether they require survey research to be overseen by institutional ethics boards or committees. In cases where ethical review has been waived, or was provided by an individual or group other than an institutional ethics board, journals may question the appropriateness of the waiver or alternative review when making determinations about whether to accept the manuscript for publication. The purpose of this article is to provide guidance for journals to consider when making determinations about the necessity of ethical review for survey research projects. We review the functions of ethics oversight and consider the importance of those functions within the context of survey research. In survey research, no intervention is delivered to research participants. As a result, there is no risk of physical harm to individuals who participate. However, there can be a risk of informational or psychological harms. In situations where there is greater than minimal risk of informational or psychological harms, the survey research should have received institutional ethics oversight. Additionally, survey research projects that enroll vulnerable individuals with diminished autonomy should receive institutional ethics oversight. We hope that this article leads to further guidance on this subject by authoritative group such as the International Committee of Medical Journal Editors.

  12. Ethical practice of social media in public relations

    CERN Document Server

    DiStaso, Marcia W

    2014-01-01

    Given the high rate of social media use by the public, organizations are compelled to engage with key audiences through these outlets. Social media engagement requires organizations to actively participate with public groups, and this highly-interactive exchange raises a new set of ethical concerns for communicators. In this rapidly changing communications environment, the long-term implications of social media are uncertain, and this book provides the much needed research to understand its impact on audiences and organizations.Through an examination of a broad range of ethics concepts includi

  13. From Ethical Justification to Delimitation of Boundaries between Country Power and Individual Rights:A Settlement Way of the Particular Ethical Conflict in Public Health%从伦理辩护到国家权力、个人权利界限的划定--公共卫生领域特殊伦理冲突的和解之道

    Institute of Scientific and Technical Information of China (English)

    张珊; 路绪锋

    2014-01-01

    In epidemic prevention work ,in order to protect public health we have no choice but to infringe the right of infectious disease patients ,this is a particular ethical conflict in public health which is different from clinical medicine . Although some scholars argue in favor of the priority of public health according to utilitarianism ,difference principle and the priority of public good ,all of these are not consistent with the individual perspective of medical ethics . In fact , upholding single theoretical perspective is the maximal obstacle on the road to reconciliation of ethical conflict ,only change the single perspective can we open the compatibility of theory .We have to transform ethical justification to practical wisdom ,that is to say ,country power and individual rights should stick to each boundary ,so as to achieve harmonious status between them .%在流行病防控等公共卫生工作中,为了维护公共健康不得不侵犯传染病患者的个人权利,这是公共卫生领域不同于临床医学的特殊伦理冲突。虽然有学者分别依据“效果论”、“差异原则”和“公共善优先”为公共健康的优先性进行了辩护,但都不能与医学伦理学的个体论视角相融洽。实际上,固守单一的理论视角是伦理冲突和解的最大障碍,只有改变单一视角,才能开启理论的兼容性。伦理辩护必须转化为实践智慧,即必须在公共卫生实践中实现国家权力与个人权利的有序协调,使国家权力和个人权利坚守各自的界限。

  14. Focus on Ethics and Public Relations Practice in a University Classroom

    Science.gov (United States)

    Smudde, Peter M.

    2011-01-01

    Public relations action relies on sound decision making about how to inspire cooperation between an organization and its publics. Such thinking must uphold principles for ethical communication. Effectively combining ethics with public relations practice for students is key. A pedagogical approach to public relations ethics, hinging on selected…

  15. Focus on Ethics and Public Relations Practice in a University Classroom

    Science.gov (United States)

    Smudde, Peter M.

    2011-01-01

    Public relations action relies on sound decision making about how to inspire cooperation between an organization and its publics. Such thinking must uphold principles for ethical communication. Effectively combining ethics with public relations practice for students is key. A pedagogical approach to public relations ethics, hinging on selected…

  16. Immigration and Health: Law, Policy, and Ethics.

    Science.gov (United States)

    Parmet, Wendy E; Sainsbury-Wong, Lorianne; Prabhu, Maya

    2017-03-01

    Immigration poses numerous challenges for health professionals and public health lawyers. This article reviews these challenges. We begin by offering some background on immigration and health and then explain some of the reasons why immigrants are less likely than natives to have health insurance. Next we turn to a discussion of some of the particular challenges relating to the health care of refugees. We conclude by analyzing and rejecting some of the arguments that are made for discriminating against immigrants with respect to the provision of public health benefits and services.

  17. Patient and citizen participation in health: the need for improved ethical support.

    Science.gov (United States)

    Williamson, Laura

    2014-01-01

    Patient and citizen participation is now regarded as central to the promotion of sustainable health and health care. Involvement efforts create and encounter many diverse ethical challenges that have the potential to enhance or undermine their success. This article examines different expressions of patient and citizen participation and the support health ethics offers. It is contended that despite its prominence and the link between patient empowerment and autonomy, traditional bioethics is insufficient to guide participation efforts. In addition, the turn to a "social paradigm" of ethics in examinations of biotechnologies and public health does not provide an account of values that is commensurable with the pervasive autonomy paradigm. This exacerbates rather than eases tensions for patients and citizens endeavoring to engage with health. Citizen and patient participation must have a significant influence on the way we do health ethics if its potential is to be fulfilled.

  18. Music and Public Health

    DEFF Research Database (Denmark)

    Bonde, Lars Ole; Juel, Knud; Ekholm, Ola

    2016-01-01

    Background: ‘Music and public health’ is a new field of study. Few scientific studies with small samples have documented health implications of musical participation. Research questions in this epidemiological study were: 1) Is there an association between self-rated health and active use of music...... in daily life? 2) What associations can be observed between musical background, uses and understanding of music as a health factor, and self-reported health? Method: Data came from the Danish Health and Morbidity Survey 2013, based on a simple random sample of 25.000 adult Danes (16+ years). Response rate......: 57%. Multiple logistic regression analyses were performed to investigate associations between musical background/activities and health-related indicators. Discussion: The study documents that a majority of informants use music to regulate physical and psychological states...

  19. Defining and Developing Global Public Health Course for Public Health Graduates

    Directory of Open Access Journals (Sweden)

    Rajendra eKarkee

    2015-07-01

    Full Text Available Global Public Health is increasingly being seen as a speciality field within the university education of Public Health. However, the exact meaning of Global Public Health is still unclear resulting in varied curricula and teaching units among universities. The contextual differences between high and low and middle income countries, and the process of globalisation need to be taken into account while developing any global public health course.Global Public Health and Public Health are not separable and Global Public Health often appears as an extension of Public Health in the era of globalisation and interdependence. Though Global Public Health is readily understood as health of global population, it is mainly practised as health problems and their solutions set within low and middle income countries. Additional specialist competencies relevant to the context of low and middle income countries are needed to work in this field. Although there can be a long list of competencies relevant to this broad topic, available literature suggests that knowledge and skills related with ethics and vulnerable groups/issues; globalisation and its impact on health; disease burden; culture, society and politics; and management are important.

  20. Integrating ethics in health technology assessment: many ways to Rome

    NARCIS (Netherlands)

    Hofmann, B.; Oortwijn, W.; Lysdahl, K. Bakke; Refolo, P.; Sacchini, D.; Wilt, G.J. van der; Gerhardus, A.

    2015-01-01

    OBJECTIVES: The aim of this study was to identify and discuss appropriate approaches to integrate ethical inquiry in health technology assessment (HTA). METHODS: The key question is how ethics can be integrated in HTA. This is addressed in two steps: by investigating what it means to integrate ethic

  1. Ethical aspects of face recognition systems in public places.

    NARCIS (Netherlands)

    Brey, Philip A.E.

    2004-01-01

    This essay examines ethical aspects of the use of facial recognition technology for surveillance purposes in public and semipublic areas, focusing particularly on the balance between security and privacy and civil liberties. As a case study, the FaceIt facial recognition engine of Identix Corporatio

  2. You Need a Code of Ethics! Not Your Publication, You!

    Science.gov (United States)

    Eveslage, Thomas

    2003-01-01

    Proposes that student journalists should clarify in writing journalism standards that characterize their publication and the moral reasoning guiding the staff. Contends that responsible journalism also requires a statement of personal values that helps define ethical behavior even when a staff member is not in journalism class or working on the…

  3. Gis and public health

    CERN Document Server

    Cromley, Ellen K

    2011-01-01

    Authoritative and comprehensive, this is the leading text and professional resource on using geographic information systems (GIS) to analyze and address public health problems. Basic GIS concepts and tools are explained, including ways to access and manage spatial databases. The book presents state-of-the-art methods for mapping and analyzing data on population, health events, risk factors, and health services, and for incorporating geographical knowledge into planning and policy. Numerous maps, diagrams, and real-world applications are featured. The companion Web page provides lab exercises w

  4. [Institutional ethics committees in Mexico: the ambiguous boundary between health care ethics and research ethics].

    Science.gov (United States)

    Valdez-Martínez, Edith; Lifshitz-Guinzberg, Alberto; Medesigo-Micete, José; Bedolla, Miguel

    2008-08-01

    To identify ethics committees in medical practice in Mexico and possible implications stemming from their composition and functions. A cross-sectional descriptive study was conducted from January-December 2005. A survey was sent by e-mail to the hospitals and family medicine centers with at 10 practices within the Mexican Institute for Social Security (Instituto Mexicano del Seguro Social) (n=437) and the Institute for Security and Social Services for State Employees (Seguridad y Servicios Sociales de los Trabajadores del Estado) (n=167) and to the Mexican Ministry of Health's most important health care centers (n=15). The following items were analyzed: name of the committee, date of formation, current status, composition, functions, and level of authority. In all, 116 committees were identified, with various names. Of these, 101 (87.1%) were active. The committees were formed from 1985-2006, with a spike occurring in 2004-2005. Of the active committees, 59 (58.4%) were charged with ethical problems/dilemmas related to clinical practice as well as those related to research projects. Of the committee members, 357 (59.0%) held managing positions in the establishment to which the committee pertained; most were medical professionals (71.5%), followed by nursing staff (11.9%). Among the members of the active committees, 77.9% had not received training in ethics. Legal conflicts can be expected, mainly within the organizations whose committees have the authority to determine a course of action. An integrated plan is needed that will set standards for the composition and proceedings of Mexico's ethics committees and the improved training of committee members.

  5. Including Public Health Content in a Bioethics and Law Course: Vaccine Exemptions, Tort Liability, and Public Health.

    Science.gov (United States)

    Crossley, Mary

    2015-01-01

    Incorporating public health content in a bioethics and law course can prompt rich discussions. This set of materials on mandatory vaccinations, nonmedical exemptions, and potential tort liability for nonvaccination explores the roles of public health law and tort law in advancing social goals and protecting individual rights and interests. © 2015 American Society of Law, Medicine & Ethics, Inc.

  6. Globalisation and public health.

    Science.gov (United States)

    Bettcher, D; Lee, K

    2002-01-01

    At the dawn of the 21st century, globalisation is a word that has become a part of everyday communication in all corners of the world. It is a concept that for some holds the promise of a new and brighter future, while for others it represents a threat that needs to be confronted and counteracted. In the area of public health, a wide range of claims have been made about the various impacts, both positive and negative, that can be attributed to globalisation. In the ever expanding literature on globalisation and health, it has become apparent that considerable confusion is emerging in both the ways that terminology is applied and concepts are defined. The determinants of health are increasingly multisectoral, and in tackling these challenges it is necessary to take a multidisciplinary approach that includes policy analyses in such areas as trade, environment, defence/security, foreign policy, and international law. In assembling the terms for this glossary, we have attempted to demonstrate the richness of the globalisation and public health debate, and in so doing have selected some of the core terms that require definition. We hope that this glossary will help to clarify this interesting and challenging area, and will also serve as a useful entry point to this new debate in public health.

  7. Corruption and ethical issues regarding public-private partnership

    OpenAIRE

    2005-01-01

    The paper raises general questions about  ethical problems that taint public-private  partnership. Everybody talks about the  economical benefits of encouraging firms  to invest in the community using different  incentives offered by the public institutions.  In the same time, every day, newspapers  bring to our attention cases of misuse of  public resources for private gain or cases  of private investors who give bribes in order  to get a contract with a public institution.  The purpose of t...

  8. Consumer directed health care: ethical limits to choice and responsibility.

    Science.gov (United States)

    Axtell-Thompson, Linda M

    2005-04-01

    As health care costs continue to escalate, cost control measures will likely become unavoidable and painful. One approach is to engage external forces to allocate resources--for example, through managed care or outright rationing. Another approach is to engage consumers to make their own allocation decisions, through "self-rationing," wherein they are given greater awareness, control, and hence responsibility for their health care spending. Steadily gaining popularity in this context is the concept of "consumer directed health care" (CDHC), which is envisioned to both control cost and enhance choice, by combining financial incentives with information to help consumers make more informed health care decisions and to appreciate the economic trade-offs of those decisions. While CDHC is gaining attention in the popular press, business publications, and academic journals, it is not without controversy about its relative merits and demerits. CDHC raises questions regarding the ethical limits of consumer responsibility for their choices. While the emphasis on consumer choice implies that autonomy is the ruling ethical principle in CDHC, it must be tempered by justice and beneficence. Justice must temper autonomy to protect disadvantaged populations from further widening disparities in health care access and outcomes that could arise from health care reform efforts. Beneficence must temper autonomy to protect consumers from unintended consequences of uninformed decisions. Thoughtful paternalism suggests that CDHC plans offer choices that are comprehensible to lay consumers, limited in their range of options, and carefully structured with default rules that minimize potential error costs.

  9. Ethical Standards for Publication in Chinese Journal of Chemical Engineering

    Institute of Scientific and Technical Information of China (English)

    2005-01-01

    Chinese Journal of Chemical Engineering (CJChE) is a publication of the Chemical Industry and Engineering Society of China (CIESC) dedicated to present the original contributions of knowledge with permanent value from chemical engineering researchers and technical staff of process industries in China and the world. The editors-in-chief, associate editors-in-chief and editorial staff of the journal share the responsibility to maintain the CJChE ethical standards for paper reviewing and handling process. The following ethical standards are thought important to the contributors from Chinese and international chemical engineering communities.

  10. Ethics that exclude: the role of ethics committees in lesbian and gay health research in South Africa.

    Science.gov (United States)

    de Gruchy, J; Lewin, S

    2001-06-01

    Prevailing state and institutional ideologies regarding race/ethnicity, gender, and sexuality help to shape, and are influenced by, research priorities. Research ethics committees perform a gatekeeper role in this process. In this commentary, we describe efforts to obtain approval from the ethics committee of a large medical institution for research into the treatment of homosexual persons by health professionals in the South African military during the apartheid era. The committee questioned the "scientific validity" of the study, viewing it as having a "political" rather than a "scientific" purpose. They objected to the framing of the research topic within a human rights discourse and appeared to be concerned that the research might lead to action against health professionals who committed human rights abuses against lesbians and gay men during apartheid. The process illustrates the ways in which heterosexism, and concerns to protect the practice of health professionals from scrutiny, may influence the decisions of ethics committees. Ethics that exclude research on lesbian and gay health cannot be in the public interest. Ethics committees must be challenged to examine the ways in which institutionalized ideologies influence their decision making.

  11. The ethics of distress: toward a framework for determining the ethical acceptability of distressing health promotion advertising.

    Science.gov (United States)

    Brown, Stephen L; Whiting, Demian

    2014-04-01

    Distressing health promotion advertising involves the elicitation of negative emotion to increase the likelihood that health messages will stimulate audience members to adopt healthier behaviors. Irrespective of its effectiveness, distressing advertising risks harming audience members who do not consent to the intervention and are unable to withdraw from it. Further, the use of these approaches may increase the potential for unfairness or stigmatization toward those targeted, or be considered unacceptable by some sections of the public. We acknowledge and discuss these concerns, but, using the public health ethics literature as a guide, argue that distressing advertising can be ethically defensible if conditions of effectiveness, proportionality necessity, least infringement, and public accountability are satisfied. We do not take a broad view as to whether distressing advertising is ethical or unethical, because we see the evidence for both the effectiveness of distressing approaches and their potential to generate iatrogenic effects to be inconclusive. However, we believe it possible to use the current evidence base to make informed estimates of the likely consequences of specific message presentations. Messages can be pre-tested and monitored to identify and deal with potential problems. We discuss how advertisers can approach the problems of deciding on the appropriate intensity of ethical review, and evaluating prospective distressing advertising campaigns against the conditions outlined.

  12. The ethics of communicative process: Discourse, otherness, and public space

    Directory of Open Access Journals (Sweden)

    Ângela Cristina Salgueiro Marques

    2011-09-01

    Full Text Available The aim of this paper is to reflect on ethical-moral questions that are present in different dimensions of the contemporary communicative processes. At a first moment, I explain how Habermas defines the concept of discourse ethics witch is capable to allow the articulation and negotiation among the plurality of points of view and citizens in the current societies. In addition, I confer prominence to the role media play in the interconnection of different audiences and dispersed speeches in order to guarantee possibilities of renewal of collective debates in the public sphere. I therefore propose that an ethics of communication instead of be restrained to media devices and its operative dynamics, should consider their connections with citizens’ concrete practices and experiences.

  13. Public health equity in refugee situations.

    Science.gov (United States)

    Leaning, Jennifer; Spiegel, Paul; Crisp, Jeff

    2011-05-16

    Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003.Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction.Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

  14. Public health equity in refugee situations

    Directory of Open Access Journals (Sweden)

    Crisp Jeff

    2011-05-01

    Full Text Available Abstract Addressing increasing concerns about public health equity in the context of violent conflict and the consequent forced displacement of populations is complex. Important operational questions now faced by humanitarian agencies can to some extent be clarified by reference to relevant ethical theory. Priorities of service delivery, the allocation choices, and the processes by which they are arrived at are now coming under renewed scrutiny in the light of the estimated two million refugees who fled from Iraq since 2003. Operational questions that need to be addressed include health as a relative priority, allocations between and within different populations, and transition and exit strategies. Public health equity issues faced by the humanitarian community can be framed as issues of resource allocation and issues of decision-making. The ethical approach to resource allocation in health requires taking adequate steps to reduce suffering and promote wellbeing, with the upper bound being to avoid harming those at the lower end of the welfare continuum. Deliberations in the realm of international justice have not provided a legal or implementation platform for reducing health disparities across the world, although norms and expectations, including within the humanitarian community, may be moving in that direction. Despite the limitations of applying ethical theory in the fluid, complex and highly political environment of refugee settings, this article explores how this theory could be used in these contexts and provides practical examples. The intent is to encourage professionals in the field, such as aid workers, health care providers, policy makers, and academics, to consider these ethical principles when making decisions.

  15. Public health law research: exploring law in public health systems.

    Science.gov (United States)

    Ibrahim, Jennifer K; Burris, Scott; Hays, Scott

    2012-11-01

    The importance of law in the organization and operation of public health systems has long been a matter of interest to public health lawyers and practitioners, but empirical research on law as a factor in health system performance has been limited in quantity and sophistication. The emergence of Public Health Law Research and Public Health Systems and Services Research within a coordinated effort to strengthen public health research and practice has dramatically changed matters. This article introduces Public Health Law Research as an integral part of Public Health Systems and Services Research, discusses the challenges of integrating the 2 fields, and highlights 2 examples of current research that demonstrate the benefits of an integrated approach to improve the use of law in public health practice.

  16. Ethics, collective health, qualitative health research and social justice

    Directory of Open Access Journals (Sweden)

    Iara Coelho Zito Guerriero

    2015-09-01

    Full Text Available AbstractThe scientific field is characterized by the disputes about the delimitation of the field problems, methods and theories that can be considered scientific. The recognition that it is not neutral, that a researcher is a moral subject, and its practices are moral ones, entail that moral reflections, that is, ethics, should be a core process of every researcher. Therefore ethics is not a heteronomous issue, and cannot be reduced to guidelines. In the first part of this article we examine the need to develop an open approach to the construction of guidelines in a plural scientific field that must take into account diverse paradigms, which implies different values. The Brazilian process of writing guidelines on research ethics for social science and humanities in the context of the Ministry of Health will be discussed as an example. In the second part we expand the analysis of research ethics posing a perspective that integrates qualitative research, social justice and discipline trends. In the final considerations we explore the possibility that research ethics is better discussed taking into account the ontology, epistemology and political values rather than one specific methodological approach or from a dichotomic perspective between biomedicine versus social science and humanities.

  17. Ethics, collective health, qualitative health research and social justice.

    Science.gov (United States)

    Guerriero, Iara Coelho Zito; Correa, Fernando Peñaranda

    2015-09-01

    The scientific field is characterized by the disputes about the delimitation of the field problems, methods and theories that can be considered scientific. The recognition that it is not neutral, that a researcher is a moral subject, and its practices are moral ones, entail that moral reflections, that is, ethics, should be a core process of every researcher. Therefore ethics is not a heteronomous issue, and cannot be reduced to guidelines. In the first part of this article we examine the need to develop an open approach to the construction of guidelines in a plural scientific field that must take into account diverse paradigms, which implies different values. The Brazilian process of writing guidelines on research ethics for social science and humanities in the context of the Ministry of Health will be discussed as an example. In the second part we expand the analysis of research ethics posing a perspective that integrates qualitative research, social justice and discipline trends. In the final considerations we explore the possibility that research ethics is better discussed taking into account the ontology, epistemology and political values rather than one specific methodological approach or from a dichotomic perspective between biomedicine versus social science and humanities.

  18. Doping and Public Health

    DEFF Research Database (Denmark)

    Christiansen, Ask Vest

    rad av världens främsta idrottsvetare och dopningsexperter hade mött upp för att presentera papers till en intresserad och engagerad publik. Temat för konferensen var "Doping and Public Health", och den aspekten behandlades också; dock tolkade flera presentatörer temat på sina egna vis, och hela...

  19. Insights in Public Health

    Science.gov (United States)

    Whelen, A Christian; Kitagawa, Kent; Maddock, Jay; Hayes, Donald; St John, Tonya Lowery; Rajan, Ranjani

    2013-01-01

    Chronically understaffed public health laboratories depend on a decreasing number of employees who must assume broader responsibilities in order to sustain essential functions for the many clients the laboratories support. Prospective scientists considering a career in public health are often not aware of the requirements associated with working in a laboratory regulated by the Clinical Laboratory Improvement Amendments (CLIA). The purpose of this pilot internship was two-fold; introduce students to operations in a regulated laboratory early enough in their academics so that they could make good career decisions, and evaluate internship methodology as one possible solution to workforce shortages. Four interns were recruited from three different local universities, and were paired with an experienced State Laboratories Division (SLD) staff mentor. Students performed tasks that demonstrated the importance of CLIA regulations for 10–15 hours per week over a 14 week period. Students also attended several directed group sessions on regulatory lab practice and quality systems. Both interns and mentors were surveyed periodically during the semester. Surveys of mentors and interns indicated overall positive experiences. One-on-one pairing of experienced public health professionals and students seems to be a mutually beneficial arrangement. Interns reported that they would participate if the internship was lower paid, unpaid, or for credit only. The internship appeared to be an effective tool to expose students to employment in CLIA-regulated laboratories, and potentially help address public health laboratory staffing shortfalls. Longer term follow up with multiple classes of interns may provide a more informed assessment. PMID:23386992

  20. Reflexive Research Ethics for Environmental Health and Justice: Academics and Movement-Building.

    Science.gov (United States)

    Cordner, Alissa; Ciplet, David; Brown, Phil; Morello-Frosch, Rachel

    2012-01-01

    Community-engaged research on environmental problems has reshaped researcher-participant relationships, academic-community interaction, and the role of community partners in human subjects protection and ethical oversight. We draw on our own and others' research collaborations with environmental health and justice social movement organizations to discuss the ethical concerns that emerge in community-engaged research. In this paper we introduce the concept of reflexive research ethics: ethical guidelines and decision-making principles that depend on continual reflexivity concerning the relationships between researchers and participants. Seeing ethics in this way can help scientists conduct research that simultaneously achieves a high level of professional conduct and protects the rights, well-being, and autonomy of both researchers and the multiple publics affected by research. We highlight our research with community-based organizations in Massachusetts, California, and Alaska, and discuss the potential impacts of the community or social movement on the research process and the potential impacts of research on community or social movement goals. We conclude by discussing ways in which the ethical concerns that surface in community-engaged research have led to advances in ethical research practices. This type of work raises ethical questions whose answers are broadly relevant for social movement, environmental, and public health scholars.

  1. 5 CFR 2638.704 - Annual ethics training for public filers.

    Science.gov (United States)

    2010-01-01

    ... year, agencies must give verbal ethics training to employees who are required by 5 CFR part 2634 to... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Annual ethics training for public filers. 2638.704 Section 2638.704 Administrative Personnel OFFICE OF GOVERNMENT ETHICS GOVERNMENT ETHICS...

  2. Transparency during public health emergencies: from rhetoric to reality.

    Science.gov (United States)

    O'Malley, P; Rainford, J; Thompson, A

    2009-08-01

    Effective management of public health emergencies demands open and transparent public communication. The rationale for transparency has public health, strategic and ethical dimensions. Despite this, government authorities often fail to demonstrate transparency. A key step in bridging the gap between the rhetoric and reality is to define and codify transparency to put in place practical mechanisms to encourage open public health communication for emergencies. The authors demonstrate this approach using the example of the development and implementation process of a public health emergency information policy.

  3. Insights in Public Health

    Science.gov (United States)

    Hayes, Donald K; Calhoun, Candice R; Joseph, Lin; Farnsworth, JoAnn Y; Arakaki, Kimberly B

    2016-01-01

    The Hawai‘i Maternal and Infant Health Collaborative, founded in 2013, is a public-private partnership committed to improving birth outcomes and reducing infant mortality. The Collaborative was developed in partnership with the Executive Office on Early Learning Action Strategy with help from the Department of Health and National Governor's Association. The Action Strategy provides Hawai‘i with a roadmap for an integrated and comprehensive early childhood system, spanning preconception to third grade. The Collaborative helps advance goals within the Action Strategy by focusing on ensuring that children have the best start in life by being healthy and welcomed. The Collaborative has completed a strategic plan and accompanying Logic Model, The First 1,000 Days, aimed at achieving the outcomes of 8% reduction in preterm births and 4% reduction in infant mortality. To date over 120 people across Hawai‘i have been involved in the Collaborative. These members include physicians and clinicians, public health planners and providers, insurance providers and health care administrators. The work is divided into three primary areas and coordinated by a cross sector leadership team. Work is specific, outcome driven, informed by data and primarily accomplished in small work groups. PMID:27738566

  4. Public Health Nutrition Education

    DEFF Research Database (Denmark)

    Torheim, Liv Elin; Birgisdottir, Bryndis Eva; Robertson, Aileen

    2016-01-01

    Public Health Nutrition Education Liv Elin Torheim* 1, Bryndis Eva Birgisdottir2, 3, Inga Thorsdottir2, 3, Aileen Robertson4, Runa Midtvåge4, Chalida Mae Svastisalee4, Hanne Gillett4, Agneta Yngve5, Arja Erkkilä6 1Department of Nursing and Health Promotion, Oslo and Akershus University College......) and healthy aging. Unhealthy dietary patterns, high blood pressure and obesity are major risk factors for NCDs such as cancers, type 2 diabetes and cardiovascular diseases. There exists enormous potential to promote health and prevent diseases through targeting unhealthy life style, and it is crucial......, educational, social, economic, structural, political and/or legislative. The knowledge, skills, competencies and cultural heritage of the broader community should form a basis for all analyses and actions. The competencies required to be an effective PHN practitioner has been described by several scholars...

  5. Medical ethics and new public management in Sweden.

    Science.gov (United States)

    Hansson, Sven Ove

    2014-07-01

    In order to shorten queues to healthcare, the Swedish government has introduced a yearly "queue billion" that is paid out to the county councils in proportion to how successful they are in reducing queues. However, only the queues for first visits are covered. Evidence has accumulated that queues for return visits have become longer. This affects the chronically and severely ill. Swedish physicians, and the Swedish Medical Association, have strongly criticized the queue billion and have claimed that it conflicts with medical ethics. Instead they demand that their professional judgments on priority setting and medical urgency be respected. This discussion provides an interesting illustration of some of the limitations of new public management and also more generally of the complicated relationships between medical ethics and public policy.

  6. Ethical Standards for Publication in Chinese Journal of Chemical Engineering

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    @@Chinese Journal of Chemical Engineering is a publication of the Chemical Industry and Engineering Society of China (CIESC) dedicated to present the original contributions of knowledge with permanent value from chemical engineering researcher and technical staff in processing industries in China and the world. The Editors-in-Chief, Associate Editors-in-Chief and Editorial Staff of the journal share the responsibility to maintain the CJChE ethical standards for paper reviewing and handling process.

  7. Public health, public trust and lobbying.

    Science.gov (United States)

    Wynia, Matthew K

    2007-06-01

    Each year, infection with Human Papillomavirus (HPV) leads to millions of abnormal Pap smears and thousands of cases of cervical cancer in the US. Throughout the developing world, where Pap smears are less common, HPV is a leading cause of cancer death among women. So when the international pharmaceutical giant Merck developed a vaccine that could prevent infection with several key strains of HPV, the public health community was anxious to celebrate a major advance. But then marketing and lobbying got in the way. Merck chose to pursue an aggressive lobbying campaign, trying to make its new vaccine mandatory for young girls. The campaign stoked public mistrust about how vaccines come to be mandated, and now it's not just Merck's public image that has taken a hit. The public health community has also been affected. What is the lesson to be learned from this story? Public health communication relies on public trust.

  8. Banking on it: public policy and the ethics of stem cell research and development.

    Science.gov (United States)

    Giacomini, Mita; Baylis, Francoise; Robert, Jason

    2007-10-01

    If the therapeutic potential of stem cell-based therapies is ever realized, demand for stem cells and derivative tissues will be tremendous and will create new challenges for health care systems, especially publicly funded health care systems. We propose a framework for the ethical analysis of stem cell research and development that considers the welfare of communities, tissue recipients, and cell sources in relation to a range of stem cell production and distribution options. Ethical desiderata include: equitable access, maximized potential therapeutic benefit across demographic and disease groups, and reasonable cost. Other ethical priorities include the minimization of stem cell line and tissue wastage, risk of immune rejection, risk of transmitting diseases, the use of human embryos, and risk to those contributing source cells. We array plausible sources of stem cells and distribution strategies to characterize 12 potential models for producing and distributing cells and tissues in the future. We describe "personalized", "matched", and "universalized" models, and compare the ethical acceptability of these models. Popular and scientific discourses about stem cells typically emphasize personalized or matched stem cell distribution models. We show that universalized models may ultimately best serve the interest of taxpayers, communities and patients who hold high stakes in the therapeutic success of stem cell science. They are therefore highly worthy of scientific pursuit. This conclusion is provisional and the framework must be reapplied as scientific knowledge, technological capacity and ethical mores evolve.

  9. Ethical issues in health research with novel online sources.

    Science.gov (United States)

    Vayena, Effy; Mastroianni, Anna; Kahn, Jeffrey

    2012-12-01

    Health-related research is increasingly drawing on novel sources of online data, such as crowdsourced information about disease outbreaks, consumer-supplied information provided to health or wellness Web sites, Internet search queries about personal health, and social network postings that identify health behaviors. We offer examples of online sources and their uses, identify ethical and policy issues they generate, and formulate key questions for future discussion and investigation. Further work in this area will require cross-disciplinary collaboration to develop ethics and policy guidance for the ethical use of these novel data sources in health-related research.

  10. Religion and health: public health research and practice.

    Science.gov (United States)

    Chatters, L M

    2000-01-01

    Research examining the relationships between religion and the health of individuals and populations has become increasingly visible in the social, behavioral, and health sciences. Systematic programs of research investigate religious phenomena within the context of coherent theoretical and conceptual frameworks that describe the causes and consequences of religious involvement for health outcomes. Recent research has validated the multidimensional aspects of religious involvement and investigated how religious factors operate through various biobehavioral and psychosocial constructs to affect health status through proposed mechanisms that link religion and health. Methodological and analytical advances in the field permit the development of more complex models of religion's effects, in keeping with proposed theoretical explanations. Investigations of religion and health have ethical and practical implications that should be addressed by the lay public, health professionals, the research community, and the clergy. Future research directions point to promising new areas of investigation that could bridge the constructs of religion and health.

  11. Corruption and ethical issues regarding public-private partnership

    Directory of Open Access Journals (Sweden)

    Bianca COBÂRZAN

    2005-10-01

    Full Text Available The paper raises general questions about ethical problems that taint public-private partnership. Everybody talks about the economical benefits of encouraging firms to invest in the community using different incentives offered by the public institutions. In the same time, every day, newspapers bring to our attention cases of misuse of public resources for private gain or cases of private investors who give bribes in order to get a contract with a public institution. The purpose of this paper is to synthesize our understanding of the entrepreneurial movement and analyze its implications for potential problems of corruption that can arise in the relation between the public and the private sector.a

  12. Corruption and Ethical Issues Regarding Public-Private Partnership

    Directory of Open Access Journals (Sweden)

    Bianca COBÂRZAN

    2005-10-01

    Full Text Available The paper raises general questions about  ethical problems that taint public-private  partnership. Everybody talks about the  economical benefits of encouraging firms  to invest in the community using different  incentives offered by the public institutions.  In the same time, every day, newspapers  bring to our attention cases of misuse of  public resources for private gain or cases  of private investors who give bribes in order  to get a contract with a public institution.  The purpose of this paper is to synthesize  our understanding of the entrepreneurial  movement and analyze its implications for  potential problems of corruption that can  arise in the relation between the public and the private sector.

  13. Saúde pública e ética na era da medicina genômica: rastreamentos genéticos Public health and ethics in the age of genomic medicine: genetic screening

    Directory of Open Access Journals (Sweden)

    Flavia Miranda Gomes de Constantino Bandeira

    2006-03-01

    Full Text Available O presente artigo tem como objetivo contextualizar o campo da saúde pública diante dos grandes avanços da biotecnologia e genética aplicada, destacando elementos para a problematização do tema tais como benefícios e questões éticas relacionados aos rastreamentos genéticos. O Projeto Genoma Humano gerou várias expectativas, dentre elas, a possibilidade de rastrear genes associados a doenças e comportamentos, e mais ainda, de intervir geneticamente no ser humano, levantando preocupações relativas ao renascimento da eugenia, ao aconselhamento genético, e ao uso da informação genética como critério de acesso aos planos de saúde e postos de trabalho. Uma discussão de todos esses tópicos é essencial para que a saúde pública seja beneficiada com as informações obtidas através da análise genômica das populações.This article has the objective to bring the field of public health into context in the face of the great advances of biotechnology and applied genetics, focusing on issues related to the theme such as benefits and ethics concerning genetic screening. The Human Genome Project has generated many expectations among which the possibility of screening genes associated to diseases and behaviors, moreover, the possibility of genetic interventions on humans, creating concerns related to the resurgence of Eugenia, of genetic counseling and the use of genetic information as a standard for access to healthcare clinics and jobs. The discussion of all these issues is essential to benefit public health with information obtained through population genomic analysis.

  14. Techno-Anthropological Ethics and Health Information Systems Technologies.

    Science.gov (United States)

    Børsen, Tom; Danborg, Pia Brandt

    2015-01-01

    One of the most important Techno-Anthropological intellectual virtues is the ability to make contextualized ethical judgments of new and emerging technologies. This Techno-Anthropological core competence is especially relevant in Health Information Systems Technologies, which is a field characterized by inherent ethical dilemmas such as the pros and cons of regulation of research databases with sensitive information, or storing and application of tissue and blood samples. In this paper we present a method to make 'proper and quick' ethical estimates in Health Information. The method guides its user to make ethical judgments by splitting the judgment process into four steps: (1) Identification of intended beneficial consequences, potential misuse, unintended side effects and long-term consequences for culture and society. (2) Linkage of intended consequences, misuse, side effects and cultural implications to appropriate ethical values. (3) Identification of ethical dilemmas related to a specific use of the Health Information Systems Technology under assessment. (4) Formulation of appropriate technological and institution design criteria that can transcend the identified ethical dilemmas. The methodology will be applied to a the discussions at a hearing on ethical challenges accompanying research involving health data organized by the Danish Council of Ethics and the case of risk reducing breast cancer surgery based on diagnosed genetic predisposition to breast cancer.

  15. [Phonoaudiology in public health].

    Science.gov (United States)

    Freire, R M

    1992-06-01

    An undestanding of the activities and functions of a speech therapist within the specific context of the Basic Health Units (Unidades Básicas de Saúde) is sought. Difficulties relating to the introduction of a new service on the basis of one of the health professions that has not hitherto belonged to the group of categories which are traditionally incorporated in these same Basic Units. When the statistical data on the demand for speech therapy services by the population who attend health centres were considered, it was discovered that 32% were of schooling age and had been referred by schools, allegedly due to "learning problems". Closer contact with these children, through speech therapy, has brought a different aspect to light i.e. that one cannot consider as disturbance/deviation/problem/pathology written signs which constitute indications of the shock between the process of literacy and that of learning how to read and write. To understand the problem from the point of view of public health, a programme of teacher counselling is proposed, with the purpose of helping the school to clarify its role as co-constructor of the child's literacy process and of returning to the teacher the responsibility for the success and/or failure of teaching how to read and write. A similar programme is proposed for creches where coincidently, a greater proportion (44%) of the younger children (2 to 5 years of age) are seen to have difficulties in oral language development.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. QUALITY ASSESSMENT OF ETHICS ANALYSES FOR HEALTH TECHNOLOGY ASSSESSMENT.

    Science.gov (United States)

    Scott, Anna Mae; Bond, Kenneth; Gutiérrez-Ibarluzea, Iñaki; Hofmann, Björn; Sandman, Lars

    2016-01-01

    Although consideration of ethical issues is recognized as a crucial part of health technology assessment, ethics analysis for HTA is generally perceived as methodologically underdeveloped in comparison to other HTA domains. The aim of our study is (i) to verify existing tools for quality assessment of ethics analyses for HTA, (ii) to consider some arguments for and against the need for quality assessment tools for ethics analyses for HTA, and (iii) to propose a preliminary set of criteria that could be used for assessing the quality of ethics analyses for HTA. We systematically reviewed the literature, reviewed HTA organizations' Web sites, and solicited views from thirty-two experts in the field of ethics for HTA. The database and HTA agency Web site searches yielded 420 references (413 from databases, seven from HTA Web sites). No formal instruments for assessing the quality of ethics analyses for HTA purposes were identified. Thirty-two experts in the field of ethics for HTA from ten countries, who were brought together at two workshops held in Edmonton (Canada) and Cologne (Germany) confirmed the findings from the literature. Generating a quality assessment tool for ethics analyses in HTA would confer considerable benefits, including methodological alignment with other areas of HTA, increase in transparency and transferability of ethics analyses, and provision of common language between the various participants in the HTA process. We propose key characteristics of quality assessment tools for this purpose, which can be applied to ethics analyses for HTA purposes.

  17. ETHICAL ASPECTS OF HEALTH SERVICES IN THE MILITARY CONTEXT

    Directory of Open Access Journals (Sweden)

    Muharrem UCAR

    2005-02-01

    Full Text Available While objective parameters like sufficiency of the resources and the number of people benefiting from services are considered to evaluate the health services, the attitudes and behaviors which patients meet during taking this health service and ethical issues like patient rights are considered as second importance. But ethical parameters are more important for patients. Military health organizations have much responsibility about ethical issues; because they are usually the only institutions for the personnel who they serve to took health service, requested health service are usually indispensable and the patient couldn?t select the physician because of the structure of the organization and military conditions. It is necessary to educate personnel in military health organizations as well as in all of the health institutions about gaining communication skills and patient rights in order to reach the desired level in ethical issues. [TAF Prev Med Bull 2005; 4(1.000: 37-45

  18. Social capital and health: implications for public health and epidemiology.

    Science.gov (United States)

    Lomas, J

    1998-11-01

    Public health and its "basic science", epidemiology, have become colonised by the individualistic ethic of medicine and economics. Despite a history in public health dating back to John Snow that underlined the importance of social systems for health, an imbalance has developed in the attention given to generating "social capital" compared to such things as modification of individual's risk factors. In an illustrative analysis comparing the potential of six progressively less individualised and more community-focused interventions to prevent deaths from heart disease, social support and measures to increase social cohesion faired well against more individual medical care approaches. In the face of such evidence public health professionals and epidemiologists have an ethical and strategic decision concerning the relative effort they give to increasing social cohesion in communities vs expanding access for individuals to traditional public health programs. Practitioners' relative efforts will be influenced by the kind of research that is being produced by epidemiologists and by the political climate of acceptability for voluntary individual "treatment" approaches vs universal policies to build "social capital". For epidemiologists to further our emerging understanding of the link between social capital and health they must confront issues in measurement, study design and analysis. For public health advocates to sensitise the political environment to the potential dividend from building social capital, they must confront the values that focus on individual-level causal models rather than models of social structure (dis)integration. The evolution of explanations for inequalities in health is used to illustrate the nature of the change in values.

  19. Health promotion, Islamic ethics and law in Iran

    Directory of Open Access Journals (Sweden)

    Bagher Larijani

    2006-03-01

    Full Text Available Health statistics demonstrate remarkable progresses in the field of primary health care and academic education in Iran within recent decades. Iran has also had obvious progresses in the field of research and the International publication rate of Iranian scientists has been quadrupled over the past decade. Progresses in biomedical researches have been associated with considerable activities in bioethics education, research and legislation. Organ transplantation, stem cell research, assisted reproductive technologies and genetics are some important instances of ethical debates in our country. "nIn this concise manuscript we intend to present some recent progresses in science and research in Iran. Considering importance of the bioethical issues, we will also review new legislations in the field of bioethics.

  20. Introduction to the Special Issue: Public Health Genetics and Genomics.

    Science.gov (United States)

    McWalter, Kirsty; Gaviglio, Amy

    2015-06-01

    This special issue of the Journal of Genetic Counseling is dedicated to public health genetics and genomics. The seventeen papers featured in this issue span such topics as genetic counselors in public health roles, newborn screening, population screening, ethics, and health beliefs and behaviors. In this introduction to the special issue, we review some history of public health genetics and genomics, present the Centers for Disease Control and Prevention's "10 Essential Public Health Services" with associated genetics specific recommendations and priorities, and briefly overview how each article ties into the world of public health genetics and genomics. We hope this issue encourages genetic counselors to visualize their ever expanding and important roles in public health genetics and genomics, as well as their contributions to improving population health.

  1. Evaluation of School of health students' ethics position in Turkey.

    Science.gov (United States)

    Şen, Emine; Dal, Nursel Alp; Üstün, Çağatay; Okursoy, Algın

    2017-03-01

    The advances in science and technology increasingly lead to the appearance of ethical issues and to the complexity of care. Therefore, it is important to define the ethics position of students studying in health departments so that high quality patient care can be achieved. The aim of this study was to examine the ethics position of the students at Shool of Health of an University in western Turkey. The study design was descriptive and cross-sectional. The study population included 540 first, second, third, and fourth year students from the Departments of Nursing, Midwifery, and Rescue and Disaster Management in the 2013-2014 academic year. Data were collected with a Personal Identification Form and The Ethics Position Questionnaire. Obtained data were analyzed with Chi-square test, Confirmatory Factor Analysis, and Nested Analysis of Variance. Ethical considerations: Before conducting the research, approval was obtained from Ege University Clinical Research Ethics Committee in İzmir and written informed consent was taken from all the participants. There was no significant difference in the mean scores for the Ethics Position Questionnaire between the students in terms of years and fields of study. Although the mean scores for the subscale idealism did not differ between fields of study, the mean scores significantly differed between years of study. However, the mean scores for the subscale relativism did not differ in terms of years and fields of study. Whether students are idealistic or relativistic in terms of ethical judgment will be effective in ethical decision-making skills during patient care. Therefore, we need to define the factors that influence students' ethics position in the future. It is suggested that the courses and practices that teach students to be aware of their ethics position to create an ethical outlook can be placed in the curriculum in health schools.

  2. A repository of codes of ethics and technical standards in health informatics.

    Science.gov (United States)

    Samuel, Hamman W; Zaïane, Osmar R

    2014-01-01

    We present a searchable repository of codes of ethics and standards in health informatics. It is built using state-of-the-art search algorithms and technologies. The repository will be potentially beneficial for public health practitioners, researchers, and software developers in finding and comparing ethics topics of interest. Public health clinics, clinicians, and researchers can use the repository platform as a one-stop reference for various ethics codes and standards. In addition, the repository interface is built for easy navigation, fast search, and side-by-side comparative reading of documents. Our selection criteria for codes and standards are two-fold; firstly, to maintain intellectual property rights, we index only codes and standards freely available on the internet. Secondly, major international, regional, and national health informatics bodies across the globe are surveyed with the aim of understanding the landscape in this domain. We also look at prevalent technical standards in health informatics from major bodies such as the International Standards Organization (ISO) and the U. S. Food and Drug Administration (FDA). Our repository contains codes of ethics from the International Medical Informatics Association (IMIA), the iHealth Coalition (iHC), the American Health Information Management Association (AHIMA), the Australasian College of Health Informatics (ACHI), the British Computer Society (BCS), and the UK Council for Health Informatics Professions (UKCHIP), with room for adding more in the future. Our major contribution is enhancing the findability of codes and standards related to health informatics ethics by compilation and unified access through the health informatics ethics repository.

  3. TB SCENARIO & PUBLIC HEALTH

    Directory of Open Access Journals (Sweden)

    Mihir K. R.

    2013-04-01

    Full Text Available Tuberculosis is a major public health problem world o ver and it is India’s worst scourge. In the words of Charles Dickens “it is the disease medicine never cured, wealth warded off, or poverty could boast exemption from.... Which sometimes moves in giant strides & sometimes at tardy sluggish pace, but slow or quick... is never sur e and certain”. India bears 28.4% of the entire world’s burden of Tuberculosis. Every year 2 2 lakh persons contract Tuberculosis, but only half of them seek medical care. One Indian die s of Tuberculosis every 3 minutes! Tuberculosis is not only a medical malady but an ec onomic disaster too it perpetuates poverty and poverty begets Tuberculosis. In view of the enor mity of the problem let us leaf through the pages of history

  4. Public relations effectiveness in public health institutions.

    Science.gov (United States)

    Springston, Jeffrey K; Weaver Lariscy, Ruth Ann

    2005-01-01

    This article explores public relations effectiveness in public health institutions. First, the two major elements that comprise public relations effectiveness are discussed: reputation management and stakeholder relations. The factors that define effective reputation management are examined, as are the roles of issues and crisis management in building and maintaining reputation. The article also examines the major facets of stakeholder relations, including an inventory of stakeholder linkages and key audiences, such as the media. Finally, methods of evaluating public relations effectiveness at both the program level and the institutional level are explored.

  5. Ethics in health care: confidentiality and information technologies

    African Journals Online (AJOL)

    Ethics CPD Supplement: Ethics in health care: confidentiality and information technologies. S3. Vol 56 No 1 ... on assuring that action is taken that is in the patient's best interests. .... that “all patients have a right to confidentiality”.10 This is also in .... multitasking-a-medical-and-mental-hazard-201201074063. 6. Knapp van ...

  6. Community Health Workers Support Community-based Participatory Research Ethics:

    Science.gov (United States)

    Smith, Selina A.; Blumenthal, Daniel S.

    2013-01-01

    Ethical principles of community-based participatory research (CBPR)— specifically, community engagement, mutual learning, action-reflection, and commitment to sustainability—stem from the work of Kurt Lewin and Paulo Freire. These are particularly relevant in cancer disparities research because vulnerable populations are often construed to be powerless, supposedly benefiting from programs over which they have no control. The long history of exploiting minority individuals and communities for research purposes (the U.S. Public Health Service Tuskegee Syphilis Study being the most notorious) has left a legacy of mistrust of research and researchers. The purpose of this article is to examine experiences and lessons learned from community health workers (CHWs) in the 10-year translation of an educational intervention in the research-to-practice-to-community continuum. We conclude that the central role played by CHWs enabled the community to gain some degree of control over the intervention and its delivery, thus operationalizing the ethical principles of CBPR. PMID:23124502

  7. Public engagement on global health challenges

    Directory of Open Access Journals (Sweden)

    Minhas Gunjeet S

    2008-05-01

    Full Text Available Abstract Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.

  8. Ethical health care policy: nursing's voice in allocation.

    Science.gov (United States)

    Sarikonda-Woitas, Candace; Robinson, Janet Hoey

    2002-01-01

    Nurse administrators must become more involved in the policy debates concerning universal access to care and allocation of health care resources. In order to promote nursing's agenda in the policy debates, nurses must be familiar with the numerous ethical issues that impact macroallocation decisions. This article explores the ethical viewpoint of the nursing profession as it relates to allocation decisions and examines how the ethical principles of the nursing profession, along with the ethical theories of egalitarianism and utilitarianism, can be used throughout the policy process to guide the development of a plan for universal access to care.

  9. Ethics education for health professionals: a values based approach.

    Science.gov (United States)

    Godbold, Rosemary; Lees, Amanda

    2013-11-01

    It is now widely accepted that ethics is an essential part of educating health professionals. Despite a clear mandate to educators, there are differing approaches, in particular, how and where ethics is positioned in training programmes, underpinning philosophies and optimal modes of assessment. This paper explores varying practices and argues for a values based approach to ethics education. It then explores the possibility of using a web-based technology, the Values Exchange, to facilitate a values based approach. It uses the findings of a small scale study to signal the potential of the Values Exchange for engaging, meaningful and applied ethics education.

  10. Public health and media advocacy.

    Science.gov (United States)

    Dorfman, Lori; Krasnow, Ingrid Daffner

    2014-01-01

    Media advocacy blends communications, science, politics, and advocacy to advance public health goals. In this article, we explain how media advocacy supports the social justice grounding of public health while addressing public health's "wicked problems" in the context of American politics. We outline media advocacy's theoretical foundations in agenda setting and framing and describe its practical application, from the layers of strategy to storytelling, which can illuminate public health solutions for journalists, policy makers, and the general public. Finally, we describe the challenges in evaluating media advocacy campaigns.

  11. Ethical analysis to improve decision-making on health technologies

    DEFF Research Database (Denmark)

    Saarni, Samuli I; Hofmann, Bjørn; Lampe, Kristian

    2008-01-01

    beyond effectiveness and costs to also considering the social, organizational and ethical implications of technologies. However, a commonly accepted method for analysing the ethical aspects of health technologies is lacking. This paper describes a model for ethical analysis of health technology......Health technology assessment (HTA) is the multidisciplinary study of the implications of the development, diffusion and use of health technologies. It supports health-policy decisions by providing a joint knowledge base for decision-makers. To increase its policy relevance, HTA tries to extend...... that is easy and flexible to use in different organizational settings and cultures. The model is part of the EUnetHTA project, which focuses on the transferability of HTAs between countries. The EUnetHTA ethics model is based on the insight that the whole HTA process is value laden. It is not sufficient...

  12. Leprosy: International Public Health Policies and Public Health Eras

    Directory of Open Access Journals (Sweden)

    Niyi Awofeso

    2011-09-01

    Full Text Available Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control.

  13. Health for all: a public health vision.

    Science.gov (United States)

    McBeath, W H

    1991-12-01

    The approach of a millennial passage invites public health to a review of past performance and a preview of future prospects toward assuring a healthy public. Since the 1974 Canadian Lalonde report, the best national plans for health progress have emphasized disease prevention and health promotion. WHO's multinational Health for All by the Year 2000 promotes basic health services essential to leading a socially and economically productive life. Healthy People 2000, the latest US guide, establishes three goals: increase healthy life span, reduce health disparities, and achieve universal access to preventive services. Its objectives can be used to excite public understanding, equip program development, evaluate progress, and encourage public accountability for health initiatives. Needed is federal leadership in defining requisite action and securing necessary resources. Elsewhere a "new public health" emphasizes community life-style and multisectoral "healthy public policy." In the United States, a national health program is needed to achieve equity in access to personal health care. Even more essential is equitable sharing in basic health determinants in society--nutritious food, basic education, safe water, decent housing, secure employment, adequate income, and peace. Vital to such a future is able and active leadership now from governments and public health professionals.

  14. Ethical sharing of health data in online platforms - which values should be considered?

    Science.gov (United States)

    Riso, Brígida; Tupasela, Aaro; Vears, Danya F; Felzmann, Heike; Cockbain, Julian; Loi, Michele; Kongsholm, Nana C H; Zullo, Silvia; Rakic, Vojin

    2017-08-21

    Intensified and extensive data production and data storage are characteristics of contemporary western societies. Health data sharing is increasing with the growth of Information and Communication Technology (ICT) platforms devoted to the collection of personal health and genomic data. However, the sensitive and personal nature of health data poses ethical challenges when data is disclosed and shared even if for scientific research purposes.With this in mind, the Science and Values Working Group of the COST Action CHIP ME 'Citizen's Health through public-private Initiatives: Public health, Market and Ethical perspectives' (IS 1303) identified six core values they considered to be essential for the ethical sharing of health data using ICT platforms. We believe that using this ethical framework will promote respectful scientific practices in order to maintain individuals' trust in research.We use these values to analyse five ICT platforms and explore how emerging data sharing platforms are reconfiguring the data sharing experience from a range of perspectives. We discuss which types of values, rights and responsibilities they entail and enshrine within their philosophy or outlook on what it means to share personal health information. Through this discussion we address issues of the design and the development process of personal health data and patient-oriented infrastructures, as well as new forms of technologically-mediated empowerment.

  15. Ethics and public perception of climate change: exploring the Christian voices in the US public debate

    NARCIS (Netherlands)

    Wardekker, J.A.; Petersen, A.C.; van der Sluijs, J.P.

    2009-01-01

    Climate change raises many questions with strong moral and ethical dimensions that are important to address in climate-policy formation and international negotiations. Particularly in the United States, the public discussion of these dimensions is strongly influenced by religious groups and leaders.

  16. An Investigation of Students' Perceptions of Ethical Practice: Engaging a Reflective Dialogue about Ethics Education in the Health Professions

    Science.gov (United States)

    Kinsella, Elizabeth Anne; Phelan, Shanon K.; Lala, Anna Park; Mom, Vanna

    2015-01-01

    The ethical climate in which occupational therapists, and other health practitioners, currently practice is increasingly complex. There have been a number of calls for greater attention to ethics education within health science curricula. This study investigated occupational therapy students' perceptions of the meaning of ethical practice as a…

  17. An Investigation of Students' Perceptions of Ethical Practice: Engaging a Reflective Dialogue about Ethics Education in the Health Professions

    Science.gov (United States)

    Kinsella, Elizabeth Anne; Phelan, Shanon K.; Lala, Anna Park; Mom, Vanna

    2015-01-01

    The ethical climate in which occupational therapists, and other health practitioners, currently practice is increasingly complex. There have been a number of calls for greater attention to ethics education within health science curricula. This study investigated occupational therapy students' perceptions of the meaning of ethical practice as a…

  18. Occupational and environmental health nursing: ethics and professionalism.

    Science.gov (United States)

    Rogers, Bonnie

    2012-04-01

    This article provides an overview of ethical issues related to the practice of occupational and environmental health nursing and possible strategies for resolution. Also, professionalism related to professional growth and advancing the specialty is discussed. Copyright 2012, SLACK Incorporated.

  19. Integrating ethics in health technology assessment: many ways to Rome.

    Science.gov (United States)

    Hofmann, Björn; Oortwijn, Wija; Bakke Lysdahl, Kristin; Refolo, Pietro; Sacchini, Dario; van der Wilt, Gert Jan; Gerhardus, Ansgar

    2015-01-01

    The aim of this study was to identify and discuss appropriate approaches to integrate ethical inquiry in health technology assessment (HTA). The key question is how ethics can be integrated in HTA. This is addressed in two steps: by investigating what it means to integrate ethics in HTA, and by assessing how suitable the various methods in ethics are to be integrated in HTA according to these meanings of integration. In the first step, we found that integrating ethics can mean that ethics is (a) subsumed under or (b) combined with other parts of the HTA process; that it can be (c) coordinated with other parts; or that (d) ethics actively interacts and changes other parts of the HTA process. For the second step, we found that the various methods in ethics have different merits with respect to the four conceptions of integration in HTA. Traditional approaches in moral philosophy tend to be most suited to be subsumed or combined, while processual approaches being close to the HTA or implementation process appear to be most suited to coordinated and interactive types of integration. The article provides a guide for choosing the ethics approach that appears most appropriate for the goals and process of a particular HTA.

  20. Confronting trade-offs in health care: Harvard Pilgrim Health Care's organizational ethics program.

    Science.gov (United States)

    Sabin, James E; Cochran, David

    2007-01-01

    Patients, providers, and policy leaders need a new moral compass to guide them in the turbulent U.S. health care system. Task forces have proposed excellent ethical codes, but these have been seen as too abstract to provide guidance at the front lines. Harvard Pilgrim Health Care's ten-year experience with an organizational ethics program suggests ways in which health care organizations can strengthen transparency, consumer focus, and overall ethical performance and contribute to the national health policy dialogue.

  1. Some ethical tradeoffs in mental health legislation and practice.

    Science.gov (United States)

    Govind, Nikhil

    2012-01-01

    An examination of the intersection of legal and medical discourses, particularly in the realm of mental health legislation, provides a rich opportunity to clarify fundamental ethical conflicts. This essay studies one such legal discourse, the draft amendments to the Mental Health Act (1987), to demonstrate that the realm of ethical decision-making is constrained not only by pragmatic administrative, training and financial issues but also by the very contradictions that are necessarily at the heart of any ethically conducted project, however well intentioned and reasoned.

  2. Social marketing: its place in public health.

    Science.gov (United States)

    Ling, J C; Franklin, B A; Lindsteadt, J F; Gearon, S A

    1992-01-01

    This review of the public health role of social marketing begins by tracing the history of social marketing and noting that social marketing adopts the traditional marketing framework of product, price, place, and promotion and embraces several methods of commercial marketing as well as consumer research. However, no universally acknowledged definition exists. A review of the literature is divided into three time periods representing early theoretical development, the evaluation of experiences, and increasing acceptance. Concerns about social marketing are discussed in terms of ethics, disempowerment, and the commercialization of health information. Examples of social marketing are then provided from developing countries and are analyzed in groupings defined as tangible products, sustained health practices, and service utilization. Practitioners' views and concerns are also reviewed. The strengths of social marketing include knowledge of the audience, systematic use of qualitative methods, use of incentives, closer monitoring, strategic use of the mass media, realistic expectations, aspiring to high standards, and recognition of price. Weaknesses of social marketing include its time, money, and human requirements; the fact that marketing elements are missing (public health lacks the flexibility to adjust products and services to clients' interests and preferences); and the potential serious impact on the future of Public Service Announcements, which may die out because social marketers pay for air time. After placing social marketing in context with other practices designed to achieve social change, the review ends with the prediction that the public health role of social marketing is likely to increase. The World Health Organization's recent call for health promotion and the UN Children's Fund's social mobilization actions are provided as examples of this increased role. It is noted, however, that social marketing alone cannot solve public health problems.

  3. Zoning should promote public health.

    Science.gov (United States)

    Hirschhorn, Joel S

    2004-01-01

    Legally, governments use their police powers to protect public health, safety, and welfare through zoning. This paper presents a case for revisiting zoning on the basis of increasing evidence that certain types of community design promote public health, as opposed to the dominant pattern of sprawl development, which does not. Zoning, and the land use planning linked to it, that prohibits or disfavors health-promoting community designs contradicts the inherent public policy goal on which it is based. If there is a paradigm shift underway, from traditional sprawl to health-promoting community designs, then health professionals and others should understand why zoning must be reassessed.

  4. [Terrorism, public health and health services].

    Science.gov (United States)

    Arcos González, Pedro; Castro Delgado, Rafael; Cuartas Alvarez, Tatiana; Pérez-Berrocal Alonso, Jorge

    2009-01-01

    Today the terrorism is a problem of global distribution and increasing interest for the international public health. The terrorism related violence affects the public health and the health care services in an important way and in different scopes, among them, increase mortality, morbidity and disability, generates a context of fear and anxiety that makes the psychopathological diseases very frequent, seriously alters the operation of the health care services and produces important social, political and economic damages. These effects are, in addition, especially intense when the phenomenon takes place on a chronic way in a community. The objective of this paper is to examine the relation between terrorism and public health, focusing on its effects on public health and the health care services, as well as to examine the possible frames to face the terrorism as a public health concern, with special reference to the situation in Spain. To face this problem, both the public health systems and the health care services, would have to especially adapt their approaches and operational methods in six high-priority areas related to: (1) the coordination between the different health and non health emergency response agencies; (2) the reinforcement of the epidemiological surveillance systems; (3) the improvement of the capacities of the public health laboratories and response emergency care systems to specific types of terrorism as the chemical or biological terrorism; (3) the mental health services; (4) the planning and coordination of the emergency response of the health services; (5) the relations with the population and mass media and, finally; (6) a greater transparency in the diffusion of the information and a greater degree of analysis of the carried out health actions in the scope of the emergency response.

  5. Ethics reflection groups in community health services: an evaluation study.

    Science.gov (United States)

    Lillemoen, Lillian; Pedersen, Reidar

    2015-04-17

    Systematic ethics support in community health services in Norway is in the initial phase. There are few evaluation studies about the significance of ethics reflection on care. The aim of this study was to evaluate systematic ethics reflection in groups in community health (including nursing homes and residency), - from the perspectives of employees participating in the groups, the group facilitators and the service managers. The reflection groups were implemented as part of a research and development project. A mixed-methods design with qualitative focus group interviews, observations and written reports were used to evaluate. The study was conducted at two nursing homes, two home care districts and a residence for people with learning disabilities. Participants were employees, facilitators and service managers. The study was guided by ethical standard principles and was approved by the Norwegian Social Science Data Services. We found support for ethics reflection as a valuable measure to strengthen clinical practice. New and improved solutions, more cooperation between employees, and improved collaboration with patients and their families are some of the results. No negative experiences were found. Instead, the ethics reflection based on experiences and challenges in the workplace, was described as a win-win situation. The evaluation also revealed what is needed to succeed and useful tips for further development of ethics support in community health services. Ethics reflection groups focusing on ethical challenges from the participants' daily work were found to be significant for improved practice, collegial support and cooperation, personal and professional development among staff, facilitators and managers. Resources needed to succeed were managerial support, and anchoring ethics sessions in the routine of daily work.

  6. Migrant Health: a value for Public Health

    Directory of Open Access Journals (Sweden)

    Patrizia Laurenti

    2012-09-01

    Full Text Available The health matters associated with migration are crucial public health challenges faced by both governments and societies. According to United Nations estimates, 120 million of the approximately 175 million migrants worldwide are migrant workers with their families (1. Legal and illegal workers have a different status and, therefore, varying levels of access to social and health services. The collective health needs and implications of this sizeable population are considerable, and different health determinants and levels of vulnerability could impact on their health (2. The main public health goal is to avoid disparities in health status and access to health services between migrants and the host population (3. The second, closely associated principle, is to ensure migrants’ health rights, as stated during the 4th Conference on Migrant and Ethnic Minority Health in Europe which took place from 21st to 23rd June 2012 in Milan, where Migrants and ethnic minorities were confirmed as a benefit to the society (4.

  7. Gene by Environment Research to Prevent Externalizing Problem Behavior : Ethical Questions Raised from a Public Healthcare Perspective

    NARCIS (Netherlands)

    Chhangur, Rabia R.; Weeland, Joyce|info:eu-repo/dai/nl/328240583; Matthys, Walter; Overbeek, Geertjan|info:eu-repo/dai/nl/25233602X

    2015-01-01

    The main public health advantages of examining gene by environment interactions (i.e., G x E) in externalizing behavior lie in the realm of personalized interventions. Nevertheless, the incorporation of genetic data in randomized controlled trials is fraught with difficulties and raises ethical

  8. Gene by Environment Research to Prevent Externalizing Problem Behavior : Ethical Questions Raised from a Public Healthcare Perspective

    NARCIS (Netherlands)

    Chhangur, Rabia R.; Weeland, Joyce; Matthys, Walter; Overbeek, Geertjan

    2015-01-01

    The main public health advantages of examining gene by environment interactions (i.e., G x E) in externalizing behavior lie in the realm of personalized interventions. Nevertheless, the incorporation of genetic data in randomized controlled trials is fraught with difficulties and raises ethical ques

  9. Emerging Ethical Issues in College Health Services.

    Science.gov (United States)

    Hersh, Jeffrey B.; And Others

    1981-01-01

    Current ethical issues of clinical competence and confidentiality are explored in relation to changes in the college population and its relationship to the community. Case examples are presented. (JN)

  10. Social media in public health.

    Science.gov (United States)

    Kass-Hout, Taha A; Alhinnawi, Hend

    2013-01-01

    While social media interactions are currently not fully understood, as individual health behaviors and outcomes are shared online, social media offers an increasingly clear picture of the dynamics of these processes. Social media is becoming an increasingly common platform among clinicians and public health officials to share information with the public, track or predict diseases. Social media can be used for engaging the public and communicating key public health interventions, while providing an important tool for public health surveillance. Social media has advantages over traditional public health surveillance, as well as limitations, such as poor specificity, that warrant additional study. Social media can provide timely, relevant and transparent information of public health importance; such as tracking or predicting the spread or severity of influenza, west nile virus or meningitis as they propagate in the community, and, in identifying disease outbreaks or clusters of chronic illnesses. Further work is needed on social media as a valid data source for detecting or predicting diseases or conditions. Also, whether or not it is an effective tool for communicating key public health messages and engaging both, the general public and policy-makers.

  11. [Ethics in clinical practice and in health care].

    Science.gov (United States)

    Pintor, S; Mennuni, G; Fontana, M; Nocchi, S; Giarrusso, P; Serio, A; Fraioli, A

    2015-01-01

    The clinical ethics is the identification, analysis and solution of moral problems that can arise during the care of a patient. Given that when dealing with ethical issues in health care some risks will be encountered (talking about ethics in general, or as a problem overlapped with others in this area, or by delegation to legislative determinations) in the text certain important aspects of the topic are examined. First of all ethics as human quality of the relationship between people for the common good, especially in health services where there are serious problems like the life and the health. It is also necessary a "humanizing relationship" between those who work in these services in order to achieve quality and efficiency in this business. It is important a proper training of health professionals, especially doctors, so that they can identify the real needs and means of intervention. It is also important that scientific research must respect fundamental ethical assumptions. In conclusion, ethics in health care is not a simple matter of "cookbook" rules, but involves the responsibility and consciousness of individual operators.

  12. Citizen Science for public health

    NARCIS (Netherlands)

    Broeder, Den Lea; Devilee, Jeroen; Oers, Van Hans; Schuit, A.J.; Wagemakers, Annemarie

    2016-01-01

    Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in

  13. Periodontal health and global public health.

    Science.gov (United States)

    Petersen, Poul E; Baehni, Pierre C

    2012-10-01

    Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal/oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging local, national and international resources to assure that people can be healthy. Social determinants of health, environmental hazards and unhealthy lifestyles are prioritized in modern public health-care. Disease prevention and health promotion are cornerstones in actions for public health. This volume of Periodontology 2000 is entitled ‘Periodontal health and global public health’; the 12 articles of this volume discuss different aspects of this statement. It covers a range of subjects from public health issues to patient care. This monograph intends to stimulate community action research in the field of periodontology in order to help the development of appropriate public health intervention and relevant surveillance programs. It also expects to stimulate health authorities and professional organizations to initiate and support actions to promote periodontal health in their respective countries.

  14. Working together for public health.

    Science.gov (United States)

    Martelli, Pompeo

    2009-06-01

    Italy's recent economic growth and strategic position in the Mediterranean Sea have made it a prime destination for immigrants and asylum seekers in Europe. Despite its well-developed health care system, statistics on foreign citizens' health are worrisome. In 1998 public health services were extended to illegal immigrants, giving them the right to necessary urgent and non-urgent medical assistance, even for a prolonged period. This paper examines a two-year joint intervention project between Centre for the Study and Research of Public Health (Mental Health), Local Health Agency ROMA E (LHA RME) and the non-governmental organization Médecins Sans Frontières (MSF) in Rome.

  15. Ethics and health promotion practice: exploring attitudes and practices in Western Australian health organisations.

    Science.gov (United States)

    Reilly, T; Crawford, G; Lobo, R; Leavy, J; Jancey, J

    2016-04-01

    Issue addressed Evidence-informed practice underpinned by ethics is fundamental to developing the science of health promotion. Knowledge and application of ethical principles are competencies required for health promotion practice. However, these competencies are often inconsistently understood and applied. This research explored attitudes, practices, enablers and barriers related to ethics in practice in Western Australian health organisations. Methods Semistructured, in-depth interviews were conducted with 10 health promotion practitioners, purposefully selected to provide a cross-section of government and non-government organisations. Interviews were recorded, transcribed and then themed. Results The majority of participants reported consideration of ethics in their practice; however, only half reported seeking Human Research Ethics Committee (HREC) approval for projects in the past 12 months. Enablers identified as supporting ethics in practice and disseminating findings included: support preparing ethics applications; resources and training about ethical practice; ability to access HRECs for ethics approval; and a supportive organisational culture. Barriers included: limited time; insufficient resourcing and capacity; ethics approval not seen as part of core business; and concerns about academic writing. Conclusion The majority of participants were aware of the importance of ethics in practice and the dissemination of findings. However, participants reported barriers to engaging in formal ethics processes and to publishing findings. So what? Alignment of evidence-informed and ethics-based practice is critical. Resources and information about ethics may be required to support practice and encourage dissemination of findings, including in the peer-reviewed literature. Investigating the role of community-based ethics boards may be valuable to bridging the ethics-evidence gap.

  16. Creating a Culture of Ethical Practice in Health Care Delivery Systems.

    Science.gov (United States)

    Rushton, Cynda Hylton

    2016-09-01

    Undisputedly, the United States' health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty-five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about the balance of benefits and burdens associated with these advances. Every day on every shift, nurses at the bedside feel an intense array of ethical issues. At the same time, administrators, policy-makers, and regulators struggle to balance commitments to patients, families, staff members, and governing boards. Ethical responsibilities and the fiduciary, regulatory, and community service goals of health care institutions are not mutually exclusive; they must go hand in hand. If they do not, our health care system will continue to lose valued professionals to moral distress, risk breaking the public's trust, and potentially undermine patient care. At this critical juncture in health care, we must look to new models, tools, and skills to confront contemporary ethical issues that impact clinical practice. The antidote to the current reality is to create a new health care paradigm grounded in compassion and sustained by a culture of ethical practice.

  17. PROFESSIONAL ACCOUNTING ETHICS: A VISUAL ANALYSIS OF PUBLIC PERCEPTION

    Directory of Open Access Journals (Sweden)

    Renato Ferreira Leitão Azevedo

    2012-03-01

    Full Text Available The decline in both the number and quality of students choosing accounting programs has been a worldwide source of concern to scholars and practitioners. According to Albrecht and Sack (2000, that decline is a consequence of several factors, such as changes in business environment, decrease in salary levels and development of alternative careers perceived as more attractive by students and lack of information and/or misunderstanding related to accounting careers. For Carnegie and Napier (2010, comprehension of such external images related to accounting careers and accountants is important for assessing the roles of these professionals in a wider social context. The success of the accounting profession, according to Belski et al. (2004, largely depends on how it is viewed by the public, considering that the image of the accounting profession has been damaged in the recent past by the widely publicized accounting frauds, scandals and failures involving accounting firms and accountants. To support a better understanding of this phenomenon, the objective of this study is to identify and analyze whether the accounting profession is negatively stereotyped by public perception according to ethics. Based on an adapted photo-survey, with 1,034 randomly selected respondents, and tests of differences between means, the central hypothesis of this study was rejected: it is not possible to state that accounting professionals are negatively stereotyped for professional ethics. Also, there were no significant differences based on gender, academic background or education levels of the respondents, but on the other hand is possible to confirm a positive perception based on confidence interval analysis. Implications for practice and recommendations for future studies are both presented in the last section.

  18. The ethics of complex relationships in primary care behavioral health.

    Science.gov (United States)

    Reiter, Jeff; Runyan, Christine

    2013-03-01

    Primary care settings are particularly prone to complex relationships that can be ethically challenging. This is due in part to three of the distinctive attributes of primary care: a whole family orientation; team-based care; and a longitudinal care delivery model. In addition, the high patient volume of primary care means that the likelihood of encountering ethically challenging relationships is probably greater than in a specialty setting. This article argues that one ethical standard of the American Psychological Association (APA, 2010, Ethical principles of psychologists and code of conduct, www.apa.org/ethics/code) (10.02, Therapy Involving Couples or Families) should be revised to better accommodate the work of psychologists in primary care. The corresponding Principles of Medical Ethics from the American Medical Association (AMA, 2012, Code of medical ethics: Current opinions with annotations, 2012-2013, Washington, DC: Author), most notably the principle regarding a physician's duty to "respect the rights of patients, colleagues, and other health professionals as well as safeguard privacy" are also noted. In addition, the article details how the three attributes of primary care often result in complex relationships, and provides suggestions for handling such relationships ethically.

  19. Public Health Events and International Health Regulations

    Centers for Disease Control (CDC) Podcasts

    2012-06-21

    Dr. Katrin Kohl, a medical officer at the CDC, discusses the World Health Organization’s International Health Regulations for assessing and reporting on public health events across the world.  Created: 6/21/2012 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 6/21/2012.

  20. Primary health care and public health: foundations of universal health systems.

    Science.gov (United States)

    White, Franklin

    2015-01-01

    The aim of this review is to advocate for more integrated and universally accessible health systems, built on a foundation of primary health care and public health. The perspective outlined identified health systems as the frame of reference, clarified terminology and examined complementary perspectives on health. It explored the prospects for universal and integrated health systems from a global perspective, the role of healthy public policy in achieving population health and the value of the social-ecological model in guiding how best to align the components of an integrated health service. The importance of an ethical private sector in partnership with the public sector is recognized. Most health systems around the world, still heavily focused on illness, are doing relatively little to optimize health and minimize illness burdens, especially for vulnerable groups. This failure to improve the underlying conditions for health is compounded by insufficient allocation of resources to address priority needs with equity (universality, accessibility and affordability). Finally, public health and primary health care are the cornerstones of sustainable health systems, and this should be reflected in the health policies and professional education systems of all nations wishing to achieve a health system that is effective, equitable, efficient and affordable.

  1. Ethical issues in using social media for health and health care research.

    Science.gov (United States)

    McKee, Rebecca

    2013-05-01

    The dramatic growth of social media in recent years has not gone unnoticed in the health sector. Media such as Facebook and Twitter are increasingly being used to disseminate information among health professionals and patients but, more recently, are being seen as a source of data for surveillance and research, for example by tracking public concerns or capturing discourses taking place outside traditional media outlets. This raises ethical issues, in particular the extent to which postings are considered public or private and the right to anonymity of those posting on social media. These issues are not clear cut as social media, by their nature, blur the boundary between public and private. There is a need for further research on the beliefs and expectations of those using social media in relation to how their material might be used in research. In contrast, there are areas where the ethical issues are more clear cut, such as when individuals are active participants in research, where traditional considerations apply.

  2. Learning professional ethics: Student experiences in a health mentor program.

    Science.gov (United States)

    Langlois, Sylvia; Lymer, Erin

    2016-01-01

    The use of patient centred approaches to healthcare education is evolving, yet the effectiveness of these approaches in relation to professional ethics education is not well understood. The aim of this study was to explore the experiences and learning of health profession students engaged in an ethics module as part of a Health Mentor Program at the University of Toronto. Students were assigned to interprofessional groups representing seven professional programs and matched with a health mentor. The health mentors, individuals living with chronic health conditions, shared their experiences of the healthcare system through 90 minute semi-structured interviews with the students. Following the interviews, students completed self-reflective papers and engaged in facilitated asynchronous online discussions. Thematic analysis of reflections and discussions was used to uncover pertaining to student experiences and learning regarding professional ethics. Five major themes emerged from the data: (1) Patient autonomy and expertise in care; (2) ethical complexity and its inevitable reality in the clinical practice setting; (3) patient advocacy as an essential component of day-to-day practice; (4) qualities of remarkable clinicians that informed personal ideals for future practice; (5) patients' perspectives on clinician error and how they enabled suggestions for improving future practice. The findings of a study in one university context suggest that engagement with the health mentor narratives facilitated students' critical reflection related to their understanding of the principles of healthcare ethics.

  3. Ethical Guidelines for Human Communication and Public Discussion: A Gandhian Intercultural Perspective.

    Science.gov (United States)

    Bode, Robert A.

    Ethical communication scholars frequently find national popular rhetoric unethical. Some proposed ethical guidelines for the public presentation of ideas call for such elements as habits of search, justice, preference for public versus private motives, respect for dissent, airing of all relevant arguments, and persuasion without coercion or…

  4. Ethics in Strategic Communication Campaigns: The Case for a New Approach to Public Relations.

    Science.gov (United States)

    Botan, Carl

    1997-01-01

    Uses the example of public relations to describe important distinctions between monologic and dialogic campaigns. Explains why the dominant monological approach to public relations has long been recognized as "ethically paralyzed." Suggests an ethically more viable dialogic approach. Discusses reasons the business community has been slow to adopt…

  5. Conditions for religious discourse in secularized ethical health care deliberation.

    Science.gov (United States)

    van Nistelrooy, Inge; Vosman, Frans

    2012-01-01

    Religious discourse is no longer self-evident in professional health care ethical deliberation in the North Atlantic cultural sphere. However, in a world of pluralism, care professionals still seek substantive views of good care. Religious and non-religious beliefs should not be excluded from ethical deliberation. They offer patients and professionals a helpful language for expressing values and beliefs. Chaplains have a role to play as allies in sense-making processes and resourcing care.

  6. Between reason and coercion: ethically permissible influence in health care and health policy contexts.

    Science.gov (United States)

    Blumenthal-Barby, J S

    2012-12-01

    In bioethics, the predominant categorization of various types of influence has been a tripartite classification of rational persuasion (meaning influence by reason and argument), coercion (meaning influence by irresistible threats-or on a few accounts, offers), and manipulation (meaning everything in between). The standard ethical analysis in bioethics has been that rational persuasion is always permissible, and coercion is almost always impermissible save a few cases such as imminent threat to self or others. However, many forms of influence fall into the broad middle terrain-and this terrain is in desperate need of conceptual refining and ethical analysis in light of recent interest in using principles from behavioral science to influence health decisions and behaviors. This paper aims to address the neglected space between rational persuasion and coercion in bioethics. First, I argue for conceptual revisions that include removing the "manipulation" label and relabeling this space "nonargumentative influence," with two subtypes: "reason-bypassing" and "reason-countering." Second, I argue that bioethicists have made the mistake of relying heavily on the conceptual categories themselves for normative work and instead should assess the ethical permissibility of a particular instance of influence by asking several key ethical questions, which I elucidate, that relate to (1) the impact of the form of influence on autonomy and (2) the relationship between the influencer and the influenced. Finally, I apply my analysis to two examples of nonargumentative influence in health care and health policy: (1) governmental agencies such as the Food and Drug Administration (FDA) trying to influence the public to be healthier using nonargumentative measures such as vivid images on cigarette packages to make more salient the negative effects of smoking, and (2) a physician framing a surgery in terms of survival rates instead of mortality rates to influence her patient to consent to

  7. From Subject to Participant: Ethics and the Evolving Role of Community in Health Research

    OpenAIRE

    Bromley, Elizabeth; Mikesell, Lisa; Jones, Felica; Khodyakov, Dmitry

    2015-01-01

    Community members play an increasingly important role in public health and health services research. New models of community-engaged research may entail novel ethical priorities. For example, the principles described in the Belmont Report focus on the wellbeing of the research subject, yet community-engaged investigators often eschew the role of subject for that of participant. We conducted semi-structured interviews with 29 community and academic investigators working on 10 community-engaged...

  8. The for-profit sector in humanitarian response: integrating ethical considerations in public policy decision making.

    Science.gov (United States)

    Huckel Schneider, Carmen; Negin, Joel

    2016-01-01

    The engagement of the for-profit private sector in health, social and humanitarian services has become a topic of keen interest. It is particularly contentious in those instances where for-profit organizations have become recipients of public funds, and where they become key decision-makers in terms of how, and to whom, services are provided. We put forward a framework for identifying and organizing the ethical questions to be considered when contracting government services to the for-profit sector, specifically in those areas that have traditionally remained in the public or not-for-profit spheres. The framework is designed to inform both academic debate and practical decision-making regarding the acceptability, feasibility and legitimacy of for-profit organizations carrying out humanitarian work. First, we outline the importance of posing ethical questions in government contracting for-profit vs. not-for-profit organizations. We then outline five key areas to be considered before then examining the extent to which ethics concerns are warranted and how they may be safeguarded.

  9. Major trends in public health law and practice: a network national report.

    Science.gov (United States)

    Hodge, James G; Barraza, Leila; Bernstein, Jennifer; Chu, Courtney; Collmer, Veda; Davis, Corey; Griest, Megan M; Hammer, Monica S; Krueger, Jill; Lowrey, Kerri McGowan; Orenstein, Daniel G

    2013-01-01

    Since its inception in September 2010, the Network for Public Health Law has responded to hundreds of public health legal technical assistance claims from around the country. Based on a review of these data, a series of major trends in public health practice and the law are analyzed, including issues concerning: the Affordable Care Act, tobacco control, emergency legal preparedness, health information privacy, food policy, vaccination, drug overdose prevention, sports injury law, public health accreditation, and maternal breastfeeding. These and other emerging themes in public health law demonstrate the essential role of law and practice in advancing the public's health. © 2013 American Society of Law, Medicine & Ethics, Inc.

  10. Should teachers of medical ethics and health professionals remain value neutral in order to respect the autonomy of students and patients?

    Science.gov (United States)

    Bøgeskov, Benjamín Olivares

    2013-09-01

    This article describes the pedagogical and ethical problems that ensue when ethical neutrality is mandated as the sole acceptable stance for teachers of ethics and health professionals (especially in public institutions). This paper argues that such a mandate can (1) violate public employees' own ethical integrity by forcing them to adopt the current legal order as their own ethical code; (2) erode trust, by requiring that the professional or teacher betray the honesty that patients and students commonly expect; and, finally, (3) undermine--by affirming that all opinions are equally acceptable--he pedagogical aim of generating critical thinking. Nevertheless, the article warns teachers and professionals against defending their own convictions by appealing to authority or the power of public office. The correct way to avoid ethical neutrality, this article asserts, is by distinguishing "opinion" from "argument": by not merely articulating, but providing convincing arguments for, one's own professional ethical opinions.

  11. [Anomie and public mental health].

    Science.gov (United States)

    Parales-Quenza, Carlos J

    2008-01-01

    This article uses the concept of anomie for understanding public mental-health issues and constructing strategies aimed at promoting health and preventing disease. Studying anomie involves many definitions and approaches; this article conceptualises anomie as dérréglement or derangement and as a total social fact as its effects and consequences are pervasive across all areas of human experience. The article suggests the pertinence of the concept to public health based on several authors' observations depicting Latin-America as being a set of anomic societies and Colombia as the extreme case. Current definitions of mental health in positive terms (not just as being the absence of mental illness) validate the need for considering anomie as an indicator of public mental health. The article proposes that if anomie expresses itself through rules as basic social structure components, then such rules should also be considered as the point of intervention in promoting mental health.

  12. Ethical and Moral Theory and Public School Administration.

    Science.gov (United States)

    Craig, Robert P.

    1993-01-01

    Examines taxonomy for understanding and applying various facets of ethical argumentation and conceptualization to administrative practice. Stresses importance of developing conceptual analysis approach from scientific, conceptual, general normative, and applied normative ethics strands of literature. Offers prescriptive approach to ethics and…

  13. [Conflicts between nursing ethics and health care legislation in Spain].

    Science.gov (United States)

    Gea-Sánchez, Montserrat; Terés-Vidal, Lourdes; Briones-Vozmediano, Erica; Molina, Fidel; Gastaldo, Denise; Otero-García, Laura

    2016-01-01

    To identify the ethical conflicts that may arise between the nursing codes of ethics and the Royal Decree-law 16/2012 modifying Spanish health regulations. We conducted a review and critical analysis of the discourse of five nursing codes of ethics from Barcelona, Catalonia, Spain, Europe and International, and of the discourse of the Spanish legislation in force in 2013. Language structures referring to five different concepts of the theoretical framework of care were identified in the texts: equity, human rights, right to healthcare, access to care, and continuity of care. Codes of ethics define the function of nursing according to equity, acknowledgement of human rights, right to healthcare, access to care and continuity of care, while legal discourse hinges on the concept of beneficiary or being insured. The divergence between the code of ethics and the legal discourse may produce ethical conflicts that negatively affect nursing practice. The application of RDL 16/2012 promotes a framework of action that prevents nursing professionals from providing care to uninsured collectives, which violates human rights and the principles of care ethics. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  14. Ethics in health care: “Physician, heal thyself”

    African Journals Online (AJOL)

    the regulations that relate to the impairment of students and practitioners.4 Then ... Sessional Professor of Ethics, Department of Family Medicine and Primary Health Care MEDUNSA ... addiction and depression are as common in healthcare .... Health Professions Council of South Africa [homepage on the Internet]. c2013.

  15. Environmental Health Research Involving Human Subjects: Ethical Issues

    Directory of Open Access Journals (Sweden)

    David B. Resnik

    2008-01-01

    Full Text Available This article reviews some of the ethical issues that arise in environmental health research with human subjects, such as minimizing risks to subjects, balancing benefits and risks in research, intentional exposure studies with human subjects, protecting third parties in research, informing subjects about environmental hazards, communicating health information to subjects, and protecting privacy and confidentiality.

  16. Pacific Health Research Guidelines: The Cartography of an Ethical Relationship

    Science.gov (United States)

    Mila-Schaaf, Karlo

    2009-01-01

    In 2004 the Health Research Council of New Zealand (HRC) published a set of "Guidelines on Pacific health research". The Guidelines were an attempt to articulate the features of ethical research relationships with Pacific peoples living in Aotearoa New Zealand. This article describes the process of developing these guidelines, using…

  17. Genomics, medicine and public health

    Directory of Open Access Journals (Sweden)

    Alexander M. Trbovich

    2006-12-01

    Full Text Available Public health genomics unifies the scientific disciplines of genetics and public health. Public health genomics aims to facilitate the transfer of newly acquired knowledge in genetic and molecular biology into classical medicine, to evaluate the currently available genetic tests, and to educate both the medical community and the general population about advancements in molecular and cell biology of medical interest. Due to various factors, the application of new genetic discoveries in classical medicine and the evaluation of the current genetic clinical tests occur at relatively slow paste. The challenge of public health genomics is to create the most effective modus for coexistence of new molecular and cell biology discoveries and classical medical techniques in applied medicine. The ultimate goal is to accomplish a truly individualized medical therapy.

  18. Public Health Genetics : Challenging "Public Health at the Crossroads"

    Directory of Open Access Journals (Sweden)

    Angela Brand

    2005-03-01

    Full Text Available

    Dear public health professionals, Honestly, isn’t it time to ask whether or not we are doing “the right things”in public health? Are our present public health strategies evidence-based? The public health agenda demands a vision that reaches beyond research to the application of public health and the determination of it’s impact. In this scenario what is the role of genomics? In the past twenty years, advances in genome research have revolutionised what is known about the role of inheritance in health and disease.[1]

    Nowadays,we know that our DNA determines not only the cause of single-gene disorders, but also determines our predisposition to common diseases.Whereas medicine is currently undergoing extraordinary developments from its morphological and phenotype orientation to a molecular and genotype orientation, promoting the importance of prognosis and prediction, public health practice has to date concerned itself with environmental determinants of health and disease and has paid scant attention to genetic variations within the population.

     The advances brought about by genomics is changing these perceptions.[2,3] Many predict, that this knowledge will enable health promotion messages and disease prevention programmes to be specifically directed at susceptible individuals or at subgroups of the population, based on their genetic profile.[4,5]

    The new technologies will allow researchers to examine genetic mutations at the functional genomic unit level, and to better understand the significance of environmental factors such as noxious agents, nutrition and personal behaviour in relation to the causation of diseases such as cardiovascular diseases, psychiatric disorders and infectious diseases.

  19. Ethically sound technology? Guidelines for interactive ethical assessment of personal health monitoring.

    Science.gov (United States)

    Palm, Elin; Nordgren, Anders; Verweij, Marcel; Collste, Göran

    2013-01-01

    Novel care-technologies possess a transformational potential. Future care and support may be provided via monitoring technologies such as smart devices, sensors, actors (robots) and Information and Communication Technologies. Such technologies enable care provision outside traditional care institutions, for instance in the homes of patients. Health monitoring may become "personalized" i.e. tailored to the needs of individual care recipients' but may also alter relations between care providers and care recipents, shape and form the care environment and influence values central to health-care. Starting out from a social constructivist theory of technology, an interactive ethical assessment-model is offered. The suggested model supplements a traditional analysis based on normative ethical theory (top-down approach) with interviews including relevant stakeholders (a bottom-up approach). This method has been piloted by small-scale interviews encircling stakeholder perspectives on three emerging technologies: (1) Careousel, a smart medicine-management device, (2) Robot Giraff, an interactive and mobile communication-device and (3) I-Care, a care-software that combines alarm and register system. By incorporating stakeholder perspectives into the analysis, the interactive ethical assessment model provides a richer understanding of the impact of PHM-technologies on ethical values than a traditional top-down model. If the assessment is conducted before the technology has reached the market - preferably in close interaction with developers and users - ethically sound technologies may be obtained.

  20. Navigating the ethics of cross-cultural health promotion research.

    Science.gov (United States)

    Haintz, Greer Lamaro; Graham, Melissa; McKenzie, Hayley

    2015-12-01

    Health promotion researchers must consider the ethics of their research, and are usually required to abide by a set of ethical requirements stipulated by governing bodies (such as the Australian National Health and Medical Research Council) and human research ethics committees (HRECs). These requirements address both deontological (rule-based) and consequence-based issues. However, at times there can be a disconnect between the requirements of deontological issues and the cultural sensitivity required when research is set in cultural contexts and settings etic to the HREC. This poses a challenge for health promotion researchers who must negotiate between meeting both the requirements of the HREC and the needs of the community with whom the research is being conducted. Drawing on two case studies, this paper discusses examples from cross-cultural health promotion research in Australian and international settings where disconnect arose and negotiation was required to appropriately meet the needs of all parties. The examples relate to issues of participant recruitment and informed consent, participants under the Australian legal age of consent, participant withdrawal when this seemingly occurs in an ad hoc rather than a formal manner and reciprocity. Although these approaches are context specific, they highlight issues for consideration to advance more culturally appropriate practice in research ethics and suggest ways a stronger anthropological lens can be applied to research ethics to overcome these challenges.

  1. Insights in Public Health

    Science.gov (United States)

    Tong, Michelle; Sentell, Tetine

    2017-01-01

    Chinese Americans constitute the largest percentage of Asian Americans. In Hawai‘i, Chinese Americans make up approximately 4.7% of the total state population. Accurately assessing health disparities across specific Asian American subgroups is critically important to health research and policy, as there is often substantial variability in risk and outcomes. However, even for Chinese Americans, the largest of the Asian American subgroups, such analyses can present challenges in population-based surveys. This article considers these challenges generally and then specifically in terms of the issue of health literacy and heart disease in Chinese Americans using existing population-based survey data sets in the United States, California, and Hawai‘i.

  2. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded

  3. A review of management of infertility in Nigeria: framing the ethics of a national health policy.

    Science.gov (United States)

    Akinloye, Oluyemi; Truter, Ernest J

    2011-01-01

    Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost-utility analysis (such as Quality Adjusted Life-Year composite index) in the management of infertility in Nigeria entails the need for caution relevant to the country's efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian) principles. The "worst off " category of Nigerians includes (1) underweight children less than 5 years of age, with special concern for infants (0-1 years of age) and (2) the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a "fair" allocation and expenditure if, and only if, the situation for these two cohorts is not thereby made worse. Nigerian health policy cannot assume this type of increased allocation of its resources to infertility care without it being hard pressed to warrant defensible moral or rational argument.

  4. American Public Health Association

    Science.gov (United States)

    ... Infectious Diseases has a new Spanish language website! https://t.co… RT @CDCgov: Know when you need ... Together we can fight antibiotic resistance. Be #AntibioticSmart. https://t.… RT @AMJPublicHealth: Whiteness of the #opioidepidemic is ...

  5. Media debates and 'ethical publicity' on social sex selection through preimplantation genetic diagnosis (PGD) technology in Australia.

    Science.gov (United States)

    Whittaker, Andrea

    2015-01-01

    This paper offers a critical discourse analysis of media debate over social sex selection in the Australian media from 2008 to 2014. This period coincides with a review of the National Health and Medical Research Council's Ethical Guidelines on the Use of Assisted Reproductive Technology in Clinical Practice and Research (2007), which underlie the regulation of assisted reproductive clinics and practice in Australia. I examine the discussion of the ethics of pre-implatation genetic diagnosis (PGD) within the media as 'ethical publicity' to the lay public. Sex selection through PGD is both exemplary of and interconnected with a range of debates in Australia about the legitimacy of certain reproductive choices and the extent to which procreative liberties should be restricted. Major themes emerging from media reports on PGD sex selection in Australia are described. These include: the spectre of science out of control; ramifications for the contestation over the public funding of abortion in Australia; private choices versus public authorities regulating reproduction; and the ethics of travelling overseas for the technology. It is concluded that within Australia, the issue of PGD sex selection is framed in terms of questions of individual freedom against the principle of sex discrimination - a principle enshrined in legislation - and a commitment to publically-funded medical care.

  6. Public health leadership education in North America

    Directory of Open Access Journals (Sweden)

    Hideo Uno

    2010-03-01

    Full Text Available Hideo Uno, Kenneth ZakariasenDepartment of Public Health Sciences, School of Public Health, University of Alberta, Edmonton, AB, CanadaAbstract: Public health leadership is one of the priority disciplines public health professionals need to learn well if they are to deal with demanding public health issues effectively and efficiently. This article looks at the trends in public health leadership education by reviewing the literature and using the Internet to explore the public health leadership programs offered in various parts of the world, and suggests several principles to be taken into account for the development of public health leadership education in the future. A variety of educational programs in public health leadership are classified into several types in terms of their formats: degree programs offered by schools of public health or other programs of public health, those offered in partnership with public health agencies, and so on. All of these programs have important implications for the overall effectiveness of public health leadership education. For public health leadership education to be effective, the partnership between academia and public health agencies is vitally important. Programs should provide opportunities to learn on the basis of practical public health experience, a commitment to life-long learning, flexibility in design, and recognition of the diverse needs of individuals and communities. The application of distance learning methods is one of the options to make this possible.Keywords: public health leadership, public health professionals, school of public health

  7. Health concerns and ethical considerations regarding international surrogacy.

    Science.gov (United States)

    Knoche, Jonathan W

    2014-08-01

    Since the advent of IVF, various arrangements for child bearing and rearing have developed. With the confluence of advanced medical technology, reproductive choice, and globalization, a market in international surrogacy has flourished. However, myriad health, social, and ethical concerns abound regarding the well-being of gestational carriers and children, the infringement of autonomy and free choice, and threats to human dignity. The present paper examines the scope, health risks, and ethical concerns of cross-border surrogacy, arguing that the risks may not exceed the benefits. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  8. Why human health and health ethics must be central to climate change deliberations.

    Directory of Open Access Journals (Sweden)

    Jerome Amir Singh

    Full Text Available Jerome Singh argues that health ethics principles must be afforded equal status to economics principles in climate change deliberations, and that the health community must play more of a leadership role.

  9. The impact of institutional ethics on academic health sciences library leadership: a survey of academic health sciences library directors.

    Science.gov (United States)

    Tooey, Mary Joan M J; Arnold, Gretchen N

    2014-10-01

    Ethical behavior in libraries goes beyond service to users. Academic health sciences library directors may need to adhere to the ethical guidelines and rules of their institutions. Does the unique environment of an academic health center imply different ethical considerations? Do the ethical policies of institutions affect these library leaders? Do their personal ethical considerations have an impact as well? In December 2013, a survey regarding the impact of institutional ethics was sent to the director members of the Association of Academic Health Sciences Libraries. The objective was to determine the impact of institutional ethics on these leaders, whether through personal conviction or institutional imperative.

  10. Health education and public policy.

    Science.gov (United States)

    Service, A

    1986-01-01

    The UK's Minister for Health has again raised the debate about the role of health educators, and in particular that of the Health Education Council, in what is termed public policy work. 1 possible definition of public policy work as regards health education is that aspect that seeks to establish certain health promoting principles as part of the conscious factors always to be considered by individuals, by opinion leaders, by manufacturers, by employers and trade unions, by service providers, by local authorities, and by central government in their plans and decisions. The Health Education Council (HEC) has no power to make or impose public policy; the Department of Health and Social Security (DHSS) has that task. The world of health education providers includes the Health Education Officers working for the Health Authorities and with the Education Authorities, an increasing number of important academic workers in the field, the HEC, the Scottish Health Education Group (SHEG), the DHSS, and some of the members of various professions who provide health education to the public as part of their daily work. Most of the HEC's work consists of providing these people with health educational tools. If the HEC begins to do more in the public policy field, it will not be at the cost of providing health educational tools. At the HEC a staff of 4 liaison workers is responsible for keeping field workers informed about future and imminent HEC work programs. They also assess needs and ideas by holding periodic meetings with Health Education Officers and others in various parts of the country. HEC's efforts have contributed substantially to increasing attention to preventive health measures on the part of the DHSS, parliamentary committees, the Royal Colleges, other professional bodies, and the media. In regard to the future, several paths deserve exploration as part of the HEC's education of decision-makers and opinion-formers. These include: local authorities, relevant

  11. Periodontal health and global public health

    DEFF Research Database (Denmark)

    Petersen, Poul E; Baehni, Pierre C

    2012-01-01

    Chronic diseases are a growing burden to people, to health-care systems and to societies across the world. The rapid increase in the burden of chronic diseases is particularly prevalent in the developing countries. Periodontal disease is one of the two most important oral diseases contributing...... to the global burden of chronic disease. In addition to social determinants, periodontal health status is related to several proximal factors. Modifiable risk factors, such as tobacco use, excessive alcohol consumption, poor diet and nutrition, obesity, psychological stress and insufficient personal....../oral hygiene, are important and these principal risk factors for periodontal disease are shared by other chronic diseases. The present monograph is devoted to the existing evidence on the practice of public health related to periodontal health. Public health is defined as the process of mobilizing and engaging...

  12. Progress in centralised ethics review processes: Implications for multi-site health evaluations.

    Science.gov (United States)

    Prosser, Brenton; Davey, Rachel; Gibson, Diane

    2015-04-01

    Increasingly, public sector programmes respond to complex social problems that intersect specific fields and individual disciplines. Such responses result in multi-site initiatives that can span nations, jurisdictions, sectors and organisations. The rigorous evaluation of public sector programmes is now a baseline expectation. For evaluations of large and complex multi-site programme initiatives, the processes of ethics review can present a significant challenge. However in recent years, there have been new developments in centralised ethics review processes in many nations. This paper provides the case study of an evaluation of a national, inter-jurisdictional, cross-sector, aged care health initiative and its encounters with Australian centralised ethics review processes. Specifically, the paper considers progress against the key themes of a previous five-year, five nation study (Fitzgerald and Phillips, 2006), which found that centralised ethics review processes would save time, money and effort, as well as contribute to more equitable workloads for researchers and evaluators. The paper concludes with insights for those charged with refining centralised ethics review processes, as well as recommendations for future evaluators of complex multi-site programme initiatives.

  13. Reflections on the ethics of recruiting foreign-trained human resources for health

    Directory of Open Access Journals (Sweden)

    Labonté Ronald

    2011-01-01

    Full Text Available Abstract Background Developed countries' gains in health human resources (HHR from developing countries with significantly lower ratios of health workers have raised questions about the ethics or fairness of recruitment from such countries. By attracting and/or facilitating migration for foreign-trained HHR, notably those from poorer, less well-resourced nations, recruitment practices and policies may be compromising the ability of developing countries to meet the health care needs of their own populations. Little is known, however, about actual recruitment practices. In this study we focus on Canada (a country with a long reliance on internationally trained HHR and recruiters working for Canadian health authorities. Methods We conducted interviews with health human resources recruiters employed by Canadian health authorities to describe their recruitment practices and perspectives and to determine whether and how they reflect ethical considerations. Results and discussion We describe the methods that recruiters used to recruit foreign-trained health professionals and the systemic challenges and policies that form the working context for recruiters and recruits. HHR recruiters' reflections on the global flow of health workers from poorer to richer countries mirror much of the content of global-level discourse with regard to HHR recruitment. A predominant market discourse related to shortages of HHR outweighed discussions of human rights and ethical approaches to recruitment policy and action that consider global health impacts. Conclusions We suggest that the concept of corporate social responsibility may provide a useful approach at the local organizational level for developing policies on ethical recruitment. Such local policies and subsequent practices may inform public debate on the health equity implications of the HHR flows from poorer to richer countries inherent in the global health worker labour market, which in turn could influence

  14. Citizen Science for public health.

    Science.gov (United States)

    Den Broeder, Lea; Devilee, Jeroen; Van Oers, Hans; Schuit, A Jantine; Wagemakers, Annemarie

    2016-12-23

    Community engagement in public health policy is easier said than done. One reason is that public health policy is produced in a complex process resulting in policies that may appear not to link up to citizen perspectives. We therefore address the central question as to whether citizen engagement in knowledge production could enable inclusive health policy making. Building on non-health work fields, we describe different types of citizen engagement in scientific research, or 'Citizen Science'. We describe the challenges that Citizen Science poses for public health, and how these could be addressed. Despite these challenges, we expect that Citizen Science or similar approaches such as participatory action research and 'popular epidemiology' may yield better knowledge, empowered communities, and improved community health. We provide a draft framework to enable evaluation of Citizen Science in practice, consisting of a descriptive typology of different kinds of Citizen Science and a causal framework that shows how Citizen Science in public health might benefit both the knowledge produced as well as the 'Citizen Scientists' as active participants.

  15. Global health ethics: an introduction to prominent theories and relevant topics.

    Science.gov (United States)

    Stapleton, Greg; Schröder-Bäck, Peter; Laaser, Ulrich; Meershoek, Agnes; Popa, Daniela

    2014-01-01

    Global health ethics is a relatively new term that is used to conceptualize the process of applying moral value to health issues that are typically characterized by a global level effect or require action coordinated at a global level. It is important to acknowledge that this account of global health ethics takes a predominantly geographic approach and may infer that the subject relates primarily to macro-level health phenomena. However, global health ethics could alternatively be thought of as another branch of health ethics. It may then relate to specific topics in themselves, which might also include micro-level health phenomena. In its broadest sense, global health ethics is a normative project that is best characterized by the challenge of developing common values and universal norms for responding to global health threats. Consequently, many subjects fall within its scope. Whilst several accounts of global health ethics have been conceptualized in the literature, a concise demarcation of the paradigm is still needed. Through means of a literature review, this paper presents a two-part introduction to global health ethics. First, the framework of 'borrowed' ethics that currently form the core of global health ethics is discussed in relation to two essential ethical considerations: 1) what is the moral significance of health and 2) what is the moral significance of boundaries? Second, a selection of exemplar ethical topics is presented to illustrate the range of topics within global health ethics.

  16. Global health ethics: an introduction to prominent theories and relevant topics

    Science.gov (United States)

    Stapleton, Greg; Schröder-Bäck, Peter; Laaser, Ulrich; Meershoek, Agnes; Popa, Daniela

    2014-01-01

    Global health ethics is a relatively new term that is used to conceptualize the process of applying moral value to health issues that are typically characterized by a global level effect or require action coordinated at a global level. It is important to acknowledge that this account of global health ethics takes a predominantly geographic approach and may infer that the subject relates primarily to macro-level health phenomena. However, global health ethics could alternatively be thought of as another branch of health ethics. It may then relate to specific topics in themselves, which might also include micro-level health phenomena. In its broadest sense, global health ethics is a normative project that is best characterized by the challenge of developing common values and universal norms for responding to global health threats. Consequently, many subjects fall within its scope. Whilst several accounts of global health ethics have been conceptualized in the literature, a concise demarcation of the paradigm is still needed. Through means of a literature review, this paper presents a two-part introduction to global health ethics. First, the framework of ‘borrowed’ ethics that currently form the core of global health ethics is discussed in relation to two essential ethical considerations: 1) what is the moral significance of health and 2) what is the moral significance of boundaries? Second, a selection of exemplar ethical topics is presented to illustrate the range of topics within global health ethics. PMID:24560262

  17. Global health ethics: an introduction to prominent theories and relevant topics.

    Science.gov (United States)

    Stapleton, Greg; Schröder-Bäck, Peter; Laaser, Ulrich; Meershoek, Agnes; Popa, Daniela

    2014-12-01

    Global health ethics is a relatively new term that is used to conceptualize the process of applying moral value to health issues that are typically characterized by a global level effect or require action coordinated at a global level. It is important to acknowledge that this account of global health ethics takes a predominantly geographic approach and may infer that the subject relates primarily to macro-level health phenomena. However, global health ethics could alternatively be thought of as another branch of health ethics. It may then relate to specific topics in themselves, which might also include micro-level health phenomena. In its broadest sense, global health ethics is a normative project that is best characterized by the challenge of developing common values and universal norms for responding to global health threats. Consequently, many subjects fall within its scope. Whilst several accounts of global health ethics have been conceptualized in the literature, a concise demarcation of the paradigm is still needed. Through means of a literature review, this paper presents a two-part introduction to global health ethics. First, the framework of 'borrowed' ethics that currently form the core of global health ethics is discussed in relation to two essential ethical considerations: 1) what is the moral significance of health and 2) what is the moral significance of boundaries? Second, a selection of exemplar ethical topics is presented to illustrate the range of topics within global health ethics.

  18. [Conscientious objection for health professionals in ethics and deontology].

    Science.gov (United States)

    Martínez León, Mercedes; Rabadán Jiménez, José

    2010-01-01

    The main objective of this paper is to highlight the numerous conflicts enters the consciousness and the laws are becoming more frequent health professionals in daily clinical practice. Clarify and define concepts such as ″conscientious objection for health professionals, to avoid confusion with other terms. This is work that aims to address the objection of conscience, not from the law but from the ethics and deontology, reviewing existing regulations both internationally and nationally. In addition to complete the studio, in a last part we discuss the state of the ″conscientious objection″ tars the recent passage of the organic law 2 / 2010, 3 march, sexual and reproductive health and the interruption of pregnancy. As a final conclusion we can say that ″conscientious objection″ is recognized in international declarations and even in the european constitution. in spain, the code of ethics and medical ethics, is one of the places where the objection of conscience of health professionals has great development for years, states that the doctor can refrain from the practice of certain professional acts such as abortion, in vitro fertilization or sterilization, if they are in contradiction with its ethical and scientific beliefs. Also recently, the general assembly of october 24, 2009, the central committee of ethics has made a declaration on ″conscientious objection″, insisting on its recognition. Finally, the organic law 2 / 2010, 3 march, sexual and reproductive health and the interruption of pregnancy, seems to be recognized ″the right to exercise conscientious objection″ of health professionals directly involved in the voluntary termination of pregnancy, after much discussion, but it is still early to assess the implementation of this right because, until july 5, 2010, will come into force this law, what will the future that we clarify the development of this important right for health professionals.

  19. The law, policy, and ethics of employers' use of financial incentives to improve health.

    Science.gov (United States)

    Madison, Kristin M; Volpp, Kevin G; Halpern, Scott D

    2011-01-01

    The Patient Protection and Affordable Care Act (ACA) turns to a nontraditional mechanism to improve public health: employer-provided financial incentives for healthy behaviors. Critics raise questions about incentive programs' effectiveness, employer involvement, and potential discrimination. We support incentive program development despite these concerns. The ACA sets the stage for a broad-based research and implementation agenda through which we can learn to structure incentive programs to not only promote public health but also address prevalent concerns. © 2011 American Society of Law, Medicine & Ethics, Inc.

  20. The ethics of allocation of scarce health care resources: a view from the centre.

    Science.gov (United States)

    Calman, K C

    1994-06-01

    Resource allocation is a central part of the decision-making process in any health care system. Resources have always been finite, thus the ethical issues raised are not new. The debate is now more open, and there is greater public awareness of the issues. It is increasingly recognised that it is the technology which determines resources. The ethical issues involved are often conflicting and relate to issues of individual rights and community benefits. One central feature of resource allocation is the basing of decisions on the outcomes of health care and on their subsequent economic evaluation. The knowledge base is therefore of great importance as is the audit of results of clinical treatment. Public involvement is seen as an integral part of this process. For all parts of the process, better methodologies are required.

  1. Chiropractic care and public health

    DEFF Research Database (Denmark)

    Johnson, Claire; Rubinstein, Sidney M; Côté, Pierre

    2012-01-01

    through the lifespan, and effective participation in community health issues. The questions that are addressed include: Is spinal manipulative therapy for neck and low-back pain a public health problem? What is the role of chiropractic care in prevention or reduction of musculoskeletal injuries...... in children? What ways can doctors of chiropractic stay updated on evidence-based information about vaccines and immunization throughout the lifespan? Can smoking cessation be a prevention strategy for back pain? Does chiropractic have relevance within the VA Health Care System for chronic pain and comorbid...... of prevention and public health? What role do citizen-doctors of chiropractic have in organizing community action on health-related matters? How can our future chiropractic graduates become socially responsible agents of change?...

  2. Health Reforms and Public Health in Georgia

    Directory of Open Access Journals (Sweden)

    Raminashvili, D.

    2012-07-01

    Full Text Available BACKGROUND: Starting from 90‘th, the Government of Georgia (GoG made several attempts to transform Georgian health care system into one with improved efficiency, accessibility, and quality services. Mandatory social health insurance which was introduced in the 1990s was abolished and private health insurance has been promoted as its replacement. The main principle of health care reform since 2006 was the transition towards complete marketization of the health care sector: private provision, private purchasing, liberal regulation, and minimum supervision.This paper aims to analyze an impact of ongoing reforms on public health and population health status.MATERIALS AND METHODS: A systematic review of the available literature was conducted through national and international organization reports; key informant interviews were conducted with major stakeholders. RESULTS: The country has attained critical achievements in relation to improved maternal and child health, national responses to HIV, TB and Malaria. Life expectancy has increased from 70.3 years in 1995 to 75.1 years in 2010. Under-5 mortality indicator has improved from 45.3 to 16.4 per 1000 live birth in 2005-2010 meaning a 64% decrease. However, Georgia is still facing a number of critical challenges securing better health for the population. Cardiovascular diseases are by far the largest cause of mortality, respiratory diseases are the leading cause of morbidity and have doubled during last decade. Georgia has one of the highest rates of male smoking in the world (over 50%.CONCLUSION: Governmental efforts in health promotion and disease prevention can have significant impact on health status by preventing chronic diseases and detecting health problems at a treatable stage. Government should consider increasing funding for public health and prevention programmes with the focus on prevention of the main risk factors affecting the population’s health: tobacco and drug use and unsafe

  3. Insights in Public Health

    Science.gov (United States)

    Choy, Lehua B; Smith, Heidi Hansen; Espiritu, Justine; Higa, Earl; Lee, Thomas; Maddock, Jay

    2015-01-01

    Abstract In 2011, a small pilot bike share program was established in the town core of Kailua, Hawai‘i, with funding from the Hawai‘i State Department of Health. The Kailua system consisted of two stations with 12 bicycles, and the goal was to secure additional funding to expand the station network in the future. Community feedback consistently indicated support for the bike share program. However, system metrics showed low levels of usage, averaging 41.5 rides per month (2011–2014). From observational data, users were primarily tourists. With minimal local staff, the bike share program had limited resources for promotion and education, which may have hindered potential use by local residents. Management of station operations and bike maintenance were additional, ongoing barriers to success. Despite the challenges, the pilot bike share program was valuable in several ways. It introduced the bike share concept to Hawai‘i, thereby helping to build awareness and connect an initial network of stakeholders. Furthermore, the pilot bike share program informed the development of a larger bike share program for urban Honolulu. As limited information exists in the literature about the experiences of smaller bike share programs and their unique considerations, this article shares lessons learned for other communities interested in starting similar bike share programs. PMID:26535166

  4. Ethical Values, the Flow of Journalistic Information and Public Relations Persons.

    Science.gov (United States)

    Ryan, Michael; Martinson, David L.

    1984-01-01

    Reports on a study that found that public relations practitioners respond in different ways to different moral-ethical dilemmas and that they tend to think they are accountable in some situations to an authority higher than management. Concludes that subjectivism is the prevailing moral-ethical theory of practitioners. (FL)

  5. Researchers’ opinions about ethically sound dissemination of BCI research to the public media

    NARCIS (Netherlands)

    Nijboer, F.; Clausen, J.; Allison, B.Z.; Haselager, P.

    2011-01-01

    BCI research and (future) applications raise ethical questions. A websurvey among 144 BCI researchers identified disseminating BCI research to the public media as a central topic. Most researchers felt that BCI scientists must responsibly communicate with the media and that general ethical guideline

  6. Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

    Science.gov (United States)

    Beveridge, Scott; Garcia, Jorge; Siblo, Matt

    2015-01-01

    Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

  7. Comparison of Ethical Dilemmas across Public and Private Sectors in Rehabilitation Counseling Practice

    Science.gov (United States)

    Beveridge, Scott; Garcia, Jorge; Siblo, Matt

    2015-01-01

    Purpose: To examine the nature of ethical dilemmas most frequently reported by rehabilitation counselors in the private and public sectors and determine if significant differences exist in how practitioners experience ethical dilemmas in these two settings. Method: A mixed-methods internet-based survey design was utilized and included descriptive,…

  8. Ethical Values, the Flow of Journalistic Information and Public Relations Persons.

    Science.gov (United States)

    Ryan, Michael; Martinson, David L.

    1984-01-01

    Reports on a study that found that public relations practitioners respond in different ways to different moral-ethical dilemmas and that they tend to think they are accountable in some situations to an authority higher than management. Concludes that subjectivism is the prevailing moral-ethical theory of practitioners. (FL)

  9. Ethical and Human Rights Foundations of Health Policy: Lessons from Comprehensive Reform in Mexico.

    Science.gov (United States)

    Frenk, Julio; Gómez-Dantés, Octavio

    2015-12-10

    This paper discusses the use of an explicit ethical and human rights framework to guide a reform intended to provide universal and comprehensive social protection in health for all Mexicans, independently of their socio-economic status or labor market condition. This reform was designed, implemented, and evaluated by making use of what Michael Reich has identified as the three pillars of public policy: technical, political, and ethical. The use of evidence and political strategies in the design and negotiation of the Mexican health reform is briefly discussed in the first part of this paper. The second part examines the ethical component of the reform, including the guiding concept and values, as well as the specific entitlements that gave operational meaning to the right to health care that was enshrined in Mexico's 1983 Constitution. The impact of this rights-based health reform, measured through an external evaluation, is discussed in the final section. The main message of this paper is that a clear ethical framework, combined with technical excellence and political skill, can deliver major policy results.

  10. Ethical questions must be considered for electronic health records.

    Science.gov (United States)

    Spriggs, Merle; Arnold, Michael V; Pearce, Christopher M; Fry, Craig

    2012-09-01

    National electronic health record initiatives are in progress in many countries around the world but the debate about the ethical issues and how they are to be addressed remains overshadowed by other issues. The discourse to which all others are answerable is a technical discourse, even where matters of privacy and consent are concerned. Yet a focus on technical issues and a failure to think about ethics are cited as factors in the failure of the UK health record system. In this paper, while the prime concern is the Australian Personally Controlled Electronic Health Record (PCEHR), the discussion is relevant to and informed by the international context. The authors draw attention to ethical and conceptual issues that have implications for the success or failure of electronic health records systems. Important ethical issues to consider as Australia moves towards a PCEHR system include: issues of equity that arise in the context of personal control, who benefits and who should pay, what are the legitimate uses of PCEHRs, and how we should implement privacy. The authors identify specific questions that need addressing.

  11. Causal inference in public health.

    Science.gov (United States)

    Glass, Thomas A; Goodman, Steven N; Hernán, Miguel A; Samet, Jonathan M

    2013-01-01

    Causal inference has a central role in public health; the determination that an association is causal indicates the possibility for intervention. We review and comment on the long-used guidelines for interpreting evidence as supporting a causal association and contrast them with the potential outcomes framework that encourages thinking in terms of causes that are interventions. We argue that in public health this framework is more suitable, providing an estimate of an action's consequences rather than the less precise notion of a risk factor's causal effect. A variety of modern statistical methods adopt this approach. When an intervention cannot be specified, causal relations can still exist, but how to intervene to change the outcome will be unclear. In application, the often-complex structure of causal processes needs to be acknowledged and appropriate data collected to study them. These newer approaches need to be brought to bear on the increasingly complex public health challenges of our globalized world.

  12. Informatics enables public health surveillance

    Directory of Open Access Journals (Sweden)

    Scott J. N McNabb

    2017-01-01

    Full Text Available Over the past decade, the world has radically changed. New advances in information and communication technologies (ICT connect the world in ways never imagined. Public health informatics (PHI leveraged for public health surveillance (PHS, can enable, enhance, and empower essential PHS functions (i.e., detection, reporting, confirmation, analyses, feedback, response. However, the tail doesn't wag the dog; as such, ICT cannot (should not drive public health surveillance strengthening. Rather, ICT can serve PHS to more effectively empower core functions. In this review, we explore promising ICT trends for prevention, detection, and response, laboratory reporting, push notification, analytics, predictive surveillance, and using new data sources, while recognizing that it is the people, politics, and policies that most challenge progress for implementation of solutions.

  13. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment.

    Science.gov (United States)

    Lysdahl, Kristin Bakke; Hofmann, Bjørn

    2016-01-01

    Complexity entails methodological challenges in assessing health care interventions. In order to address these challenges, a series of characteristics of complexity have been identified in the Health Technology Assessment (HTA) literature. These characteristics are primarily identified and developed to facilitate effectiveness, safety, and cost-effectiveness analysis. However, ethics is also a constitutive part of HTA, and it is not given that the conceptions of complexity that appears relevant for effectiveness, safety, and cost-effectiveness analysis are also relevant and directly applicable for ethical analysis in HTA. The objective of this article is therefore to identify and elaborate a set of key characteristics of complex health care interventions relevant for addressing ethical aspects in HTA. We start by investigating the relevance of the characteristics of complex interventions, as defined in the HTA literature. Most aspects of complexity found to be important when assessing effectiveness, safety, and efficiency turn out also to be relevant when assessing ethical issues of a given health technology. However, the importance and relevance of the complexity characteristics may differ when addressing ethical issues rather than effectiveness. Moreover, the moral challenges of a health care intervention may themselves contribute to the complexity. After identifying and analysing existing conceptions of complexity, we synthesise a set of five key characteristics of complexity for addressing ethical aspects in HTA: 1) multiple and changing perspectives, 2) indeterminate phenomena, 3) uncertain causality, 4) unpredictable outcome, and 5) ethical complexity. This may serve as an analytic tool in addressing ethical issues in HTA of complex interventions.

  14. A Study of Reactions to Ethical Dilemmas in Public Relations.

    Science.gov (United States)

    Stacks, Don W.; Wright, Donald K.

    In order to justify ethical instruction for media students, 109 university students in basic communication courses were asked to confront a moral-ethical problem, specifically, the request for information that a sponsoring company or organization wished suppressed. Respondents were randomly assigned to one of four conditions: working for a public…

  15. [Public health education in Austria. An overview].

    Science.gov (United States)

    Diem, Günter; Dorner, Thomas Ernst

    2014-04-01

    The future challenges for the Austrian health care system require an increasing number of public health experts of different professions in all fields of public health. In this article the offer of public health education in Austrian universities and universities for applied sciences was searched based on the predominantly online available information on web platforms of the schools. Currently (2013), there are three postgraduate public health university courses and two public health doctoral programs in Austria. Additionally, 34 degree programmes could be identified, in which parts of public health are covered. But also in medical curricula at Austrian medical schools, public health contents have found their place. In Austria, there is already a multifaceted offer for public health education. However, to build an appropriate public health work force, capable to manage the public health challenges in all its dimensions in terms of health in all policies, this offer should still be intensified.

  16. Quality of publication ethics in the instructions to the authors of Iranian journals of medical sciences.

    Science.gov (United States)

    Salamat, Fatemeh; Sobhani, Abdol-Rasoul; Mallaei, Mahin

    2013-03-01

    Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals) in October 2011. Checklist items (n=15) were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198) were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5%) of the 160 journals were in English and 84 (52.5%) were in Farsi. The most frequently mentioned items related to publication ethics comprised "commitment not to send manuscripts to other journals and re-publish manuscripts" (85%, 83.8%), "aim and scope" of the journal (81.9%), "principles of medical ethics in the use of human samples" (74.4%), and "review process" (74.4%). On the other hand, the items of "principles of advertising" (1.2%), "authorship criteria" (15%), and "integrity in publication of clinical trial results" (30.6%) were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals.

  17. Biotechnological innovation impacts, social and ethical aspects and public acceptability; Sicurezza, implicazioni etico-sociali e percezione pubblica delle biotecnologie

    Energy Technology Data Exchange (ETDEWEB)

    Capuano, V. [ENEA, Centro Ricerche Casaccia, Rome (Italy). Dipt. Innovazione

    1997-11-01

    Biotechnology is a highly distinctive area of scientific activity and its applications can strongly influence human life. Biotechnological innovations impact on sanitary, environmental, social, ethical and economic aspects and it is particularly important a greater public understanding of biotechnology issues in the view of increasing its acceptability. Knowledge and acceptance do not go always in the same direction, as the last is influenced by various complex factors, but without a knowledgeable public there can be no effective democratic agreement. So it appears important that scientific community and industry can promote and diffuse more knowledge among citizens and consumers, taking into account also of social and ethical issues raised by public and public interest groups. In this report bio safety of biotechnology applications and social and ethical issues are analyzed. They receive much attention in the discussion in the biotechnology arena (scientists, industry, institutions and the public). In particular health and environmental risks, gene therapy, transgenic animals, patent issues and genetic resources access, consumers rights are considered. Since the media are central to the dissemination of information and views about science, is has been evidenced their role, in addition to a short analysis of public perception and communication strategies.

  18. A code of ethics for health care ethics consultants: journey to the present and implications for the field.

    Science.gov (United States)

    Tarzian, Anita J; Wocial, Lucia D

    2015-01-01

    For decades a debate has played out in the literature about who bioethicists are, what they do, whether they can be considered professionals qua bioethicists, and, if so, what professional responsibilities they are called to uphold. Health care ethics consultants are bioethicists who work in health care settings. They have been seeking guidance documents that speak to their special relationships/duties toward those they serve. By approving a Code of Ethics and Professional Responsibilities for Health Care Ethics Consultants, the American Society for Bioethics and Humanities (ASBH) has moved the professionalization debate forward in a significant way. This first code of ethics focuses on individuals who provide health care ethics consultation (HCEC) in clinical settings. The evolution of the code's development, implications for the field of HCEC and bioethics, and considerations for future directions are presented here.

  19. [Ethical issues in a market dispute between clinical laboratories and a health plan: case report].

    Science.gov (United States)

    Pinheiro, Malone Santos; de Brito, Ana Maria Guedes; Jeraldo, Verônica de Lourdes Sierpe; Pinheiro, Kariny Souza

    2011-01-01

    In Brazil the private health plans appear as an alternative to the public health assistance. This segment suffered great intensification in the seventies and eighties, culminating in the entry of large insurance company in the scenario of supplementary medicine. Quickly, the service providers associated with these insurance companies, consolidating them in the market and triggering a relationship of dependency. This article analyzed, in the form of a case report, a marketing dispute between clinical laboratories and a health plan, emphasizing the moral and ethical aspects involved in this episode.

  20. Methods of legitimation: how ethics committees decide which reasons count in public policy decision-making.

    Science.gov (United States)

    Edwards, Kyle T

    2014-07-01

    In recent years, liberal democratic societies have struggled with the question of how best to balance expertise and democratic participation in the regulation of emerging technologies. This study aims to explain how national deliberative ethics committees handle the practical tension between scientific expertise, ethical expertise, expert patient input, and lay public input by explaining two institutions' processes for determining the legitimacy or illegitimacy of reasons in public policy decision-making: that of the United Kingdom's Human Fertilisation and Embryology Authority (HFEA) and the United States' American Society for Reproductive Medicine (ASRM). The articulation of these 'methods of legitimation' draws on 13 in-depth interviews with HFEA and ASRM members and staff conducted in January and February 2012 in London and over Skype, as well as observation of an HFEA deliberation. This study finds that these two institutions employ different methods in rendering certain arguments legitimate and others illegitimate: while the HFEA attempts to 'balance' competing reasons but ultimately legitimizes arguments based on health and welfare concerns, the ASRM seeks to 'filter' out arguments that challenge reproductive autonomy. The notably different structures and missions of each institution may explain these divergent approaches, as may what Sheila Jasanoff (2005) terms the distinctive 'civic epistemologies' of the US and the UK. Significantly for policy makers designing such deliberative committees, each method differs substantially from that explicitly or implicitly endorsed by the institution.

  1. Ethics, collective health, qualitative health research and social justice

    OpenAIRE

    Iara Coelho Zito Guerriero; Fernando Peñaranda Correa

    2015-01-01

    AbstractThe scientific field is characterized by the disputes about the delimitation of the field problems, methods and theories that can be considered scientific. The recognition that it is not neutral, that a researcher is a moral subject, and its practices are moral ones, entail that moral reflections, that is, ethics, should be a core process of every researcher. Therefore ethics is not a heteronomous issue, and cannot be reduced to guidelines. In the first part of this article we examine...

  2. Ethical issues in health care institutions. Lesson 2: Ethical considerations in group decision making and groupthink.

    Science.gov (United States)

    Alie, R E

    1991-01-01

    In this second lesson of a five-part WMU/AHRA magazine course on ethics, Dr. Alie tackles an interesting concept--group-think. According to the author, this tendency occurs when cohesive groups lose their ability to critically evaluate alternatives in problem solving. Since groups such as committees or task forces frequently resolve issues and make policy in health care organizations, warning signs of this phenomenon are detailed as well as suggestions to help avoid the problem.

  3. Strengthening public health research for improved health

    Directory of Open Access Journals (Sweden)

    Enrique Gea-Izquierdo

    2012-08-01

    Full Text Available Research in public health is a range that includes from fundamental research to research in clinical practice, including novel advances, evaluation of results and their spreading. Actually, public health research is considered multidisciplinary incorporating numerous factors in its development. Establishing as a mainstay the scientific method, deepens in basic research, clinical epidemiological research and health services. The premise of quality and relevance is reflected in international scientific research, and in the daily work and good biomedical practices that should be included in the research as a common task. Therefore, the research must take a proactive stance of inquiry, integrating a concern planned and ongoing development of knowledge. This requires improve international coordination, seeking a balance between basic and applied research as well as science and technology. Thus research cannot be considered without innovation, weighing up the people and society needs. Acting on knowledge of scientific production processes requires greater procedures thoroughness and the effective expression of the results. It is noted as essential to establish explicit principles in review and evaluation of the adjustments of actions, always within the standards of scientific conduct and fairness of the research process. In the biomedical scientific lines it have to be consider general assessments that occur related to the impact and quality of health research, mostly leading efforts to areas that require further attention. However, other subject areas that may be deficient or with lower incidence in the population should not be overlook. Health research as a source of new applications and development provides knowledge, improving well-being. However, it is understandable without considering the needs and social demands. Therefore, in public health research and to improve the health of the population, we must refine and optimize the prevention and

  4. Snakes and ladders: state interventions and the place of liberty in public health policy.

    Science.gov (United States)

    Dawson, Angus J

    2016-08-01

    In this paper I outline and explore some problems in the way that the Nuffield Council of Bioethics' report Public Health: Ethical Issues (2007) presents its 'Intervention Ladder'. They see the metaphor of a ladder both as capturing key normative priorities and as making a real and important contribution to ethical policymaking in public health. In this paper I argue that the intervention ladder is not a useful model for thinking about policy decisions, that it is likely to produce poor decisions and that it is incompatible with the report's stated approach to relevant public health policy values.

  5. [Cellular phones and public health].

    Science.gov (United States)

    Leventhal, Alex; Karsenty, Eric; Sadetzki, Siegal

    2004-08-01

    The increased use of mobile cellular phone by the public is associated with a wave of contradictory reports about the possible health effects, due to the exposure of the users to electromagnetic non-ionizing radiation. This article reviews the state of the art of the present knowledge concerning the biological and medical effects of exposure to cellular phones, with an emphasis on its possible carcinogenic effect. Health conditions, which have been ascribed to the use of mobile phones mainly include some types of cancer and changes of brain activity. However, the balance of evidence from available studies has not yet supported these claims. Following the recommendation of special international expert committees, the IARC (International Association for Research on Cancer) is conducting a multi-center study to determine the possible effect of cellular phone use on brain and salivary gland tumors. Israel is one of the participants of this study. The only established health effect associated with the use of such technology is an increased risk for road accidents, unrelated to the amount of radiation emitted by phone. The challenge posed by this new technology to health authorities all over the world has lead to the definition of a new principle, the so-called "prudent avoidance", used as guidelines for the definition of an adequate public health policy. The public policy in Israel has used the prudent avoidance principles, while awaiting the results of the multi-national epidemiological studies.

  6. "Un-Googling” publications: The ethics and problems of anonymization

    DEFF Research Database (Denmark)

    Shklovski, Irina; Vertesi, Janet

    2013-01-01

    to the ethics of exposure of our research participants. We present one approach to anonymization of research results with search engines in mind, which we call un-Googling, that we have developed to minimize risk to our participants. We discuss the considerations that this approach raises and pose a challenge...... to the HCI community to take up this discussion not only as an ethical consideration but also as a socio-technical research and design opportunity....

  7. Human experimentation: historical perspective of breaches of ethics in US health care.

    Science.gov (United States)

    Layman, Elizabeth J

    2009-01-01

    Health care supervisors and managers may participate in ethical discussions and serve on ethics committees in their health care organizations. To aid them in their participation and service, this article expands upon the knowledge of ethics that they obtained in their academic training. The article provides readers with a common language based on frequently cited cases and key documents. The article traces a brief history of human experimentation, describes ethical breaches in the United States, and summarizes key documents guiding current thought on informed and voluntary consent. The article concludes with 3 common misconceptions that health care supervisors and managers will want to avoid in ethical discussions and ethical decision making. Health care supervisors and managers will be prepared to meaningfully contribute to the discussion of ethical issues and to the resolution of ethical problems in their health care organizations.

  8. Competency Guidelines for Public Health Laboratory Professionals: CDC and the Association of Public Health Laboratories.

    Science.gov (United States)

    Ned-Sykes, Renée; Johnson, Catherine; Ridderhof, John C; Perlman, Eva; Pollock, Anne; DeBoy, John M

    2015-05-15

    These competency guidelines outline the knowledge, skills, and abilities necessary for public health laboratory (PHL) professionals to deliver the core services of PHLs efficiently and effectively. As part of a 2-year workforce project sponsored in 2012 by CDC and the Association of Public Health Laboratories (APHL), competencies for 15 domain areas were developed by experts representing state and local PHLs, clinical laboratories, academic institutions, laboratory professional organizations, CDC, and APHL. The competencies were developed and reviewed by approximately 170 subject matter experts with diverse backgrounds and experiences in laboratory science and public health. The guidelines comprise general, cross-cutting, and specialized domain areas and are divided into four levels of proficiency: beginner, competent, proficient, and expert. The 15 domain areas are 1) Quality Management System, 2) Ethics, 3) Management and Leadership, 4) Communication, 5) Security, 6) Emergency Management and Response, 7) Workforce Training, 8) General Laboratory Practice, 9) Safety, 10) Surveillance, 11) Informatics, 12) Microbiology, 13) Chemistry, 14) Bioinformatics, and 15) Research. These competency guidelines are targeted to scientists working in PHLs, defined as governmental public health, environmental, and agricultural laboratories that provide analytic biological and/or chemical testing and testing-related services that protect human populations against infectious diseases, foodborne and waterborne diseases, environmental hazards, treatable hereditary disorders, and natural and human-made public health emergencies. The competencies support certain PHL workforce needs such as identifying job responsibilities, assessing individual performance, and providing a guiding framework for producing education and training programs. Although these competencies were developed specifically for the PHL community, this does not preclude their broader application to other professionals

  9. Publicity in dentistry: assessment of the ethical aspects involved

    Directory of Open Access Journals (Sweden)

    Artênio José Isper Garbin

    2010-04-01

    Full Text Available Objective: To verify whether the professionals who make use of advertising in Dentistry by means of billboards respect the ethical aspects determined by the Federal Council of Dentistry Resolution No 71, 2006. Methods: This was an observational study in which 178 billboards of dental clinics in the municipality of São Paulo were assessed. Results: Among the billboards analyzed, 91.4% belonged to private persons and 9.6% to corporate bodies. With regard to the ethical aspects related to the advertisement, only 44.9% of the billboards presented all the mandatory items in accordance with the Federal Council of Dentistry. The item found the least number of times in the advertisements was the registration number in the Regional Council of Dentistry (34.8%. Among the items allowed by the Federal Council of Dentistry, the telephone number (65.2% was the most commonly found. Among the ethical infractions, 1.7% of the billboards advertised the terms of payment. Conclusion: Professionals are not following the ethical precepts established by the Code of Ethics in Dentistry, and awareness of these professionals needs to be aroused, so that information about their services is communicated and divulged in an ethical manner.

  10. The ethics of advertising for health care services.

    Science.gov (United States)

    Schenker, Yael; Arnold, Robert M; London, Alex John

    2014-01-01

    Advertising by health care institutions has increased steadily in recent years. While direct-to-consumer prescription drug advertising is subject to unique oversight by the Federal Drug Administration, advertisements for health care services are regulated by the Federal Trade Commission and treated no differently from advertisements for consumer goods. In this article, we argue that decisions about pursuing health care services are distinguished by informational asymmetries, high stakes, and patient vulnerabilities, grounding fiduciary responsibilities on the part of health care providers and health care institutions. Using examples, we illustrate how common advertising techniques may mislead patients and compromise fiduciary relationships, thereby posing ethical risks to patients, providers, health care institutions, and society. We conclude by proposing that these risks justify new standards for advertising when considered as part of the moral obligation of health care institutions and suggest that mechanisms currently in place to regulate advertising for prescription pharmaceuticals should be applied to advertising for health care services more broadly.

  11. Ethics and skeptics: what lies behind ethical codes in occupational health.

    Science.gov (United States)

    Guidotti, Tee L

    2005-02-01

    Ethical codes, or systems, are conditioned and their enforcement is permitted by social processes and attitudes. In occupational health, our efforts to adhere to our own ethical frameworks often are undermined by forces and interests outside the field. Failure to acknowledge the profoundly social nature of ethical codes impedes our ability to anticipate consequences, to legitimate decisions based on utility and benefit, and to find social structures that support, rather than invalidate, our view of ethical behavior. We examine three sets of social philosophies. Jane Jacobs, the visionary urban planner, has written Systems of Survival: A Dialogue on the Moral Foundations of Commerce and Politics, which is a restatement in modern terms of a critical passage in Plato's most important dialogue, the Republic. She (and Plato) postulate two major ethical systems, renamed here the "guardian system," which is characterized by loyalty, cohesiveness, and confidentiality, and the "marketplace system," which is characterized by trade, decentralization, and shared information. Occupational health, in this formulation, often runs afoul of the guardian mentality and also may be subject to inappropriate negotiation and compromise in the marketplace system. George Lakoff, a semiotician, has written Moral Politics: What Conservatives Know That Liberals Don't, which argues that there are two fundamental social paradigms based on concepts of the family. One, which he calls the Strict Father, emphasizes discipline, the positive aspects of taking risks, and the need to individuals to be self-sufficient. The other, which he calls the Nurturing Parent, emphasizes empowerment, the positive aspects of security, and the need for community and relationships. Occupational health practice violates aspects of both and therefore is supported by neither. Classical Chinese thought involved many schools of thought, including Confucianism and Legalism. It has been suggested that Confucianism provides

  12. Ethics Instruction for Future Geoscientists: Essential for Contributions to Good Public Policy

    Science.gov (United States)

    Leinen, M.; Mogk, D. W.

    2016-12-01

    Geoscientists work in a world of uncertainty in the complex, dynamic, and chaotic Earth system that is fraught with opportunities to become involved in ethical dilemmas. To be effective contributors to the public discourse on Earth science policy, geoscientists must conduct their work according to the highest personal and professional ethical standards. The geosciences as a discipline relies on the fidelity of geoscience data and their interpretations, geoscience concepts and methodologies must be conveyed to policy makers in ways that allow them to make informed decisions, corporations require a workforce that conducts their affairs according to the highest standards, and the general public expects the highest standards of conduct of geoscientists as they underwrite much of the research supported through tax dollars and the applications of this research impacts personal and societal lives. Geoscientists must have the foundations to identify ethical dilemmas in the first instance, and to have the ethical decision-making skills to either prevent, mitigate or otherwise address ethical issues that arise in professional practice. Awareness of ethical issues arises in many dimensions: Ethics and self (engaging self-monitoring and self-regulating behaviors); Ethics and profession (working according to professional standards); Ethics and society (communicating effectively to policy makers and the general public about the underlying science that informs public policy); and, Ethics and Earth (recognizing the unique responsibilities of geoscientists in the stewardship of Earth). To meet these ethical challenges, training of future geoscientists must be done a) at the introductory level as all students should be aware of ethical implications of geoscience concepts as they impact societal issues; undergraduate geoscience majors need to be explicitly trained in the standards and norms of the geoscience community of practice; graduate students need to be fully prepared to deal

  13. Teaching Ethics and Values in Public Administration Programs: Innovations, Strategies, and Issues. SUNY Series in Public Administration.

    Science.gov (United States)

    Bowman, James, Ed.; Menzel, Donald, Ed.

    The 17 chapters in this book consider innovations, teaching strategies, and issues in ethics instruction for professional and graduate programs in public affairs/administration. Following an introductory chapter which summarizes data reported in a 1995 national survey of 138 graduate departments of public affairs/administration, chapter titles…

  14. Law and public health at CDC.

    Science.gov (United States)

    Goodman, Richard A; Moulton, A; Matthews, G; Shaw, F; Kocher, P; Mensah, G; Zaza, S; Besser, R

    2006-12-22

    Public health law is an emerging field in U.S. public health practice. The 20th century proved the indispensability of law to public health, as demonstrated by the contribution of law to each of the century's 10 great public health achievements. Former CDC Director Dr. William Foege has suggested that law, along with epidemiology, is an essential tool in public health practice. Public health laws are any laws that have important consequences for the health of defined populations. They derive from federal and state constitutions; statutes, and other legislative enactments; agency rules and regulations; judicial rulings and case law; and policies of public bodies. Government agencies that apply public health laws include agencies officially designated as "public health agencies," as well as health-care, environmental protection, education, and law enforcement agencies, among others.

  15. Personal Responsibility in Oral Health: Ethical Considerations

    DEFF Research Database (Denmark)

    Albertsen, Andreas

    2012-01-01

    Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people...... responsible by introducing measures that decrease their share of available resources. Introducing personal responsibility in oral health also has limitations of a more practical nature. Knowledge, social status and other diseases affect the degree to which people can be said to be responsible for their poor...... oral health. These factors affect people’s oral health and their ability to take care of it. Both the conceptual and practical issues at stake are not reasons to abandon the idea of personal responsibility in oral health, but they do affect what the notion means and when it is reasonable to hold people...

  16. An ecological public health approach to understanding the relationships between sustainable urban environments, public health and social equity.

    Science.gov (United States)

    Bentley, Michael

    2014-09-01

    The environmental determinants of public health and social equity present many challenges to a sustainable urbanism-climate change, water shortages and oil dependency to name a few. There are many pathways from urban environments to human health. Numerous links have been described but some underlying mechanisms behind these relationships are less understood. Combining theory and methods is a way of understanding and explaining how the underlying structures of urban environments relate to public health and social equity. This paper proposes a model for an ecological public health, which can be used to explore these relationships. Four principles of an ecological public health-conviviality, equity, sustainability and global responsibility-are used to derive theoretical concepts that can inform ecological public health thinking, which, among other things, provides a way of exploring the underlying mechanisms that link urban environments to public health and social equity. Theories of more-than-human agency inform ways of living together (conviviality) in urban areas. Political ecology links the equity concerns about environmental and social justice. Resilience thinking offers a better way of coming to grips with sustainability. Integrating ecological ethics into public health considers the global consequences of local urban living and thus attends to global responsibility. This way of looking at the relationships between urban environments, public health and social equity answers the call to craft an ecological public health for the twenty-first century by re-imagining public health in a way that acknowledges humans as part of the ecosystem, not separate from it, though not central to it.

  17. A review of management of infertility in Nigeria: framing the ethics of a national health policy

    Directory of Open Access Journals (Sweden)

    Akinloye O

    2011-08-01

    Full Text Available Oluyemi Akinloye1,2, Ernest J Truter21Department of Chemical Pathology, Reproductive and Molecular Endocrinology Unit, College of Health Sciences, Ladoke Akintola University of Technology, Osogbo, Osun State, Nigeria; 2Department of Biomedical Sciences, Faculty of Health and Wellness Science, Cape Peninsula University of Technology, Bellville Campus, Cape Town, South AfricaAbstract: Infertility has recently been construed to be a serious problem in sub-Saharan Africa. This problem seems to be viewed as of low priority with reference to the effective and efficient allocation of available health resources by national governments as well as by international donors sponsoring either research or service delivery in the public health sector. In this paper the problem of infertility in Nigeria is surveyed with a view to assessing the ethical dimension of proposals to manage infertility as a public sector priority in health care delivery. The population/individual and public/private distinction in the formulation of health policy has ethical implications that cannot simply be ignored and are therefore engaged in critically assessing the problem of infertility. Cost–utility analysis (such as Quality Adjusted Life-Year composite index in the management of infertility in Nigeria entails the need for caution relevant to the country's efforts to achieve Millennium Development Goals. This should remain the case whether the ethical evaluation appeals to utilitarian or contractarian (Rawlsian principles. The "worst off" category of Nigerians includes (1 underweight children less than 5 years of age, with special concern for infants (0–1 years of age and (2 the proportion of the population below a minimum level of dietary consumption. The Rawlsian ethic implies that any Federal Ministry of Health policy aimed at establishing public programs for infertility management can be considered a "fair" allocation and expenditure if, and only if, the situation for

  18. Reproductive cloning and human health: an ethical, international, and nursing perspective.

    Science.gov (United States)

    Sanchez-Sweatman, L R

    2000-03-01

    Human reproductive cloning came to the public's attention when Dolly, a sheep, was cloned in Scotland in 1997. This news quickly spread around the world causing both excitement at the possibilities that cloning techniques could offer, as well as apprehension about the ethical, social and legal implications should human reproductive cloning become possible. Many international organizations, such as the World Health Organization, the International Council of Nurses, and governments were concerned about the impact of human reproductive cloning on human health, dignity and human rights. To this end, many institutions have drafted resolutions, protocols and position statements outlining their concerns. This paper will outline some of the major ethical issues surrounding human reproductive cloning, the position of various international organizations and governments, and specifically the position of the International Council of Nurses.

  19. Conscientious objection: personal and professional ethics in the public square.

    Science.gov (United States)

    Montgomery, Jonathan

    2015-01-01

    English law expects health professionals to have, and act upon, consciences, but formal conscience clauses are not the main legal recognition of this expectation. Rather, they should be regarded as an anomaly with roots in very specific political settlements between society and health professions, whose legitimacy is historically contingent, and as an aspect of the 'price' to be paid for securing services. There are sound reasons for the protection of conscientious discretion as an aspect of professional identify, but specific rights of personal conscientious objection are difficult to reconcile with legitimate public expectations of comprehensive and non-discriminatory services. Professional identities include moral commitments, such as the privileging of patient safety over administrative convenience. These should not be permitted to be overridden by personal moralities during the course of service delivery (as opposed to debating in the abstract what the proper courses of action should be). Consequently, formal conscientious objection clauses should be reduced to a minimum and regularly revisited. It is generally more satisfactory to address clashes between the personal moralities of professionals and public expectations through more flexible means, enabling accommodation of a plurality of views where possible but acknowledging that this is a matter of striking an appropriate balance. Employment law rather than healthcare law provides the best mechanism for regulating this process.

  20. [Social marketing and public health].

    Science.gov (United States)

    Arcaro, P; Mannocci, A; Saulle, R; Miccoli, S; Marzuillo, C; La Torre, G

    2013-01-01

    Social marketing uses the principles and techniques of commercial marketing by applying them to the complex social context in order to promote changes (cognitive; of action; behavioral; of values) among the target population in the public interest. The advent of Internet has radically modified the communication process, and this transformation also involved medical-scientific communication. Medical journals, health organizations, scientific societies and patient groups are increasing the use of the web and of many social networks (Twitter, Facebook, Google, YouTube) as channels to release scientific information to doctors and patients quickly. In recent years, even Healthcare in Italy reported a considerable application of the methods and techniques of social marketing, above all for health prevention and promotion. Recently the association for health promotion "Social marketing and health communication" has been established to promote an active dialogue between professionals of social marketing and public health communication, as well as among professionals in the field of communication of the companies involved in the "health sector". In the field of prevention and health promotion it is necessary to underline the theme of the growing distrust in vaccination practices. Despite the irrefutable evidence of the efficacy and safety of vaccines, the social-cultural transformation together with the overcoming of compulsory vaccination and the use of noninstitutional information sources, have generated confusion among citizens that tend to perceive compulsory vaccinations as needed and safe, whereas recommended vaccinations as less important. Moreover, citizens scarcely perceive the risk of disease related to the effectiveness of vaccines. Implementing communication strategies, argumentative and persuasive, borrowed from social marketing, also for the promotion of vaccines is a priority of the health system. A typical example of the application of social marketing, as

  1. Personal responsibility in oral health: ethical considerations.

    Science.gov (United States)

    Albertsen, Andreas

    2012-11-30

    Personal responsibility is a powerful idea supported by many values central to West European thought. On the conceptual level personal responsibility is a complex notion. It is important to separate the concept of being responsible for a given state of affairs from the concept of holding people responsible by introducing measures that decrease their share of available resources. Introducing personal responsibility in oral health also has limitations of a more practical nature. Knowledge, social status and other diseases affect the degree to which people can be said to be responsible for their poor oral health. These factors affect people's oral health and their ability to take care of it. Both the conceptual and practical issues at stake are not reasons to abandon the idea of personal responsibility in oral health, but they do affect what the notion means and when it is reasonable to hold people responsible. They also commit people who support the idea of personal responsibility in oral health to supporting the idea of societal responsibility for mitigating the effects of factors that diminish people's responsibility and increase the available information and knowledge in the population.

  2. Ethical issues in electronic health records: A general overview

    Directory of Open Access Journals (Sweden)

    Fouzia F Ozair

    2015-01-01

    Full Text Available Electronic health record (EHR is increasingly being implemented in many developing countries. It is the need of the hour because it improves the quality of health care and is also cost-effective. Technologies can introduce some hazards hence safety of information in the system is a real challenge. Recent news of security breaches has put a question mark on this system. Despite its increased usefulness, and increasing enthusiasm in its adoption, not much attention is being paid to the ethical issues that might arise. Securing EHR with an encrypted password is a probable option. The purpose of this article is to discuss the various ethical issues arising in the use of the EHRs and their possible solutions.

  3. Ethical and managerial considerations regarding state physician health programs.

    Science.gov (United States)

    Boyd, J Wesley; Knight, John R

    2012-12-01

    Many physicians are referred to state physician health programs (PHPs) for evaluation, monitoring, and treatment of mental health and substance use disorders. Most PHPs are "diversion" or "safe haven" programs, meaning that physicians who suffer from alcohol or drug problems can have their case diverted to the PHP in lieu of being reported to the state licensing board. If the physician agrees to cooperate with the PHP and adhere to any recommendations it might make, the physician can avoid disciplinary action and remain in practice. These programs are therefore quite powerful and yet, to our knowledge, there has not been any systematic scrutiny of the ethical and management issues that arise in standard PHP practice. Given our 20 years of service as associate directors of one state PHP we analyze and evaluate the standard operating procedure of many PHPs and offer ethical critique as well as suggestions for improvement.

  4. Splitting embryos on the slippery slope: ethics and public policy.

    Science.gov (United States)

    Macklin, Ruth

    1994-09-01

    Neither the George Washington University embryo splitting experiment nor the technique of embryo splitting itself has ethical flaws. The experiment harmed or wronged no one, and the investigators followed intramural review procedures for the experiment, although some might fault them for failing to seek extramural consultation or for not waiting until national guidelines for research on preembryos were developed. Ethical objections to such cloning on the basis of possible loss of individuality, possible lessening of individual worth, and concern about potential harm to the resulting children are discussed and challenged, as are objections to the creation of embryos for the purpose of genetic diagnosis. Many of the ethical questions raised by the George Washington experiment are similar to those posed by existing reproductive technologies that allow the simultaneous production of several embryos. A multidisciplinary group should consider whether regulation of cloning is needed, and laws should be enacted to prohibit a commercial market for all frozen embryos.

  5. ETHICS IN HEALTH CARE: INDUCEMENT AND HUMAN SUBJECTS

    Directory of Open Access Journals (Sweden)

    MUNIR HOSSAIN TALUKDER

    2011-05-01

    Full Text Available Currently, most health researchers or donor organizations considerinducement as a vital part in promoting research. They propose benefits, such as post research free medical treatment, food, insurance facilities, or even cash, in order to meet sufficient number of subjects. So, inducement may influence one to participate in a research. Is it ethical to offer inducement to human subjects? What are the risks in such practice? What will happen if the donor agencies use subjects by hiding possible risks from them? When an inducement can satisfy ethical criteria? The CIOMS, FDA, and other ethical guidelines hold that inducement is unethical because it involves enough risk for voluntary informed consent. Supporting this position, a group of ethicists has argued that inducement undermines voluntariness especially when subjects are poor and vulnerable, and thus, unethical. In contrast to them, others argue that inducement contributes to discover new knowledge which can improve miserable condition of the poor. In their view, an inducement maintains all ethical criteria including subject’s autonomy, and therefore, morally permissible. The paper focuses this debate and analyzes both types ofargument. It examines whether inducement invalidate informed consent.Even if inducement may not violate the basic components of informedconsent, the paper concludes, subjects may claim a prima facie right to enjoy research outcomes.

  6. The Ethics of Belief, Cognition, and Climate Change Pseudoskepticism: Implications for Public Discourse.

    Science.gov (United States)

    Torcello, Lawrence

    2016-01-01

    The relationship between knowledge, belief, and ethics is an inaugural theme in philosophy; more recently, under the title "ethics of belief" philosophers have worked to develop the appropriate methodology for studying the nexus of epistemology, ethics, and psychology. The title "ethics of belief" comes from a 19th-century paper written by British philosopher and mathematician W.K. Clifford. Clifford argues that we are morally responsible for our beliefs because (a) each belief that we form creates the cognitive circumstances for related beliefs to follow, and (b) we inevitably influence each other through those beliefs. This study argues that recent cognitive research supports Cliffordian insights regarding patterns of belief formation and social influence. From the confirmation offered by such research, it follows that informational accuracy holds serious ethical significance in public discourse. Although scientific and epistemological matters are not always thought to be linked to normative morality, this study builds on Clifford's initial insights to show their linkage is fundamental to inquiry itself. In turn, Clifford's ethical and epistemic outline can inform a framework grounded in "public reason" under which seemingly opposed science communication strategies (e.g., "information deficit" and "cultural cognition" models) are philosophically united. With public discourse on climate change as the key example, empirically informed and grounded strategies for science communication in the public sphere are considered. Copyright © 2016 Cognitive Science Society, Inc.

  7. Public health aspects of tobacco control revisited

    NARCIS (Netherlands)

    Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana

    2010-01-01

    The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make

  8. Public health interventions: evaluating the economic evaluations

    Directory of Open Access Journals (Sweden)

    Martin Forster

    2013-10-01

    Full Text Available Recent years have witnessed much progress in the incorporation of economic considerations into the evaluation of public health interventions. In England, the Centre for Public Health Excellence within the National Institute for Health and Care Excellence works to develop guidance for preventing illness and assessing which public health interventions are most effective and provide best value for money...

  9. Public health aspects of tobacco control revisited

    NARCIS (Netherlands)

    Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana

    2010-01-01

    The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make

  10. Public health aspects of tobacco control revisited

    NARCIS (Netherlands)

    Gallagher, Jennifer E.; Alajbeg, Ivan; Buechler, Silvia; Carrassi, Antonio; Hovius, Marjolijn; Jacobs, Annelies; Jenner, Maryan; Kinnunen, Taru; Ulbricht, Sabina; Zoitopoulos, Liana

    The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make

  11. Public health aspects of tobacco control revisited.

    NARCIS (Netherlands)

    Gallagher, J.E.; Alajbeg, I.; Buchler, S.; Carrassi, A.; Hovius, M.; Jacobs, A.; Jenner, M.; Kinnunen, T.; Ulbricht, S.; Zoitopoulos, L.

    2010-01-01

    The tobacco epidemic presents a major public health challenge, globally, and within Europe. The aim of the Public Health Work Stream at the 2nd European Workshop on Tobacco Use Prevention and Cessation for Oral Health Professionals was to review the public health aspects of tobacco control and make

  12. [Shared governance and reasonableness as ethical contributions to health policy].

    Science.gov (United States)

    Costa-Alcaraz, Ana M; Calvo-Rigual, Fernando; Siurana-Aparisi, Juan Carlos

    2013-01-01

    Health is one of the fundamental human rights. Recognizing it as a right means that the State has an obligation to ensure a minimum level of opportunities is maintained, and to restore it when lost. This minimum level may not be covered in periods of economic crisis, such as the one we are currently experiencing.Managed care, focused on economic questions, emerged after the crisis of 1973 in order to help make clinical decisions based on economic factors. In practice, the result of managed care was to turn economic cost control into an end in itself while forgetting about equity; something for which it has been challenged from an ethical perspective. Since then, many authors have attempted to reconcile efficiency and equity in health management, but the debate remains open.In this article, and basing our approach on the theories of P. Ruger and Norman Daniels, we argue that shared health governance and accountability for reasonableness can offer significant ethical contributions in the process of achieving an efficient and fair health system. In the model we propose, citizens, professionals and health institutions all play an active role in capacity building in the field of health. These capacities are related to healthy lifestyles, accessible and transparent information, the promotion of self-care, the acquisition of knowledge, skills and appropriate attitudes, leadership based on values and co-responsibility to achieve set goals in a reasonable way. If we develop these capacities, we will have used the current economic crisis as an opportunity for improving ethical practice in the field of health.

  13. Ethical and public policy aspects of childhood obesity: opinions of scientists working on an intervention study.

    Science.gov (United States)

    Wickins-Drazilova, D; Williams, G

    2010-08-01

    Scientists working on an obesity intervention project were asked questions, via questionnaire and interviews, relating to ethical and public-policy aspects of tackling childhood obesity. The main areas of enquiry concerned elements responsible for the rise in childhood obesity, key ethical areas of obesity interventions, helpfulness and effectiveness of policy measures, socioeconomic factors, and media coverage and political debate. Key results from this indicate that: there is disagreement about the amount of information about the causes of obesity that is needed before implementing interventions; an improvement in health and nutrition education of both children and adults through positive messages is seen as highly desirable; scientists regard environment, rather than genetics, as playing the major role in rising obesity levels; the level of individual responsibility being placed on parents and children may be unfair and unhelpful; whole-system, long-term and sensitive policy actions are needed rather than relying on quick fixes such as miracle pills; and there are country-specific issues related to rising obesity levels that need to be considered, though the respondents tended to have a great deal of faith in EU-wide interventions.

  14. Public health in South-East Asia in the 21st century.

    Science.gov (United States)

    2000-01-01

    This paper presents the proceedings of the Regional Conference on Public Health in Southeast Asia in the 21st Century, held in Calcutta, India, on November 22-24, 1999. Organized by the WHO, the conference reviewed the progress in Public Health education and training, practice and research in the countries of the region. Discussions were focused on the quality of the Schools of Public Health, professional capacities, societal commitment, shrinking resources for health and the resultant need for greater efficiency of interventions and the realization of national Public Health goals. It also stressed the importance of Public Health for national, socioeconomic and political development. Moreover, the participants identified key strategies and initiatives for strengthening Public Health in the region. These measures include focusing on the promotion of health in all settings; social mobilization and community action; strengthening the scientific and ethical foundation for evidence-based policy formulation in Public Health; and the creation of an Executive Management Team.

  15. Public perceptions of health care professionals' participation in pharmaceutical marketing.

    Science.gov (United States)

    Crigger, Nancy J; Courter, Laura; Hayes, Kristen; Shepherd, K

    2009-09-01

    Trust in the nurse-patient relationship is maintained not by how professionals perceive their actions but rather by how the public perceives them. However, little is known about the public's view of nurses and other health care professionals who participate in pharmaceutical marketing. Our study describes public perceptions of health care providers' role in pharmaceutical marketing and compares their responses with those of a random sample of licensed family nurse practitioners. The family nurse practitioners perceived their participation in marketing activities as significantly more ethically appropriate than did the public responders. Further research is warranted before conclusions can be drawn, but these early findings suggest that nurse practitioners should consider a conservative approach to participating in pharmaceutical marketing.

  16. Ethics of the profession of public relations--does the public relations affects on journalism in Croatia?

    Science.gov (United States)

    Tanta, Ivan; Lesinger, Gordana

    2013-09-01

    The UK's leading professional body for public relations "Chartered Institute of Public Relations" (CIPR) said that the public relations is about reputation--they are the result of what you do, what you say and what others say about you. Furthermore CIPR says that public relations are discipline whose objectives are safeguarding reputation, establishing understanding and pot pores, and the impact on the thinking and behavior of the public. Although the primary goal of public relations is to preserve and build a reputation, to tell the truth to a customer who has hired experts in this area, it seems that in its own way of development, public relations practitioners have stopped worrying about their reputation and the perception of the discipline within the public they address. All relevant professional bodies for public relations, including the Croatian Association for Public Relation (HUOJ), had set up codes of ethics and high standards according which the members and practitioners should be evaluated. Among other things stays that practitioner of public relations is required to check the reliability and accuracy of the data prior to their distribution and nurture honesty and accountability to the public interest. It seems that right this instruction of code of ethics has been often violated. In a public speech in Croatia, and therefore in the media, exist manipulation, propaganda, and all the techniques of spin, which practitioners of public relations are skillfully using in the daily transfer of information to the users and target groups. The aim of this paper is to determine what is the perception of the profession to the public. As in today's journalism increasingly present plume of public relations, we wish to comment on the part where journalism ends and begins PR and vice versa. In this paper, we analyze and compare codes of ethics ethics associations for public relations, as well as codes of ethics journalists' associations, in order to answer the question

  17. Ethics in the practice of speech-language pathology in health care settings.

    Science.gov (United States)

    Kummer, Ann W; Turner, Jan

    2011-11-01

    ETHICS refers to a moral philosophy or a set of moral principles that determine appropriate behavior in a society. Medical ethics includes a set of specific values that are considered in determining appropriate conduct in the practice of medicine or health care. Because the practice of medicine and medical speech-language pathology affects the health, well-being, and quality of life of individuals served, adherence to a code of ethical conduct is critically important in the health care environment. When ethical dilemmas arise, consultation with a bioethics committee can be helpful in determining the best course of action. This article will help to define medical ethics and to discuss the six basic values that are commonly considered in discussions of medical ethics. Common ethical mistakes in the practice of speech-language pathology will be described. Finally, the value of a bioethics consultation for help in resolving complex ethical issues will be discussed.

  18. Public Policy Systems Dealing with Ethically Contested Medical Technological Innovations

    NARCIS (Netherlands)

    Hoppe, Rob

    2008-01-01

    The questions tackled in this paper are: How do we deal with ethically contested medical innovations?, and Can we do better? First, I analyse how we deal with these problems by a division of labour and competitive boundary work between the medical R&D system's research and technological imperative,

  19. The Partnership of Public Health and Anthropology

    OpenAIRE

    Jelenc, Marjetka

    2016-01-01

    Public health focuses on health of the population and it is concerned with threats to health based on population health analysis. Anthropology covers most aspects that concern human beings. Both sciences converge on community and this fact represents a foundation for the partnership between public health and anthropology. Biological/medical anthropology is one of the highly developed fields of anthropology and the most important for public health.

  20. The importance of vocational ethics in paramedic education, vocational ethics course for paramedics

    Directory of Open Access Journals (Sweden)

    Pakdemirli Ahu

    2016-01-01

    Full Text Available Ethics are rules of behaviors which morally good or bad. Bioethics is the study of ethics about by advances in biology and medicine. Health care providers should have knowledge about health professional ethics principles, public officials’ ethical behavior principles and ethical principles concerned about other legislation. They should find the required information to make logical, objective and accurate decisions where they may face with ethical problems in their professional life. Unfortunately in our country there isn’t any special vocational ethics course designed for paramedics. Our aim is to design a Vocational Ethics Course for Paramedics which includes all issues of bioethics.

  1. Ethics as a precursor to organization–public relationships: Building trust before and during the OPR model

    OpenAIRE

    Shannon A. Bowen; Chun-Ju Flora Hung-Baesecke; Yi-Ru Regina Chen

    2016-01-01

    This study builds on the public relations theory of organization–public relationships (OPRs) by exploring the role of ethics as a precursor to building OPRs. We qualitatively explore the existing relationship variables in the context of ethical behavior as a precursor to building authentic, long-term relationships with publics that will eventually benefit an organization’s effectiveness and reputation. These variables have not yet been explored in terms of ethics. We conducted elite interview...

  2. PUBLIC HEALTH ETHICS: TRADITION, PROFESSION, AND VALUES ÉTICA DE LA SALUD PÚBLICA: TRADICIÓN, PROFESIÓN Y VALORES ÉTICA DA SAÚDE PÚBLICA: TRADIÇÃO, PROFISSÃO E VALORES

    Directory of Open Access Journals (Sweden)

    Lawrence O Gostin

    2003-01-01

    Full Text Available This article asks the difficult questions- what is public health? and what is public health ethics? The article also recognizes that even though public health and biomedical ethics overlap, they have distinct aspects. The article examines the unique population-based perspective of public health and how it can be distinguished from patientcentered biomedical ethics. Additionally, public health scholars and practitioners often use ethical analyses with other forms of reasoning, particularly law and human rights. The article, therefore, explores the relationship among public health ethics, public health law and human rights. The various meanings of each form of reasoning are discussed, as well as the similarities and differences among them. The article concludes with a proposal for reconciling the inherent tradeoffs between public health and civil liberties. Prior to exercising compulsory powers, public health officials should examine the risk to the public; the likelihood that the intervention will be effective; the opportunity costs; the burdens on human rights and the policy's fairnessEste artículo analiza las difíciles preguntas ¿qué es salud pública? y ¿qué es ética de la salud pública? El artículo también reconoce que aunque la salud pública y la ética biomédica se superponen, abordan distintos aspectos. El artículo examina el enfoque único de la salud pública centrado en la población y cómo éste puede ser distinguido del enfoque de la ética biomédica, centrado en el paciente. Adicionalmente, los teóricos y practicantes de la salud pública frecuentemente utilizan el análisis ético con otras formas de razonamiento, particularmente el legal y el de derechos humanos. Por consiguiente, el artículo discute los diversos significados de cada razonamiento, como también las similitudes y diferencias entre ellos. El artículo concluye con una propuesta para reconciliar las tensiones inherentes entre la salud pública y las

  3. Complex health care interventions: Characteristics relevant for ethical analysis in health technology assessment

    Directory of Open Access Journals (Sweden)

    Lysdahl, Kristin Bakke

    2016-03-01

    Full Text Available Complexity entails methodological challenges in assessing health care interventions. In order to address these challenges, a series of characteristics of complexity have been identified in the Health Technology Assessment (HTA literature. These characteristics are primarily identified and developed to facilitate effectiveness, safety, and cost-effectiveness analysis. However, ethics is also a constitutive part of HTA, and it is not given that the conceptions of complexity that appears relevant for effectiveness, safety, and cost-effectiveness analysis are also relevant and directly applicable for ethical analysis in HTA. The objective of this article is therefore to identify and elaborate a set of key characteristics of complex health care interventions relevant for addressing ethical aspects in HTA. We start by investigating the relevance of the characteristics of complex interventions, as defined in the HTA literature. Most aspects of complexity found to be important when assessing effectiveness, safety, and efficiency turn out also to be relevant when assessing ethical issues of a given health technology. However, the importance and relevance of the complexity characteristics may differ when addressing ethical issues rather than effectiveness. Moreover, the moral challenges of a health care intervention may themselves contribute to the complexity. After identifying and analysing existing conceptions of complexity, we synthesise a set of five key characteristics of complexity for addressing ethical aspects in HTA: 1 multiple and changing perspectives, 2 indeterminate phenomena, 3 uncertain causality, 4 unpredictable outcome, and 5 ethical complexity. This may serve as an analytic tool in addressing ethical issues in HTA of complex interventions.

  4. [Parmentier hygiene and public health].

    Science.gov (United States)

    Lafont, O

    2014-05-01

    The legend about Parmentier is quite reductive when it limits his activity to the promotion of potato. This military pharmacist intended mainly to make science serve human being, whatever could be his various activities. Actor of the foundation of food chemistry, reorganizer of military pharmacy, he has always been highly concerned with hygiene and public health. He then studied the quality of water, particularly in the case of river Seine, or the purity of air, especially in hospitals. The affair of Dunkerque exhumations or that of cesspools, or the utilisation of human excrements in agriculture were parts of the occurrences for which he had the opportunity to find a scientific approach allowing to solve the difficult questions that were asked to him, for the best benefit of public health. The exhaustive study he published in "Bulletin de pharmacie" for the conservation of meat shows that he did not ignore anything about freezing of food in order to preserve it. It is necessary not to forget the important role he played, as soon as he were informed of Jenner's discovery, for the diffusion of vaccination in France. It is simply astounding to observe how modern were the questions he solved and how intense was his spirit of dedication to the public good, when exerting his functions in "Comité de Salubrité de la Seine" or "Conseil de Santé des Armées", as well as outside these prestigious institutions. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  5. Saúde Pública e meio ambiente: evolução do conhecimento e da prática, alguns aspectos éticos Public Health and environment: evolution of the knowledge and the practice, some ethical aspects

    Directory of Open Access Journals (Sweden)

    Helena Ribeiro

    2004-04-01

    Health Sector for the Environmental Health area in the World and in Brazil and presents some ethical aspects in Environmental Health. Finally, there is a discussion on the adoption of the sustainable development and the equity concepts in the proposals of Environmental Health promotion.

  6. PUBLIC HEALTH ETHICS: TOWARDS A RESEARCH AGENDA ÉTICA EN SALUD PÚBLICA: HACIA UNA AGENDA DE INVESTIGACIÓN ÉTICA NA SAÚDE PÚBLICA: EM DIREÇÃO A UM TEMÁRIO DE PESQUISAS

    Directory of Open Access Journals (Sweden)

    Alison Thompson

    2003-01-01

    Full Text Available Public health ethics, as distinct from clinical/medical bioethics, is an emerging field of study in academic settings. As part of a larger effort to address what the conceptual and content boundaries of this field are, or ought to be, a group at the University of Toronto hosted an international working symposium to discuss and outline a research agenda for public health ethics. The symposium, which took place in May 2002, was organized into four major areas of ethical concern central to public health: individual rights and the common good; risk and precaution; surveillance and regulation; and social justice and global health equity. This paper will provide an overview of some of the main themes and issues that emerged from the key papers that were developed from the symposium and discuss their importance in the emerging field of public health ethics. Significant issues were identified, such as the importance of distinguishing public health ethics from traditional bioethics; the development of the notion of common interests; broad definitions of public health, that include upstream sources of health inequities, and an understanding of the theoretical landscape from which public health ethics has emergedLa ética en salud pública, como distinta de la bioética clínica/médica, es un campo de estudio emergente en el ámbito académico. Como parte de un mayor esfuerzo para abordar el contenido y los límites que este campo tiene o debiera tener, un grupo de la Universidad de Toronto realizó un Simposio Internacional con el fin de discutir y definir una agenda de investigación para la ética en salud pública. El Simposio, realizado en mayo de 2002, fue organizado en torno a cuatro mayores áreas de preocupación ética sobre salud pública: derechos individuales y bien común; riesgos y precaución; vigilancia y regulación; y justicia social y equidad en la salud global. Este artículo proveerá un panorama de algunos de los principales temas y

  7. Ethics-based decision-making and health impact assessment.

    Science.gov (United States)

    Tannahill, Andrew; Douglas, Margaret J

    2014-03-01

    To compare the use of health impact assessment (HIA) and the decision-making triangle (DMT) framework for evidence-informed, ethics-based decision-making and consider implications for practice. We compared HIA and the DMT approach with reference to: their use of evidence and theory; their application of ethical principles or values; and how they aid decision-making. A good fit between the HIA and DMT approaches was found. Ways in which they could be of benefit to each other were identified. The DMT approach and HIA are highly compatible: they are rooted in largely shared ethical principles or values; both involve appropriate use of evidence and theory; and both are concerned with enhancing the quality of decision-making in the interests of population health. The DMT approach and HIA are of potential value to each other: established HIA methods and tools can be of practical help in using the DMT approach; and the DMT framework provides insights to how HIA methods and processes could be improved and the vision of 'impacts that matter' widened.

  8. Enhancing public health law communication linkages.

    Science.gov (United States)

    Silverman, Ross D

    2008-01-01

    Although interest in the field of public health law has dramatically increased over the past two decades, there remain significant challenges in communicating and sharing public health law-related knowledge. Access to quality information, which may assist in a public health department's efforts to protect the public's health, welfare, and safety, varies widely from jurisdiction to jurisdiction, and interjurisdictional communication remains at best a patchwork quilt with many holes. What follows is an analysis of several approaches the Public Health Law Association or other public health law-related organizations might undertake to serve as a conduit for the identification, gathering, and dissemination of extant public health law information, as well as the development of new public health law-related content, with a particular focus on the use of electronic means for such efforts.

  9. Insufficient Sleep Is a Public Health Epidemic

    Science.gov (United States)

    ... this? Submit Button Past Emails CDC Features Insufficient Sleep Is a Public Health Problem Language: English Español ( ... insufficient sleep is an important public health concern. Sleep-Related Unhealthy Behaviors The Behavioral Risk Factor Surveillance ...

  10. Ethics, government and sexual health: insights from Foucault.

    Science.gov (United States)

    Winch, Sarah

    2005-03-01

    The work of Michel Foucault, the French philosopher who was interested in power relationships, has resonated with many nurses who seek a radically analytical view of nursing practice. The purpose of this article is to explore 'ethics' through a Foucauldian lens, in a conceptual and methodological sense. The intention is to provide a useful framework that will help researchers critically to explore aspects of nursing practice that relate to the construction of the self, morality and identity, be that nurse or patient related. The fundamentals of the research method of genealogy and the methods of ethics are reviewed. Using an example taken from the sexual health practice area, advice is given on how to structure data collection, incorporate interview data, avoid discourse determinism and measure resistance.

  11. Quality of Publication Ethics in the Instructions to the Authors of Iranian Journals of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Fatemeh Salamat

    2013-03-01

    Full Text Available Providing a perfect instruction to authors can prevent most potential publication ethics errors. This study was conducted to determine the quality of ethical considerations in the instructions to the authors of Iranian research scientific journals of medical sciences (accredited by the Commission for Accreditation and Improvement of Iranian Medical Journals in October 2011. Checklist items (n=15 were extracted from the national manual of ethics in medical research publications, and the validity of the manual of ethics was assessed. All the accredited Iranian journals of medical sciences (n=198 were entered into the study. The instructions to the authors of 160 accredited Iranian journals were available online and were reviewed. The ANOVA and Kendall Correlation coefficient were performed to analyze the results. A total of 76 (47.5% of the 160 journals were in English and 84 (52.5% were in Farsi. The most frequently mentioned items related to publication ethics comprised “commitment not to send manuscripts to other journals and re-publish manuscripts” (85%, 83.8%, “aim and scope” of the journal (81.9%, “principles of medical ethics in the use of human samples” (74.4%, and “review process” (74.4%. On the other hand, the items of “principles of advertising” (1.2%, “authorship criteria” (15%, and “integrity in publication of clinical trial results” (30.6% were the least frequently mentioned ones. Based on the study findings, the quality of publication ethics, as instructed to the authors, can improve the quality of the journals.

  12. Exploring perceptions and experiences of Bolivian health researchers with research ethics.

    Science.gov (United States)

    Sullivan, Sarah; Aalborg, Annette; Basagoitia, Armando; Cortes, Jacqueline; Lanza, Oscar; Schwind, Jessica S

    2015-04-01

    In Bolivia, there is increasing interest in incorporating research ethics into study procedures, but there have been inconsistent application of research ethics practices. Minimal data exist regarding the experiences of researchers concerning the ethical conduct of research. A cross-sectional study was administered to Bolivian health leaders with research experience (n = 82) to document their knowledge, perceptions, and experiences of research ethics committees and infrastructure support for research ethics. Results showed that 16% of respondents reported not using ethical guidelines to conduct their research and 66% indicated their institutions did not consistently require ethics approval for research. Barriers and facilitators to incorporate research ethics into practice were outlined. These findings will help inform a comprehensive rights-based research ethics education program in Bolivia. © The Author(s) 2015.

  13. Using routinely collected health data for surveillance, quality improvement and research: Framework and key questions to assess ethics, privacy and data access

    Directory of Open Access Journals (Sweden)

    Simon de Lusignan

    2016-01-01

    Full Text Available Background The use of health data for public health, surveillance, quality improvement and research is crucial to improve health systems and health care. However, bodies responsible for privacy and ethics often limit access to routinely collected health data. Ethical approvals, issues around protecting privacy and data access are often dealt with by different layers of regulations, making approval processes appear disjointed.Objective To create a comprehensive framework for defining the ethical and privacy status of a project and for providing guidance on data access.Method The framework comprises principles and related questions. The core of the framework will be built using standard terminology definitions such as ethics-related controlled vocabularies and regional directives. It is built in this way to reduce ambiguity between different definitions. The framework is extensible: principles can be retired or added to, as can their related questions. Responses to these questions should allow data processors to define ethical issues, privacy risk and other unintended consequences.Results The framework contains three steps: (1 identifying possible ethical and privacy principles relevant to the project; (2 providing ethics and privacy guidance questions that inform the type of approval needed; and (3 assessing case-specific ethics and privacy issues. The outputs from this process should inform whether the balance between public interests and privacy breach and any ethical considerations are tipped in favour of societal benefits. If they are then this should be the basis on which data access is permitted. Tightly linking ethical principles to governance and data access may help maintain public trust.

  14. Ethics reporting practices in clinical research publications: A review of four Indian journals

    Directory of Open Access Journals (Sweden)

    Mahesh N Belhekar

    2014-01-01

    Full Text Available Background: Manuscript authors of scientific journals are expected to report if their studies were conducted according to international and national ethical guidelines and inform readers regarding ethics approval and informed consent obtained from participants and/or their legally acceptable representative/s. In the present study we assessed the reporting practices of ethics approval and informed consent (assent in case of pediatric studies in four Indian journals. Materials and Methods: Original research articles published over a period of 4 years (2009-2012 in four major national clinical journals, viz. Journal of Association of Physicians of India (JAPI, Indian Journal of Surgery (IJS, Journal of Obstetrics and Gynecology of India (JOGI, and Indian Journal of Orthopedics (IJO were reviewed with regard to documentation of ethics approval and written informed consent and assent in case of pediatric participants. Results: We reviewed 673 research articles and found that, overall ethical approval was mentioned in 163 (24.2% and informed consent or assent was mentioned in 179 (26.5% articles in all four journals. Individually we found, in JAPI of the 174 manuscripts reviewed, 74 (42.5% reported having obtained approval from the ethics committee and 68 (39.1% reported taking written informed consent from participants. In IJS of 123 manuscripts, 18 (14.6% reported ethics committee approval and 20 (16.2% reported informed consent from participants. In JOGI of 152 manuscripts, 21 (13.8% reported ethics committee approval while 49 (32.2% reported informed consent from participants. In IJO, of 224 manuscripts, 50 (22.3% reported ethics committee approval and 42 (18.7% reported obtaining informed consent. Conclusion: Majority of the publications did not provide information regarding compliance to ethical guidelines in spite of the availability of various guidelines. Thus, there is a need for awareness and training on bioethics for authors, reviewers, and

  15. Multinational repositories: Ethical, legal and political/public aspects

    Energy Technology Data Exchange (ETDEWEB)

    Boutellier, C. [ARiUS - Association for Regional and International Underground Storage, Tafernstrasse 11, CH-5405 Baden, Dattwil (Switzerland)]. E-mail: Christine.Boutellier@arius-world.org; McCombie, C. [ARiUS - Association for Regional and International Underground Storage, Tafernstrasse 11, CH-5405 Baden, Dattwil (Switzerland)]. E-mail: Charles.McCombie@arius-world.org; Mele, I. [ARAO - Agency for Radwaste Management, Parmova 53, SI-1000 Ljubljana (Slovenia)]. E-mail: irena.mele@gov.si

    2006-07-01

    Concepts for shared multinational repositories face a great challenge in achieving acceptance, despite the fact that they promise advantages in safety, security, environmental protection and costs. When considering advantages of shared multinational repositories, it is instructive to examine which are the ethical, legal and political issues that mostly affect the feasibility of implementing such facilities. This paper addresses the key questions from two opposite sides. The early part takes a 'top-down' view, looking at the international debate on ethical issues, summarising a wide range of national political attitudes and identifying relevant international legislation and treaties. The latter looks 'bottom-up' at the problem, by discussing the situation of a small country, Slovenia. Slovenia has limited financial resources for implementing disposal - but it has a firm commitment to fulfilling its responsibilities for safely managing all Radioactive Wastes (RAW) arising in the country. Strategies considered to do so are laid out in this paper. (author)

  16. Public Health Interventions for School Nursing Practice

    Science.gov (United States)

    Schaffer, Marjorie A.; Anderson, Linda J. W.; Rising, Shannon

    2016-01-01

    School nurses (SNs) use public health nursing knowledge and skills to provide nursing services to school populations. The Public Health Intervention Wheel is a practice framework that can be used to explain and guide public health nursing interventions. SNs who were also members of the National Association of School Nurses completed an electronic…

  17. Statement on Publication Ethics for Editors and Publishers

    Science.gov (United States)

    2016-01-01

    The digitization and related developments in journal editing and publishing necessitate increasing the awareness of all stakeholders of science communication in the emerging global problems and possible solutions. Journal editors and publishers are frequently encountered with the fast-growing problems of authorship, conflicts of interest, peer review, research misconduct, unethical citations, and inappropriate journal impact metrics. While the number of erroneous and unethical research papers and wasteful, or 'predatory', journals is increasing exponentially, responsible editors are urged to 'clean' the literature by correcting or retracting related articles. Indexers are advised to implement measures for accepting truly influential and ethical journals and delisting sources with predatory publishing practices. Updating knowledge and skills of authors, editors and publishers, developing and endorsing recommendations of global editorial associations, and (re)drafting journal instructions can be viewed as potential tools for improving ethics of academic journals. The aim of this Statement is to increase awareness of all stakeholders of science communication of the emerging ethical issues in journal editing and publishing and initiate a campaign of upgrading and enforcing related journal instructions. PMID:27510376

  18. Public Health Disease Surveillance Networks.

    Science.gov (United States)

    Morse, Stephen S

    2014-02-01

    Zoonotic infections are important sources of human disease; most known emerging infections are zoonotic (e.g., HIV, Ebola virus, severe acute respiratory syndrome, Nipah virus, and enteropathogenic Escherichia coli) and originated as natural infections of other species that acquired opportunities to come in contact with humans. There are also serious infectious diseases classically considered zoonotic, such as influenza, rabies, bubonic plague, brucellosis, and leptospirosis. More recently, it has been recognized that wildlife constitutes a particularly important source of novel zoonoses. With all this microbial movement, surveillance is considered the first line of public health defense. The zoonotic origin of many human and livestock infections argues strongly for the synergistic value of a One Health approach, which provides the capability to identify pathogens crossing into new species and could provide earlier warning of potential epidemics. This article discusses public health surveillance and major recent surveillance initiatives and reviews progress toward implementing a One Health surveillance framework. Networks discussed include global intergovernmental organizations and recent combined efforts of these organizations; Web-based nongovernmental systems (e.g., ProMED, the Program for Monitoring Emerging Diseases); and networks of bilateral or multilateral government programs (e.g., the CDC's Global Disease Detection [GDD] platform; the U.S. Department of Defense's Global Emerging Infections Surveillance and Response System [GEIS]; regional and subregional networks; and the U.S. Agency for International Development's Emerging Pandemic Threats [EPT] program and its surveillance component, PREDICT). Syndromic surveillance also has potential to complement existing systems. New technologies are enabling revolutionary capabilities for global surveillance, but in addition to serious technical needs, both sustainability and data-sharing mechanisms remain

  19. [Social medicine, public health and governance for health].

    Science.gov (United States)

    Holčík, Jan

    2016-01-01

    Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

  20. Aboriginal and Torres Strait Islander Public Health: Online and Integrated into Core Master of Public Health Subjects.

    Science.gov (United States)

    Angus, Lynnell; Ewen, Shaun; Coombe, Leanne

    2016-04-26

    The Master of Public Health (MPH) is an internationally recognised post-graduate qualification for building the public health workforce. In Australia, MPH graduate attributes include six Indigenous public health (IPH) competencies. The University of Melbourne MPH program includes five core subjects and ten specialisation streams, of which one is Indigenous health. Unless students complete this specialisation or electives in Indigenous health, it is possible for students to graduate without attaining the IPH competencies. To address this issue in a crowded and competitive curriculum an innovative approach to integrating the IPH competencies in core MPH subjects was developed. Five online modules that corresponded with the learning outcomes of the core public health subjects were developed, implemented and evaluated in 2015. This brief report outlines the conceptualisation, development, and description of the curriculum content; it also provides preliminary student evaluation and staff feedback on the integration project. Significance for public healthThis approach to a comprehensive, online, integrated Indigenous public health (IPH) curriculum is significant, as it ensures that all University of Melbourne Master of Public Health (MPH) graduates will have the competencies to positively contribute to Indigenous health status. A workforce that is attuned not only to the challenges of IPH, but also to the principles of self-determination, Indigenous agency and collaboration is better equipped to be comprised of ethical and judgment-safe practitioners. Additionally, the outlined approach of utilizing IPH content and examples into core MPH subjects ensures both the Australian relevance for an Australian-based health professional course and international appeal through the modules inclusion of International Indigenous case-studies and content. Furthermore, approaches learned in a challenging Indigenous Australian context are transferable and applicable to other IPH

  1. Applications of health information exchange information to public health practice

    DEFF Research Database (Denmark)

    Kierkegaard, Patrick; Kaushal, Rainu; Vest, Joshua R.

    2014-01-01

    Health information exchange (HIE) can support several aspects of public health practice by increasing the availability, timeliness, and comprehensiveness individual-level patient information. The potential benefits to disease monitoring, disaster response, and other public health activities served...... qualitative interviews and template analyses, we identified public health efforts and activities that were improved by participation in HIE. We derived the codes for the template analysis through a literature review. HIE supported public health activities consistent with expectations in the literature...

  2. 42 CFR 90.9 - Public health advisory.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 1 2010-10-01 2010-10-01 false Public health advisory. 90.9 Section 90.9 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS AND HEALTH... PROCEDURES § 90.9 Public health advisory. ATSDR may issue a public health advisory based on......

  3. Public Health Challenges and Priorities for Kazakhstan

    Directory of Open Access Journals (Sweden)

    Altyn Aringazina

    2012-11-01

    Full Text Available The Republic of Kazakhstan is one of the largest and fastest growing post-Soviet economies in Central Asia. Despite recent improvements in health care in response to Kazakhstan 2030 and other state-mandated policy reforms, Kazakhstan still lags behind other members of the Commonwealth of Independent States of the European Region on key indicators of health and economic development. Although cardiovascular diseases are the leading cause of mortality among adults, HIV/AIDS, tuberculosis, and blood-borne infectious diseases are of increasing public health concern. Recent data suggest that while Kazakhstan has improved on some measures of population health status, many environmental and public health challenges remain. These include the need to improve public health infrastructure, address the social determinants of health, and implement better health impact assessments to inform health policies and public health practice. In addition, more than three decades after the Declaration of Alma-Ata, which was adopted at the International Conference on Primary Health Care convened in Kazakhstan in 1978, facilitating population-wide lifestyle and behavioral change to reduce risk factors for chronic and communicable diseases, as well as injuries, remains a high priority for emerging health care reforms and the new public health. This paper reviews the current public health challenges in Kazakhstan and describes five priorities for building public health capacity that are now being developed and undertaken at the Kazakhstan School of Public Health to strengthen population health in the country and the Central Asian Region.

  4. New places and ethical spaces: philosophical considerations for health care ethics outside of the hospital.

    Science.gov (United States)

    Barina, Rachelle

    2015-06-01

    This paper examines the meaning of space and its relationship to value. In this paper, I draw on Henri Lefebvre to suggest that our ethics produce and are produced by spaces. Space is not simply a passive material container or neutral geographic location. Space includes the ideas on which buildings are modeled, the ordering of objects and movement patterns within the space, and the symbolic meaning of the space and its objects. Although often unrecognized, space itself is value-laden, and its values are suggested as people interact within that space. By reflecting on the spaces of health care, we will see that we not only must attend to the quandaries caused by the delivery of health care in non-acute places, but also to the values that produce and are produced by spaces. These values influence our moral imagination and shape us as people.

  5. Evaluation in health promotion: thoughts from inside a human research ethics committee.

    Science.gov (United States)

    Allen, Judy; Flack, Felicity

    2015-12-01

    Health promotion research, quality improvement and evaluation are all activities that raise ethical issues. In this paper, the Chair and a member of human resear ch ethics committees provide an insiders' point of view on how to demonstrate ethical conduct in health promotion research and quality improvement. Several common issues raised by health promotion research and evaluation are discussed including researcher integrity, conflicts of interest, use of information, consent and privacy.

  6. Public health workforce: challenges and policy issues

    Directory of Open Access Journals (Sweden)

    Beaglehole Robert

    2003-07-01

    Full Text Available Abstract This paper reviews the challenges facing the public health workforce in developing countries and the main policy issues that must be addressed in order to strengthen the public health workforce. The public health workforce is diverse and includes all those whose prime responsibility is the provision of core public health activities, irrespective of their organizational base. Although the public health workforce is central to the performance of health systems, very little is known about its composition, training or performance. The key policy question is: Should governments invest more in building and supporting the public health workforce and infrastructure to ensure the more effective functioning of health systems? Other questions concern: the nature of the public health workforce, including its size, composition, skills, training needs, current functions and performance; the appropriate roles of the workforce; and how the workforce can be strengthened to support new approaches to priority health problems. The available evidence to shed light on these policy issues is limited. The World Health Organization is supporting the development of evidence to inform discussion on the best approaches to strengthening public health capacity in developing countries. WHO's priorities are to build an evidence base on the size and structure of the public health workforce, beginning with ongoing data collection activities, and to map the current public health training programmes in developing countries and in Central and Eastern Europe. Other steps will include developing a consensus on the desired functions and activities of the public health workforce and developing a framework and methods for assisting countries to assess and enhance the performance of public health training institutions and of the public health workforce.

  7. Shaping and authorising a public health profession

    Directory of Open Access Journals (Sweden)

    Katarzyna Czabanowska

    2015-12-01

    doctors, nurses, lawyers, and architects can enjoy the benefits of the 2005/36/EC Directive amended by 2013/55/EU Directive on the recognition of professional qualifications, public health professionals are left out from these influential (elite professions. Firstly, we use the profession traits theory as a framework in arguing whether public health can be a legitimate profession in itself; secondly, we explain who public health professionals are and what usually is required for shaping the public health profession; and thirdly, we attempt to sketch the road to the authorisation or licensing of public health professionals. Finally, we propose some recommendations.

  8. Global health and national borders: the ethics of foreign aid in a time of financial crisis

    Directory of Open Access Journals (Sweden)

    Johri Mira

    2012-06-01

    Full Text Available Abstract Background The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively on aid expenditures. The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health. Methods We undertook a critical review of contemporary accounts of justice. We selected theories that: (i articulate important and widely held moral intuitions; (ii have had extensive impact on debates about global justice; (iii represent diverse approaches to moral reasoning; and (iv present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks. Results Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities. Conclusions Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important

  9. Global health and national borders: the ethics of foreign aid in a time of financial crisis.

    Science.gov (United States)

    Johri, Mira; Chung, Ryoa; Dawson, Angus; Schrecker, Ted

    2012-06-28

    The governments and citizens of the developed nations are increasingly called upon to contribute financially to health initiatives outside their borders. Although international development assistance for health has grown rapidly over the last two decades, austerity measures related to the 2008 and 2011 global financial crises may impact negatively on aid expenditures. The competition between national priorities and foreign aid commitments raises important ethical questions for donor nations. This paper aims to foster individual reflection and public debate on donor responsibilities for global health. We undertook a critical review of contemporary accounts of justice. We selected theories that: (i) articulate important and widely held moral intuitions; (ii) have had extensive impact on debates about global justice; (iii) represent diverse approaches to moral reasoning; and (iv) present distinct stances on the normative importance of national borders. Due to space limitations we limit the discussion to four frameworks. Consequentialist, relational, human rights, and social contract approaches were considered. Responsibilities to provide international assistance were seen as significant by all four theories and place limits on the scope of acceptable national autonomy. Among the range of potential aid foci, interventions for health enjoyed consistent prominence. The four theories concur that there are important ethical responsibilities to support initiatives to improve the health of the worst off worldwide, but offer different rationales for intervention and suggest different implicit limits on responsibilities. Despite significant theoretical disagreements, four influential accounts of justice offer important reasons to support many current initiatives to promote global health. Ethical argumentation can complement pragmatic reasons to support global health interventions and provide an important foundation to strengthen collective action.

  10. Examining Ethical Reasoning and Transformational Leadership Style in Nigeria Public Sector

    Directory of Open Access Journals (Sweden)

    Chikelu Okey Felix

    2016-04-01

    Full Text Available A significant number of studies reported linkages between ethical moral reasoning and transformational leadership (TFL style, but questioned its moral foundation based on shared values and ethics. Thus, the issue of public leaders’ and subordinates’ degree of moral judgment and TFL behavior as perceived by followers is explored. The Defining Issues Test (DIT-2 and the Multifactor Leadership Questionnaire (MLQ X5 were completed by leaders and subordinates severely (Avolio & Bass, 2004; Rest, Narvaez, Bebeau, & Thoma, 1999. Path analysis of the structural model indicates positive significant statistical relationship between cognitive moral development (CMD and TFL style (β = 0.120, t = 1.286, p < .10. Nevertheless, we indicate that the capacity to experience, discover, and anticipate ethical threats encourages the use of post-conventional stage in decision making, and this result adds to our understanding of the relationship between ethical reasoning and leadership style.

  11. STUDY ON THE ETHICS OF THE COACHES OF PUBLIC SPORTS CLUBS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Mihai Constantin Razvan BARBU

    2013-06-01

    Full Text Available In this paper I identified and presented the role of ethics in the activity of the coaches. I highlighted the main issues the coaches confront in relationship with themselves or with the other participants. The morality of the coaches is important since they have an important influence on the players they train, acting, the same as the managers, as an ethic catalyst within the sport club. In this paper I presented the ethical level of the coaches from the municipal clubs of Romania, based on a sample of 40 coaches acting in 20 public sport clubs from Romania. The main finding of the paper is that the coaches demonstrated a good level of ethics in their activity.

  12. Physical Education's Role in Public Health.

    Science.gov (United States)

    Sallis, James F.; McKenzie, Thomas L.

    1991-01-01

    Analyzes contributions physical education makes to child and adult health. Topics discussed are current levels of U.S. children's physical activity; status of elementary physical education programs; health-related physical activity interventions; public health analysis of elementary physical education; and public health role and goal for physical…

  13. Ethical guidelines to publication of chemical research. American Chemical Society.

    Science.gov (United States)

    1994-01-01

    The guidelines embodied in this document were revised by the editors of the Publication Division of the American Chemical Society in January 1994 and endorsed by the Society Committee on Publications.

  14. ETHICS IN PUBLIC ADMINISTRATION. CASE STUDY – ROMANIA

    OpenAIRE

    Rãzvan VIORESCU; Gabriela NEMÞOI

    2015-01-01

    Public services represent useful activities designated to meet a social need. The laws and regulations empower the activities of public services, without indicating the motives for public services. The impact of government in day to day life of citizens and communities is increasingly greater in terms of both public affairs management and budgetary aspect. The power to spend the community resources and to influence the lives of others means at the same time a great responsibility. That is the...

  15. Building evidence for legal decision making in real time: legal triage in public health emergencies.

    Science.gov (United States)

    Hodge, James G; Lant, Timothy; Arias, Jalayne; Jehn, Megan

    2011-09-01

    Similar to the triaging of patients by health care workers, legal and public health professionals must prioritize and respond to issues of law and ethics in declared public health emergencies. As revealed by the 2009-2010 H1N1 influenza outbreak and other events, there are considerable inconsistencies among professionals regarding how to best approach these issues during a public health emergency. Our project explores these inconsistencies by attempting to assess how practitioners make legal and ethical decisions in real-time emergencies to further critical public health objectives. Using a fictitious scenario and interactive visualization environment, we observed real-time decision-making processes among knowledgeable participants. Although participants' decisions and perspectives varied, the exercise demonstrated an increase in the perception of the relevance of legal preparedness in multiple aspects of the decision-making process and some key lessons learned for consideration in future repetitions of the exercise and actual, real-time emergency events.

  16. Undergraduate Public Health Majors: Why They Choose Public Health or Medicine?

    Science.gov (United States)

    Hilton, Warren

    2013-01-01

    This mixed methods study examined the relationship between the motivations for attending college of undergraduate students with a focus on students with a public health major, and their desire to pursue graduate training in public health and subsequently, public health careers. The study highlighted the current public health workforce shortage and…

  17. Enhancing crisis leadership in public health emergencies.

    Science.gov (United States)

    Deitchman, Scott

    2013-10-01

    Reviews of public health emergency responses have identified a need for crisis leadership skills in health leaders, but these skills are not routinely taught in public health curricula. To develop criteria for crisis leadership in public health, published sources were reviewed to identify attributes of successful crisis leadership in aviation, public safety, military operations, and mining. These sources were abstracted to identify crisis leadership attributes associated with those disciplines and compare those attributes with crisis leadership challenges in public health. Based on this review, the following attributes are proposed for crisis leadership in public health: competence in public health science; decisiveness with flexibility; ability to maintain situational awareness and provide situational assessment; ability to coordinate diverse participants across very different disciplines; communication skills; and the ability to inspire trust. Of these attributes, only competence in public health science is currently a goal of public health education. Strategies to teach the other proposed attributes of crisis leadership will better prepare public health leaders to meet the challenges of public health crises.

  18. Health Insurance Marketplace Public Use Files

    Data.gov (United States)

    U.S. Department of Health & Human Services — A set of seven (7) public use files containing information on health insurance issuers participating in the Health Insurance Marketplace and certified qualified...

  19. Qualitative and mixed methods in public health

    National Research Council Canada - National Science Library

    Padgett, Deborah

    2012-01-01

    "This text has a large emphasis on mixed methods, examples relating to health research, new exercises pertaining to health research, and an introduction on qualitative and mixed methods in public health...

  20. The role of public health in the prevention of war: rationale and competencies.

    Science.gov (United States)

    Wiist, William H; Barker, Kathy; Arya, Neil; Rohde, Jon; Donohoe, Martin; White, Shelley; Lubens, Pauline; Gorman, Geraldine; Hagopian, Amy

    2014-06-01

    In 2009 the American Public Health Association approved the policy statement, "The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War." Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health's ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes. A working group grew out of the American Public Health Association's Peace Caucus to build upon the 2009 policy by proposing competencies to understand and prevent the political, economic, social, and cultural determinants of war, particularly militarism. The working group recommends that schools of public health and public health organizations incorporate these competencies into professional preparation programs, research, and advocacy.

  1. [Ethical issues in health care of gender violence].

    Science.gov (United States)

    Bugarín-González, R; Bugarín-Diz, C

    2014-01-01

    Gender violence is a health problem that occasionally gives rise to ethical dilemmas for the family doctor. One of the most important conflict is probably when a patient admits to being abused by her partner, but appeals to keep the information confidential, and refuses to present an injury report. There also other problematic situations. This essay attempts to reflect on these issues and help professionals in making decisions. Copyright © 2014 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  2. Ethics and data protection in human biomarker studies in environmental health.

    Science.gov (United States)

    Casteleyn, Ludwine; Dumez, Birgit; Van Damme, Karel; Anwar, Wagida A

    2013-08-01

    Human biomarker studies in environmental health are essential tools to study the relationship between health and environment. They should ultimately contribute to a better understanding of environmentally induced adverse health effects and to appropriate preventive actions. To ensure the protection of the rights and dignity of study participants a complex legal and ethical framework is applied, consisting of several international directives, conventions, and guidelines, whether or not translated in domestic laws. Main characteristics of ethics and data protection in studies using biomarkers in the field of environmental health are summarized and current discussions on related questions and bottlenecks highlighted. In the current regulatory context, dominated by the protection of the individual study participant, difficulties are reported due to the different interpretation and implementation of the regulations of concern within and across borders. Advancement of consistency and compatibility is recommended and efforts are ongoing. An increasing demand for secondary use of data and samples poses additional challenges in finding a right balance between the individual rights of the study participants on the one hand and the common interest of, and potential benefit for the public or community at large on the other. Ethics committees could play a key role in assessing problems originating from the sometimes competing needs at individual and societal level. Building trust in science amongst (potential) study participants and within the community allows the inclusion of arguments from the societal perspective. This requires increased attention for respectful communication efforts. Striving for public participation in decision making processes may promote policy relevant research and the related translation of study results into action.

  3. Feminism and public health nursing: partners for health.

    Science.gov (United States)

    Leipert, B D

    2001-01-01

    It is a well-known fact that nursing and feminism have enjoyed an uneasy alliance. In recent years, however, nursing has begun to recognize the importance of feminism. Nevertheless, the literature still rarely addresses the relevance of feminism for public health nursing. In this article, I articulate the relevance of feminism for public health nursing knowledge and practice. First, I define and describe feminism and public health nursing and then I discuss the importance of feminism for public health nursing practice. The importance of feminism for the metaparadigm concepts of public health nursing is then reviewed. Finally, I examine several existing challenges relating to feminism and public health nursing research, education, and practice. The thesis of this article is that feminism is vitally important for the development of public health nursing and for public health care.

  4. Moral dilemmas in professions of public trust and the assumptions of ethics of social consequences

    Directory of Open Access Journals (Sweden)

    Dubiel-Zielińska Paulina

    2016-06-01

    Full Text Available The aim of the article is to show the possibility of applying assumptions from ethics of social consequences when making decisions about actions, as well as in situations of moral dilemmas, by persons performing occupations of public trust on a daily basis. Reasoning in the article is analytical and synthetic. Article begins with an explanation of the basic concepts of “profession” and “the profession of public trust” and a manifestation of the difference between these terms. This is followed by a general description of professions of public trust. The area and definition of moral dilemmas is emphasized. Furthermore, representatives of professions belonging to them are listed. After a brief characterization of axiological foundations and the main assumptions of ethics of social consequences, actions according to Vasil Gluchman and Włodzimierz Galewicz are discussed and actions in line with ethics of social consequences are transferred to the practical domain. The article points out that actions in professional life are obligatory, impermissible, permissible, supererogatory and unmarked in the moral dimension. In the final part of the article an afterthought is included on how to solve moral dilemmas when in the position of a representative of the profession of public trust. The article concludes with a summary report containing the conclusions that stem from ethics of social consequences for professions of public trust, followed by short examples.

  5. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program.

    Science.gov (United States)

    Markiewicz, Milissa; Bevc, Christine A; Hegle, Jennifer; Horney, Jennifer A; Davies, Megan; MacDonald, Pia D M

    2012-02-23

    In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1) elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2) examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public health emergency preparedness and response system.

  6. Linking public health agencies and hospitals for improved emergency preparedness: North Carolina's public health epidemiologist program

    Directory of Open Access Journals (Sweden)

    Markiewicz Milissa

    2012-02-01

    Full Text Available Abstract Background In 2003, 11 public health epidemiologists were placed in North Carolina's largest hospitals to enhance communication between public health agencies and healthcare systems for improved emergency preparedness. We describe the specific services public health epidemiologists provide to local health departments, the North Carolina Division of Public Health, and the hospitals in which they are based, and assess the value of these services to stakeholders. Methods We surveyed and/or interviewed public health epidemiologists, communicable disease nurses based at local health departments, North Carolina Division of Public Health staff, and public health epidemiologists' hospital supervisors to 1 elicit the services provided by public health epidemiologists in daily practice and during emergencies and 2 examine the value of these services. Interviews were transcribed and imported into ATLAS.ti for coding and analysis. Descriptive analyses were performed on quantitative survey data. Results Public health epidemiologists conduct syndromic surveillance of community-acquired infections and potential bioterrorism events, assist local health departments and the North Carolina Division of Public Health with public health investigations, educate clinicians on diseases of public health importance, and enhance communication between hospitals and public health agencies. Stakeholders place on a high value on the unique services provided by public health epidemiologists. Conclusions Public health epidemiologists effectively link public health agencies and hospitals to enhance syndromic surveillance, communicable disease management, and public health emergency preparedness and response. This comprehensive description of the program and its value to stakeholders, both in routine daily practice and in responding to a major public health emergency, can inform other states that may wish to establish a similar program as part of their larger public

  7. Big bad data: law, public health, and biomedical databases.

    Science.gov (United States)

    Hoffman, Sharona; Podgurski, Andy

    2013-03-01

    The accelerating adoption of electronic health record (EHR) systems will have far-reaching implications for public health research and surveillance, which in turn could lead to changes in public policy, statutes, and regulations. The public health benefits of EHR use can be significant. However, researchers and analysts who rely on EHR data must proceed with caution and understand the potential limitations of EHRs. Because of clinicians' workloads, poor user-interface design, and other factors, EHR data can be erroneous, miscoded, fragmented, and incomplete. In addition, public health findings can be tainted by the problems of selection bias, confounding bias, and measurement bias. These flaws may become all the more troubling and important in an era of electronic "big data," in which a massive amount of information is processed automatically, without human checks. Thus, we conclude the paper by outlining several regulatory and other interventions to address data analysis difficulties that could result in invalid conclusions and unsound public health policies. © 2013 American Society of Law, Medicine & Ethics, Inc.

  8. The individual mandate: implications for public health law.

    Science.gov (United States)

    Parmet, Wendy E

    2011-01-01

    No provision of the Patient Protection and Affordable Care Act (PPACA) has been more contentious than the so-called "individual mandate," the constitutionality of which is now before several appellate courts. Critics claim that the mandate represents an unprecedented attempt by the federal government to compel individual action. Yet, states frequently employ similar mandates to protect the public's health. These public health mandates have also often aroused deep opposition. This essay situates PPACA's mandate, and the opposition to it, in that broader context. The article reviews the arguments that public health's population perspective provides in support of mandates, as well as the reasons why mandates often ignite intense legal and political opposition. Most importantly, by holding individuals accountable for population-based problems, mandates may undercut the public health arguments that justify them. The article concludes by arguing that public health policymakers need to know more about the unintended political and legal costs of mandates. © 2011 American Society of Law, Medicine & Ethics, Inc.

  9. 42 CFR 93.220 - Public Health Service or PHS.

    Science.gov (United States)

    2010-10-01

    ... RESEARCH MISCONDUCT Definitions § 93.220 Public Health Service or PHS. Public Health Service or PHS means... 42 Public Health 1 2010-10-01 2010-10-01 false Public Health Service or PHS. 93.220 Section 93.220 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES HEALTH ASSESSMENTS...

  10. Aspectos éticos do uso de produtos fluorados no Brasil: uma visão dos formuladores de políticas públicas de saúde Ethical aspects of the use of fluoride products in Brazil: a view of public health policy formulators

    Directory of Open Access Journals (Sweden)

    Pola Alessandra Kalamatianos

    2006-03-01

    Full Text Available O flúor tem sido empregado para prevenir cárie dentária, principalmente em águas de abastecimento e dentifrícios. Um efeito indesejável, a fluorose dentária leve, tem suscitado preocupações entre especialistas. Neste trabalho identificam-se, na literatura, aspectos éticos decorrentes do emprego de flúor em saúde pública relacionados à contradição "prevenção da cárie versus ocorrência de fluorose leve" e investiga-se a ocorrência de dilemas éticos entre profissionais envolvidos em decisões sobre o uso desses produtos. Foram identificadas publicações em bases de dados empregando-se os termos de busca ética, bioética, "ethics" e derivações do radical "fluor". O material subsidiou a construção de um questionário aplicado a pesquisadores e autoridades sanitárias, e os dados gerados submetidos à análise de conteúdo. O dilema ético emergente da análise pode ser sintetizado: "Empregar produto com flúor para prevenir cárie dentária tem o inconveniente de produzir graus leves de fluorose dentária, mas não utilizá-lo em saúde pública tem o inconveniente de não impedir o aparecimento de uma doença (cárie evitável com o seu uso." Tal dilema tem sido resolvido admitindo-se que haveria justiça no emprego do flúor e que seu benefício seria maior do que o malefício ­ sendo este mínimo. Alguns entrevistados reconheceram que há violação do princípio ético da autonomia.Fluoride has been used to prevent dental caries. It is used in supply water and toothpastes. One undesirable effect has been found: mild dental fluorosis. Such stains have aroused concern among specialists. This paper examines, in the literature, ethical aspects resulting from the use of fluoride in public health associated with the "caries prevention versus mild fluorosis occurrence" contradiction and investigates the occurrence of any ethical dilemma among the professionals involved in decision on the use of such products. Databases were

  11. Clinical governance and research ethics as barriers to UK low-risk population-based health research?

    Directory of Open Access Journals (Sweden)

    Douglas Flora

    2008-11-01

    Full Text Available Abstract Background Since the Helsinki Declaration was introduced in 1964 as a code of practice for clinical research, it has generally been agreed that research governance is also needed in the field of public health and health promotion research. Recently, a range of factors led to the development of more stringent bureaucratic procedures, governing the conduct of low-risk population-based health research in the United Kingdom. Methods Our paper highlights a case study of the application process to medical research ethics committees in the United Kingdom for a study of the promotion of physical activity by health care providers. The case study presented here is an illustration of the challenges in conducting low-risk population-based health research. Results Our mixed-methods approach involved a questionnaire survey of and semi-structured interviews with health professionals (who were all healthy volunteers. Since our study does not involve the participation of either patients or the general population, one would expect the application to the relevant research ethics committees to be a formality. This proved not to be the case! Conclusion Research ethics committees could be counter-productive, rather than protecting the vulnerable in the research process, they can stifle low-risk population-based health research. Research ethics in health services research is first and foremost the responsibility of the researcher(s, and we need to learn to trust health service researchers again. The burden of current research governance regulation to address the perceived ethical problems is neither appropriate nor adequate. Senior researchers/academics need to educate and train students and junior researchers in the area of research ethics, whilst at the same time reducing pressures on them that lead to unethical research, such as commercial funding, inappropriate government interference and the pressure to publish. We propose that non-invasive low

  12. PERCC Tools: Public Health Preparedness for Clinicians

    Centers for Disease Control (CDC) Podcasts

    2011-08-29

    CDC’s Office of Public Health Preparedness and Response funds Preparedness and Emergency Response Research Centers (PERRCs) to examine components of the public health system. This podcast is an overview of mental and behavioral health tools developed by the Johns Hopkins PERRC.  Created: 8/29/2011 by Emergency Risk Communication Branch (ERCB)/Joint Information Center (JIC); Office of Public Health Preparedness and Response (OPHPR).   Date Released: 8/30/2011.

  13. Nuclear education in public health and nursing

    Energy Technology Data Exchange (ETDEWEB)

    Winder, A.E.; Stanitis, M.A.

    1988-08-01

    Twenty-three public health schools and 492 university schools of nursing were surveyed to gather specific information on educational programs related to nuclear war. Twenty public health schools and 240 nursing schools responded. Nuclear war-related content was most likely to appear in disaster nursing and in environmental health courses. Three schools of public health report that they currently offer elective courses on nuclear war. Innovative curricula included political action projects for nuclear war prevention.

  14. Assessing entrepreneurship in governmental public health.

    Science.gov (United States)

    Jacobson, Peter D; Wasserman, Jeffrey; Wu, Helen W; Lauer, Johanna R

    2015-04-01

    We assessed the feasibility and desirability of public health entrepreneurship (PHE) in governmental public health. Using a qualitative case study approach with semistructured interview protocols, we conducted interviews between April 2010 and January 2011 at 32 local health departments (LHDs) in 18 states. Respondents included chief health officers and senior LHD staff, representatives from national public health organizations, health authorities, and public health institutes. Respondents identified PHE through 3 overlapping practices: strategic planning, operational efficiency, and revenue generation. Clinical services offer the strongest revenue-generating potential, and traditional public health services offer only limited entrepreneurial opportunities. Barriers include civil service rules, a risk-averse culture, and concerns that PHE would compromise core public health values. Ongoing PHE activity has the potential to reduce LHDs' reliance on unstable general public revenues. Yet under the best of circumstances, it is difficult to generate revenue from public health services. Although governmental public health contains pockets of entrepreneurial activity, its culture does not sustain significant entrepreneurial activity. The question remains as to whether LHDs' current public revenue sources are sustainable and, if not, whether PHE is a feasible or desirable alternative.

  15. Unhealthy marketing of pharmaceutical products: An international public health concern.

    Science.gov (United States)

    Mulinari, Shai

    2016-05-01

    I consider the current state of pharmaceutical marketing vis-à-vis ethical and legal standards and advocate measures to improve it. There is abundant evidence of unethical or illicit marketing. It fuels growing concerns about undue corporate influence over pharmaceutical research, education, and consumption. The most extensive evidence of industry transgressions comes from the United States (US), where whistle-blowers are encouraged by financial rewards to help uncover illicit marketing and fraud. Outside the US increasing evidence of transgressions exists. Recently I have observed a range of new measures to align pharmaceutical marketing practices with ethical and legal standards. In the interest of public health, I highlight the need for additional and more profound reforms to ensure that information about medicines supports quality and resource-efficient care.

  16. Scaling ethics up and down: moral craft in clinical genetics and in global health research.

    Science.gov (United States)

    Parker, Michael

    2015-01-01

    This paper engages with the question of what it is to 'do good medical ethics' in two ways. It begins with an exploration of what it might mean to say that health professionals practise good medical ethics as part of practising good ethical medicine. Using the example of the Genethics Club, a well-established national ethics forum for genetics professionals in the UK, the paper develops an account of moral craftsmanship grounded in the concepts of shared moral commitments and practices, moral work, ethics and living morality. In the light of this discussion, the paper goes on to consider what it might mean for a specialist in medical ethics, a bioethicist, to do good medical ethics. Finally, a research agenda focusing on the challenges of thinking about good medical ethics in a global context and a proposal for an innovative approach to bioethics methodology is outlined.

  17. Injury prevention and public health

    Directory of Open Access Journals (Sweden)

    David A. Sleet

    2010-06-01

    Full Text Available Injuries are one of the most under-recognized public health problems facing the world today. With more than 5 million deaths every year, violence and injuries account for 9% of global mortality, as many deaths as from HIV, Malaria and Tuberculosis combined. Eight of the 15 leading causes of death for people ages 15 to 29 years are injury-related: road traffic injuries, suicides, homicides, drowning, burns, war injuries, poisonings and falls. For every death due to war, there are three deaths due to homicide and five deaths due to suicide. However, most violence happens to people behind closed doors and results not in death, but often in years of physical and emotional suffering [1]. Injuries can be classified by intent: unintentional or intentional. Traffic injuries, fire-related injuries, falls, drowning, and poisonings are most often classified as unintentional injuries; injuries due to assault, selfinflicted violence such as suicide, and war are classified as intentional injuries, or violence. Worldwide, governments and public and private partners are increasingly aware of the strains that unintentional injuries and violence place on societies. In response they are strengthening data collection systems, improving services for victims and survivors, and increasing prevention efforts [1].

  18. The potential conflict between policy and ethics in caring for undocumented immigrants at academic health centers.

    Science.gov (United States)

    Cacari Stone, Lisa; Steimel, Leah; Vasquez-Guzman, Estela; Kaufman, Arthur

    2014-04-01

    Academic health centers (AHCs) are at the forefront of delivering care to the diverse medically underserved and uninsured populations in the United States, as well as training the majority of the health care workforce, who are professionally obligated to serve all patients regardless of race or immigration status. Despite AHCs' central leadership role in these endeavors, few consolidated efforts have emerged to resolve potential conflicts between national, state, and local policies that exclude certain classifications of immigrants from receiving federal public assistance and health professionals' social missions and ethical oath to serve humanity. For instance, whereas the 2010 Patient Protection and Affordable Care Act provides a pathway to insurance coverage for more than 30 million Americans, undocumented immigrants and legally documented immigrants residing in the United States for less than five years are ineligible for Medicaid and excluded from purchasing any type of coverage through state exchanges. To inform this debate, the authors describe their experience at the University of New Mexico Hospital (UNMH) and discuss how the UNMH has responded to this challenge and overcome barriers. They offer three recommendations for aligning AHCs' social missions and professional ethics with organizational policies: (1) that AHCs determine eligibility for financial assistance based on residency rather than citizenship, (2) that models of medical education and health professions training provide students with service-learning opportunities and applied community experience, and (3) that frontline staff and health care professionals receive standardized training on eligibility policies to minimize discrimination towards immigrant patients.

  19. The Economic Crisis and Public Health

    Directory of Open Access Journals (Sweden)

    Victor Sidel

    2009-06-01

    Full Text Available The current global economic crisis seriously threatens the health of the public. Challenges include increases in malnutrition; homelessness and inadequate housing; unemployment; substance abuse, depression, and other mental health problems; mortality; child health problems; violence; environmental and occupational health problems; and social injustice and violation of human rights; as well as decreased availability, accessibility, and affordability of quality medical and dental care. Health professionals can respond by promoting surveillance and documentation of human needs, reassessing public health priorities, educating the public and policymakers about health problems worsened by the economic crisis, advocating for sound policies and programs to address these problems, and directly providing necessary programs and services.

  20. Public Health and Midwifery in Indonesia.

    Science.gov (United States)

    2007-11-02

    JPRS: ^472 21 March 1961 PUBLIC HEALTH AND MIDWIFERY IN INDONESIA 3y M. Joedono DISTRIBUTION STATEMENT A Approved for Public Release...established to service the translation and research needs of the various government departments. ,-^’ JPRS: J^72 CSO: 1335-S/d PUBLIC HEALTH AND MIDWIFERY

  1. The role of ethical banks in health care policy and financing in Spain.

    Science.gov (United States)

    Salvador-Carulla, Luis; Solans, Josep; Duaigues, Mónica; Balot, Jordi; García-Gutierrez, Juan Carlos

    2009-01-01

    Ethical, social, or civic banks, constitute a secondary source of financing, which is particularly relevant in Southern and Central Europe. However there is no information on the scientific literature on this source of health care financing. We review the characteristics of saving banks in Spain and illustrate the contribution of one institution "Obra Social Caixa Catalunya" (OS-CC) to the health care financing in Spain. Savings bank health care funding was equivalent to 3 percent of the public health expenditure for 2008. The programs developed by OS-CC illustrate the complex role of savings banks in health financing, provision, training, and policy, particularly in the fields of integrated care and innovation. Financing is a basic tool for health policy. However, the role of social banking in the development of integrated care networks has been largely disregarded, in spite of its significant contribution to complementary health and social care in Southern and Central Europe. Decision makers both at the public health agencies and at the social welfare departments of savings banks should become aware of the policy implications and impact of savings bank activities in the long-term care system.

  2. The Norwegian national project for ethics support in community health and care services.

    Science.gov (United States)

    Magelssen, Morten; Gjerberg, Elisabeth; Pedersen, Reidar; Førde, Reidun; Lillemoen, Lillian

    2016-11-08

    Internationally, clinical ethics support has yet to be implemented systematically in community health and care services. A large-scale Norwegian project (2007-2015) attempted to increase ethical competence in community services through facilitating the implementation of ethics support activities in 241 Norwegian municipalities. The article describes the ethics project and the ethics activities that ensued. The article first gives an account of the Norwegian ethics project. Then the results of two online questionnaires are reported, characterizing the scope, activities and organization of the ethics activities in the Norwegian municipalities and the ethical topics addressed. One hundred and thirty-seven municipal contact persons answered the first survey (55 % response rate), whereas 217 ethics facilitators from 48 municipalities responded to the second (33 % response rate). The Norwegian ethics project is vast in scope, yet has focused on some institutions and professions (e.g., nursing homes, home-based care; nurses, nurses' aides, unskilled workers) whilst seldom reaching others (e.g., child and adolescent health care; physicians). Patients and next of kin were very seldom involved. Through the ethics project employees discussed many important ethical challenges, in particular related to patient autonomy, competence to consent, and cooperation with next of kin. The "ethics reflection group" was the most common venue for ethics deliberation. The Norwegian project is the first of its kind and scope, and other countries may learn from the Norwegian experiences. Professionals have discussed central ethical dilemmas, the handling of which arguably makes a difference for patients/users and service quality. The study indicates that large (national) scale implementation of CES structures for the municipal health and care services is complex, yet feasible.

  3. The Role of Public Health in the Prevention of War: Rationale and Competencies

    Science.gov (United States)

    Barker, Kathy; Arya, Neil; Rohde, Jon; Donohoe, Martin; White, Shelley; Lubens, Pauline; Gorman, Geraldine; Hagopian, Amy

    2014-01-01

    In 2009 the American Public Health Association approved the policy statement, “The Role of Public Health Practitioners, Academics, and Advocates in Relation to Armed Conflict and War.” Despite the known health effects of war, the development of competencies to prevent war has received little attention. Public health’s ethical principles of practice prioritize addressing the fundamental causes of disease and adverse health outcomes. A working group grew out of the American Public Health Association’s Peace Caucus to build upon the 2009 policy by proposing competencies to understand and prevent the political, economic, social, and cultural determinants of war, particularly militarism. The working group recommends that schools of public health and public health organizations incorporate these competencies into professional preparation programs, research, and advocacy. PMID:24825229

  4. Opportunities in Reform: Bioethics and Mental Health Ethics.

    Science.gov (United States)

    Williams, Arthur Robin

    2016-05-01

    Last year marks the first year of implementation for both the Patient Protection and Affordable Care Act and the Mental Health Parity and Addiction Equity Act in the United States. As a result, healthcare reform is moving in the direction of integrating care for physical and mental illness, nudging clinicians to consider medical and psychiatric comorbidity as the expectation rather than the exception. Understanding the intersections of physical and mental illness with autonomy and self-determination in a system realigning its values so fundamentally therefore becomes a top priority for clinicians. Yet Bioethics has missed opportunities to help guide clinicians through one of medicine's most ethically rich and challenging fields. Bioethics' distancing from mental illness is perhaps best explained by two overarching themes: 1) An intrinsic opposition between approaches to personhood rooted in Bioethics' early efforts to protect the competent individual from abuses in the research setting; and 2) Structural forces, such as deinstitutionalization, the Patient Rights Movement, and managed care. These two themes help explain Bioethics' relationship to mental health ethics and may also guide opportunities for rapprochement. The potential role for Bioethics may have the greatest implications for international human rights if bioethicists can re-energize an understanding of autonomy as not only free from abusive intrusions but also with rights to treatment and other fundamental necessities for restoring freedom of choice and self-determination. Bioethics thus has a great opportunity amid healthcare reform to strengthen the important role of the virtuous and humanistic care provider.

  5. Elective ventilation for organ donation: law, policy and public ethics.

    Science.gov (United States)

    Coggon, John

    2013-03-01

    This paper examines questions concerning elective ventilation, contextualised within English law and policy. It presents the general debate with reference both to the Exeter Protocol on elective ventilation, and the considerable developments in legal principle since the time that that protocol was declared to be unlawful. I distinguish different aspects of what might be labelled elective ventilation policies under the following four headings: 'basic elective ventilation'; 'epistemically complex elective ventilation'; 'practically complex elective ventilation'; and 'epistemically and practically complex elective ventilation'. I give a legal analysis of each. In concluding remarks on their potential practical viability, I emphasise the importance not just of ascertaining the legal and ethical acceptability of these and other forms of elective ventilation, but also of assessing their professional and political acceptability. This importance relates both to the successful implementation of the individual practices, and to guarding against possible harmful effects in the wider efforts to increase the rates of posthumous organ donation.

  6. Ethical Disputes and Public Service Televison. Case Study: Otvoreno Political Talk Show, Broadcasted on 21st of January, 2010

    Directory of Open Access Journals (Sweden)

    Gordana Škaljac Narančić

    2011-12-01

    Full Text Available Ratings of the television programs as well as commercial effects become crucial measures of the media success and journalists’ efficiency neglecting minimal ethical standards. The profit maximisation logic and mere survival in times of the economic crisis also has the impact on preserving the sensitive ethical standards. In this respect, the television, as the most influential medium, especially public television, has the biggest responsibility. Violation of the ethical norms on public television means that it does not fulfil its key role – the role of public service. In important cases of the violation of ethical rules, the lack of clear responses of the regulators is the other side of the problem. The case study in this text shows us how easy it is to turn to the contempt of the professional journalistic standards and, consequently, ethical norms. This leads us to think how difficult is today to remain professional and ethical in times of the tangible commercialism and sensationalism.

  7. Public health reform and health promotion in Canada.

    Science.gov (United States)

    Kirk, Megan; Tomm-Bonde, Laura; Schreiber, Rita

    2014-06-01

    More than 25 years have passed since the release of the Ottawa Charter for Health Promotion. This document represented a substantial contribution to public health in its emphasis on the economic, legal, political and cultural factors that influence health. With public health renewal underway across Canada, and despite overwhelming support in the public health community for the Ottawa Charter, how much its principles will be included in the renewal process remains unclear. In this paper, we present the historical understanding of health promotion in Canada, namely highlighting the contributions from the Lalonde Report, Alma Ata Declaration, the Ottawa Charter for Health Promotion and the more recent population health movement. We discuss public health renewal, using the province of British Columbia in Canada as an example. We identify the potential threats to health promotion in public health renewal as it unfolds.

  8. Global public health today: connecting the dots

    Directory of Open Access Journals (Sweden)

    Marta Lomazzi

    2016-02-01

    Full Text Available Background: Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design: A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results: Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions: The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the

  9. Conflicts of Interest: Manipulating Public Health

    Science.gov (United States)

    Stein, Richard; Davis, Devra Lee

    2014-01-01

    Evaluating the potential health impacts of chemical, physical, and biological environmental factors represents a challenging task with profound medical, public health, and historical implications. The history of public health is replete with instances, ranging from tobacco to lead and asbestos, where the ability to obtain evidence on potential…

  10. Climate Change and Public Health Policy.

    Science.gov (United States)

    Smith, Jason A; Vargo, Jason; Hoverter, Sara Pollock

    2017-03-01

    Climate change poses real and immediate impacts to the public health of populations around the globe. Adverse impacts are expected to continue throughout the century. Emphasizing co-benefits of climate action for health, combining adaptation and mitigation efforts, and increasing interagency coordination can effectively address both public health and climate change challenges.

  11. Hippocrates and Bernays: A Medical Ethics Perspective on the Ethics of Public Relations.

    Science.gov (United States)

    Kruckeberg, Dean

    While comparisons of public relations practitioners and attorneys remain attractive among practitioners and scholars searching for evidence of public relation's emergence as a profession, practitioners would be better served by emulating physicians in their "healing" role rather than attorneys in their "advocacy" role. Public…

  12. Solidarity: a (new) ethic for global health policy.

    Science.gov (United States)

    Harmon, Shawn H E

    2006-12-01

    This article explores solidarity as an ethical concept underpinning rules in the global health context. First, it considers the theoretical conceptualisation of the value and some specific duties it supports (ie: its expression in the broadest sense and its derivative action-guiding duties). Second, it considers the manifestation of solidarity in two international regulatory instruments. It concludes that, although solidarity is represented in these instruments, it is often incidental. This fact, their emphasis on other values and their internal weaknesses diminishes the action-guiding impact of the solidarity rules. The global health and human subject research scene needs a completely new instrument specifically directed at means by which solidarity can be achieved, and a reformed infrastructure dedicated to realising that value.

  13. Salutogenesis and Ayurveda: indications for public health management.

    Science.gov (United States)

    Morandi, Antonio; Tosto, Carmen; Roberti di Sarsina, Paolo; Dalla Libera, Dacia

    2011-12-01

    Ayurveda, the ancient traditional medicine of India, defines health as a state of complete physical, mental and spiritual well-being. The focus of Ayurveda is on a predictive, preventive and personalized medicine. This is obtained through a low-cost personalized counseling about lifestyle measures (diet, activities, etc.), trying to involve the patient directly in the process of healing, increasing his self-awareness and good relationships with other people and nature. The approach of Ayurveda toward positive health shares its features with that of salutogenesis as described by Antonovsky. Prevention strategies pragmatically suggested by Ayurveda - including factors such as promotion of health education, individual awareness, integration of spirituality and ethics in healthcare system- may be applied in public health management, in order to improve perceived and objective life quality, promote healthy aging, limit drugs use (avoiding expensive side-effects) and reduce chronic diseases social costs. Ayurveda has a universal-coverage, being person-centered and consequently intercultural.

  14. Constructing violence as a public health problem.

    Science.gov (United States)

    Winett, L B

    1998-01-01

    Once viewed primarily as a criminal justice problem, violence and its prevention are now often claimed by public health professionals as being within their purview. The author reviewed 282 articles published in public health and medical journals from 1985 through 1995 that discussed violence as a public health problem. She found that while authors tended to identify social and structural causes for violence, they suggested interventions that targeted individuals' attitudes or behaviors and improved public health practice. Her study illuminates the tension between public health professionals' vision of the social precursors of violence and their attempts to apply a traditional set of remedies. In targeting individuals to rid the nation of violence, the public health community is deemphasizing societal causes.

  15. Communication and Ethical Behavior in the Public Service

    OpenAIRE

    Arta Musaraj; Julejda Gerxhi

    2010-01-01

    Setting up public administration which operates effectively and taking over responsibilities, both crucial on the point of view of the democracy indicators, requires great effort from all social stake holders in setting up and maintaining a public service organization. This notion implies the setting in function of the instruments and procedures that prevent undesirable behavior and provide encouragement of good behavior among operators of those services. While doing this, communication as a ...

  16. [Centenary of the Health Council of the Netherlands. V. Ethical-social issues

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2002-01-01

    Since its inception, the Health Council of the Netherlands has included normative aspects in its reports. Over the past decades, ethics and rights have received increasing attention, particularly since the establishment of the Standing Committee on Medical Ethics and Health Law in 1977. In particula

  17. Review of Ethics in Mental Health Research by James M. DuBois

    Directory of Open Access Journals (Sweden)

    Pies Ronald

    2008-04-01

    Full Text Available Abstract The burgeoning field of medical ethics raises complicated questions for mental health researchers. The critical issues of risk assessment, beneficence, and the moral duties researchers owe their patients are analyzed in James DuBois's well written Ethics in Mental Health Research.

  18. [Centenary of the Health Council of the Netherlands. V. Ethical-social issues

    NARCIS (Netherlands)

    Have, H.A.M.J. ten

    2002-01-01

    Since its inception, the Health Council of the Netherlands has included normative aspects in its reports. Over the past decades, ethics and rights have received increasing attention, particularly since the establishment of the Standing Committee on Medical Ethics and Health Law in 1977. In

  19. The State Public Health Laboratory System

    OpenAIRE

    Inhorn, Stanley L.; Astles, J. Rex; Gradus, Stephen; Malmberg, Veronica; Snippes, Paula M.; Wilcke, Burton W.; White, Vanessa A.

    2010-01-01

    This article describes the development since 2000 of the State Public Health Laboratory System in the United States. These state systems collectively are related to several other recent public health laboratory (PHL) initiatives. The first is the Core Functions and Capabilities of State Public Health Laboratories, a white paper that defined the basic responsibilities of the state PHL. Another is the Centers for Disease Control and Prevention National Laboratory System (NLS) initiative, the go...

  20. Review for the volume Practicing Relational Ethics in Organizations, Authors: Gitte Haslebo, Maja Loua Haslebo, Taos Institute Publications, ISBN 978-0-9819076-8-0

    OpenAIRE

    Sandu, Antonio

    2012-01-01

    The volume Practicing Relational Ethics in Organizations having as authors Gitte Haslebo and Maja Loua Haslebo issued by Taos Institute Publications Ohio USA, discusses relational ethics and ethical practice in the organization. The problem of ethical practice in the organization besides being a necessity for business it overlaps with aspects of organizational culture, personnel management, leadership. Within the organizational ethics, the authors select the issue of relational ethics from a ...