Skip to main content

Ethical Issues

A myriad of ethical issues surround health promotion, disease prevention and research as related to public health.  For example, two ethical challenges involve the role of government in health promotion and disease prevention as well as human subjects protection as they pertain to the public health research agenda. According to Callahan and Jennings (2002), public health has dual obligations to the government (which regulates it) and the public (that it serves).  This dichotomy creates special ethical problems for the public health profession. For example, laws such as immunization and seat belt requirements have an explicit normative element: Callahan and Jennings claim that these regulations promote and protect the lives of citizens. The trick is balancing the paternalistic interests of the state with the libertarian notion of freedom.
            While government interference in the health of its citizenry might at first glance be deemed a positive policy, that is not always the case. For example, consider the eugenics sterilization program in America.  According to the documentary "The Lynchburg Story," between 1905 and 1972 over 70,000 Americans were forcibly sterilized because the state deemed them unfit to reproduce.  Not all of these victims were cognitively challenged, rather some were just poor. When discussing governmental human rights violations and health, Farmer (1999) made the following comment, "Social inequalities based on race or ethnicity, gender, religious creed, and – above all – social class are the motive force behind most human rights violations. In other words, violence against individuals is usually embedded in entrenched structural violence" (p. 1488).  Thus a key ethical problem in the public health system remains ensuring the rights of disenfranchised groups.   
            Human rights violations, especially with marginalized groups such as those in Lynchburg or Tuskegee, provide the main rationale for governmental oversight of all research involving human subjects.  This oversight generally follows a biomedical model a model that stringently regulates research.  For example, clinical drug trials require absolute voluntary cooperation and informed consent of research subjects. Participants must be aware of their rights as well as risks and benefits of this study. However, many research interests in public health do not involve invasive procedures. As such, it may be useful to relax research protocols in public health research that deals with large populations or communities. For instance, at ETSU, administrative oversight of research is divided into a campus and medical Institutional Review Board (IRB). This division allows research that is oriented socially and behaviorally, particularly non-manipulative studies, to qualify for exemption from full review.

References
Callahan, D., & Jennings, B. (2002). Ethics and public health: Forging a strong relationship.
American Journal of Public Health, 92(2), 169-176.
Eadie, B. (Producer), & Trombley, S. (1994). The Lynchburg Story [Motion picture]. U.S.:
Worldview Pictures Production.
Farmer, P. (1999). Pathologies of power: Rethinking health and human rights. American Journal
of Public Health, 89(10), 1486-1496.

Comments

Post a Comment

Popular posts from this blog

Notes To Myself - Rambling

Just thinking out loud here – rambling is to follow To go along with my last entry (song lyrics about coming to terms with yourself “when a man of my age”) Love It hurts. It cuts. It’s intense. Let me explain: I know how I feel about Jon, we have dated for a little over two years. It’s wonderful from the get go. I’ve dated him for two years and known him for a little over three years. What I have learned, I love.   Our feelings for one another have progressed along the way.   Am I in love?   Yes. Do I love him? Yes. Emotional barriers came tumbling down in the course of our interactions. I feel as though I know him and I equally feel that I am known by him. This is a powerful thing to me. I want this intimacy more than I care to admit.   How wonderful to share with another, to allow them to know the good and the bad, and in turn, they continue to want to know you and to be with you. The same is true in reverse, I know about him and I continue...
Post a Comment
Read more

Let Go Or Be Dragged

The following thoughts have been simmering in my mind as of late. I’ve had a lot of time to think during my recent bout of illness. I wasn’t feeling well enough to do anything else and so I had time to contemplate my current state of  internal affairs, that is, do a self inventory of sorts. I discovered that I was believing something that was no longer true, I was holding on to something that had passed, but in my mind, it was still something for me to latch onto and to “keep alive” and kicking so to speak. I know I shouldn’t believe everything I think, but was surprised when I examined this particular item. Perhaps I should say this was more of an assumption than anything, but I do think I have been cultivating this idea and giving it life, when in all reality, I should have released it some time ago.  A relationship that had come and gone, and yet, I found myself attached to this thought process that it was something still, and in thinking about this, I realized I was ...
Post a Comment
Read more

Virgin Offered as a Burnt Offering

An observation from this weekend.  I attended a funeral for a relative of mine who recently had passed away. She was a member of the Eastern Star (an order associated with Free Masonry). My aunt was a wonderful lady, generous and kind and full of good works to her family and community. My thoughts here are not in relation to her, or to the Order itself, it has more to do with the scriptural references that were used.  In association to the five pointed star that symbolizes their Order, they referenced several Biblical figures as exemplars to consider. Three of the five caught my attention as ladies from the Order spoke ·          Adah (daughter of Jephthah) ·          Ruth ·          Esther These heroines of the Bible, persevered seemingly because of their faith in G-D and their submission to men. Men wrote the words that eventually became cod...
Post a Comment
Read more