Ethical codes and frameworks

EMPHNETGhaiath M. A. Hussein

MBBS, MHSc. (Bioethics), PhD ResearcherEmail :.ghaiathme@gmail com

[Insert Venue][Insert Dates]

2013

Module’s objectives

2

• List and critically describe the current PHE codes and frameworks

• Utilize ethical analysis frameworks in identifying potential ethical issues and to conduct ethical analysis of public health interventions,

• Apply the appropriate tools and frameworks to systematically analyse the ethical issues and dilemmas that arise during the practice of public health interventions

Module’s Outline

• What the ethical codes and frameworks? And why are they needed?

• The difference between codes, frameworks, and legislative approaches to Public Health

• Examples of the application Public Health Ethics codes and frameworks in analysing PH ethical issues (in practice and research)

Code & Frameworks?

• What is/are the difference(s) between codes and frameworks?

• Why do you think we need them?• Have you developed or used one of them in your

practice?

The American Public Health Code

• respects the rights of individuals in the community• ensure an opportunity for input from community• ensuring that the basic resources are accessible to all

people in the community• should obtain the community's consent• anticipate and respect diverse values, beliefs, and

cultures • should protect the confidentiality of information• should engage in collaborations and affiliations in ways

that build the public's trust

The code is available at ::// . . /http www apha org codeofethics

An Ethics Framework for Public Health

Nancy E. Kass, ScD, Am J Public Health. 2001 November; 91(11): 1776–1782.

1. What are the public health goals of the proposed program?

2. How effective is the program in achieving its stated goals?3. What are the known or potential burdens of the

program?4. Can burdens be minimized? Are there alternative

approaches?5. Is the program implemented fairly?6. How can the benefits and burdens of a program be fairly

balanced?

Nuffield’s Stewardship modeAcceptable public health goals include (examples?):• reducing the risks of ill health that result from other people's actions; • reducing causes of ill-health relating to environmental conditions; • protecting and promoting the health of children and other vulnerable people;• ensuring that it is easy for people to lead a healthy life; • appropriate access to medical services; and• reducing unfair health inequalities.At the same time, public health programs should:• not attempt to coerce adults to lead healthy lives;• minimise the use of measures that are implemented without

consulting people (either individually or using democratic procedures); and

• minimize measures that are very intrusive or conflict with important aspects of personal life, such as privacy

Lord Krebs K, Unwin J, et al.: Public health: ethical issues. London: Nuffield Council on Bioethics; 2007.

Now… your turn

• Which model of codes/frameworks you would endorse? Why?

• Exercise: in groups, choose one of the programs/departments you work(ed) with then assess it using one of the above frameworks/codes?

References & Readings

• THOMAS, J. C., SAGE, M., DILLENBERG, J. & GUILLORY, V. J. 2002. A code of ethics for public health. Journal Information, 92.

• Childress JF, Faden RR, Gaare RD, Gostin LO, Kahn J, Bonnie RJ, Kass NE, Mastroianni AC, Moreno JD, Nieburg P: Public health ethics: mapping the terrain.

• Lord Krebs K, Unwin J, et al.: Public health: ethical issues. London: Nuffield Council on Bioethics; 2007.

Required Readings:• Childress JF, Faden RR, Gaare RD, Gostin LO, Kahn J, Bonnie RJ, Kass NE, Mastroianni AC, Moreno JD,

Nieburg P: Public health ethics: mapping the terrain. J Law Med Ethics 2002, 30(2):170-178.• American Public Health Association (APHA)

http://www.apha.org/programs/education/progeduethicalguidelines.htm• Kass N. An Ethics Framework for Public Health. AJPH. 91(11): 1776-1782. November 2001.

Optional/additional readings: • American Medical Association Code of Ethics: http://

www.amaassn.org/ama/pub/physician-resources/medical-ethics.shtml• Lord Krebs K, Unwin J, et al.: Public health: ethical issues. London: Nuffield Council on Bioethics; 2007.• Roberts MJ, Reich MR. Ethical analysis in Public Health. Lancet (2002) 359:1055-1059• Field RI, Caplan AL. A proposed ethical framework for vaccine mandates: competing values and the case of

HPV. Kennedy Inst Ethics J 2008;18(2):111-124.