Ethical Basis of the Practice of Public Health

ID 250 Subject & Catalog Number

Description

This course serves as an introduction to ethical issues in the practice of public health. Students will identify a number of key ethical issues and dilemmas arising in efforts to improve and protect population health and will become familiar with the principal arguments and evidence supporting contesting views. The class aims to enhance the students' capacity for using ethical reasoning in resolving the ethical issues that will arise throughout their careers. Unlike courses in medical ethics, which mainly examine ethical dilemmas facing individual clinicians, the population-level focus of this course directs our attention to questions of ethics and justice that must be addressed at the societal level.

These include:
► What social response is required of a just society to the needs of its members for protecting and restoring health?
► Is population health something other than the aggregate of the health concerns of the individuals who make up a society at a given time? And what are the ethical implications of the answers?
► When are inequalities in health inequitable, and what priority should be assigned to reducing disparities in health when pursuing this goal might compromise the effort to maximize population health?
► Which ethical choices, if any, are unavoidable in developing the methodologies for measurement of health and of the global burden of disease?
► Which ethical choices if any are unavoidable in developing and using methods for priority-setting such as cost-effectiveness analysis and cost-benefit analysis? Are the ethical commitments of the profession of public health consistent with some methods and not others?
► Should the institution of universal health coverage be guided by ethical precepts and if so, what are these values and how should they guide policy?
► Can and should public health's dedication to improving population health conflict with the priorities of some individuals whose choices to not reflect such high priority for health? Should these individual preferences always be respected? Are there effective strategies that pursue population health in the face of such conflicts while preserving the individual's freedom to make unhealthy choices?
► How should responsibility for poor health be assigned, and what are the ethical implications of this assignment for poor health due to health problems due to smoking, obesity, and other unhealthy behavior? To the extent that the socioeconomic health gradient reflects differences in how well people take care of themselves are these disparities in health individual failings rather than social injustices?