Ethical issues surrounding childhood tuberculosis

2020 ◽  
Vol 24 (5) ◽  
pp. 27-31
Author(s):  
P. Hummel ◽  
N. Ahamed ◽  
F. Amanullah
Keyword(s):  
Public Health ◽  
Social Support ◽  
Research And Development ◽  
Service Provision ◽  
Research Agenda ◽  
Ethical Issues ◽  
Management Strategies ◽  
Ethical Challenges ◽  
Reporting Service ◽  
Childhood Tb

Each year, at least one million children become ill with tuberculosis (TB) and more than 253 000 died of TB in 2016. The ethical issues surrounding childhood TB remain underexplored, and established or proposed management strategies are scarce. In this paper, we identify ethical challenges that are raised by childhood TB. Some of them are familiar from TB in other populations but arise with increased severity in children. We discuss interconnected and mutually reinforcing difficulties clustered around the topics of susceptibility, diagnosis, reporting, service provision, treatment, psychological and social support, and research and development (R&D) neglect. We formulate suggestions on how to address these ethical issues. For developing sound research agendas and policies based on the WHO End TB Strategy, it is essential that diagnosis and reporting improve. There is a duty to care for and provide available interventions to children with TB even if they are not a major source of transmission, and therefore no major impact on public health is expected. Treatment should be accompanied by counselling, health education, psychological and material support to TB-affected children and their families. Children need to be included equitably and more systematically into the TB research agenda.

Pandemic Disease, Public Health, and Ethics

2019 ◽  
pp. 796-811 ◽  
Author(s):  
Maxwell Smith ◽  
Ross Upshur
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Ethical Challenges ◽  
Pandemic Preparedness ◽  
Scarce Resources ◽  
Ethical Frameworks ◽  
Health Measures ◽  
Care Workers ◽  
The Face ◽  
Conducting Research

Infectious disease pandemics raise significant and novel ethical challenges to the organization and practice of public health. This chapter provides an overview of the salient ethical issues involved in preparing for and responding to pandemic disease, including those arising from deploying restrictive public health measures to contain and curb the spread of disease (e.g., isolation and quarantine), setting priorities for the allocation of scarce resources, health care workers’ duty to care in the face of heightened risk of infection, conducting research during pandemics, and the global governance of preventing and responding to pandemic disease. It also outlines ethical guidance from prominent ethical frameworks that have been developed to address these ethical issues and concludes by discussing some pressing challenges that must be addressed if ethical reflection is to make a meaningful difference in pandemic preparedness and response.

The Ethics of AI in Biomedical Research, Patient Care, and Public Health

2020 ◽  
pp. 702-718 ◽  
Author(s):  
Alessandro Blasimme ◽  
Effy Vayena
Keyword(s):  
Public Health ◽  
Patient Care ◽  
Biomedical Research ◽  
Disease Surveillance ◽  
Ethical Issues ◽  
Ethical Review ◽  
Ethical Challenges ◽  
Healthcare Provision ◽  
Social Scientists ◽  
Ethical Frameworks

This chapter explores ethical issues raised by the use of artificial intelligence (AI) in the domain of biomedical research, healthcare provision, and public health. The litany of ethical challenges that AI in medicine raises cannot be addressed sufficiently by current regulatory and ethical frameworks. The chapter then advances the systemic oversight approach as a governance blueprint, which is based on six principles offering guidance as to the desirable features of oversight structures and processes in the domain of data-intense biomedicine: adaptivity, flexibility, inclusiveness, reflexivity, responsiveness, and monitoring (AFIRRM). In the research domain, ethical review committees will have to incorporate reflexive assessment of the scientific and social merits of AI-driven research and, as a consequence, will have to open their ranks to new professional figures such as social scientists. In the domain of patient care, clinical validation is a crucial issue. Hospitals could equip themselves with “clinical AI oversight bodies” charged with the task of advising clinical administrators. Meanwhile, in the public health sphere, the new level of granularity enabled by AI in disease surveillance or health promotion will have to be negotiated at the level of targeted communities.

scholarly journals COVID-19 Pandemic in Thailand: Implementing Containment Measures and Their Ethical Challenges

2020 ◽  
Author(s):  
Hongsuda Sornklin ◽  
Thitiwan Kerdsomboon ◽  
Yongyuth Yuthavong ◽  
Prasit Palittapongarnpim ◽  
Soraj Hongladarom ◽  
...  
Keyword(s):  
Public Health ◽  
Clinical Trial ◽  
Ethical Issues ◽  
Technology Development ◽  
Research Integrity ◽  
Ethical Challenges ◽  
National Science ◽  
Office Of Research Integrity ◽  
Containment Measures ◽  
New Challenges

Abstract Containment measures have been implemented in Thailand after the country was hit by the Covid-19 pandemic. The top priority is to save people’s lives. Unavoidably, serious consequences that affected the people’s income, privacy, needs, equality, and equity emerged, presenting new challenges. In order to begin to investigate these complex ethical questions, the Office of Research Integrity of National Science and Technology Development Agency organized a meeting in order to bring together key experts in various fields related to the Covid-19 pandemic to discuss what was going on in Thailand and how to manage it properly. Three key ethical settings, each of which caused significant effects, were discussed in the meeting, namely public health, medical services, and research and clinical trial settings. Many key ethical issues were revealed during the meeting, as well as how best to address and manage them properly.

Control of Mosquito-Borne Illnesses: A Challenge to Public Health Ethics

2019 ◽  
pp. 458-471
Author(s):  
Laura Greisman ◽  
Barbara Koenig ◽  
Michele Barry
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Mosquito Control ◽  
Virus Disease ◽  
Health Interventions ◽  
Ethical Challenges ◽  
Insecticide Treated Nets ◽  
Public Health Interventions ◽  
Middle Income ◽  
Public Health Agencies

This chapter delves into the ethical issues surrounding the implementation of public health interventions for control of mosquito-borne illnesses. Emerging and reemerging mosquito-borne infections remain a public health threat worldwide, prompting public health agencies to strengthen individual and population-wide measures for mosquito control. Ethical issues surrounding surveillance activities and key public health interventions for mosquito control are discussed, including provision of insecticide-treated nets (ITNs), the spraying of aerial pesticides, and the introduction of genetically modified mosquitoes. A case study of Zika virus disease highlights specific ethical challenges surrounding the safety of insect repellent use in pregnancy and the complex issue of women’s reproductive rights arising in a fast-moving epidemic. The chapter emphasizes the need for community engagement at all levels of mosquito control interventions, and it highlights the disproportionate impact of mosquito-borne disease on the poor, calling to action the need to strengthen health systems in low- and middle-income countries.

scholarly journals Participatory Disease Surveillance Systems: Ethical Framework (Preprint)

2018 ◽  
Author(s):  
Lester Darryl Geneviève ◽  
Andrea Martani ◽  
Tenzin Wangmo ◽  
Daniela Paolotti ◽  
Carl Koppeschaar ◽  
...  
Keyword(s):  
Public Health ◽  
Research Ethics ◽  
Public Health Surveillance ◽  
Ethical Issues ◽  
Well Being ◽  
Health Surveillance ◽  
Ethical Framework ◽  
Surveillance Systems ◽  
Ethical Challenges ◽  
Participatory Surveillance

UNSTRUCTURED Advances in information technology are changing public health at an unprecedented rate. Participatory surveillance systems are contributing to public health by actively engaging digital (eg, Web-based) communities of volunteer citizens to report symptoms and other pertinent information on public health threats and also by empowering individuals to promptly respond to them. However, this digital model raises ethical issues on top of those inherent in traditional forms of public health surveillance. Research ethics are undergoing significant changes in the digital era where not only participants’ physical and psychological well-being but also the protection of their sensitive data have to be considered. In this paper, the digital platform of Influenzanet is used as a case study to illustrate those ethical challenges posed to participatory surveillance systems using digital platforms and mobile apps. These ethical challenges include the implementation of electronic consent, the protection of participants’ privacy, the promotion of justice, and the need for interdisciplinary capacity building of research ethics committees. On the basis of our analysis, we propose a framework to regulate and strengthen ethical approaches in the field of digital public health surveillance.

scholarly journals Exploring the Ethics of Implementation of Epigenomics Technologies in Cancer Screening: A Focus Group Study

2021 ◽  
Vol 14 ◽  
pp. 251686572110636
Author(s):  
Eline M Bunnik ◽  
Ineke LLE Bolt
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Early Stage ◽  
Personal Responsibility ◽  
Population Screening ◽  
Ethical Challenges ◽  
Data Governance ◽  
Focus Group Study ◽  
Stage Of Development ◽  
Societal Pressure

New epigenomics technologies are being developed and used for the detection and prediction of various types of cancer. By allowing for timely intervention or preventive measures, epigenomics technologies show promise for public health, notably in population screening. In order to assess whether implementation of epigenomics technologies in population screening may be morally acceptable, it is important to understand – in an early stage of development – ethical and societal issues that may arise. We held 3 focus groups with experts in science and technology studies (STS) (n = 13) in the Netherlands, on 3 potential future applications of epigenomic technologies in screening programmes of increasing scope: cervical cancer, female cancers and ‘global’ cancer. On the basis of these discussions, this paper identifies ethical issues pertinent to epigenomics-based population screening, such as risk communication, trust and public acceptance; personal responsibility, stigmatisation and societal pressure, and data protection and data governance. It also points out how features of epigenomics (eg, modifiability) and changing concepts (eg, of cancer) may challenge the existing evaluative framework for screening programmes. This paper aims to anticipate and prepare for future ethical challenges when epigenomics technologies can be tested and introduced in public health settings.

Violence and Public Health Ethics

2019 ◽  
pp. 616-631
Author(s):  
Omrana Pasha ◽  
Myra F. Hyder ◽  
Adnan A. Hyder
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Health Workers ◽  
Public Health Practice ◽  
Ethical Challenges ◽  
Ethical Practice ◽  
Provision Of Services ◽  
Context Specific ◽  
Public Health Practitioners ◽  
The Impact

This chapter discusses the ethical issues and impact of interpersonal and self-directed violence on the health of the global population. Interpersonal and self-directed violence (self-harm) are leading causes of death and disability globally, and international guidelines recommend provision of services to those affected by violence, research into the prevalence of violence, and advocacy and training to prevent violence. Importantly, public health practice and research on violence present both global and context-specific ethical challenges. This chapter describes the impact of violence on public health, the role of public health practitioners in addressing violence, fundamental ethical principles and guidelines for public health workers to address violence, and ethical challenges for research and programs dealing with violence, including fair approaches to violence screening and response, safe means of collecting data about violence, reducing risks when resources are limited, and autonomy versus paternalism in suicide management. The chapter concludes by suggesting strategies for the ethical practice of public health in the context of violence.

An Overview of Ethics, Public Health, and Communicable Diseases

2019 ◽  
pp. 427-434
Author(s):  
Holly A. Taylor
Keyword(s):  
Public Health ◽  
Disease Transmission ◽  
Ethical Issues ◽  
Communicable Diseases ◽  
Health Interventions ◽  
Ethical Challenges ◽  
Treatment Regimens ◽  
Severity Of Disease ◽  
Multiple Factors ◽  
Prevention And Treatment

This chapter provides an overview of the Ethics, Public Health, and Communicable Diseases section of The Oxford Handbook of Public Health Ethics. Ethical issues relevant to the prevention and treatment of communicable diseases vary based on multiple factors, including ease of disease transmission, the severity of disease, and the availability of effective approaches to the prevention and treatment of disease. One chapter in this section is devoted to immunization, reflecting its crucial role in the prevention of and near eradication of multiple infectious diseases. Other chapters focus on different communicable diseases. The chapter on tuberculosis highlights ethical challenges of combatting an airborne, infectious disease. The chapter on mosquito-borne illnesses examines another context where impoverished living conditions contribute both to the spread of disease and to ethics challenges of disease management. Lastly, the chapter on HIV/AIDS highlights how ethical analysis of public health interventions can shift with the advancement of science and the development of effective methods of prevention and treatment regimens.

scholarly journals Ethical challenges experienced by public health nurses related to adolescents’ use of visual technologies

2018 ◽  
Vol 26 (6) ◽  
pp. 1822-1833 ◽  
Author(s):  
Hilde Laholt ◽  
Kim McLeod ◽  
Marilys Guillemin ◽  
Ellinor Beddari ◽  
Geir Lorem
Keyword(s):  
Public Health ◽  
Focus Group ◽  
Child Neglect ◽  
Ethical Issues ◽  
Public Health Nurses ◽  
Ethical Challenges ◽  
Focus Group Discussions ◽  
Group Discussions ◽  
Ethical Concerns ◽  
Visual Technologies

Background: Visual technologies are central to youth culture and are often the preferred communication means of adolescents. Although these tools can be beneficial in fostering relations, adolescents’ use of visual technologies and social media also raises ethical concerns. Aims: We explored how school public health nurses identify and resolve the ethical challenges involved in the use of visual technologies in health dialogues with adolescents. Research design: This is a qualitative study utilizing data from focus group discussions. Participants and research context: We conducted focus group discussions using two semi-structured discussion guides with seven groups of public health nurses (n = 40) working in Norwegian school health services. The data were collected during January and October 2016. Discussions were audio recorded, transcribed, and coded into themes and subthemes using systematic text condensation. Ethical considerations: The leader of the public health nursing service who agreed to provide access for the study and the Norwegian Center for Research Data that reviewed and approved the study. All participants gave informed consent. Findings: In adolescents’ use of visual materials with public health nurses, ethical concerns were raised regarding suicide ideations, socially unacceptable content, violation of privacy, and presentations of possible child neglect. The nurses utilized their professional knowledge and experience when identifying and navigating these ethical dilemmas; they resolved ethical uncertainties through peer discussion and collaboration with fellow nurses and other professionals. Discussion: We discussed the findings in light of Annemarie Mol’s interpretation of the ethics of care. Mol expands the notion of ethical care to include the action of technologies. Conclusion: Although the increasing use of visual technologies offered benefits, school nurses faced ethical challenges in health dialogues with adolescents. To address and navigate these ethical issues, they relied on their experience and caring practices based on their professional ethics. Uncertainties were resolved through peer dialogue and guidance.

scholarly journals Considerations for applying bioethics norms to a biopharmaceutical industry setting

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Luann E. Van Campen ◽  
◽  
Tatjana Poplazarova ◽  
Donald G. Therasse ◽  
Michael Turik
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Contextual Factors ◽  
Clinical Care ◽  
Health Programs ◽  
Biopharmaceutical Industry ◽  
Ethical Challenges ◽  
Legal Compliance ◽  
Multiple Stakeholders ◽  
Public Health Programs

AbstractBackgroundThe biopharmaceutical industry operates at the intersection of life sciences, clinical research, clinical care, public health, and business, which presents distinct operational and ethical challenges. This setting merits focused bioethics consideration to complement legal compliance and business ethics efforts. However, bioethics as applied to a biopharmaceutical industry setting often is construed either too broadly or too narrowly with little examination of its proper scope.Main textAny institution with a scientific or healthcare mission should engage bioethics norms to navigate ethical issues that arise from the conduct of biomedical research, delivery of clinical care, or implementation of public health programs. It is reasonable to assume that while bioethics norms must remain constant, their application will vary depending on the characteristics of a given setting. Context “specification” substantively refines ethics norms for a particular discipline or setting and is an expected, needed and progressive ethical activity. In order for this activity to be meaningful, the scope for bioethics application and the relevant contextual factors of the setting need to be delineated and appreciated. This paper defines biopharmaceutical bioethics as:the application of bioethics norms (concepts, principles, and rules) to the research, development, supply, commercialization, and clinical use of biopharmaceutical healthcare products. It provides commentary on this definition, and presents five contextual factors that need to be considered when applying bioethics norms to a biopharmaceutical industry setting: (1) dual missions; (2) timely and pragmatic guidance; (3) resource stewardship; (4) multiple stakeholders; and (5) operational complexity.ConclusionUnderstanding the scope of the biopharmaceutical enterprise and contextual factors of a biopharmaceutical industry setting is foundational for the application of bioethics norms. Establishing a common language and approach for biopharmaceutical bioethics will facilitate breadth and depth of discussion and subsequent implementation to benefit patients, the healthcare system and society.

Sign in / Sign up

Export Citation Format

Share Document