Ethical Considerations in Epidemiology

For your discussion this week, you should consult a text or other sources on Ethics in Healthcare. Basic ethical principles apply to epidemiological issues. You will integrate these ethical principles and considerations into an ethical situation for this week’s discussion. These true scenarios all have inherent ethical and other problems that require considerations and principles that can be applied to an individual in a public health scenario.

In Week 3 you signed up for a true ethical case study for this week’s DQ. There are four different epidemiology/public health scenarios, and we will incorporate ethical considerations to provide a framework for human subjects protection, and to understand how the cases can be managed. In the discussion forum for this week, 4 separate threads will be set up, named by the topic of each individual case study. You will post your response under the thread of the case study to which you have selected which will be copied into that thread. They are copied here as well:

Case Study #1: Personal Payment
You are working at a rural health clinic, and a police officer calls you and tells you he is bringing you a 13 year old girl who was apprehended for engaging in sexual acts with a male because he is concerned about her health. After a lengthy conversation, you learn that in this poor community, teens pay for rides to fast food restaurants and stores by performing various sex acts as payment.

Case Study #2: Shared SNAP
A 16 year old pregnant, brittle, Type 1 diabetic at 20 weeks twin gestation is discharged from the hospital where she lives with her mother, father, her father’s friend, and his wife who has severe developmental delays. You are a public health worker assigned to visit this teen and learn that the father of the teen’s babies is her father’s 46 year old friend which is acceptable to her parents. The teen is on Medicaid, and the Supplemental Nutrition Assistance Program (SNAP) which all the member of the household share. You are concerned about the welfare of the mom and babies as it appears that the household is eating from their garden because there is little to no food in the house towards the end of the month.

Case Study #3: Immunization Implications
A measles outbreak occurred in California between the end of 2014 and the beginning of 2015. Over 170 known cases of measles occurred with one third of them linked to travel to a Disney resort. Several children were hospitalized due to the measles. It was determined that nearly 50% of the affected children had not been vaccinated. There is a concern that future outbreaks could be more serious as the anti vaccination movement grows.

Case Study #4: Use and Abuse
You work in a wealthy, suburban, orthopedic surgeon’s office. The community news has reported about the growing problem of heroin abuse among high school students. Over the last several years, three current or former high school football players have died of heroin overdoses. All of those students were given prescription opioids following orthopedic surgery. A 16 year old high school football player has undergone surgery to repair a torn meniscus, ACL, and joint effusion. He continues to complain of pain on his 2 week surgical appointment and the physician gives him another prescription for 80 Percocet. You are concerned about addiction.
With these thoughts in mind, for this week,

1. What ethical, legal, moral, social, health, cultural, and community implications apply to this scenario?
2. How do these implications frame the scenario, provide direction for understanding, and a plan of action?
3. Describe potential outcomes for the case study and the implications of various actions.
4. If you were the epidemiologist, researcher, or public health official in this scenario, propose a resolution that could be considered for the situation you selected.
   Respond to three or more postings within your group as well as a different ethical case study by your colleagues, addressing such things as:
   • Is there more than one “right” or ethical/moral answer for this situation? Why or why not?
   • What would clearly be incorrect or unethical plans or actions in this case?
   • What other members of the multidisciplinary team need to become involved and how in this situation?
   Remember the basic rules of posting:
5. You must include citations to support what you write and they must be in APA format. At least one should be another source besides your texts and readings, and follow the basic rules of not more than 5 years old and be peer-reviewed scholarly sources.
6. Emotion and intent clearly come through in this medium.
7. Be courteous, non-judgmental, and supportive, even when you disagree.
8. Postings must have substance: “I agree” or “Good posting” are examples of postings that do not meet this criteria and will not count as a required posting.
9. Always check the grading rubric as you reply to ensure you meet all criterion and earn all the points possible.
10. Review the grading rubric to ensure you are meeting all criteria.