Industrial Chemicals, Pesticides, Public Health, and Ethics

Author(s):  
Elise M. R. Smith ◽  
Mark F. Miller

This chapter provides an overview of ethical issues related to the development of industrial chemicals. While they do contribute to advancements in agriculture, medicine, transportation, hygiene, and human leisure, these chemicals can concomitantly pose serious threats to human and environmental health. The chapter examines the public health cost-benefit of environmental chemicals and the regulatory frameworks for human health protection in various countries, focusing on evidence-based decision-making, risk analysis, a precautionary approach, and international consensus. Specific ethical concerns discussed relate to the impacts and lasting effects of pesticides, the influence of economic stability and profit derived from industrial chemicals, conflicts between public health priorities and environmental protections, and inequities and injustices in the distribution of risks and burdens associated with industrial chemicals.

2014 ◽  
Vol 9 (1) ◽  
pp. 38-43 ◽  
Author(s):  
Frederick M Burkle ◽  
Christopher M Burkle

AbstractLiberia, Sierra Leone, and Guinea lack the public health infrastructure, economic stability, and overall governance to stem the spread of Ebola. Even with robust outside assistance, the epidemiological data have not improved. Vital resource management is haphazard and left to the discretion of individual Ebola treatment units. Only recently has the International Health Regulations (IHR) and World Health Organization (WHO) declared Ebola a Public Health Emergency of International Concern, making this crisis their fifth ongoing level 3 emergency. In particular, the WHO has been severely compromised by post-2003 severe acute respiratory syndrome (SARS) staffing, budget cuts, a weakened IHR treaty, and no unambiguous legal mandate. Population-based triage management under a central authority is indicated to control the transmission and ensure fair and decisive resource allocation across all triage categories. The shared responsibilities critical to global health solutions must be realized and the rightful attention, sustained resources, and properly placed legal authority be assured within the WHO, the IHR, and the vulnerable nations. (Disaster Med Public Health Preparedness. 2014;0:1-6)


2007 ◽  
Vol 122 (5) ◽  
pp. 573-578 ◽  
Author(s):  
Peter J. Levin ◽  
Eric N. Gebbie ◽  
Kristine Qureshi

The federal pandemic influenza plan predicts that 30% of the population could be infected. The impact of this pandemic would quickly overwhelm the public health and health-care delivery systems in the U.S. and throughout the world. Surge capacity for staffing, availability of drugs and supplies, and alternate means to provide care must be included in detailed plans that are tested and drilled ahead of time. Accurate information on the disease must be made available to health-care staff and the public to reduce fear. Spokespersons must provide clear, consistent messages about the disease, including actions to be taken to contain its spread and treat the afflicted. Home care will be especially important, as hospitals will be quickly overwhelmed. Staff must be prepared ahead of time to assure their ability and willingness to report to work, and public health must plan ahead to adequately confront ethical issues that will arise concerning the availability of treatment resources. The entire community must work together to meet the challenges posed by an epidemic. Identification and resolution of these challenges and issues are essential to achieve adequate public health preparedness.


Author(s):  
Ginette Wessel

Beginning in 2008, city policymakers across the nation became increasingly involved in regulatory debates and policy revisions surrounding mobile food vending. Despite vendors’ abilities to reactivate neglected urban areas and increase food access for underserved neighborhoods, many issues related to unfair competition, public health and safety, and prejudices continue to dominate regulatory frameworks that limit vendors’ entrepreneurial freedoms and spatial opportunities. Using three regulatory conflicts between food vendors and policymakers, this chapter highlights the motivating factors that can guide regulatory decision-making and the ways vendors destabilize and shape formal mechanisms of regulatory control. Topics include public health, restaurant protectionism, and cultural injustice at both state and city levels. This research suggests that despite rigid regulatory policies and the variety of economic, social, and political factors that influence governments’ responses to mobile food vending, active municipal investment in the public realm combined with vendors’ grassroots efforts can generate just policies. The chapter concludes with a discussion on the significance of vendor advocacy and the supportive roles of food vending organizations across the United States to illustrate the ways vendors increase social justice in cities.


Author(s):  
Adnan A. Hyder ◽  
David M. Bishai

An understanding of what influences policy decisions, what determines investments for specific public health interventions, and how agreements are made regarding new programs in public health is crucial for helping navigate the ethical implications of public health programs and interventions. This chapter provides an overview of the Public Health Policy and Politics section of The Oxford Handbook of Public Health Ethics. The section’s overall goal is to highlight ethical issues emerging from the work in, and study of, politics and policy development in public health, both within countries and globally. The chapters in this section analyze a set of ethical issues related to politics and public health policies, interventions, and programs, and emphasize the importance of communication among various disciplines, such as bioethics, political science, and development studies.


Author(s):  
Rachel E. Fabi

This chapter explores the ethics and public health issues associated with immigrant and refugee populations, both in the United States and globally. People move across borders for a variety of reasons, including the pursuit of economic opportunities, family reunification, or safety from violence. In order to engage with the public health ethics questions related to different types of migration, this chapter delves into the normative positions of cosmopolitanism, nationalism, and communitarianism. These positions are then applied to ethical issues in migration, including human rights, freedom of movement, open borders, and obligations to noncitizens. Finally, this chapter examines the ethical implications of three public health issues: immigrant health screening, immigration detention, and the provision of publicly funded health care to undocumented immigrants.


MISSION ◽  
2021 ◽  
pp. 8-17
Author(s):  
Felice A. Nava ◽  
Lucia Trevisi ◽  
Alfio Lucchini

Background Hepatitis C is a disease correlated with severe systemic consequences having elevated social and health costs. The HCV elimination is a public health concern that may be solved reaching DAAs treatment for drug users. The principal aim of this work is to evaluate the cost-benefit of a point of care for HCV treatment of drug users inside Drug abuse services (Ser.D.). Methods The study consists in a cost-benefit analysis able to evaluate the "return of health" induced by a point of care for a HCV treatment. Results The work shows that the point of care is cost-benefit in comparison with the "traditional" treatment being cost saving for the public health system. The data suggest that the cost of the point of care is corresponding to euros 593,40 while the cost of not treatment of euros 8.679,60 (due to the direct and indirect costs of the disease). Conclusions The study demonstrate the point of care is an effective model of care able to reduce the barriers of treatment and to induce a "health return" in term of cost saving for the public health systems. Indeed, the work shows how the point of care may make the elimination HCV plans sustainable for the public health agencies.


2017 ◽  
Vol 1 ◽  
pp. maapoc.0000004
Author(s):  
Felipe Ades

Brazil is a developing country of continental proportions and faces challenges in organizing an effective, universal, and affordable public health system. In a context of limited resources, the budget allocation to health care must be consistent with the health priorities of each population. The Brazilian population is ageing and the number of new cancer cases is likely to steadily increase in the near future. To deal with the extra cancer burden, strategies to match this future health necessity must be proactively put in place. Keeping the balance between the incorporation of a new drug and the sustainability of the public health system is a complex matter. Decisions for incorporation must be assessed, taking into consideration the ability of the drug to improve the public health in relation to its monetary impact. This is a societal discussion, and multiple stakeholders are involved in this process - from health authorities to pharmaceutical companies, researchers, and civil society. This article discusses the issues of incorporating a drug into the public health system and the strategies to improve access to innovative medicines, from the regulatory to the drug development perspectives.


2018 ◽  
Vol 63 (5) ◽  
pp. 651-662 ◽  
Author(s):  
Vesna Bjegovic-Mikanovic ◽  
Milena Santric-Milicevic ◽  
Anna Cichowska ◽  
Martin Krayer von Krauss ◽  
Galina Perfilieva ◽  
...  

2008 ◽  
Vol 2 (2) ◽  
pp. 114-118 ◽  
Author(s):  
James Tabery ◽  
Charles W. Mackett ◽  

ABSTRACTThe prospect of a severe influenza pandemic poses a daunting public health threat to hospitals and the public they serve. The event of a severe influenza pandemic will put hospitals under extreme stress; only so many beds, ventilators, nurses, and physicians will be available, and it is likely that more patients will require medical attention than can be completely treated. Triage is the process of sorting patients in a time of crisis to determine who receives what level of medical attention. How will hospitals sort patients to determine priority for treatment? What criteria will be used? Who will develop these criteria? This article formulates an answer to these questions by constructing a conceptual framework for anticipating and responding to the ethical issues raised by triage in the event of a severe influenza pandemic. (Disaster Med Public Health Preparedness. 2008;2:114–118)


2020 ◽  
Vol 4 (s1) ◽  
pp. 65-65
Author(s):  
Jeffrey S Farroni ◽  
Emma Tumilty

OBJECTIVES/GOALS: Innovative educational approaches and training modalities are important for training a diverse workforce in the authentic skills needed to advance all phases of clinical and translational research. Endeavors to study and develop policies that promote the translational science spectrum are steeped in value judgments. Learning how to navigate moral ambiguity and ethical reasoning enlightens our understanding of stakeholder obligations, roles and responsibilities. Ethics education can be challenging if learners are insufficiently engaged in the necessary critical reflection. In this course, decision-making in public health is informed through the analysis of the ethical issues, developing alternative courses of action and providing justification for actions taken in response to real-world dilemmas. The course is provided to students with a variety of backgrounds (science, health, policy) in a Master of Public Health degree program. Course objective were to: 1) Identify ethical issues in public health policy, practice, and research using appropriate concepts and terms; 2) Recognize the full spectrum of determinants of health and related information needed to resolve ethical conflicts in public health policy, practice, and research; 3) Present varied and complex information in written and oral formats; 4) Assess potential solutions to ethical conflicts in public health policy, practice, and research and 5) Decide ethical courses of action for public health policy, practice, and research. We adopted an open pedagogy as a guiding praxis to inform public health ethics discourse amongst our learners. In this way, learner agency was maximized to develop course materials within a generalized framework and shared with each other through the perspectives of each individual. The goal was to not only analyze complex ethical dimensions of public health issues but also gain insights into the disciplinary lenses of one’s peers. METHODS/STUDY POPULATION: Each week was divided into two sessions, a seminar and workshop. Course instructors introduce topics in a one-hour session and then allow students to decide what information is needed for a second session where the ethical issues of the topic will be discussed. Information-gathering tasks are then distributed amongst students in areas that are not their specialty, e.g. social history to be researched by learner with a biology background. The second session then involves the reporting back of background information by each student and a discussion of the ethical issues that arise. Through this process, the ability to communicate with others in different disciplines is supported, while exploring other disciplines and then engaging in ethical discussion and reasoning. Topics were introduced during the seminar session each week over the span of five weeks: 1) global public health, 2) disease prevention & control, 3) environmental & occupational public health, 4) resource allocation & priority setting and 5) research ethics. Learners were tasked with identifying the needed information to address the ethical, policy, and research aspects of the public health question(s) presented in these seminars. Students independently submitted resources they discovered to course instructors prior to the workshop. The following session began with a workshop where learners briefly presented their findings and deliberated on specific facets of the public health issue from that previous seminar while discussing a specific case. Students were assessed on their preparation (submission of identified resources), workshop presentation and participation. Research Preparation: In each seminar, the class decided what key information would be required to support the discussion at the workshop, which revolved around a relevant case study on that week’s topic. Course instructors facilitated the groups identification of material to be researched and the delegation of tasks within the group. Each student submitted a summary document (template provided) to course instructors prior to class for their area of research related to the case. Research Presentation: At the beginning of each workshop, each student was asked to present the research work to the rest of the class so that everyone has the same information for the case study discussion. These short (5-10 minutes) presentations followed the format of the preparation summary. Participation/collaboration: Both the seminar and the workshop asked students to be active learners within the class, participating in discussion, strategizing for information-gathering tasks, presenting researched material and arguments to others, and participating in case study discussion. Participation was assessed in relation to the value of the contributions made by students. RESULTS/ANTICIPATED RESULTS: The open pedagogy allowed the learners to construct the necessary materials to discuss issues with each other and develop not only a deeper understanding of the ethical dimension of public health issues but a shared understanding of each other’s disciplinary lenses. Course feedback was generally very positive, with learners either agreeing (33%) or strongly agreeing (67%) that the course was effective overall. In asking what learners liked best about the course, some indicated the “open pedagogy learning style” and “I liked the discussion format.” The positive comments mostly highlighted the discussion format. Areas for improvement noted by the learners included wanting “a longer course to cover more topics” and that the material was covered in “too short a time frame.” Other comments included that the course “was a bit disorganized” or that “the discussions were not very structured.” While the discussions by their very nature were unstructured, there is opportunity to refine this pedagogy to find right balance of learner agency. DISCUSSION/SIGNIFICANCE OF IMPACT: The goal of this teaching method was to empower the learner with the important critical thinking skills to navigate challenging ethical dilemmas in public health they may encounter in their careers. These skills include the identification of the ethical or moral conflict(s), collecting the necessary information to examine/resolve the dilemma, think creatively about the information that is unavailable and how to discuss/disseminate information to a broad constituency. This an educational model that is easily adaptable for learners working in other areas of the translational research spectrum, e.g. basic, pre-clinical, clinical and implementation sciences.


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