scholarly journals Real-World Ethical Dilemmas in Laboratory Safety for Microbiology Under-Resourced and Outreach Teaching

2021 ◽  
Vol 12 ◽  
Author(s):  
Beverly L. Smith-Keiling
Keyword(s):  
Public Health ◽  
Real World ◽  
Task Force ◽  
Institutional Support ◽  
Ethical Challenges ◽  
Safety Standards ◽  
Ethical Frameworks ◽  
American Society ◽  
American Society For Microbiology ◽  
Authentic Learning Experiences

With modernization of safety standards for microbiology outreach teaching laboratories, ethical challenges arise in teaching microbiology for the public good without short-changing students in under-resourced situations, or when institutional support is subpar. Still, educators want students to engage using applied skills for inquiry, research-based microbial learning activities – safely. Following several United States microbial outbreaks, federal investigation traced sources back to teaching laboratories. Policy discussions ensued. The American Society for Microbiology (ASM) Task Force provides recommended but not mandated guidelines; however, guidelines are not amenable by all. Here, a real-world, ethical scenario of a university-level outreach microbiology laboratory course hosted at several locations provides context for under-resourced challenges in safety compliance. In this example of biomedical and public health ethical considerations, upper administration puts the onus on instructors to assure safe labs for their students and the general public. Temporarily hired instructors without curriculum or sufficient institutional support are put in precarious positions with often egregious practices to get the job done. This scenario is examined with different public health ethical frameworks and principles: non-maleficence, beneficence, health maximization, efficiency of policy regulations, respect for institutional and instructor autonomy, justice, and proportionality balancing stakeholder concerns. Sample curricular strategies are employed to mitigate these challenges. Taking a utilitarianism framework of the greatest good for the most benefit, this paper advocates for social justice supporting access to education as a moral duty. Administrations should ensure instructors are supported sufficiently to provide safe, authentic learning experiences. Solutions for under-resourced outreach teaching are needed for public trust.

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 “The health equity curse”: ethical tensions in promoting health equity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bernie Pauly ◽  
Tina Revai ◽  
Lenora Marcellus ◽  
Wanda Martin ◽  
Kathy Easton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Health Equity ◽  
Ethical Challenges ◽  
Services Research ◽  
Ethical Concerns ◽  
Ethical Frameworks ◽  
Ph Values ◽  
Constant Comparative Analysis ◽  
Health Agenda

Abstract Background Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use. Methods As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. Results Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control. Conclusions Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.

scholarly journals “The Health Equity Curse”: Ethical Tensions in Promoting Health Equity

2020 ◽  
Author(s):  
Bernie Pauly ◽  
Tina Revai ◽  
Lenora Marcellus ◽  
Wanda Martin ◽  
Kathy Easton ◽  
...  
Keyword(s):  
Public Health ◽  
Health Systems ◽  
Health Equity ◽  
Ethical Challenges ◽  
Services Research ◽  
Ethical Concerns ◽  
Ethical Frameworks ◽  
Ph Values ◽  
Constant Comparative Analysis ◽  
Health Agenda

Abstract Background: Public health (PH) practitioners have a strong moral commitment to health equity and social justice. However, PH values often do not align with health systems values, making it challenging for PH practitioners to promote health equity. In spite of a growing range of PH ethics frameworks and theories, little is known about ethical concerns related to promotion of health equity in PH practice. The purpose of this paper is to examine the ethical concerns of PH practitioners in promoting health equity in the context of mental health promotion and prevention of harms of substance use.Methods: As part of a broader program of public health systems and services research, we interviewed 32 PH practitioners. Results: Using constant comparative analysis, we identified four systemic ethical tensions: [1] biomedical versus social determinants of health agenda; [2] systems driven agendas versus situational care; [3] stigma and discrimination versus respect for persons; and [4] trust and autonomy versus surveillance and social control.Conclusions: Naming these tensions provides insights into the daily ethical challenges of PH practitioners and an opportunity to reflect on the relevance of PH frameworks. These findings highlight the value of relational ethics as a promising approach for developing ethical frameworks for PH practice.

scholarly journals Report from the American Society of Transplantation Psychosocial Community of Practice Adherence Task Force: Real-world options for promoting adherence in adult recipients

2018 ◽  
Vol 32 (9) ◽  
pp. e13353 ◽  
Author(s):  
Larissa Myaskovsky ◽  
Michelle T. Jesse ◽  
Kristin Kuntz ◽  
Abbie D. Leino ◽  
John Devin Peipert ◽  
...  
Keyword(s):  
Community Of Practice ◽  
Real World ◽  
Task Force ◽  
American Society

scholarly journals The Future of Whole-Genome Sequencing for Public Health and the Clinic

2016 ◽  
Vol 54 (8) ◽  
pp. 1946-1948 ◽  
Author(s):  
Marc W. Allard
Keyword(s):  
Public Health ◽  
Whole Genome Sequencing ◽  
Genome Sequencing ◽  
Whole Genome ◽  
Microbial Forensics ◽  
Microbial Taxonomy ◽  
Support Mechanisms ◽  
American Society ◽  
American Society For Microbiology ◽  
The Impact

An American Society for Microbiology (ASM) conference titled the Conference on Rapid Next-Generation Sequencing and Bioinformatic Pipelines for Enhanced Molecular Epidemiological Investigation of Pathogens provided a venue for discussing how technologies surrounding whole-genome sequencing (WGS) are advancing microbiology. Several applications in microbial taxonomy, microbial forensics, and genomics for public health pathogen surveillance were presented at the meeting and are reviewed. All of these studies document that WGS is revolutionizing applications in microbiology and that the impact of these technologies will be profound. ASM is providing support mechanisms to promote discussions of WGS techniques to foster applications and interpretations.

scholarly journals Ethical challenges in pathogen sequencing: a systematic scoping review

2020 ◽  
Vol 5 ◽  
pp. 119
Author(s):  
Stephanie Johnson ◽  
Michael Parker
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Sequence Data ◽  
Public Health Practice ◽  
Empirical Work ◽  
Outbreak Investigation ◽  
Ethical Challenges ◽  
Public And Private ◽  
Ethical Frameworks ◽  
Sequencing Technologies

Background: Going forward, the routine implementation of genomic surveillance activities and outbreak investigation is to be expected. We sought to systematically identify the emerging ethical challenges; and to systematically assess the gaps in ethical frameworks or thinking and identify where further work is needed to solve practical challenges. Methods: We systematically searched indexed academic literature from PubMed, Google Scholar, and Web of Science from 2000 to April 2019 for peer-reviewed articles that substantively engaged in discussion of ethical issues in the use of pathogen genome sequencing technologies for diagnostic, surveillance and outbreak investigation. Results: 28 articles were identified; nine United States, five United Kingdom, five The Netherlands, three Canada, two Switzerland, one Australia, two South Africa, and one Italy. Eight articles were specifically about the use of sequencing in HIV. Eleven were not specific to a particular disease. Results were organized into four themes: tensions between public and private interests; difficulties with translation from research to clinical and public health practice; the importance of community trust and support; equity and global partnerships; and the importance of context. Conclusion: While pathogen sequencing has the potential to be transformative for public health, there are a number of key ethical issues that must be addressed, particularly around the conditions of use for pathogen sequence data. Ethical standards should be informed by public values, and further empirical work investigating stakeholders’ views are required. Development in the field should also be under-pinned by a strong commitment to values of justice, in particular global health equity.

scholarly journals Role of Clinicogenomics in Infectious Disease Diagnostics and Public Health Microbiology

2016 ◽  
Vol 54 (7) ◽  
pp. 1686-1693 ◽  
Author(s):  
Lars F. Westblade ◽  
Alex van Belkum ◽  
Adam Grundhoff ◽  
George M. Weinstock ◽  
Eric G. Pamer ◽  
...  
Keyword(s):  
Public Health ◽  
Infectious Disease ◽  
Sequence Data ◽  
General Meeting ◽  
Disease Diagnostics ◽  
Infectious Disease Diagnostics ◽  
High Throughput Dna Sequencing ◽  
American Society ◽  
American Society For Microbiology

Clinicogenomics is the exploitation of genome sequence data for diagnostic, therapeutic, and public health purposes. Central to this field is the high-throughput DNA sequencing of genomes and metagenomes. The role of clinicogenomics in infectious disease diagnostics and public health microbiology was the topic of discussion during a recent symposium (session 161) presented at the 115th general meeting of the American Society for Microbiology that was held in New Orleans, LA. What follows is a collection of the most salient and promising aspects from each presentation at the symposium.

An Overview of Conceptual Foundations, Ethical Tensions, and Ethical Frameworks in Public Health

2019 ◽  
pp. 3-11
Author(s):  
Andrew W. Siegel ◽  
Maria W. Merritt
Keyword(s):  
Public Health ◽  
Human Rights ◽  
Ethical Theory ◽  
Public Health Ethics ◽  
Moral Foundations ◽  
Ethical Challenges ◽  
Ethical Frameworks ◽  
Health Ethics ◽  
Side Constraints ◽  
Conceptual Foundations

The field of public health ethics has plural foundations in major normative ethical theories, principally consequentialism and deontology, and in ethical concepts such as social justice and human rights. This overview provides some basic background on ethical theory and introduces chapters in the related section of The Oxford Handbook of Public Health Ethics. The four chapters together elucidate the moral foundations of public health ethics. One chapter characterizes public health and describes the ethical challenges raised by its distinctive characteristics, while the next examines the ways in which public health interventions may be morally justifiable. The following two chapters focus, respectively, on justice and human rights, considering the operation of each not only as moral foundations, but also as side constraints in frameworks of public health ethics.

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