Course Goals HSM 775 Bioethics for Public Health Professionals.
Course Goals
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Transcript of Course Goals
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Course Goals
HSM 775
Bioethics for Public Health Professionals
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To sensitize public health professionals to the moral dimensions of professional life and practice
• Life is complex• Ethical issues embedded• Potential for good and bad
consequences• Ethics is branch of philosophy• Concerns of ethics• Professional relationships
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To develop in public health students skills of ethical analysis
• Cognitive skills required• Ethics is science of the moral• Concepts, principles, and rules• Problem solving practical• Choices have consequences• Critical thinking key to
discriminating good from bad
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To introduce public health professionals to the array of ethical issues that are currently encountered in the practice of public health
• Myriad of issues• Science and technology• Population explosion• Value differences
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To foster in public health professionals respect for disagreement and toleration of ambiguity
• Ethics precise and rigorous, however . . .
• Equally virtuous disagree• Grounds must be rational• Toleration critical• Life is ambiguous• Situations were no definitive
behavior ideal
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To assist public health professionals in explicating the moral responsibilities incurred in becoming a member of the public health profession
• Cooperative relationship• Professional promise• Good of public and professional• Seeking the good—ethics• Terms of just cooperation
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To enable students to attain the competencies of a public health professional
• Decision making in ethics• Professional ethics• Clinical ethics• Organizational ethics• Social ethics
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To motivate public health professionals continued learning in ethics
• Authentic education• Positive attitude • Motivation to seek further
opportunities for learning
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Disclaimer
• No intent to disavow any ethical tradition
• Pluralistic society• Concepts basic and reasonable• Not knowingly inconsistent with any
religion or culture
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Questions?Comments?
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Public Health in Context
“The Ends and Means of
Health Care”
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What Is Health?
• World Health Organization:– “Health is complete social well
being.”
• Daniel Callahan:– “Health is the individual’s
experience of well-being and integrity of mind and body.”
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What are the Means of Achieving the Goal of
Health?
• Economic Resources• Human Behavior:
– Knowledge/Education– Personal Motivation
• Access to “Medicine”• Public Health
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Health Care
• According to Callahan, health care consists of “organized methods [deriving from health policy] to promote the health of the members of a society, ordinarily encompassing the fields of public health and medicine.”
• Furthermore he states: “a society’s health policy will be the organization of those methods into some overall financial and distributional structure designed to pursue the general goals of health care and, ultimately, of health.”
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Distinctions/Questions
• Goals of health policy/goals of health care/goals of health?
• Ends of health care determined inductively or normatively?
• Goals of medicine/goals of health care?
• Medicine as a profession?Medicine as a social construct?
• Allocation of resources: what can be made available/what should be made available?
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Why Must Reconsidering the Goals of Health Care Be So Important Now? • New biomedical knowledge and
technological innovation• Heavy economic pressures on
current system(s).• Rise of chronic disease• Aging populations• Medicalization of problems once
considered non-medical• Improved understanding of
behavioral determinants of health• Appreciation of socio-economic
status on health
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Hastings Center Project:Goals of Medicine
• The prevention of disease and injury, and the promotion of health (HPDP: “HippyDippy”)
• The relief of pain and suffering• The care and cure of those
with a malady, and the care of those who cannot be cured.
• The avoidance of a premature death and the pursuit of a peaceful death
Priority?
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Politics and Policy
Why is it not possible to drive health policy forward toward a consensus?
• Large pluralistic society versus small homogenous one
• The important role of the “market.”• The unabated drive for constant
biomedical progress and technological innovation.
• The increase in health care costs due to combination of market forces and progress which are responded to with managerial and economic techniques, not a reconsideration of goals.
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Public Health
• Public health, with medicine, is the other principal ingredient in health care.
• Are the goals of public health different than those of medicine?
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Public Health
• Characteristic mark is interest in population, not individual, health
• Focus on overall trends of morbidity and mortality and their causes
• Epidemiology is the key discipline for measuring these trends
• Focus on:– disease and infection surveillance– food and water safety– sanitation– health promotion/disease prevention
• Immunizations, smoking cessation, wellness education, and like such programs can have a greater affect on health care than can the provision of good medical care.
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Proximate Goals for
Health Care• Ultimate versus proximate• Goal setting linked to ethics:
ethics of ends and ethics of means
• Three policy directions offered by Callahan:– Goals responsive to the needs of
population sub-groups– Goals that enhance population
health– Goals that facilitate equitable
health care