The Role of Ethics in Public Health Policy
In 1985, Ryan White, a young teenager who had contracted HIV through a blood transfusion, was barred from attending middle school in his hometown of Kokomo, Indiana.
At that time, relatively little was known about HIV and AIDS; speculation and fear were common. Believing that Ryan’s presence posed a health risk to other children, parents and teachers pressured the principal and school board to keep him out of school. A lengthy legal battle ensued. The Indiana State Health Commissioner and the Centers for Disease Control assured the community that HIV could not be transmitted through casual contact.
Yet, even after Ryan was readmitted to school, he was required to eat with disposable utensils and use a separate bathroom. Ryan and his family were ostracized and continued to receive death threats until they moved away. At his new school in Cicero, Indiana, Ryan received a much warmer welcome from staff and students who had been educated about HIV/AIDS prior to his arrival.
Rising through these tremendous difficulties, Ryan White and his family became highly regarded advocates, bringing national attention to the need for public health education and lessening the stigma associated with HIV and AIDS. After Ryan’s death in 1990, congress enacted The Ryan White Comprehensive AIDS Resources Emergency (CARE) Act, which has been reauthorized several times.
The legislation created the largest federally funded program solely for people affected by HIV/AIDS; over the years, adjustments have been made to keep pace with evolving priorities, although the program retains its focus on promoting access to care for those who may not be able to afford it.
Role of Ethics in Public Health Policy
Ryan White’s story illustrates many of the ethical dilemmas that surround public health policy. For instance:
- How should public health leaders adhere to the principle of “do no harm” when a health syndrome is not well understood by the public, or even by many health care professionals?
- When, if ever, is it permissible to “hurt the few” (in this case, by denying individual rights and dignity) to “save the many”?
- Is health care a right or a privilege? Should legislation be enacted to provide care to those who cannot afford it?
- When, if ever, is it acceptable to devote government funds to address one issue (e.g., HIV/AIDS-related research, treatment, and education) as opposed to other issues that would also benefit from funding?
Today, new ethical dilemmas related to the global health epidemic of HIV/AIDS, as well as other public health issues, continue to emerge. Those who wish to shape public health policy must be able to learn from the past, examine the context surrounding an issue, and anticipate potential questions and ethical concerns.
This week, you examine the role of ethics in public health policy. In the Discussion, you assess potential ethical issues related to a specific public health issue. Also this week, you begin working on the final component of your Scholar-Practitioner Project: the Advocacy Pitch.
Analyze potential ethical dilemmas in public health issues
Apply ethical theories, morals, and principles to public health issues and interventions
Create advocacy pitches for public health issues
Learning Objectives
Students will:
- Analyze potential ethical dilemmas in public health issues
- Apply ethical theories, morals, and principles to public health issues and interventions
- Create advocacy pitches for public health issues