Ethical Dilemmas in Public Health

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It is critical for administrators in the public health sector to acquaint themselves with the ethical principles that govern the public sector as well as the complexities that surround them. Interest in the legal, ethical, and social aspects of public health is contemporarily at its highest point and is likely to continue growing in the future. According to the medical and public health communities, there is a difference between blacks and whites in terms of disease prevalence. In a study that was carried out in the U.S., about 35- 40% of blacks tested positive for syphilis in Macon County, Alabama. The public health sector felt that it had to study the cause of syphilis in blacks and compare it against a study of the same disease in whites. The study of syphilis in whites was done for several years. It was completed by the PHS in 1928 in Mississippi and the results showed that only 25% of the sample, who were all whites, tested positive for syphilis. The PHS planned to continue the study of syphilis in blacks and provide treatment as well.

Focus on the TSUS by the political as well as public attention led to regulatory changes regarding research conduct. African-Americans were outraged when they became aware of the TSUSs conduct. The TSUS served to magnify and reinforce the mistrust that many African-Americans had towards the government, the services offered, and those who were in power and supported the act (Parker, 2003). The widespread and the magnified mistrust had to be confronted by the researchers to fulfill the regulatory requirements that were brought about by the Tuskegee as well as other scandals in the research. Enrollment in research study groups for the minority became more difficult because of the mistrust, which was prevalent and collaboration between the researchers and the community was elusive. Members of the minority groups failed to maximally benefit from the advances of the researches as they were conducted without the relevant peoples participation. The mistrust spawned due to earlier injustices. And the legacy of mistrust among the community with minority members played a great role in African-Americans disinclination to take part in any research.

Greater understanding of the process as well as the purpose of the research allayed many participation fears. Education not only in the school but also in the community as whole seeks to tell more about research as its purposes and procedures. For many activities of the human, trust comes out as a very important and a necessary precondition.

Another variable in the research about syphilis was the legacy of race. The thread in the TSUS legacy deserved specific attention. Scientific justifications for the TSUS were brought about by the assumptions about race as well as racial differences (Thomas, 2002). That showed that all the men who had registered did so because they were blacks and thus the research problem was syphilis in the blacks. Another legacy of the research was the debate about the TSUS itself. The authors sought to show the original study design of syphilis was appropriate both scientifically and ethically. It became clear that even after the advent of penicillin, it was not wrong in any way for the TSUS enrollees to be denied the drug for the research to go on. These arguments focus on examining untreated syphilis cases. There are skills that are fundamental in the PHS. Before a research study is conducted, the researchers should be capable of identifying the underlying ethical issues. Additionally, they should posses the ethical decision making skills necessary both as individuals as well as for the agencies they are affiliated to. A greater component of ethical decision making entails weighing the benefits to the affected. Researchers should also be aware of the best means of prevention, which run deep into understanding the determinants of health.

The public health sector and agencies cannot work well without the trust of the public. They should build and maintain the public trust. As an administrator I would use the media to address the causes of the disease in question as well as the health requirements in an attempt to prevent adverse health outcomes. I would strive to achieve the health of the community in such a way that all the rights of the individuals in the community are respected. Additionally, I would advocate the community members empowerment so as to make sure that the basic conditions and resources that are necessary for their health are accessible to all.

Humans are naturally interdependent and characteristically social. They look to each other for companionships and friendship and also rely on one another for their survival and safety. A critical indicator of a healthy community is, therefore, positive collaboration among the institutions within the community as well as positive relationships among its members (Thomas, 2004). Thus, the policies of public health, their priorities, and the programs to be undertaken should be developed and evaluated in a way that will ensure an input opportunity from the members of the community is availed.

References

Parker, L. S. (2003). The legacy of the Tuskegee syphilis study. Ethics and Public Health: Model Curriculum, 37-58.

Thomas, J. (2002). Principles of the ethical practice of public health. Public Health Leadership Society, 1-16.

Thomas, J. (2004). Skills for the ethical practice of public health. Public Health Leadership Society, 5-14.

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