Our concern is to present ethics as a systematic field of study and a major historical contributor to the development and shaping of society. As a field of study, public health ethics seeks to understand and clarify principles and values which guide public health actions. 2001, Chichester: Wiley, 2. Halper E: Ethics in film. The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research: The Belmont Report. Public Health in England. Case studies in this context are short narratives describing a real-world or at least realistic example of a professional ethical dilemma. Each group receives a different case study, which illustrates an underlying ethical problem or conflict. Professional secret: knowledge which, if revealed, will harm the client, the profession and the society that obtain services from the profession. Google Scholar. 1994, Milwaukee: Marquette University Press, 97-111. 2003, 3: 104-109. Philos Sci. The four pillars of medical ethics are: Beneficence (doing good) Non-maleficence (to do no harm) Autonomy (giving the patient the freedom to choose freely, where they are able) Justice (ensuring fairness) These four principles represent a framework for analysing the best action to take in a given situation. Despite this, however, the tension between individual rights and broader conceptions of public benefit is a profound one for public health as a field of practice. 7. A Specialised Course for Students and Professionals. Dr Nandini K Kumar, Former Deputy Director General - Senior Grade, Indian Council of Medical Research, New Delhi. The last may be associated with particular religions, cultures, professions, or virtually any other group that is at least . Understanding these terms has essential relevance to ethics-related discussion of the field. 11. Yet the task of defining and describing health itself is complex and ridden with competing values [32, 33]. endobj Equally, such principles may not command complete acceptance and can be challenged [15], making them highly useful in terms of encouragement for reflection and debate. To gain the trust of the public, public health officials and the media must be honest and trust the public. resolution . At that time, it was already recognized that the field of public health was experiencing dynamic . Section 3 provides guidance for the "how" of public health ethics; it provides a set of considerations for use Dawson A: Professional codes of practice and ethical conduct. 7. Public Health Rev. The Office of Science, in collaboration with the CDC Public Health Ethics Committee (PHEC) is responsible for building CDCs public health ethics infrastructure, including fostering an environment and culture that supports and develops ethical practices, raising staff awareness of public health ethics, and providing tools for analyzing ethical issues. As a field of practice, public health ethics is the application of relevant principles and values to public health decision making. Teaching and learning in public health ethics involves making choices about what to teach, as well as how to teach it. This also includes a fair distribution of health outcomes in societies, which is often discussed in terms of public health as health equity. These benefits are achievable when healthcare professionals have the knowledge, skills, and expertise to make ethical decisions in their daily work. The frequent focus of public health on benefit for populations holds the potential for concern with individual welfare to be side- lined. Broader ethical principles will provide a basis on which specific rules may be formulated, criticised and interpreted [16]. endobj Balancing and coming to conclusions about the rights and duties of individuals, communities, populations and governments with regard to protecting and maintaining health is in many ways the central, deeply complex task of public health work [2]. Recognize that acting ethically is in your own best interest. This may of course be true, but we have found that going back to first principles in the way that we have described is often a means to exposing differences in understanding, which warrant fruitful exploration as part of the ethics-focused debate that follows. Ethical values are essential for any healthcare provider. This contrasts sharply with conventional "medical" ethics that focus on individual patients and their autonomy and health-care journey. Public Health Ethik. As a consequence, the concept of public health can also be interpreted differently [34, 35]. 7 0 obj 2023 BioMed Central Ltd unless otherwise stated. Ethics Considerations for Accreditation. Healthcare ethics is the collection of principles that guide doctors, nurses, and other clinicians in providing medical care. Maria finds out that obligatory measles immunisation is effectively implemented in regions in Hungary and the Czech Republic. Carr D: Making Sense of Education. The CDC Office of Science provides leadership for the public health ethics activities. Yet at the same time, evidence strongly suggests that public health professionals often receive little training and guidance on how to reach decisions informed by careful ethical thinking and become confident in a moral sense about the trade-offs they are frequently required to make in practice [1, 3]. These conclusions are not simply (or even most importantly) practical ones; they are ethical. 2009, Oxford: Oxford University Press, Coughlin SS, Soskolne CL, Goodman KW: Case Studies in Public Health Ethics. To receive email updates about this page, enter your email address: We take your privacy seriously. Ethics easily assumes this latter kind of position, but reaching it may be unfamiliar for our participants. They help us to know which pages are the most and least popular and see how visitors move around the site. Our purpose in this paper is to explain and discuss a framework for a university-based short course in public health ethics. 7. 2003, Abingdon: Routledge. Does the intervention refrain from eroding a sense of social cohesion and solidarity? vuS.x{^}^@(>n0 :MnqIAvwe*e)%{5STzFw[MnI{lOsOtg33{NA=0@j:83b`Nx 7g+8n//& Provides "starting points" to guide ethical reflection about balancing. nonmaleficence. Debate about the nature of health and its relation to allied concepts such as well-being, illness, disease and disability is important both to help frame and understand the discussions that follow; and also to prompt at the earliest stage of the course dialogue between its participants. Teaching Ethics: An interdisciplinary Approach. Authority vested in the responsibilities / powers of organized government. For example, nurses are held to ethical principles contained within the American Nurses Association Code of Ethics. Intetionally action that cause harm. For example, epidemic models should be run with the whole range of . Introduction. According to Childress et al., proportionality: Is essential to show that the probable public health benefits outweigh the infringed general moral considerations []. Seven Principles of Health Care Ethics 1.Autonomy or self-determination 2.Beneficence 3.Nonmaleficence 4.Confidentiality 5.Justice 6.Role fidelity . Maria Morales, head of the Infectious Disease Control unit of the Ministry of Health of the State X, is asked by her minister to make a suggestion if measles immunisation should be made mandatory in their region as recently 2 children died after a measles outbreak. It is equally possible to conceive of the principle of justice (sometimes social justice) as having grounds in the fundamental value of human autonomy. References. Public health ethics involves a systematic process to clarify, prioritize and justify possible courses of public health action based on ethical principles, values and beliefs of stakeholders, and scientific and other information. Engelhardt HT, Wildes KW: The four principles of health care ethics: why a libertarian interpretation is unavoidable. For more information on public health ethics at CDC please email PHEthics@cdc.gov. Beyond this, the balancing of private goods and public interests provides a way into debating many of the central problems of ethics in public health policy and practice such as resource allocation, the location of individual responsibility and foundational rights in the sphere of health and health care. Manage cookies/Do not sell my data we use in the preference centre. In fact, our preference is for the ethical principle underscoring this obligation to be referred to as one of health maximisation. <> Whereas biomedical research ethics has tended to emphasize the centrality of consent, research upon populations often raises . Edited by: Gillon R, Lloyd A. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. Provision 3: The nurse promotes, advocates for, and protects the rights, health and . Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. 2010, London: SAGE. They are likely to be much more familiar with fields and disciplines in which evidence is developed and presented: and arguments may be made for a particular position; but normative declarations are not (or at least not often) made in relation to these processes. Teaching ethics in public health programmes is not routine everywhere - at least not in most schools of public health in the European region. 78 0 obj << /Linearized 1 /O 80 /H [ 722 528 ] /L 203718 /E 74977 /N 16 /T 202040 >> endobj xref 78 16 0000000016 00000 n 0000000667 00000 n 0000001250 00000 n 0000001404 00000 n 0000001585 00000 n 0000001765 00000 n 0000002294 00000 n 0000003154 00000 n 0000003690 00000 n 0000004486 00000 n 0000004848 00000 n 0000011031 00000 n 0000020858 00000 n 0000020936 00000 n 0000000722 00000 n 0000001229 00000 n trailer << /Size 94 /Info 77 0 R /Root 79 0 R /Prev 202030 /ID[<2b7bee0870bc86dfbc6e9911229827a3><2b7bee0870bc86dfbc6e9911229827a3>] >> startxref 0 %%EOF 79 0 obj << /Type /Catalog /Pages 75 0 R >> endobj 92 0 obj << /S 442 /Filter /FlateDecode /Length 93 0 R >> stream 2. Principles of Healthcare Ethics . Autonomy (freedon to decide right to refuse)confidentiality (private information) social justice. Does it fight inequalities (inequities)? Represented on the PHLS Public Health Code of Ethics Committee are public health professionals from local and state Principles of the Ethical Practice of Public Health, Version 2.2 The essence of an inside out approach lies in the development of moral capacity on the part of the individual; encouraging them, along Aristotelian lines, to engage in examination and reflection on their life and experience in order to come to a sense of what it is to live ethically and to inhabit an ethical persona. Veatch RM: A Theory of Medical Ethics. . Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. A review. V]qvvgGTF?;B{qh X*G1zP:C-(ViOgzi3 1994, 11 (2): 145-153. Nigeria Bar journal 2003 1:57 (1986) 4.NWLR (at 38)785. To have a concise set of principles, we focus only on justice. Does the intervention refrain from employing coercion and manipulation? At a time when emerging technologies such as big . 8. Boorse C: Health as theoretical concept. This article is intended to be a brief introduction to the use of ethical principles in health care ethics. In the field of public health, the primary end sought is the health of the broader constituency of the public and improvements to this are the key outcome used to measure success [10]. In this paper, we have presented and justified our short course framework for ethics teaching and learning in public health. Because of their place in the hierarchy, we need to note that an important anticipated outcome of our teaching and learning will be that students should be able to link the principles to overarching theories that exist above them. Public Health Cares about Ethics. Is no one (including third parties) stigmatised, discriminated against or excluded as a consequence of the proposed intervention? Another critical tool for public health decision making and action is public health ethics. Health Care Ethics: An Introduction. Public Health Ethics. Public Health constantly infers activity, as often as possible, carried out by governments, focused on the conservation of the soundness of . Each small group in turn presents their justification and anticipation of counter-argument to the group as a whole in a plenary session. Plan for the need for lifelong learning in the field of public health. We argue here that because the principles are mid-level, and hold connections both with a number of normative theories and with the multiple prescriptions of codes and guidelines, they therefore garner wide acceptance [9]. They can follow the detailed steps as presented in Table2. 6 Ethical Issues in Healthcare in 2020. has unique ethical challenges. Will no one be harmed by the proposed intervention? Our approach can be summarised as the use of case studies to stimulate debate and discussion around the principles that we have identified and discussed. 10.1093/phe/phr027. autonomy and confidentiality. Goldberg D: In support of a broad model of public health: disparities, social epidemiology, and public health causation. How should teaching and learning in this field be enacted? However, the journal is committed to covering the whole range of issues across the field of the ethics of public health and prevention. Public health programs and policies should incorporate a variety of approaches that anticipate and respect diverse values, beliefs, and cultures in the community. Acad Med. Cent Eur J Public Health. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. Respond to identified public health needs within their appropriate contextual . volume15, Articlenumber:73 (2014) Overview. J Appl Philos. A commitment to ethics is the foundation of ethical behavior. Public health practitioners our course participants may struggle with the move from is to ought that is this central characteristic of normative ethics. These two statements prompt the advocacy of a moral duty to use scarce health resources efficiently. From Public Health and the State - Changing Views in Massachusetts, 1842-1936 - Barbara Gutman Rosenkrantz Harvard University Press - 1972 Historical Relationship an early supportive relationship prior to the early 20th century a period of professionalization and practice transformation spurred by the emergence of bacteriology an acceleration . Kass N: An ethics framework for public health. Second, Seedhouse D: Health: The Foundations for Achievement. Public Health Ethics. The importance of individual principles such as we are advocating is also demonstrated by their being reflected in significant parts of the bioethics and public health ethics literature [913]. . Below are the links to the authors original submitted files for images. P., Sherlaw, W. et al. In this way, if programme curricula do not allow more time for ethics, students of public health can at least be sensitised to ethics and ethical argumentation. 2022-08-04T13:31-04:00 We chose not to include effectiveness as an explicit principle because it is somewhat implicit in the principle of health maximisation, and the strong sense this particular principle conveys that ethical public health action should naturally entail improvement in population health). The Office of Science is also responsible for providing guidance for initiating and implementing public health ethics consultations and for educating CDC staff about public health ethics. Its apparently self- evident importance marks it out as the other core principle within the Hippocratic tradition: physicians should heal and help their patients, according to the physicians abilities and judgment [19]. If you need to go back and make any changes, you can always do so by going to our Privacy Policy page. 8. 2. %PDF-1.4 % Students of clinical ethics will find additional information and deeper analysis in the suggested readings below. Are privacy and personal data respected? Their form demands, and their function yields, dynamic group discussions in which the participants specific professional and personal experience can be brought to bear on the problem highlighted within the case concerned. Grundlagen und Anwendungen[Ethical Principles for Public Health Practice. But student-generated experience as material for case studies is equally, if not more, valuable because it is rooted in the professional lives of learners. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. During the Covid-19 pandemic, public health decision makers . These cookies may also be used for advertising purposes by these third parties. The APHA Public Health Code of Ethics contains six core values and obligations for U.S. public health. In public health crises involving significant shortages of resources, public health and health care systems become overwhelmed and the norms guiding care must shift to focus on community benefit rather than individual well-being or autonomy. statement and Ethics and ethical practice are integrated into all aspects of nursing care. Focus on populations, institutions, communities. These principles are must for providing effective treatment to the patients for their well-being and also for the development of the country. > 10.1111/j.1365-2753.2011.01750.x. Does it foster free choice? J Law Med Ethics. Integrity in business means maintaining relationships with customers and vendors while adhering to an internal code of ethics. APA Newsletter. Ethical principles in nursing: Justice. Article Naturally, during the course of such deliberation, it is both possible and likely that a particular principle or principles will assume more or less importance. BMC Medical Ethics 10.1111/j.1468-5930.1994.tb00104.x. We were well aware of the pressures contributing to this state of affairs. Public health professionals are frequently called upon in their daily practice to make both explicit and implicit choices that extend beyond the objective and practical and into the contested and ethical [1]. 2014, Frankfurt a.M: Campus. 10.1097/00001888-200512000-00020. Public Health Ethics. Efficiency, along with associated notions such as cost and benefit are complex matters. The authors want to acknowledge the employing institutions of the authors: Maastricht University, Kings College London and the cole des hautes tudes en sant publique. Saving Lives, Protecting People, Presidential Early Career Award for Scientists and Engineers (PECASE), Human Participant Protection in CDC Research, Changes to Certificate of Confidentiality (CoC), Certificate of Confidentiality for CDC Funded Research, Guidance on Certificates of Confidentiality for CDC Funded Research, Suggested Consent Language Describing the CoC Protections, Small Business Innovation Research (SBIR) Program, Innovation in Fluoridation Technology Promises Improvements in Oral Health, Transforming the Way that Patients Recover from Surgery or Injury with At-home, Virtual Physical Therapy, U.S. Department of Health & Human Services. Of Birmingham. In fact, the tasks of evaluating normative beliefs within public health on the one hand, and normative judgments made by philosophers on the other, are complementary, indeed intertwined. legislation banning smoking in public places or limiting movement during periods of contagion), the burden of proof for doing so needs always to lie with those advocating restriction. Non-maleficence and beneficence can be understood in both deontological and consequentialist terms. Within public health policy and practice, there are often occasions where degrees of harm are traded off against the possibilities of greater harms, or perhaps positive benefit: for example, banning smoking in public places may cause harm to individual smokers but will prevent greater harms (and arguably produce benefit) through acting as a general disincentive to smoking among the wider population. 2009, 2 (1): 84-88. Favorable risk-benefit ratio. The brief description and discussion of context that we have so far engaged in leads us towards beginning to describe and discuss our choices in relation to what we actually teach about. AMA Principles of Medical Ethics Principles I. Given the major task of squeezing ethics in to the crowded public health curriculum, employing them to provide the content foundation of our course framework allowed the opportunity for fairly swift appreciation of their relevance in the short time that we had available; while also proposing them as stimulators of more lengthy reflection, possibly undertaken outside and beyond formal class hours. Edited by: Strech D, Marckmann G. 2010, Mnster: Lit, 43-65. %PDF-1.2 % Teaching seven principles for public health ethics: towards a curriculum for a short course on ethics in public health programmes. [In Public Health Ethics]. 2. Naturally a principle is broader than the rules it expresses. II. Jennings B, Kahn J, Mastroianni A, Parker LS: Ethics and Public Health: Model Curriculum. uuid:0d59090b-9481-4f8d-b3d7-1b5f0b7953dd They will most likely have views on what this evidence implies for the lives of individuals and populations. Our experience is that those undertaking the kind of course we describe may enter it believing that they broadly share similar conceptions of health and public health. Does it have a sustainable, long-term effect on the publics health? The distinctive difference between the principle of non-maleficence on the one hand and that of beneficence on the other lies in the fact that the former frequently but not always involves the omission of harmful action and the latter active contribution towards the welfare of others [9]. The first one was by Craig Krugman in 2007 [4]. J.F., Principles of Biomedical Ethics, 5th ed. World Medical Association. Teaching seven principles for public health ethics: towards a Health (1 days ago) WebThis approach - focusing on the application of seven mid-level principles to cases (non-maleficence, beneficence, health maximisation, efficiency, respect for Google Scholar, Downie RS, Tannahill A, Tannahill C: Health Promotion: Models and Values. 12.7 Population screening and public health Notes. While the field of medical ethics . (New York: Oxford University Press, 2001): at 19-21. (Bioethics) Doctoral Researcher, Uni. Is the proposed intervention cost-effective? This justification of the use of mid-level principles as the content foundation of our teaching, and their location in a hierarchy of normative ethical theorising and judgment, leads us briefly to describing and discussing the principles themselves. PUBLIC HEALTH CODE OF ETHICS Easy to use tools applying ethics to public health are presented. Hb```f``$02 +Pcg~u7\kBXg4N7 \k,ubDKs9=]N-(ht'&0iQe@)[z|kfg4.5>M^]S%?Lh" x4Jk8 VYA\UJ.W$No5UXHU&aalZlHaGBm*)jHCA F r\Y0Gbl/ +vT$Fa ^}@n PPxY6}F]Wjj\^ !vfQ'vL1d_h",u%#Mi p endstream endobj 93 0 obj 422 endobj 80 0 obj << /Type /Page /Parent 74 0 R /Resources 81 0 R /Contents 83 0 R /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 81 0 obj << /ProcSet [ /PDF /Text /ImageC ] /Font << /F1 86 0 R /F2 84 0 R >> /XObject << /Im1 91 0 R >> /ExtGState << /GS1 90 0 R >> /ColorSpace << /Cs5 82 0 R >> >> endobj 82 0 obj [ /CalRGB << /WhitePoint [ 0.9505 1 1.089 ] /Gamma [ 2.22221 2.22221 2.22221 ] /Matrix [ 0.4124 0.2126 0.0193 0.3576 0.71519 0.1192 0.1805 0.0722 0.9505 ] >> ] endobj 83 0 obj << /Length 455 /Filter /FlateDecode >> stream 1994, Chichester: Wiley, 135-147. p{0y|xO/co endstream endobj 84 0 obj << /Type /Font /Subtype /Type1 /FirstChar 32 /LastChar 240 /Widths [ 250 220 404 500 500 844 818 235 320 320 394 500 250 320 250 327 500 500 500 500 500 500 500 500 500 500 250 250 500 500 500 321 765 623 605 696 780 584 538 747 806 338 345 675 553 912 783 795 549 795 645 489 660 746 676 960 643 574 641 320 309 320 500 500 360 404 500 400 509 396 290 446 515 257 253 482 247 787 525 486 507 497 332 323 307 512 432 660 432 438 377 320 239 320 500 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 500 0 388 0 0 0 790 0 0 0 250 0 0 250 500 250 250 0 512 250 250 250 250 250 0 0 250 0 0 0 0 0 250 0 250 250 0 0 1000 250 0 0 0 0 0 0 0 404 404 0 235 0 250 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 250 ] /Encoding /MacRomanEncoding /BaseFont /NCPOIE+AGaramond-Regular /FontDescriptor 85 0 R >> endobj 85 0 obj << /Type /FontDescriptor /Ascent 712 /CapHeight 746 /Descent -232 /Flags 34 /FontBBox [ -183 -269 1099 851 ] /FontName /NCPOIE+AGaramond-Regular /ItalicAngle 0 /StemV 74 /XHeight 352 /CharSet (/five/q/U/N/K/B/bullet/r/space/V/b/T/C/six/s/seven/W/c/d/F/comma/D/t/eig\ ht/copyright/e/E/G/hyphen/u/quotedblright/nine/f/P/n/I/Y/period/v/colon/\ h/x/J/w/i/semicolon/L/H/ellipsis/y/zero/j/M/l/g/one/k/z/O/ampersand/A/tw\ o/m/quoteright/three/o/parenleft/R/p/a/S/four/quotedblleft/parenright) /FontFile3 89 0 R >> endobj 86 0 obj << /Type /Font /Subtype /Type1 /FirstChar 32 /LastChar 181 /Widths [ 255 280 438 510 510 868 834 248 320 320 420 510 255 320 255 347 510 510 510 510 510 510 510 510 510 510 255 255 510 510 510 330 781 627 627 694 784 580 533 743 812 354 354 684 560 921 780 792 588 792 656 504 682 744 650 968 648 590 638 320 329 320 510 500 380 420 510 400 513 409 301 464 522 268 259 484 258 798 533 492 516 503 349 346 321 520 434 684 439 448 390 320 255 320 510 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 255 510 510 255 255 255 255 255 800 255 255 255 255 255 255 255 510 255 255 255 522 ] /Encoding /WinAnsiEncoding /BaseFont /NCPOJF+AGaramond-Semibold /FontDescriptor 87 0 R >> endobj 87 0 obj << /Type /FontDescriptor /Ascent 713 /CapHeight 742 /Descent -232 /Flags 262178 /FontBBox [ -177 -269 1123 866 ] /FontName /NCPOJF+AGaramond-Semibold /ItalicAngle 0 /StemV 105 /XHeight 352 /CharSet (/g/f/U/n/A/I/period/r/space/h/V/s/i/W/H/question/t/zero/l/u/one/k/P/N/B/\ v/two/T/m/b/C/w/o/c/d/R/F/y/p/a/e/E/S) /FontFile3 88 0 R >> endobj 88 0 obj << /Filter /FlateDecode /Length 6091 /Subtype /Type1C >> stream At the same time, students will need points of reference and justification for the ethical positions that they are constructing through their consideration of problems and cases. This is because we are allowing the expression of values through emphasising the importance of experience (that on which, in large part, our values are founded) [38]. Tong, R. (2012) "Ethics, Infertility, and Public Health: Balancing Public . /Metadata 7 0 R/OpenAction 8 0 R/Outlines 206 0 R/PageLayout/SinglePage/PageMode/UseOutlines/Pages 85 0 R/StructTreeRoot 415 0 R/Type/Catalog/ViewerPreferences<>>> All authors read and approved the final manuscript. Having outlined and discussed the seven principles that form the content basis of teaching on our short course, we turn now to describing and discussing the processes for teaching and learning related to these content foundations. For instance, the policy may breach autonomy or privacy and have undesirable consequences. Scientific validity. 10.1111/j.1748-720X.2002.tb00384.x. All public health advice should consider the impact on overall health, rather than solely be concerned with a single disease. Case studies have a central role in the process of teaching and learning that aims to build the capacity of moral awareness and discrimination. Hyq99. https://doi . [Conceptional basics of a public health ethic]. More . endobj Accountability: To take responsibility for one's actions, decisions and their consequences. Anomaly J: Public health and public goods. Foundations and Applications]. H|}Pg7DUc,T+SzvoF #$ `=;gm{9s:c{nzszr{7yfvw=#&@2L-OJ`YMyY#L#)tT5]@*%Ti3gVAd2BZs K"CKV,_PZWmH24OXLVCfKb,2e%yym#*ajH_q\hJ,,Ce7ZkedMi1f@se-(J@B+Yl7!_-LV*wTE4OV=bWS7MKyf$ jby jt=hew9:&sAvvGA~R$LpFLNI $% ) C;-wT/^BD @K9x [J8sru^sjNI'>P&-v;R/pgn"TDVqO7_ cZncO>] +,FztS[WaHa{ ;uH=s+W) Participants are asked to: Identify as specifically as possible what they believe to be the ethical challenges and potential conflicts within the case; Frame these challenges in explicitly ethical language (i.e. Br Med J. We also attempt to explain and clarify the normative character of much ethical thinking, a central feature of its character that is likely to differ from other fields and disciplines with which participants may be more familiar. Equally, students need to be encouraged to develop an awareness that how they understand health (both generally and in the context of public health particularly) will have implications for how they frame ethical discourses and move towards resolving moral problems. In applying an ethics framework, public health ethics inquiry carries out three core functions, namely 1) identifying and clarifying the ethical dilemma posed, 2) analyzing it in terms of alternative courses of action and their consequences, and 3) resolving the dilemma by deciding which course of action best incorporates and balances the guiding principles and values.