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PUBH 712 – Global Health Ethics Spring 2018

Instructor: Karine Dubé, DrPH Research Assistant Professor Public Health Leadership Program (PHLP) 4108 McGavran-Greenberg Hall Chapel Hill, NC 27516 Email: karine_dube@med.unc.edu Office Phone: (919) 966-6617; Cell Phone: (919) 259-2489 Office Hours: By Appointment (In Person or Remotely) Teaching Assistant: Breanne Lesnar MPH & Global Health Certificate Candidate ‘18 Public Health Leadership Program (PHLP) Email: lesnar1b@live.unc.edu

Learning Objectives and Competencies Learning Objectives

Develop and refine your skills in ethical review of public health practice and research.

Develop and refine your ability to analyze individual cases and to make informed and reasoned judgments about the proper conduct of scientific research.

Improve your research and writing through independent examination of key ethical theories, policies, and regulations.

Foundational CEPH Competencies This course builds skills in the following competencies outlined by the Council on Education for Public Health (CEPH):

Apply awareness of cultural values and practices to the design or implementation of public health policies or programs (D2.7).

Discuss multiple dimensions of the policy-making process, including the roles of ethics and evidence (D2.12).

Evaluate policies for their impact on public health and health equity leadership (D2.15).

Describe the importance of cultural competence in communicating public health content (D2.20).

ASPPH Global Health Competencies This course builds competencies in the following two domains identified by the Association of Schools & Programs of Public Health (ASPPH) as abilities required by Master’s level students in Global Health Programs:

Domain 3: Ethical Reasoning and Professional Practice, defined as the ability to identify and respond with integrity to ethical issues in diverse economic, political, and cultural contexts, and promote accountability for the impact of policy decisions upon public

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health practice at local, national, and international levels. o 3.1 Apply the fundamental principles of international standards for the

protection of human subjects in diverse cultural settings. o 3.2 Analyze ethical and professional issues that arise in responding to public

health emergencies. o 3.3 Explain the mechanism used to hold international organizations accountable

for public health practice standards. o 3.4 Promote integrity in professional practice.

Domain 4: Health Equity and Social Justice, defined as the framework for the analysis of strategies to address health disparities across socially, demographically, or geographically defined populations.

o 4.1 Apply social justice and human rights principles in public health policies and programs.

o 4.3 Critique policies with respect to impact on health equity and social justice. o 4.4 Analyze distribution of resources to meet the health needs of marginalized

and vulnerable groups. UNC Global Health Concentration Competencies This course builds skills in the following competencies outlined by the UNC Global Health Concentration:

Apply fundamental principles of cultural competence to build effective partnerships (#1).

Identify and respond to ethical issues in diverse economic, political and cultural contexts and analyze ethical issues in global health research and practice (#3).

Identify methods for assuring global health program sustainability in resource-constrained settings (#4).

Evaluate the processes and outcomes of global health programs and policies (#5).

Analyze the impact of the economic, political, environmental and cultural dimensions of globalization on local and global health (#6).

Texts and Resources Required Texts

Dawson, A. (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. New York, NY. Cambridge University Press. 2011. [Note: All page numbers listed in the weekly syllabi are from the paperback version of the book and may differ from electronic or other copies].

Additional resources will be available on Sakai. Supplementary Texts

Macklin, R. Ethics in Global Health: Research, Policy and Practice. New York, NY. Oxford University Press. 2011.

Additional resources will be available on Sakai

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Technology This course will use Sakai for materials, assessments, interactions, and resources. You can access Sakai at https://sakai.unc.edu. The Gillings School of Global Public Health has created a Sakai Orientation for you to use to familiarize yourself with the system: https://courses.sph.unc.edu/sakai_orientation/. Appropriate Use of Course Materials The materials used in this class, including, but not limited to, exams, quizzes, rubrics, and homework assignments are copyright protected works. Any unauthorized copying of the class materials is a violation of federal law and may result in disciplinary actions being taken against the student. Additionally, the sharing of class materials without the specific, express approval of the instructor may be a violation of the University's Student Honor Code and an act of academic dishonesty, which could result in further disciplinary action. This includes, among other things, uploading class materials to websites for the purpose of sharing those materials with other current or future students. Helpful Website

World Health Organization – Global Health Ethics: http://www.who.int/ethics/en/

Assignments and Evaluation Course Structure This course is organized into 15 content modules, each spanning one week. Assignments will include individual work (discussion forums and individual essays), as well as group projects and discussion. Assigned Readings Students are expected to read all required readings by the start of the week, so that they can fully participate in the discussion forums. Optional readings are not required, but provided as supplementary resources. Students are also encouraged to incorporate outside resources as necessary.

Written Assignments All written assignments should draw extensively upon the assigned readings and other external resources, and references should be cited accordingly. Teamwork Peer evaluations will be sent at the end of the semester. There will be a grade assigned to completing the peer evaluations, and a grade assigned to teamwork. Discussion Forums Students are required to contribute one original post in response to questions posted in each discussion forum, and then to reflect on and respond to at least two additional posts contributed by their classmates. In general, students will be given a choice between two different topics, and must contribute one strong original post. Original posts should have a minimum of 2 – 3 paragraphs and should incorporate contents from assigned readings (or

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external references) when possible. Comments to classmates should be substantial and advance the discussion (instead of simply ‘Nice post!’). Grading Rubrics for each assignment type will be posted in the assignment folder and on the Lessons Tab on Sakai. Final letter grades will be determined using the following unweighted scale:

H (Clear Excellence) 93 % P (Entirely Satisfactory) 70 % L (Low Pass) 60 % F (Failing) <60 %

Course Feedback We encourage real-time feedback throughout the course. Please feel free to submit feedback to the course instructors at anytime during the semester. There will also be a course evaluation at the end of the semester.

Honor Code As a student at UNC-Chapel Hill, you are bound by the University’s Honor Code, through which UNC maintains standards of academic excellence and community values. It is your responsibility to learn about and abide by the code. All written assignments or presentations (including team projects) should be completed in a manner that demonstrates academic integrity and excellence. Work should be completed in your own words, but your ideas should be supported with well-cited evidence and theory. To ensure effective functioning of the Honor System at UNC, students are expected to: a. Conduct all academic work within the letter and spirit of the Honor Code, which prohibits the giving or receiving of unauthorized aid in all academic processes. b. Learn the recognized techniques of proper attribution of sources used in written work; and identify allowable resource materials or aids to be used during completion of any graded work. c. Sign a pledge on all graded academic work certifying that no unauthorized assistance has been received or given in the completion of the work. d. Report any instance in which reasonable grounds exist to believe that a fellow student has violated the Honor Code. If you have any questions about your rights and responsibilities, please consult the Honor Code or consult these other resources:

Honor System tutorial

UNC Library Plagiarism Tutorial

UNC Writing Center Handout on Plagiarism

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Recognizing, Valuing and Encouraging Diversity & Inclusion in the Classroom As instructors of PUBH 712, we share the School’s commitment to diversity and expect all students to uphold all UNC diversity and inclusion policies. “We are committed to ensuring that the School is a diverse, inclusive, civil, and welcoming community. Diversity and inclusion are central to our mission — to improve public health, promote individual well-being and eliminate health inequities across North Carolina and around the world. Diversity and inclusion are assets that contribute to our strength, excellence and individual and institutional success. We welcome, value and learn from individual differences and perspectives. These include but are not limited to: cultural and racial/ethnic background; country of origin; gender; age; socioeconomic status; physical and learning abilities; physical appearance; religion; political perspective; sexual identity and veteran status. Diversity, inclusiveness, and civility are core values we hold, as well as characteristics of the School that we intend to strengthen.

Accessibility UNC-CH supports all reasonable accommodations, including resources and services, for students with disabilities, chronic medical conditions, a temporary disability, or a pregnancy complication resulting in difficulties with accessing learning opportunities. All accommodations are coordinated through the UNC Office of Accessibility Resources & Services (ARS), http://accessibility.unc.edu; Phone 919-962-8300, Email accessibility@unc.edu. Students must document/register their need for accommodations with ARS before accommodations can be implemented.

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WEEK 1: January 10 – 14, 2018 Introduction to Public Health and Public Health Ethics

ASSIGNMENT DUE 1/14/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES SYNCHRONOUS SESSION: Syllabus Overview with Course Instructors – Karine Dubé, DrPH and Breanne Lesnar Thursday, January 11, 2018 at 5:00 pm ET (recording will be available after the session) KEY TOPICS

Individual vs. population health

Collective good vs. personal autonomy

Commitment to social justice

Public health ethics vs. medical ethics vs. research ethics REQUIRED READINGS

Ortmann LW, Barrett DH, Saenz C, Bernheim RG, Dawson A, Valentin JA, et al. Public Health Ethics: Global Cases, Practice, and Context. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 3-35. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_1.

Dawson A. Resetting the Parameters: Public Health as the Foundation for Public Health Ethics. In: Dawson A (ed.). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 1-19.

Thomas JC, Sage M, Dillenberg J. Guillory VJ. A Code of Ethics for Public Health. American Journal of Public Health 2002; 92: 1057-9.

Public Health Leadership Society. Principles of the Ethical Practice of Public Health. 2002. Available at: https://www.apha.org/~/media/files/pdf/membergroups/ethics_brochure.ashx

Kass N. An Ethics Framework for Public Health. American Journal of Public Health 2001; 91: 1776-82. (This is a key reading that will be used throughout the semester).

OPTIONAL READINGS

Hirschberg I, Littmann J, Stretch D. Where Public Health Meets Ethics. Conceptual Foundations and Practical Challenges of Public Health. In: Strech D, Hirscherg I, Marckmann G (eds.) Ethics in Public Health and Health Policy: Concepts, Methods, Case Studies. Springer Science and Business Media, 2013, pp. 5-23.

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WEEK 2: January 15 – 21, 2018 Ethical Decision-Making, Moral Reasoning, and Case Analysis

ASSIGNMENT DUE 1/21/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Common steps in ethical decision making and moral reasoning

Case analysis

Normative pluralism (tension between several normative frameworks) REQUIRED READINGS

Lee LM, Spector-Bagdady K, Sakhuja M. Essential Cases in the Development of Public Health Ethics. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 37-58. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_2.

Coughlin SS. Case Analysis and Moral Reasoning. In: Coughlin SS. Case Studies in Public Health Ethics, 2nd Edition. American Public Health Association, 2009, pp. 1-13.

Roberts MJ. Reich MR. Ethical Analysis in Public Health. The Lancet 2002; 359: 1055-9.

Pence G. Ethical Reasoning, Moral Theories, Principles, and Bioethics. In: Pence G. Medical Ethics: Accounts of Ground-Breaking Cases, 7th Edition. McGraw-Hill Education, 2014, pp. 1-18.

Jonsen AR. Casuistry: An Alternative or Complement to Principles. Kennedy Institute of Ethics Journal 1995; 5: 237-51.

OPTIONAL READINGS

Nuffield Council on Bioethics. Public Health: Ethical Issues. Available online at http://nuffieldbioethics.org/wp-content/uploads/2014/07/Public-health-ethical-issues.pdf. Note: Another good resource, with the approach and frameworks highlighted in Chapter 2 (pp. 11-28).

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WEEK 3: January 22 – 28, 2018 Philosophical and Historical Foundations of Public Health Ethics

ASSIGNMENT DUE 1/28/2018: INDIVIDUAL VOICETHREAD POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Philosophical theories of ethics

Practical approaches to ethics

Utilitarianism

Rights, liberties and libertarianism

Equality and egalitarianism

Virtue ethics

Ethical issues in public health surveillance

REQUIRED READINGS

Daniels N. Resource Allocation and Priority Setting. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 61-94. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_3.

Brülde B. Health, Disease and the Goal of Public Health. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 20-47.

Solum L, Legal Theory Lexicon, “Utilitarianism”. Available online at http://lsolum.typepad.com/legaltheory/2014/08/legal-theory-lexicon-utilitarianism.html.

Grill K. Normative and Non-Normative Concepts: Paternalism and Libertarian Paternalism. In: Strech D, Hirscherg I, Marckmann G (eds.) Ethics in Public Health and Health Policy: Concepts, Methods, Case Studies. Springer Science and Business Media, 2013, pp. 27-46.

World Health Organization (WHO). Guidelines on Ethical Issues in Public Health Surveillance. 2017. Available at: http://www.who.int/ethics/publications/public-health-surveillance/en/

OPTIONAL READINGS

Hausman DM. Liberty, Rights, and Libertarianism. In: Hausman DM. Economic Analysis, Moral Philosophy and Public Policy. Cambridge University Press, 1996, pp. 159-73.

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WEEK 4: January 29 – February 4, 2018 Behavioral, Economic, and Psychological Foundations of Public Health Ethics

GROUP ASSIGNMENT DUE 2/4/2018 SYNCHRONOUS SESSION: Ethical Controversies in Global Public Health – Brandon Brown, PhD, MPH University of California – Riverside, Thursday February 1, 2018 at 5 pm ET KEY TOPICS

Well-being and welfare

Health and welfare

Preferences

Markets and market failures

Defaults, nudges and incentives REQUIRED READINGS

John S. Risk and Precaution. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 67-84.

Guttman N, Salmon CT. Guilt, Fear, Stigma and Knowledge Gaps: Ethical Issues in Public Health Communication Interventions. Bioethics 2004;18: 531-52.

Rossi J, Yudell M. The Use of Persuasion in Public Health Communication: An Ethical Critique. Pub Health Ethics 2012; 5: 192-205.

OPTIONAL READINGS

Miller DT, Prentice DA. Psychological Levers of Behavior Change. In: Shafer E (ed). The Behavioral Foundations of Public Policy. Princeton University Press, 2013, pp. 301-9.

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WEEK 5: February 5 – 11, 2018 Justice and the Social Determinants of Health

ASSIGNMENT DUE 2/11/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Types of justice

Social determinants of health and inequity REQUIRED READINGS

Daniels N. Equity and Population Health: Towards a Broader Bioethics Agenda. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 191-210.

Wilson J. Health Inequities. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 211-30.

Gostin LO, Powers M. What Does Social Justice Require for the Public’s Health? Public Health Ethics and Policy Imperatives. Health Affairs 2006; 25: 1053-60.

Levy S, Sidel VW. The Nature of Social Injustice and Its Impact on Public Health. In: Levy S, Sidel VW (eds). Social Injustice and Public Health. Oxford University Press, 2005, pp. 5-21.

OPTIONAL READINGS

Beauchamp DE. Public Health as Social Justice. Inquiry 1976; 13: 3-14.

Preda A, Voigt K. The Social Determinants of Health: Why Should We Care? American Journal of Bioethics 2015; 15: 25-36.

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WEEK 6: February 12 –18, 2018 Global Health and Human Rights

ASSIGNMENT DUE 2/18/2018: INDIVIDUAL VOICETHREAD POST + TWO RESPONSES TO CLASSMATES SYNCHRONOUS SESSION: Refugee and Migrant Health – Sean Philpott-Jones, PhD, MS Bioethics Clarkson University, Thursday February 15, 2018 at 5 pm ET KEY TOPICS

Human dignity and human rights

Types of rights

Synergies between human rights and public health ethics

Refugee and migrant health REQUIRED AUDIO

Human Rights in Global Health Governance. Special Lecture with Dr. Benjamin Meier recorded on October 16, 2017. Available on Sakai.

REQUIRED READINGS

United Nations. Universal Declaration of Human Rights. 1948. Available online at: http://www.un.org/Overview/rights.html.

United Nations. Declaration of Alma Ata. 1978. Available online at: http://www.who.int/publications/almaata_declaration_en.pdf?ua=1.

Nixon S., Forman L. Exploring Synergies Between Human Rights and Public Health: A Whole Greater Than the Sum of Its Parts. BMC International Health and Human Rights 2008; 8: 2. Doi:10.1186/1472-698X-8-2.

Wolff J. The Human Right to Health. In: Benatar S, Brock G (eds). Global Health and Global Health Ethics. Cambridge University Press, 2011, pp. 108-18.

OPTIONAL READINGS

Chan M. Return to Alma-Ata. Available online at http://www.who.int/dg/20080915/en/#.

Farmer P. Challenging Orthodoxies in Health and Human Rights. Presentation at the 134th Annual Meeting of the American Public Health Association (2006).

Weiss P, Freedman HA. Protecting Human Rights Through International and National Law. In: Levy S, Sidel VW (eds). Social Injustice and Public Health. Oxford University Press, 2005, pp. 480-92.

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WEEK 7: February 19 – 25, 2018 Cultural Diversity and Community Health

ASSIGNMENT DUE 2/15/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Diversity

Community

Culturally-defined conceptions of health and well-being

Cultural competence

Participatory public health REQUIRED READINGS

Scrimshaw SC. Culture, Behavior, and Health. In Merson MH, Black RE, Mills AJ (eds). Global Health: Diseases, Programs Systems and Policies, 3rd Edition. Jones and Bartlett, 2012, pp. 43-73. Available online at http://bit.ly/2hQynYY.

Pinto AD, Smylie J. Indigenous Health and Ethics: Lessons for Global Health. In: Pinto AD, Upshur REG (eds). An Introduction to Global Health Ethics. Routledge, 2013, pp. 73-85.

MacQueen KM, McLellan E, Metzger DS, et al. What Is Community? An Evidence-Based Definition for Participatory Public Health. American Journal of Public Health 2001; 91: 1929-38.

OPTIONAL READINGS

Andrulis DP, Siddiqui NJ, Gantner JL. Preparing Racially And Ethnically Diverse Communities For Public Health Emergencies. Health Affairs 2007; 26: 1269-79.

Flicker S, Worthington CA. Public Health Research Involving Aboriginal Peoples: Research Ethics Board Stakeholders' Reflections on Ethics Principles and Research Processes. Canadian Journal of Public Health/Revue Canadienne de Santé Publique 2012; 103: 19-22.

Gostin LO. Global Health Law: Health in a Global Community. In: Gostin LO. Public Health Law and Ethics: A Reader. University of California Press, 2010, pp. 233-84. Available online at http://bit.ly/2hnOcVM.

Good Participatory Practice (GPP) Guidelines (you will find GPP for biomedical HIV prevention research, TB research, and emerging pathogens). Available at: https://www.avac.org/good-participatory-practice

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WEEK 8: February 26 – March 4, 2018 Health Behavior in Low- and Middle-Income Countries

ASSIGNMENT DUE 3/4/2018: INDIVIDUAL VOICETHREAD POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Communicable and non-communicable disease in low- and middle-income countries

Neoliberalism vs. communalism

Structural, economic, and political barriers to public health practice in low- and middle-income countries

REQUIRED READINGS

Coreil J, Bryant CA, Henderson JN. Health Behavior in Developing Countries. In: Coreil J, Bryant CA, Henderson JN. Social and Behavioral Foundations of Public Health. Sage Publications, 2001, pp. 235-56.

McIntyre D, Thiede M, Birch S. Access as a Policy-Relevant Concept in Low- and Middle-Income Countries. Health Economics, Policy and Law 2009; 4: 179-93.

Mills A. Health Care Systems in Low- and Middle-Income Countries. New England Journal of Medicine 2015; 370: 552-7.

Glasgow S, Schrecker T. The Double Burden of Neoliberalism? Noncommunicable Disease Policies and the Global Political Economy of Risk. Health & Place 2016; 39: 204-11.

OPTIONAL READINGS

Peters DH, Garg A, Bloom G, et al. Poverty and Access to Health Care in Developing Countries. Annals of the New York Academy of Science 2008; 1136: 161-71.

Lachat C, Otchere S, Roberfroid D, et al. Diet and Physical Activity For the Prevention of Noncommunicable Diseases in Low- and Middle-Income Countries: A Systematic Policy Review. PLoS Medicine 2013; 10: e1001465. doi: 10.1371/journal.pmed.1001465.

Atkinson K, Lowe S, Moore S. Human Development, Occupational Structure and Physical Inactivity Among 47 Low and Middle Income Countries. Preventive Medicine Reports 2015; 3: 40-5.

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WEEK 9: March 5 – 11, 2018 Public Health, Aging and Gender *Spring Break Begins March 9th at 5 pm

ASSIGNMENT DUE 3/18/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Gender as a social determinant of health

Age as a social determinant of health

Vulnerability

Gender and human rights

Feminist approaches to ethics REQUIRED READINGS

Macklin R. Global Inequalities in Women's Health: Who Is Responsible for Doing What? In: Macklin R. Ethics in Global Health: Research, Policy and Practice. Oxford University Press, 2012, pp. 131-47.

Sullivan DJ. The Nature and Scope of Human Rights Oglibations concerning Women’s Right to Health. Health and Human Rights 1995; 1: 368-98.

Rogers W. Feminism and Public Health Ethics. Journal of Medical Ethics 2006; 32: 351-4.

Polivka L. Globalization, Population Aging, and Ethics. Journal of Aging and Identity 2001; 6: 147-63.

OPTIONAL READINGS

Wrigley A, Dawson A. Vulnerability and Marginalized Populations. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 203-240. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_7.

Macklin R. Toward a Theory of Vulnerability. In: Macklin R. Ethics in Global Health: Research, Policy and Practice. Oxford University Press, 2012, pp. 148-67.

Hellsten SK. From Human Wrongs to Universal Rights: Communication and Feminist Challenges for the Promotion of Women’s Health in the Third World. Developing World Bioethics 2001; 1: 98-115.

Polivka L, Borrayo EA. Globalization, Population Aging, and Ethics, Part II: Toward a Just Global Society. Journal of Aging and Identity 2002; 7: 195–211.

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WEEK 10: March 19 – 25, 2018 Infectious Diseases – HIV/AIDS

ASSIGNMENT DUE 3/25/2018: INDIVIDUAL VOICETHREAD POST + TWO RESPONSES TO CLASSMATES INDIVIDUAL WRITTEN ASSIGNMENT #1 DUE 4/1/2018 SYNCHRONOUS SESSION: Ethical Issues involving Infectious Diseases – Karine Dubé, DrPH Thursday, March 22, 2018 at 5:00 pm ET (recording will be available after the session) KEY TOPICS

Ethical challenges in infectious disease control

Public health laws and legal challenges in infectious disease control

Harm principle

Duty not to infect others (collective good vs. personal autonomy)

Free riding REQUIRED READINGS

Selgelid MJ. Disease Prevention and Control. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 95-136. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_4.

Verweij M. Infectious Disease Control. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 100-7.

Gostin LO. A Theory and Definition of Public Health Law. In: Gostin LO. Public Health Law: Power, Duty, Restraint. University of California Press, 2000, pp. 3-32.

Coughlin SS. AIDS Prevention and Treatment. In: Coughlin SS. Case Studies in Public Health Ethics. American Public Health Association, 2009, pp. 99-104.

Dubé K, Sylla L, Dee L, Taylor J, Evans D, Bruton CD, et al. Research on HIV Cure. Mapping the Ethics Landscape. PLoS Med 2017; 14(12): e1002470.

OPTIONAL READINGS

WHO. WHO Guidelines on Ethical Issues in Public Health Surveillance. 2017. Available at: http://www.who.int/ethics/publications/public-health-surveillance/en/.

Bayer R. Ethics and Infectious Disease Control: STDs, HIV, TB. In: Jennings B, Kahn J, Mastroianni A, Parker LS (eds). Ethics and Public Health: Model Curriculum. HRSA/APHA/Hastings Center, 2003, pp. 133-46.

Amon JJ. The “Right to Know” or “Know Your Rights”? Human Rights and a People-Centered Approach to Health Policy. In: Biehl J, Petryna A (eds). When People Come First. Princeton University Press, 2013, pp. 91-108.

Haddad LB, Philpott-Jones S, Schonfeld T. Contraception and Prevention of HIV Transmission: A Conflict of Public Health Principles. Journal of Family Planning and Reproductive Health Care 2015. 41(1): 20-3.

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WEEK 11: March 26 – April 1, 2018 Infectious Diseases – Tuberculosis, Ebola and Other Emerging Diseases

ASSIGNMENT DUE 4/1/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES KEY TOPICS

Federalism, police power and parens patrii

Ethics of public health emergencies

Ethics in the face of uncertainty

Proportionality, necessity and least restrictive alternative

Quarantine and isolation

Humanitarianism and solidarity

Intersection of public health ethics, medical ethics and research ethics

Human-animal interactions REQUIRED READINGS

WHO. Guidance for Managing Ethical Issues in Infectious Disease Outbreaks. 2017. Available at: http://apps.who.int/iris/bitstream/10665/250580/1/9789241549837-eng.pdf?ua=1.

Yakubu A, Folayan MO, Sani-Gwarzo N, et al. The Ebola Outbreak in Western Africa: Ethical Obligations for Care. Journal of Medical Ethics 2014; doi: 10.1136/medethics-2014-102434.

Pan American Health Organization. Zika Ethics Consultation: Ethics Guidance on Key Issues Raised by the Outbreak. PAHO, 2016. Available online at http://iris.paho.org/xmlui/bitstream/handle/123456789/28425/PAHOKBR16002_eng.pdf.

Chamberlain AT, Lavery JV, White A, et al. Ethics of Maternal Vaccination. Science 2017; 358(6362): 452-3.

Markel H, Gostin LO, Fidler DP. Extensively Drug-Resistant Tuberculosis: An Isolation Order, Public Health Powers, and a Global Crisis. Journal of the American Medical Association 2007; 298: 83-6.

Singer P, Benatar S, Bernstein M, et al. Ethics and SARS: Lessons from Toronto. British Medical Journal 2003; 5: 1342-4.

OPTIONAL READINGS

Markel H. Facing Tuberculosis. In: Merkel H. When Germs Travel: Six Major Epidemics That Have Invaded America and the Fears They Have Unleashed. Vantage Books, 2005, pp. 15-46.

Byron K, Howard D. 'Hey Everybody, Don't Get Pregnant': Zika, WHO and an Ethical Framework for Advising. Journal of Medical Ethics 2016; pii: medethics-2016-103862. doi: 10.1136/medethics-2016-103862.

Thompson AK. Bioethics Meets Ebola: Exploring the Moral Landscape. British Medical Bulletin 2016; 117: 5-13.

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WEEK 12: April 2 – 8, 2018 Infectious Diseases – Vaccination and Mandatory Treatment

GROUP ASSIGNMENT DUE 4/8/2018 KEY TOPICS

Ethical challenges in mandatory and voluntary immunization

Public health laws and legal challenges in mandatory and voluntary immunization

Harm principle

Duty not to infect others (collective good vs. personal autonomy)

Free riding

Stewardship and sustainability REQUIRED READINGS

Dawson A. Vaccination Ethics. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 143-53.

Van den Hoven M. Why One Should Do One’s Bit: Thinking about Free Riding in the Context of Public Health Ethics. Public Health Ethics 2012; 5: 154-60.

Cortes-Penfield N. Mandatory Influenza Vaccination for Health Care Workers as the New Standard of Care: A Matter of Patient Safety and Nonmaleficient Practice. American Journal of Public Health 2014; 104: 2060-5.

Colgrove J. The Ethics and Politics of Compulsory HPV Vaccination. New England Journal of Medicine 2006; 355: 2389-91.

Dawson AJ, Verweij M. The Steward of the Millian State. Public Health Ethics 2008; 1(3): 193-5.

Dawson AJ. Snakes and Ladders: State Interventions and the Place of Liberty in Public Health Policy. Journal of Medical Ethics 2016; 42: 510-3.

OPTIONAL READINGS

Battin M, Francis LP, Jacobson JA, Smith CB. From the Magic Mountain to a Dying Homeless Man and His Dog: Imposing Isolating and Treatment in Tuberculosis Care. In: Battin M, Francis LP, Jacobson JA, Smith CB. The Patient as Victim and Vector: Ethics and Infectious Disease, Oxford University Press, 2009, pp.141-63.

Caplan A. Blog: The Moral Failure of HPV Vaccination. Bioethics.net Blog. Available online at http://www.bioethics.net/2013/01/the-moral-failure-of-hpv-vaccination/.

Philpott-Jones S. NPR Commentary: Manufacturing Controversy about Vaccines. Available online at http://wamc.org/post/sean-philpott-manufacturing-controversy-about-vaccines.

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WEEK 13: April 9 – 15, 2018 Non-Communicable Diseases – Obesity and Smoking

ASSIGNMENT DUE 4/15/2018: INDIVIDUAL FORUM POST + TWO RESPONSES TO CLASSMATES KEY TOPICS:

Positive and negative conceptions of individual health

Goals of health promotion

Techniques of individual behavior modification

Ethics of “choice”

Self-harm and self-inflicted harm REQUIRED READINGS

Schmidt H. Chronic Disease Prevention and Health Promotion. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 137-176. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_5.

Carter SM, Rychetnik L, Lloyd B, et al. Evidence, Ethics, and Values: A Framework for Health Promotion. American Journal of Public Health 2011; 101: 465-72.

Carter SM, Cribb A, Allegrante JP. How to Think about Health Promotion Ethics. Public Health Reviews 2012; 34:122-45.

Kass N, Hecht K, Paul A, Birnbach K. Ethics and Obesity Prevention: Ethical Considerations in 3 Approaches to Reducing Consumption of Sugar-Sweetened Beverages. American Journal of Public Health 2014; 104: 787-95.

OPTIONAL READINGS

Ashcroft R. Smoking, Health and Ethics. In: Dawson A (ed). Public Health Ethics: Key Concepts and Issues in Policy and Practice. Cambridge University Press, 2011, pp. 85-99.

Courtwright A. Stigmatization and Public Health Ethics. Bioethics 2013; 27: 74-80.

Voigt K. Smoking and Social Justice. Public Health Ethics 2010; 3: 91-106.

Miller DT, Prentice DA. Psychological Levers of Behavior Change. In: Shafer E (ed). The Behavioral Foundations of Public Policy. Princeton University Press, 2-13, pp. 301-9.

Wansink B. Turning Mindless Eating into Healthy Eating. In: Shafer E (ed). The Behavioral Foundations of Public Policy. Princeton University Press, 2013, pp. 310-28.

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WEEK 14: April 16 – 22, 2018 Non-Communicable Diseases – Injuries, Trauma, Other Environmental or Socially Determined Illness and Mental Illness

ASSIGNMENT DUE 4/22/2018: INDIVIDUAL VOICETHREAD POST + TWO RESPONSES TO CLASSMATES KEY TOPICS:

Injuries and trauma

Differential impact of disease

Environmental justice

Social justice

Fairness

Global burden of mental illness

Social and cultural determinants of mental health REQUIRED READINGS

Jennings B. Environmental and Occupational Public Health. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 177-202. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_6.

Gosselin RA, Spiegal DA, Coughlin R, Zirkle LG. Injuries: The Neglected Burden in Developing Countries. Bulletin of the World Health Organization 2009; 87: 246-246.

Montesanti SR, Thurston WE. Mapping the Role of Structural and Interpersonal Violence in the Lives of Women: Implications for Public Health Interventions and Policy. BMC Women’s Health 2015; 15: 100-13.

Nantulya VM, Reich MR. Equity Dimensions of Road Traffic Injuries in Low- and Middle-Income Countries. Injury Control and Safety Promotion 2003; 10: 13-20.

Hall AE, Chowdhury S, Hallowell N, et al. Implementing Risk-Stratified Screening For Common Cancers: A Review of Potential Ethical, Legal and Social Issues. Journal of Public Health 2014; 36: 285-91.

Becker A, Motgi A, Weigel J, et al. The Unique Challenges of Mental Health and MDRTB: Cultural Perspectives on Metrics of Disease. In: Farmer P, Kim JY, Kleinman A, Basilico M (eds). Reimagining Global Health: An Introduction. University of California Press, 2013, pp. 212-44.

Ngui EM, Khasakhala L, Ndetei D, Weiss Roberts L. Mental Disorders, Health Inequalities and Ethics: A Global Perspective. International Reviews in Psychiatry 2010; 22: 235–44.

De Menil V, Glassman A. Making Room for Mental Health: Recommendations for Improving Mental Health Care in Low- and Middle-Income Countries. Available online at: http://bit.ly/2h7fYZb.

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OPTIONAL READINGS

Hosseinpoor AR, Bergen N, Kunst A, et al. Socioeconomic Inequalities in Risk Factors For Non Communicable Diseases in Low-Income and Middle-Income Countries: Results From The World Health Survey. BMC Public Health 2012; 12: 912. DOI: 10.1186/1471-2458-12-912

Cooper S, Ssebunnya J, Kigozi F, et al. Viewing Uganda's Mental Health System Through a Human Rights Lens. International Review of Psychiatry 2010; 22: 578-88.

WEEK 15: April 23 – 29, 2018 Public Health Research in Resource-Limited Settings and Emerging Ethical Issues in Global Health

INDIVIDUAL WRITTEN ASSIGNMENT #1 DUE 5/1/2018 KEY TOPICS:

Research ethics in resource-limited settings

Ethical issues in clinical trial design (e.g. placebo-controlled trials)

Ethical issues in informed consent

Ethical issues for clinical research in public health emergencies

Research capacity strengthening

Good participatory practice guidelines and stakeholder engagement

Operationalizing ethics (e.g., in-practice ethics)

Ethics of emerging biotechnologies REQUIRED READINGS

Meslin E, Garba I. International Collaboration for Global Public Health. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 241-284. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_8.

Barrett DH, Ortmann LW, Brown N, DeCausey BR, Saenz C, Dawson A. Public Health Research. In Barrett DH (ed.). Public Health Ethics: Cases Spanning the Globe. Springer, 2016, pp. 285-318. Available at: https://link.springer.com/chapter/10.1007/978-3-319-23847-0_9.

Emanuel EJ, Wendler D, Killen J, Grady C. What Makes Clinical Research in Developing Countries Ethical? The Benchmarks of Ethical Research. Journal of Infectious Diseases 2004; 189: 930 – 7.

Dawson L, Garner S, Anude C, Ndebele P, Karuna S, Holt R, Broder G, Handibode J, Hammer SM, Sobieszczyk ME, NIAID HIV Vaccine Trials Network. Testing the Waters: Ethical Considerations for Including PrEP in a Phase IIb Vaccine Efficacy Trial. Clinical Trials 2015; 12(4): 394 – 402.

Schopper D, Ravinetto R, Schwartz L, Kamaara E, Shell S, Segelid MJ, Ahmad A, Dawson A, Singh J, Jesani A, Upshur R. Research Ethics Governance in Times of Ebola. Public Health Ethics 2017; 10(1): 49 – 60.

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Hyder AA, Rattani A, Pratt B. Research Capacity Strengthening in Low- and Middle-Income Countries: Ethical Explorations. The Journal of Law, Medicine & Ethics 2017: 129 – 137.

OPTIONAL READINGS

Pitler LR. Ethics of AIDS Trials in Developing Countries: A Review. Food Drug Law J 2002; 57(1): 133 – 53.

Cohen MS, McCauley M, Sugarman J. Establishing HIV Treatment as Prevention in the HIV Prevention Trials network 052 Randomized Trial: A Ethical Odyssey. Clinical Trials 2012; 9: 340 – 7.

Kiguba R, Kutabami P, Kiwuwa P, Katabira E, Sewankamgo NK. Assessing the Quality of Informed Consent in a Resource-Limited Setting: A Cross-Sectional Study. BMC Medical Ethics 2012; 13:21.

Lairumbi GM, Michael P, Fitzpatrick R, English MC. Ethics in Practice: The State of Debate on Promoting the Social Value of Global Health Research in Resource Poor Settings Particularly Africa. BMC Medical Ethics 2011; 12: 22.

Nuffield Council on Bioethics. Emerging Biotechnologies: Technology, Choice and the Public Good. 2012. Available at: http://nuffieldbioethics.org/wp-content/uploads/2014/07/Emerging_biotechnologies_full_report_web_0.pdf

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Semester at a Glance

PUBH 712 SEMESTER AT A GLANCE – SPRING 2018

Week

Topic

Assignments

Week 1

January 10 – 14, 2018

Introduction to Public Health and Public Health

Ethics

Note: Shortened week

Individual Forum Post + Two Responses to Classmates (due 1/14/18)

SYNCHRONOUS SESSION #1

Week 2

January 15 – 21, 2018

Ethical Decision-Making, Moral Reasoning, and

Case Analysis

Note: Monday, January 15, 2018 is a holiday.

Individual Forum Post + Two Responses to Classmates (due 1/21/18)

Week 3

January 22 – 28, 2018

Philosophical and Historical Foundations of

Public Health Ethics

Individual VoiceThread Post + Two

Responses to Classmates (due 1/28/18)

Week 4

January 29 – February 4, 2018

Behavioral, Economic, and Psychological

Foundations of Public Health Ethics

Group Assignment #1 (due 2/4/18)

SYNCHRONOUS SESSION #2

Week 5

February 5 – 11, 2018

Justice and the Social Determinants of Health

Individual Forum Post + Two Responses to Classmates (due 2/11/18)

Week 6

February 12 – 18, 2018

Global Health and Human Rights

Individual VoiceThread Post + Two Responses to Classmates (due 2/18/18)

SYNCHRONOUS SESSION #3

Week 7

February 19 – 25, 2018

Cultural Diversity and Community Health

Individual Forum Post + Two Responses to

Classmates (due 2/25/18)

Week 8

February 26 – March 4, 2018

Health Behavior in Low- and Middle-Income

Countries

Individual VoiceThread Post + Two Responses to Classmates (due 3/4/18)

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Week 9

March 5 – 11, 2018

Public Health, Aging and Gender

Note: Spring Break starts on Friday, March 9, 2018 at 5 pm.

Individual Forum Post + Two Responses to Classmates (due 3/18/18)

March 9 – 18, 2018 SPRING BREAK – NO CLASS

Week 10

March 19 – 25, 2018

Infectious Diseases – HIV/AIDS

Individual VoiceThread Post + Two Responses to Classmates (due 3/25/18)

Individual Written Assignment #1 (due 4/1/18)

SYNCHRONOUS SESSION #4

Week 11

March 26 – April 1, 2018

Infectious Diseases – Tuberculosis, Ebola, and Other Emerging Diseases

Note: Friday, March 30, 2018 is a holiday.

Individual Forum Post + Two Responses to Classmates (due 4/1/18)

Week 12

April 2 – 8, 2018

Infectious Diseases – Vaccination and

Mandatory Treatment

Group Assignment #2 (due 4/8/18)

Week 13

April 9 – 15, 2018

Non-Communicable Diseases – Obesity and

Smoking

Individual Forum Post + Two Responses to Classmates (due 4/15/18)

Week 14

April 16 – 22, 2018

Non-Communicable Diseases – Injuries,

Trauma, Other Environmental or Socially Determined Illnesses and

Mental Illness

Individual VoiceThread Post + Two Responses to Classmates (due 4/22/18)

Week 15

April 23 – 29, 2018

Public Health Research in Resource-Limited

Settings

CLASSES END ON FRIDAY, APRIL 27, 2018

Individual Written Assignment #2 (due 5/1/18)