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Public Health Ethics and Core values _Case Studies

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Public Health Ethics and Core values _Case Studies

The relationship between the state and its citizens in the public health domain has been

explored extensively. This relationship has been influenced by various Supreme Court cases and

other occurrences and events that have shaped the public health field. This discussion is

dependent on the Jacobson v. Massachusetts, 197 U.S. 11 (1905) and the U.S. Public Health

Service Research on Sexually Transmitted Disease: Alabama and Guatemala are the primary

scenarios that have been used as a point of reference for this essay. These instances have shown

how the historical relationship between state and citizen while taking into account public health

issues.

Public health intervention touches on equal protection from diseases; respect for liberty;

and the foundations of social solidarity (Lee et al., 2016). Therefore, all actions that the

government takes in public health will influence/ affect the extent to which the behavior of

citizens will be restrained in the name of promoting public health by imposing mandatory

quarantines, child vaccination, and other restrictions that improve the overall public health. The

interests of the state to promote public health and well-being and the various interventions

adopted end up being in conflict with the citizens' civil liberties. Jacobson v. Massachusetts has

been used as a point of reference for numerous public health initiatives over the centuries since

the Supreme Court found a way to promote public health without violating any of the

constitutional liberties enjoyed by citizens. In this case, the Supreme Court did not require that

healthy citizens submit to vaccination, only that it was a constitutional requirement for citizens to

be vaccinated or otherwise pay a fine. The relationship between the state and citizens has been

defined by tensions between individual autonomy and the protection of public health.
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With regards to the chosen case studies, there were numerous ethical values and

principles that were called into question. Lee et al. (2016) has claimed that despite wanting to

improve public health, the government and public health researcher can breach ethics and cause

significant harm to research subjects. The principle of autonomy is one of the ethical principles

that came into question following the Jacobson decision since it imposed mandatory restrictions

on citizens' personal liberties. To what extent can the federal government implement actions to

protect public health while touching on the constitutional freedoms given to citizens (Lee et al.,

2016). This also raised the question of what included and excluded constitutionally protected

liberties and the limits of the power exercised by the government on its citizens in public health

initiatives. The study of STDS in Alabama and Guatemala also raised ethical questions.

Rodriguez & García (2013) has argued that this series of research is among the most unethical

research conducted in the U.S. In Guatemala, the principle of nonmaleficence that is grounded in

doing no harm was highly violated since the research participants were exposed to STD in clinics

that were not even sterilized. The Tuskegee study violated autonomy and justice since the

participants were not fully informed, and the research only included African Americans.

Nonmaleficence was also violated since it did more harm than good.

The ethical standards and principles violated in the case studies were fundamental in

informing and educating the public about health issues and functions. Since this domain is

grounded in engaging all community members, which would promote the principle of justice,

and being honest and accurate would help reinforce autonomy. American Public Health

Association (n.d) has argued that there is a need to ensure that health practitioners and

organizations conduct ethical analysis and any action taken should be morally justified.
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Additionally, all public health initiatives should be aligned with public health core values and all

related obligations.

All in all, the Jacobson v. Massachusetts, 197 U.S. 11 (1905) and the U.S. Public Health

Service Research on Sexually Transmitted Disease: Alabama and Guatemala have received wide

attention in the field of public health as a result of the ethical standard and principles and

standards that were violated. Public health initiatives and interventions should meet the

American Public Health Association guidelines.

References

Lee, L. M., Spector-Bagdady, K., & Sakhuja, M. (2016). Essential cases in the development of

public health ethics. Public Health Ethics: Cases Spanning the Globe, 37-58.

Rodriguez, M. A., & García, R. (2013). First, do no harm: the U.S. sexually transmitted disease

experiments in Guatemala. American Journal of Public Health, 103(12), 2122-2126.

American Public Health Association. (n.d). Public Health Code of Ethics. https://www.apha.org/-

/media/files/pdf/membergroups/ethics/code_of_ethics.ashx