Ethical Dilemmas that may Arise
Conflicts of interest
Conflicts of interest may arise in the proposed study if health workers self-report on the progress of the 2012 cholera management programs (Damnariu, 2012). Since the health workers started and supervised most of these programs, they may give positive reviews, even if they do not believe in them. They may do so to please their sponsors, or to avoid looking at “failures.” Such an action would undermine the research objectives, which is to provide an accurate depiction of the progress of the 2012 public health interventions for managing cholera in Sierra Leone. Therefore, this conflict of interest may make it difficult to have a correct understanding of the successes and failures of these programs.
Minimizing Risks vs. Providing Benefits
It may be difficult to minimize research risks and provide benefits to users of the research findings if the proposed study does not address the potential conflict that exists in information collection and data use. This conflict may emerge in different ways. For example, in the quest to provide accurate knowledge about public health programs, the proposed research may invade the privacy of some health workers and their agencies by requiring them to disclose information concerning their public health programs (Coughlin, 2006). Such an action could be unwelcomed by the health agencies, and their employees, but, at the same time, the research needs to depict an accurate analysis of the performance of the health programs. In this regard, there is a conflict between risk minimization and the need to provide users with accurate information about past health programs (Coughlin, 2006).
How to address the above Ethical Dilemmas
Respecting the role of institutions in promoting public health practice is a core value of public health (Damnariu, 2012). It could help to address the potential conflict of interest between public health workers and the researchers, in the proposed study, because it demonstrates that the success of institutions, in public health practice, depends on building trust with communities. However, institutional theory shows that this trust is a product of effective communication, transparency, justice, and reciprocity (Damnariu, 2012). Respecting this fact could address the first ethical dilemma. We could address the second ethical dilemma (minimizing risk vs. providing benefits) by following the principle of proportionality outlined in the public health framework of Lee (2012). It stipulates that the benefits accrued from research should outweigh the associated infringements. Therefore, it could be justifiable to infringe on the privacy of health workers if such an action contributes to the improvement of community wellbeing.
How Impactful would Ethical Theories, Morals, and Principles address the Ethical Dilemmas?
The success of the ethical principles and values highlighted in this paper depends on the ethical qualities of the public health leader (Borza, Rahotă, Mihalache, Buhaş, & Cârjan, 2013). The leader should have the will to implement the recommendations without bias or compromise. Failure to do so could lead to negative health outcomes and the failure of stakeholders to resolve the ethical dilemmas that could undermine the success of the proposed study (Borza et al., 2013).
Another Ethical Dilemma that could Impact the Public Health Issue
Public health workers should improve the welfare of affected communities (Borza et al., 2013). According to Coughlin (2006), public health researchers should communicate their findings early so that community members act appropriately by protecting themselves from negative health exposures. Similarly, he says researchers should make sure their findings are scientifically accurate and appropriate (Coughlin, 2006). In the proposed study, the requirement for early disclosure could affect the progress of ongoing public health interventions in Sierra Leone, which strive to manage cholera, because a negative report on a health program could discourage community members from supporting it. However, at the same time, people have the right to know whether these interventions are working, or not. Therefore, the need to balance community interests and those of the health agencies creates an alternative ethical dilemma for the proposed study.
References
Borza, C., Rahotă, D., Mihalache, G., Buhaş, C., & Cârjan, F. (2013). The ethical qualities of a leader in public health and preventive medicine. Romanian Journal of Functional & Clinical, Macro- &Microscopical Anatomy & of Anthropology/RevistaRomâna de AnatomieFunctionalasiClinica, Macro siMicroscopicasi de Antropologie, 12(2), 154–156.
Coughlin, S. (2006). Ethical issues in epidemiologic research and public health practice. Emerg Themes Epidemiology, 3(1), 16-18.
Damnariu, C. D. (2012). General principles of ethics in public health. ActaMedicaTransilvanica, 17(1), 145–146.
Lee, L. M. (2012). Public health ethics theory: Review and path to convergence. Journal of Law, Medicine, & Ethics, 40(1), 85–98. Web.