Discussion 6: Case study on Ethics in Public Health Research

PROMPT

• What are the ethical implications of this case study?
• What are the ethical implications of alternative courses of action?
• What should we do in this situation and how can we justify that decision?

Before you begin your discussion this week prepare by reading Chapter 9 in your textbook. Read the case study located in section 9.9 of your textbook, Case 4: Internet-based HIV-AIDS Education and Prevention Programs in Vulnerable Populations: Black Men Who Have Sex with Men.  View the video summarizing the issues related to ethics in public health research. You will respond to Steps 1 and 2 of the 3-Step process by Wednesday and respond to Step 3 by Saturday.

Step 1: Analyze the Ethical Dimensions of the Public Health Issue and Context

There are two public health professionals involved in decision-making in this scenario. Dr. Albert is a social scientist with strong training in conducting research. Dr. Baines is a community worker who focuses on interventions with the community. 

Dr. A wants to use this opportunity as a research study that could generate new information that could be generalized to other communities. 

Dr. B wants to focus their efforts on intervening in their own community rather than spending time on conduction research.

This intervention would focus on a small subset of their community population, black men who have sex with men. Conducting research would allow them to generalize their findings to a broader population, but would also mean that the subjects in the control group don’t get the intervention. Conducting this education as an intervention would mean focusing on all black men who have sex with men within their community, but the outcomes could not be published as a research study that could benefit other communities and populations.

Respond to these questions on your discussion board:

• As public health professionals, do Dr. Albert and Dr. Baines have ethical obligations to other populations within their community?  How about outside the community? Which obligation should be their highest priority, the subset of men who have sex with men, their whole community, or populations outside their community?
• On what basis is the public health agency justified in advancing interventions that target only a subgroup of the community?

Step 2: Formulate Alternative Courses of Action and Evaluate their Ethical Dimensions

• What is the appropriate public health goal in this situation? Providing an intervention that will improve the health of the members of their community, or doing research to create new knowledge that could impact many communities?
• If the educational program is used as a research study, what are the possible benefits and risks to the experimental participants? What are the possible risks and benefits to the control group?
• Based on your answer to the first question, is approval from an IRB necessary?

Step 3: Provide Justification for a Particular Public Health Decision

For this step, your discussion team will communicate and decide together the answers to these questions. Your team can discuss and decide using your discussion board or you are welcome to set a time for your team to meet virtually through Microsoft Teams, Zoom, etc. Your groups are large so it might be challenging to find a time that works for everyone. If this is the case, please use the discussion board so everyone can weigh in on the decisions. One team member should make a final post on behalf of the team to share your team’s decision and justification. 

• Should this project go forward as a research study or as an intervention?
• What is the justification for your decision? (Which ethical principles take priority and why?)