As public health professionals we will all experience and make ethical decisions throughout our careers. We will be forced to make these decisions not only based on our own culture and values but also looking at the values of those we are serving. My question is do we know what our personal ethical framework consists of? Are you one who has a utilitarian viewpoint in which the ‘right’ decision is the one that benefits the most, does the greatest amount of good? Do you believe in the positive-rights view in which you decision is based on “favoring those who are worst off from a lifetime perspective” (Roberts & Reich, 2002, p. 1057), saying that those who have more to live for should receive the most care? Do you base your decisions off of local community and cultural values? What happens if those cultural values violate what you consider basic human rights? Further more, how much does cost-effectiveness or morbidity/mortality rates play into your decisions? These are all questions we as public health students need to think about and cultivate answers to.
I am going to assume that as individuals interested in the public health filed, most of us believe that access to health care is a basic human right. I would say this is a building block for my ethical framework. The issue with this is we live in a world of limited resources, it is unreasonable to think we can provide the best health care to every living human being. This is the reality of our current world. So, if health is a right of EVERYONE, young, old, white, black, ect, how do we as public health professions decide who receives this basic human right and who doesn’t? I believe the young African child dying of AIDs deserves the same level of health care as the aging American woman dying of heart disease. I have an idealistic view in and un-idealistic world. So, how do I choose? The reality is as professionals we have to learn how to prioritize or health efforts. We have to prioritize what illness deserves the most funds and attention, what population of individuals need health care the most. How we prioritize will be based off out ethical beliefs, our current resources as well as many other factors.
As a public health student I feel part of my education is learning to cultivate my own beliefs, values and ethical framework. We are given this time to not only learn the basics of what comprises public health, but how we fit into the public health world. The answers to these questions will help us decide what field we want to work in and what organization would best suit us. I recommend that we all continue to ask ourselves these questions as we expand our knowledge within the growing field of public health.
Roberts, M. , & Reich, M. (2002). Ethical analysis in public health. The Lancet,