Monthly Archives: November 2015

Workshop review — Committed Professionals: Handling Obstacles to Ethics in Public Health

Matthew Prior

Abstract Public health professionals face tough ethical questions in our daily practice and need guidance on how to handle the ethical contours of our complex profession. Public health is a multidisciplinary field with professionals from epidemiology to education, medicine to microbiology, engineering to environmental sciences, veterinary medicine to virology, and many more. Public health professionals work in a variety of settings — public and private, state and local, national and international. We are professionals committed to social justice and health equity who bring our varied discipline-specific skills to bear on complex problems that affect health and wellbeing. Our ‘patient’ is the community as well as the individual. We come from a variety of ethical traditions, not all of which map well to the goals of public health. As a nascent field, public health ethics borrowed heavily from other ethical approaches in medicine and health. Numerous frameworks have extended these early approaches by adding a clear focus on justice — social justice and distributive justice — and on public beneficence — doing good for the community. In parallel, a public health code of ethics — the field’s ethical expectations of professionals — was developed in the early 2000s. APHA is working to revise the field’s code of ethics to encompass expectations for organizations as well as individuals. We must continue to develop tools and train public health professionals to identify, articulate, and handle the inevitable ethical dimensions of our field.

On Friday, November 13, Dr. Lisa M. Lee, Executive Director for the Presidential Commission for the Study of Bioethical Issues, presented a keynote address for The Future of Professional Ethics workshop series hosted by Indiana University‘s School of Public Health and the Poynter Center for the Study of Ethics and American Institutions.

The workshop event began with a panel discussion featuring Dr. Lee and Indiana University Bloomington faculty members Albert Gay, Jon Macy, and Antonio Williams of the School of Public Health, and Mark Bauman of Medical Sciences Program. This discussion focused on a number of ethical public health topics ranging from the Public Health Service Syphilis Study at Tuskegee project to health communication pertaining to e-cigarettes. The discussions sparked dialogue about the role of ethics in public health from the panelists and the audience of faculty and students alike.

Dr. Lee’s keynote presentation, “Committed Professionals: Handling Obstacles to Ethics in Public Health,” highlighted several key topics, including the evolution of public health ethics over the years, professional ethics in public health, and ethical obstacles and opportunities in public health. Dr. Lee emphasized the importance of being “good” (beneficent) public health professionals; some of their qualities, she noted, include accountability to the public they serve, transparency, and the ability to make ethical decisions when faced with real ethical conflicts. She highlighted some of the work of the Bioethics Commission on the topic of democratic deliberation as a strategy for coming to ethical conclusions when faced with conflicts.

Dr. Lee noted several barriers to public health ethics highlighted by a lack of ethics training in many schools on public health, poorly defined ethics competencies required by many professional accrediting organizations, and an outdated, but persistent, view of ethics as an obstacle to public health work. Further referring to the Bioethics Commission’s work, she noted that ethical considerations, when integrated “early and explicitly” in public health preparedness and practice, facilitate public health activities by anticipating potential concerns and providing decision-making tools to resolve conflicts should they arise.

Dr. Lee closed by suggesting some opportunities and resources for people to get involved in public health ethics, including IUB’s very-own Association for Practical and Professional Ethics (APPE).

This well-attended presentation shows how highly Indiana University students and faculty value professional and public health ethics. In attendance were representatives from a variety of schools, programs, and departments including business, medical sciences, kinesiology, and public health. The audience was engaged throughout and offered many thoughtful questions during the discussion period, including many from students with well-formed thoughts on ethics.

Dr. Lee and the Bioethics Commission staff would like to thank the School of Public Health and the Poynter Center for being such wonderful hosts and for the zeal in which it embraced this very important topic.

Matthew Prior
Communication and Outreach Lead
Presidential Commission for the Study of Bioethical Issues
November 24, 2015

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Ethics in the era of journalists as “essentially anyone with a cell phone”

Saul Kutinicki

In the flurry of controversy surrounding media coverage and one professor’s attempt to bar journalists from entering the protest space of student athletes at the University of Missouri last week, the question of ethics in journalism couldn’t be more important. Regardless of how these events will continue to unfold and what sort of central issues emerge out of a confrontation, which appears to have been recorded on a cell phone, there are certain aspects worth highlighting. I consider these recent episodes in light of some remarks by IU Bloomington journalism Professor Jim Kelly at the first Future of Professional Ethics workshop organized by the Poynter Center.

Journalism, which is now a part of The Media School at IUB, has traditionally provided a liberal arts education that creates a path for students to enter a variety of journalistic professions. There is no professional licensure required to be a journalist. Instead, Kelly claims, the professionalism of journalists has historically rested squarely in their own standards of practices and code of ethics. As Kelley indicates, the current job market for journalism professionals has been more focused on hiring graduates with skills in public relations and advertising rather than service-type fields, such as investigative journalism, political commentary, and consumer rights reporting. Along with these changing expectations, there have also been changes in the way news is written, recorded, and distributed. Online platforms forego most editorial processes, and more news sources are being driven primarily by diversified forms of PR work than by a mission to provide informational and local reporting. While newsprint has always been driven by advertising revenue, the notions of professionalism within journalism have traditionally helped to maintain the integrity of journalistic education and practice.

The changing media-scape, identified by Kelly, raises concerns about how journalism can continue to be framed as serving a public good. He emphasizes how changes in the media landscape should make the issue of professionalism and ethics central to an education in journalism. He explains how journalism is becoming less recognizable as a distinct profession in the midst of increased online circulation of news, documentary, and photography reportage.

To illustrate the issue, consider the photographer, Tim Tai, who appears in a video circulating this week from the Missouri protests. Tai attempts to approach the protest site, insisting that he is “doing his job” and that barring him from taking photographs is a direct violation of a “free press.”

Countless comments now and in coming weeks will echo the Tai’s sentiments and many will invoke the principles of “free speech.” Yet the question remains, what are the ethical concerns at the heart of such principles as free speech? And what are the ethical stakes of a protest initiated and led by black students and student athletes, who have expressed a desire to limit certain forms of media coverage that they may deem harmful to their cause? Beyond these specific questions, we might also ask: How many amateur “journalists” (essentially anyone with a cell phone) will uphold the ethical practices or raise the ethical challenges that have traditionally been the purview of the professional journalists? Such questions get at some of the overarching concerns that the Poynter Center and the Future Professional Ethics workshops will continue to grapple with in the following year.

November 17, 2015

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A Professional Life: A Question of Stages?

Emma Arrington Stone Young

A Professional Life in Stages

On September 15, 2015, Joseph Coleman spoke at the Poynter Center about his new book, Unfinished Work: The Struggle to Build an Aging American Workforce. Through personal interviews with dozens of subjects in the USA, Netherlands, France, and Japan, Coleman explores how these individuals and their nations are handling the world-wide boom in older workers.

Of the many interesting topics that arise – the long-lasting effects of the Great Recession, employer strategies, worker motivations, and who’s ultimately responsible for what – one that especially caught my attention was the notion that we might want to be thinking about professional working life as a series of stages rather than a single stage preceded by education and followed by retirement. Sweden has been relatively successful at creating social programs that re-train and re-employ middle-aged and older workers in new sectors after layoffs, Coleman says, suggesting that there might be benefits if industry and government more deliberately plan for workers to phase out of one industry and in to another.

It’s easy to think of benefits: At the individual level, workers may have new capacities to offer after children are raised, or may find more personal fulfillment in having more than one career. But it could work for industry too: Mid-life transitions from more to less physically demanding jobs might improve the overall health of the labor pool, and workers might bring more value as a fresh perspective in a new sector than by continually updating their training in the same sector. And in the broadest perspective, strategic programs to offer older workers the chance to renew themselves with a beneficial career change could, when needed, open up jobs for young workers (as when there is an over-supply of recent college graduates) and develop economic opportunities based on the unique strengths of older workers.

Of course, the notion of working life as a single stage between education and retirement only applies to certain relatively high-status occupations in the first place – professions and “skilled” trades. It has long been relatively easy to make career changes among certain kinds of occupation: it would startle no one to hear of a single career that included stints in law, politics, business, and academia. It isn’t clear whether transitions between “professional” and “non-professional” jobs could be as easily accomplished. In the US at least, access to professional careers and their accompanying class status is most often determined before the age of thirty, and in general the high cost of licensure and the pressures of class status maintenance are potential roadblocks.

On the other hand, workers in midlife may in some ways be the ideal candidates to take on the complex moral reasoning involved in professional life, as well as the pragmatic hurdles of advanced degree programs, even if their first career was not considered professional. Several decades of cultural pressure to professionalize young has produced an enormous problem: a glut of young workers with advanced degrees, few opportunities, and little experience. So a thoughtful shift toward encouraging more workers to consider professional careers after gaining life experience in jobs considered blue, white, or pink collar, or years of working in the home, might actually have some far-reaching effects: At a large enough scale, it would certainly change the demographics of degree programs and alter the stock narrative of status attainment. And it might create a new kind of professional. It’s certainly a provocative notion.


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Ethics and Electronic Health Records: Privacy, Professionalism, Provider Burden, and Patient Control

Announcing a seminar in the Future of Professional and Practical Ethics series sponsored by the Indiana University Center for Law, Ethics and Applied Research in Health Information (CLEAR) and the IU Center for Bioethics.

Seminar poster

Ethics and Electronic Health Records

Privacy, Professionalism,
Provider Burden, and Patient Control

Electronic health records (EHRs) are transforming health care and creating new ethical challenges for clinicians, researchers, and patients. In this session, an expert on ethics and computers in medicine will address central issues for the EHR era.

Presenter: Kenneth W. Goodman, PhD
Professor and Director, Institute for Bioethics and Health Policy,
University of Miami Miller School of Medicine, and
Director, WHO Collaborating Center in Global Health and Policy

Moderator: Peter H. Schwartz, MD, PhD
Faculty Investigator, IU Center for Bioethics,
Associate Professor of Medicine, IU School of Medicine, and
Associate Professor of Philosophy, IUPUI

Thursday, November 12, 2015
Noon – 1 PM
Health Information & Translational Science (HITS) Building
Room 1110
410 W. 10th St., Indianapolis, IN

See the IU Center for Bioethics page in the Compendium.

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More on the cost of higher education

Our review of the first workshop at IUB, Professions and Service to All: Challenges, Problems, and Solutions, we mentioned the unintended consequences of the relentless climb of college tuition. A recent New York Times editorial, The Law School Debt Crisis, highlights the role of corruption in law schools fueled by the federal Direct PLUS Loan program.

You should read the editorial; I can’t do it justice, but here’s a summation: The high rate of tuition creates high student debt which is not relieved by the plethora of high-paying law jobs promised by law school recruiters because the promise is empty.

There is too much wrong about this picture to enumerate, so I’ll just mention one: How can we believe that law schools are instruments of the common good when they act like organized crime?

Ken Pimple
November 1, 2015
1:10 pm EST

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