Public Health Ethics: Cases Spanning the Globe

Barrett, Drue H.; Ortmann, Leonard; Dawson, Angus; Saénz, Carla; Reis, Andreas; Bolan, Gail

doi:10.1007/978-3-319-23847-0

Cited by 27 publications

(3 citation statements)

References 279 publications

(219 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Allocation of resources in the health sector is not often equitable. In many cases, they are distributed based on the donor's interest, which often aims to reduce risks from a specific disease, and, in fewer cases, based on the recipient's interest (29).…”

Section: Discussionmentioning

confidence: 99%

Forms of Health System Fragmentation During Conflict: The Case of Yemen

Dureab

Hussain

Sheikh

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

The continuous and protracted conflict in Yemen has evolved into the worst humanitarian situation in modern history. All public structures in the country, including the health system and its basic functions, have been under tremendous pressures. One of the key obstacles to improve the health outcomes in Yemen is fragmentation of the health system. This study aims at exploring and documenting the forms of health system fragmentation in humanitarian and conflict-affected contexts by studying Yemen as a case study. We collected national qualitative data from key informants through in-depth interviews. A pool of respondents was identified from the Ministry of Public Health and Population, donors, and non-governmental organizations. Data were collected between May and June 2019. We interviewed eight key informants and reviewed national health policy documents, and references provided by key informants. Interviews were recorded, transcribed, and analyzed using qualitative content analysis. We further conducted a literature review to augment and triangulate the findings. Six themes emerged from our datasets and analyses, representing various forms of fragmentation: political, structural, inter-sectoral, financial, governance, and health agenda-related forms. Health system fragmentation in Yemen existed before the conflict eruption and has aggravated as the conflict evolves. The humanitarian situation and the collapsing health system enabled the influx of various national and international health actors. In conclusion, the protracted conflict and fragile situation in Yemen have accentuated the fragmentation of the health system. Addressing these fragmentations' forms by all health actors and building consensus on health system agenda are recommended. Health system analysis and in-depth study of fragmentation drivers in Yemen can be beneficial to build common ground and priorities to reduce health system fragmentation. Furthermore, capacity building of a health system is fundamental for the humanitarian development nexus, health system integration, and recovery efforts in the future.

show abstract

Section: Discussionmentioning

confidence: 99%

Forms of Health System Fragmentation During Conflict: The Case of Yemen

Dureab

Hussain

Sheikh

et al. 2021

Front. Public Health

View full text Add to dashboard Cite

show abstract

“…In contrast, public health is focused on the prevention or mitigation of diseases in a population. It has two main values which can compete with each other: maximizing benefit to the population and achieving equity within that population [60]. There are two main strategies for prevention, focusing on factors that affect the entire population (e.g., informational campaigns) and focusing on those identified as at highest risk [61].…”

Section: The Intersection Of Public Health and Clinical Medicinementioning

confidence: 99%

Polygenic risk scores in the clinic: new perspectives needed on familiar ethical issues

2021

View full text Add to dashboard Cite

Clinical use of polygenic risk scores (PRS) will look very different to the more familiar monogenic testing. Here we argue that despite these differences, most of the ethical, legal, and social issues (ELSI) raised in the monogenic setting, such as the relevance of results to family members, the approach to secondary and incidental findings, and the role of expert mediators, continue to be relevant in the polygenic context, albeit in modified form. In addition, PRS will reanimate other old debates. Their use has been proposed both in the practice of clinical medicine and of public health, two contexts with differing norms. In each of these domains, it is unclear what endpoints clinical use of PRS should aim to maximize and under what constraints. Reducing health disparities is a key value for public health, but clinical use of PRS could exacerbate race-based health disparities owing to differences in predictive power across ancestry groups. Finally, PRS will force a reckoning with pre-existing questions concerning biomarkers, namely the relevance of self-reported race, ethnicity and ancestry, and the relationship of risk factors to disease diagnoses. In this Opinion, we argue that despite the parallels to the monogenic setting, new work is urgently needed to gather data, consider normative implications, and develop best practices around this emerging branch of genomics.

show abstract

“…Yet genomic research and applications must navigate the tension between personalizing for the individual and optimizing for public health. This tension has long existed within public healthwell before the integration of molecular genetic data into the field [3]. However, the personal nature of genomic information can make it particularly tempting to focus on individual, rather than public, health metrics.…”

Section: Introductionmentioning

confidence: 99%