Identifying and navigating ethical issues in public health

Imagine you had a vaccine that, if given to one million children, can prevent 11,000 hospitalizations and 2,500 severe cases of disease, but that will also cause 1,000 hospitalizations and 500 severe cases of diseases in children who would not otherwise have fallen ill. Would you initiate a widespread vaccination program in a disease-endemic region? Is it ethical to give the armed gang in your community money so they let medical supplies go through? Should you accept funding from a popular fast food company when developing a campaign to fight obesity? What criteria should you use to allocate a private donation of 10 million dollars that the donor has given to you to address a problem related to “global health”?

Public health policy, practice, and research entail numerous ethical challenges. How should one decide what the right thing to do is? This course will equip participants with the tools, skills, and know-how that are necessary to assess and deal with ethical challenges that may arise in high, middle and low income countries. We will discuss real-life cases from participant's experiences, explore ethical approaches, and engage in ethical deliberations to find ethically-justifiable solutions.

By the end of the course, participants will:

• Be familiar with several real-life ethical challenges that may arise in public health work conducted in low, middle, and high income countries;
• Be able to critically reflect on a wide range of ethical arguments for addressing these issues, such as consequences and ethical principles;
• Be able to critically evaluate the feasibility of different solutions in the face of real-world constraints;
• Know how to identify an ethical issue and how to find an ethically justifiable solution based on ethical frameworks and values.

There are no prerequisites for this course. Bring your own experience, the ethical challenges you have faced in your work, and a desire to discuss them in group to assess the ethical dimensions and explore ethically justifiable solutions.

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The course is highly interactive. Each session is designed to engage you and encourage you to discuss your own experiences, moral intuitions, judgments, and values through discussion of cases, deliberation exercises, participant presentations, invited speakers’ talks, and simulations.

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Course evaluation will be based on:

• Participants must attend at least 80% of the course;
• Participation: will be assessed through engagement in class discussions and is evaluated based on the demonstration of critical assessment and reflection. We are interested in hearing not only what each participant thinks, but why they think it, and how they respond to honest, reasonable, and respectful questioning of the positions they hold. Participants are expected to engage in respectful and engaging discourse and to abide by the Community Learning Commitments that will be presented on the first day. This expectation includes maintaining awareness of one’s contributions as well as preserving time and space for the contributions of others.
• Final Presentation (to be delivered on day 2 and 3): it should last approximately 15 minutes and is intended to allow participants to demonstrate their critical reasoning on a public or global health ethical challenge of their choice.

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At least one facilitator will be on-site in Lugano, and some may join online. Participants are welcomed to join either on-site in Lugano, or online. In case of a change of regional policies (e.g., Covid) or personal reasons, the course could change to online.

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