Ethics in health care have a long history. The emergence of bioethics for instance came into be after the Second World War and was triggered by a confluence of factors. Today, ethical issues continue to influence public health. Despite the formulation of professional code of ethics in public health, the challenge to adhere remains significant. The current case involving Cynthia, her husband Robert and her mother is a clear indication of the ethical issues in public health. Three major categories of ethical issues arise from the case and will be analyzed including issues of responsibilities, paternalism and decision making.
Looking at responsibilities, health providers have a duty to ensure that every individual is given medical and health support to save life and to ensure their wellness (Rogers, 2004). In this scenario, Robert is interfering with this responsibility of public health officers to fulfill this duty, when he says that his wife would wish to be removed from support machines. Consequently, as a spouse Robert have the responsibility to keep his partners wish. On the other hand, Cynthia’s mother is determined to see her daughter going regardless. The courts have the responsibility of determining what to be done in this case, since no evidence is presented to grant Robert his wife’s wish.
The second aspect of ethics in this case is based on decision making. Health professionals are torn in between deciding on Cynthia’s wellness and the need to fulfill her alleged wishes of not being put in support machines. Robert on the other hand is concerned about fulfilling his wife’s desire of not wanting to be put in support machines for long, a decision that does not go well with Cynthia’s mother. The judicial authority also upholds decisions that support human life as stipulated in the constitution (Edelman, Mandle, & Kudzma, 2013). In addition, the court must respect individual’s autonomy in decision making. In the current scenario, the court needs to have evidence on the alleged wishes of the patient, to make a decision (Bernstein & Sweeney, 2012). With no tangible evidence to sustain Robert’s claim, the court maintains that Cynthia be maintained in hospital.
Lastly, the issue of public health ethical issues in this case can be seen in paternalism. Paternalism is described as the behavior of a person, a group of people or an organization, which infringes on one’s autonomy for their own good. Even though it was clear that Cynthia wanted to die in dignity and not be put through support machines for long, her mother and the court maintained that she be sustained by machines. The reasoning here is that, Cynthia had a chance to recover from her situation and live a better life (Tulchinsky & Varavikova, 2014). Consequently, Cynthia’s mother would have granted Robert’s wish to have her wife let go so as to save her from the agony, even though she was not convinced of the decision.
Ethical issues in public health are diverse and are experienced in day to day operations of health professionals in their efforts to sustain public health. The code of ethics put forth for health care professionals such as the American Nurse Association (ANA) among other professional codes in the field are meant to guide in decision making in public health issues (Tulchinsky & Varavikova, 2014). Even though, there are situations that present conflicting issues that affect public health. Balancing between what is right and what is just is usually an issue of concern in public health as seen in the current case. As public health professionals, it is important to be conversant with the professional code of ethics in order to maintain integrity and enhance public health at all times.
- Bernstein, A. B., & Sweeney, M. H. (2012). Public health surveillance data: legal, policy, ethical, regulatory, and practical issues. MMWR Surveill Summ, 61, 30-34.
- Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (Eds.). (2013). Health promotion throughout the life span. Elsevier Health Sciences.
- Rogers, W. (2004). Ethical issues in public health: a qualitative study of public health practice in Scotland. J Epidemiol Community Health 58, 446-450.
- Tulchinsky, T. H., & Varavikova, E. A. (2014). The new public health: an introduction for the 21st century. Academic Press.
