Module05 ethical issues in vaccination
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This document outlines an ethics module on vaccination. It aims to identify ethical issues related to vaccination, analyze arguments for and against mandatory vaccination, and establish an ethical framework for vaccination in the Eastern Mediterranean region context. The module introduces key concepts of vaccines, immunization, and vaccination. It discusses the benefits of herd immunity and reduced disease versus potential harms of side effects. The module also examines ethical considerations around the duty to care for others and debates around compulsory versus voluntary vaccination. It provides references for additional readings on vaccination ethics.
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The Belmont Report (Three Benchmark Rules)
The Belmont Report, published in 1979, is a seminal document in the field of research ethics. It was developed by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in response to unethical research practices, particularly the infamous Tuskegee Syphilis Study. The report sets forth three fundamental ethical principles, often referred to as the "Three Benchmark Rules," that guide the ethical conduct of research involving human subjects. These principles are:
Respect for Persons:
The principle of respect for persons emphasizes the autonomy and dignity of individuals. It requires that individuals be treated as autonomous agents capable of making informed decisions about their participation in research. Researchers must obtain informed consent from potential subjects and provide them with all relevant information regarding the purpose, risks, benefits, and alternatives of the study. Special provisions must be made for individuals with diminished autonomy, such as children or those with cognitive impairments, to ensure their rights and welfare are protected.
Beneficence:
The principle of beneficence emphasizes the obligation to maximize benefits and minimize harm to research subjects. Researchers must ensure that the potential benefits of the study outweigh the potential risks. They should conduct a thorough risk-benefit analysis and design their studies to maximize potential benefits while minimizing any potential harm or discomfort to participants. Additionally, researchers must make ongoing assessments of the risks and benefits throughout the course of the study and take necessary steps to minimize harm and maximize benefits.
Justice:
The principle of justice requires the fair distribution of the burdens and benefits of research. It emphasizes the need for equal access to participation in research, regardless of factors such as race, gender, socioeconomic status, or other characteristics. Researchers must ensure that the selection of research subjects is fair and avoid exploiting vulnerable populations. Additionally, the benefits derived from research should be distributed equitably, ensuring that the burdens of research are not borne solely by disadvantaged groups while the benefits accrue to others.
These Three Benchmark Rules provided in the Belmont Report serve as the foundation for modern ethical guidelines and regulations governing research involving human subjects. They have significantly influenced the development of ethical review boards and informed consent processes, ensuring the protection of individuals' rights and well-being in research studies.
Biases in epidemiology
This document discusses various types of biases that can occur in epidemiological studies. It defines bias as systematic error that results in an incorrect estimate of the association between exposure and disease. Several types of biases are described, including selection bias, information bias, and confounding. Selection bias occurs when the study population is not representative of the target population and can arise from inappropriate definitions of eligibility, sampling frames, or follow-up. Information bias results from inaccurate or missing data.
Medical ethics and public health
This document discusses medical ethics and ethical issues in public health. It begins with background on the history of medical ethics and the high esteem doctors have held. It defines ethics as moral principles and rules of conduct. The four main principles of medical ethics are discussed as beneficence, non-maleficence, autonomy, and justice. Several ethical issues in everyday medical practice and current problems like AIDS, abortion, and euthanasia are examined. Ethical issues specific to public health like immunization, water fluoridation, and infectious diseases are also analyzed through case studies. The document concludes that representative and consensus-based processes should guide decisions on ethical issues in public health.
Field and Community Trials
1) Field trials evaluate prevention strategies by testing interventions on healthy individuals at risk of disease. They aim to determine if an agent or procedure reduces disease risk.
2) Field trials are generally conducted in real-world settings rather than clinical settings and can involve individuals, groups, or entire communities.
3) Random allocation of participants to intervention and control groups is important to reduce bias and ensure groups are comparable outside of the intervention being tested.
Belmont report
The Belmont Report summarizes the basic ethical principles identified by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. It discusses three principles that should guide research with human subjects: respect for persons, beneficence, and justice. The report was created to identify ethical standards for research and outline how risks and benefits, informed consent, and subject selection should be handled.
ETHICAL ISSUES IN BIOMEDICAL RESEARCH
Principles of essentiality
Principles of voluntariness, informed consent and community agreement
Principles of non-exploitation
Principles of privacy and confidentiality
Principles of precaution and risk minimisation
Principles of professional competence
Principles of accountability and transparency
Ethical issues of hiv and aids in health
This document discusses several ethical issues related to HIV/AIDS in healthcare. It outlines how HIV is transmitted through sexual contact, blood transfusions, or from mother to child during pregnancy. While social stigma remains, transmission requires intimate contact and is not possible through everyday interactions like shaking hands or sharing facilities. The document then examines ethics issues such as disclosure of HIV status, disability rights, access to resources for treatment, employment discrimination, dissatisfaction with medical care, high suicide rates, duty to warn partners, and counseling best practices including helping clients address disclosure concerns, coping with treatment challenges, and engaging in risk reduction.
Introduction to ethical issues in public health, Public Health Institute (PHI...
An introduction to ethical issues in public health practice and research I gave to master students in the Public Health Institute in Sudan -- My Home Country. This was on Jan. 5, 2012.
Recommended
The Belmont Report (Three Benchmark Rules)
The Belmont Report, published in 1979, is a seminal document in the field of research ethics. It was developed by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research in response to unethical research practices, particularly the infamous Tuskegee Syphilis Study. The report sets forth three fundamental ethical principles, often referred to as the "Three Benchmark Rules," that guide the ethical conduct of research involving human subjects. These principles are:
Respect for Persons:
The principle of respect for persons emphasizes the autonomy and dignity of individuals. It requires that individuals be treated as autonomous agents capable of making informed decisions about their participation in research. Researchers must obtain informed consent from potential subjects and provide them with all relevant information regarding the purpose, risks, benefits, and alternatives of the study. Special provisions must be made for individuals with diminished autonomy, such as children or those with cognitive impairments, to ensure their rights and welfare are protected.
Beneficence:
The principle of beneficence emphasizes the obligation to maximize benefits and minimize harm to research subjects. Researchers must ensure that the potential benefits of the study outweigh the potential risks. They should conduct a thorough risk-benefit analysis and design their studies to maximize potential benefits while minimizing any potential harm or discomfort to participants. Additionally, researchers must make ongoing assessments of the risks and benefits throughout the course of the study and take necessary steps to minimize harm and maximize benefits.
Justice:
The principle of justice requires the fair distribution of the burdens and benefits of research. It emphasizes the need for equal access to participation in research, regardless of factors such as race, gender, socioeconomic status, or other characteristics. Researchers must ensure that the selection of research subjects is fair and avoid exploiting vulnerable populations. Additionally, the benefits derived from research should be distributed equitably, ensuring that the burdens of research are not borne solely by disadvantaged groups while the benefits accrue to others.
These Three Benchmark Rules provided in the Belmont Report serve as the foundation for modern ethical guidelines and regulations governing research involving human subjects. They have significantly influenced the development of ethical review boards and informed consent processes, ensuring the protection of individuals' rights and well-being in research studies.
Biases in epidemiology
This document discusses various types of biases that can occur in epidemiological studies. It defines bias as systematic error that results in an incorrect estimate of the association between exposure and disease. Several types of biases are described, including selection bias, information bias, and confounding. Selection bias occurs when the study population is not representative of the target population and can arise from inappropriate definitions of eligibility, sampling frames, or follow-up. Information bias results from inaccurate or missing data.
Medical ethics and public health
This document discusses medical ethics and ethical issues in public health. It begins with background on the history of medical ethics and the high esteem doctors have held. It defines ethics as moral principles and rules of conduct. The four main principles of medical ethics are discussed as beneficence, non-maleficence, autonomy, and justice. Several ethical issues in everyday medical practice and current problems like AIDS, abortion, and euthanasia are examined. Ethical issues specific to public health like immunization, water fluoridation, and infectious diseases are also analyzed through case studies. The document concludes that representative and consensus-based processes should guide decisions on ethical issues in public health.
Field and Community Trials
1) Field trials evaluate prevention strategies by testing interventions on healthy individuals at risk of disease. They aim to determine if an agent or procedure reduces disease risk.
2) Field trials are generally conducted in real-world settings rather than clinical settings and can involve individuals, groups, or entire communities.
3) Random allocation of participants to intervention and control groups is important to reduce bias and ensure groups are comparable outside of the intervention being tested.
Belmont report
The Belmont Report summarizes the basic ethical principles identified by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. It discusses three principles that should guide research with human subjects: respect for persons, beneficence, and justice. The report was created to identify ethical standards for research and outline how risks and benefits, informed consent, and subject selection should be handled.
ETHICAL ISSUES IN BIOMEDICAL RESEARCH
Principles of essentiality
Principles of voluntariness, informed consent and community agreement
Principles of non-exploitation
Principles of privacy and confidentiality
Principles of precaution and risk minimisation
Principles of professional competence
Principles of accountability and transparency
Ethical issues of hiv and aids in health
This document discusses several ethical issues related to HIV/AIDS in healthcare. It outlines how HIV is transmitted through sexual contact, blood transfusions, or from mother to child during pregnancy. While social stigma remains, transmission requires intimate contact and is not possible through everyday interactions like shaking hands or sharing facilities. The document then examines ethics issues such as disclosure of HIV status, disability rights, access to resources for treatment, employment discrimination, dissatisfaction with medical care, high suicide rates, duty to warn partners, and counseling best practices including helping clients address disclosure concerns, coping with treatment challenges, and engaging in risk reduction.
Introduction to ethical issues in public health, Public Health Institute (PHI...
An introduction to ethical issues in public health practice and research I gave to master students in the Public Health Institute in Sudan -- My Home Country. This was on Jan. 5, 2012.
Anjali icmr ppt
The document summarizes the revised National Ethical Guidelines for Biomedical and Health Research involving Human Participants released by the Indian Council of Medical Research (ICMR) in 2017.
It provides an overview of the history and development of ethical guidelines in India and internationally. The key sections and principles covered in the new guidelines are summarized, including informed consent process, vulnerable groups, responsible conduct of research, and ethical review procedures. The guidelines aim to protect dignity, rights, safety and well-being of research participants according to core ethical principles of respect for persons, beneficence, non-maleficence and justice.
Vaccine Trials
This document outlines the process for vaccine trials from pre-clinical evaluation through post-licensure safety monitoring. It discusses the various phases of vaccine trials including phase I safety/immunogenicity trials, phase II dose-ranging trials, phase III large-scale efficacy/safety trials, and phase IV post-marketing surveillance. It also covers topics like emergency approval, notable past safety issues, and efforts to improve global vaccine safety monitoring. The overall goal is to demonstrate a vaccine's safety, immunogenicity and efficacy through rigorous clinical testing before and after product approval and implementation.
Field trial and community trail.pptx
Field trials involve assessing methods or procedures among individuals or groups in real-world settings to reduce disease risk. They can precisely evaluate single variables but require more subjects and are costly. Community trials allocate whole communities to interventions and focus on changing knowledge and attitudes through education. They are helpful for public health decisions but have risks of selection bias and controls receiving interventions. Both aim to test strategies under natural conditions.
Error, confounding and bias
This document discusses different types of error and bias that can occur in epidemiological studies. It defines random error as occurring due to chance and resulting in imprecise measures, while systematic error or bias results in invalid measures that are not true. Types of bias discussed include selection bias, information bias, and confounding. Selection bias can arise from how cases and controls are selected, while information bias occurs when exposure or disease status is incorrectly classified. The document emphasizes the importance of reducing both random and systematic errors to obtain valid study results.
Ethical issues in biomedical research
The Presentation will take the reader through various ethical issues in biomedical research. It covers topics like The Nuremberg Code, Declaration of Helsinki, Declaration of Geneva, selected code and regulations that guide research with human subjects, etc.
History of bioethics
This document provides a history of the development of bioethics and medical ethics from ancient civilizations to modern times. It describes some of the earliest ethical codes from ancient Egypt, Babylon, India, Greece, Rome, and Islamic and Jewish traditions. It then outlines the progression of medical ethics standards over time, including influential codes and guidelines developed in response to unethical human experimentation, with a focus on the atrocities that occurred in the United States in the 20th century. Key milestones discussed include the Nuremberg Code, Declaration of Helsinki, and Belmont Report.
Randomized controlled trial: Going for the Gold
Dr. Gaurav Kamboj's document discusses the hierarchy of evidence and research designs. It provides background on the history of randomization in research from its first use in 1747 to establish the gold standard of randomized controlled trials (RCTs). The document describes the basic design of RCTs and different types of RCT study designs including parallel, crossover, factorial, and cluster designs. It outlines the basic steps to conduct an RCT including developing a protocol, selecting study populations, random allocation of subjects, intervention/manipulation, follow-up, and outcome assessment.
The Nuremberg Code
The document summarizes the history and key principles of the Nuremberg Code, which was established after World War II in response to unethical medical experiments conducted by Nazi doctors on concentration camp prisoners without consent. The Nuremberg Code set forth 10 ethical principles for human experimentation, including requirements for voluntary and informed consent, that experiments yield socially useful results not obtainable by other means, and that risks to subjects be avoided wherever possible. It had a significant influence on later guidelines for ethical clinical research involving human subjects.
Cross sectional study
This document discusses cross-sectional studies. It defines a cross-sectional study as an observational study that measures exposure and health outcomes in a population at a single point in time, providing a "snapshot" of prevalence. It describes key characteristics, including simultaneously collecting exposure and outcome data, estimating prevalence rather than incidence, and inability to determine temporal relationships between variables. The document outlines advantages as being quick and inexpensive but also limitations such as inability to establish causation.
History of Clinical Trials
The document provides a history of clinical trials and discusses several important studies that helped establish modern ethics guidelines for human subject research. It describes the unethical medical experiments performed by Nazi doctors on concentration camp prisoners. It then discusses the Nuremberg Code established after World War 2 that set the first comprehensive standards for ethical clinical research. Several controversial US studies from the mid-20th century are also summarized, including the Tuskegee Syphilis Study and experiments that deliberately infected children. This led to increased regulations and standards like the Belmont Report to better protect human research participants.
Public health surveillance
This document discusses public health surveillance. It begins by defining surveillance and its main components, which include the ongoing collection and analysis of health data to facilitate disease prevention and control. The document then lists the main uses of surveillance data, such as estimating disease burden and evaluating programs. It describes three main sources of surveillance data: individuals, healthcare providers, and environmental conditions. The document outlines the five main steps of surveillance and discusses selecting health problems for surveillance based on factors like disease severity. It also describes different data collection methods, like notifications, surveys, and disease registries. In closing, it outlines the flow of surveillance information between data providers, analysts, and those responsible for public health response and decision-making.
COVID Ethical Issues
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The document discusses the role and responsibilities of an Institutional Ethics Committee (IEC). The main points are:
1. An IEC is an independent body that reviews clinical trials and ensures the ethical treatment of human subjects. It evaluates protocols, informed consent forms, and other aspects of research proposals.
2. The IEC's main responsibilities are to protect participants, ensure universal ethical values are followed, and help develop research that meets local health needs.
3. The IEC reviews documents like protocols, consent forms, recruitment materials, safety information, and investigators' qualifications before research begins and conducts continuing annual reviews. It documents its approval, required modifications, or disapproval of proposed studies in writing.
Bias in clinical research
This is an interesting ppt discussing in detail about bias in clinical research and how to overcome it...
Meta-analysis and systematic reviews
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Ethics in health research
This document discusses ethics in health research. It provides an overview of the origins and principles of ethics, including teleological and deontological perspectives. It then discusses ethics specifically in the context of health research, including how research must be useful and avoid harm. The document outlines several historical examples of unethical human experimentation, such as the Nazi experiments and Unit 731 tests during WWII. It also discusses international efforts to establish ethical guidelines, including the Nuremberg Code, Declaration of Helsinki, and Belmont Report. The core ethical principles of autonomy, beneficence, justice, and respect for the environment are covered. Elements of informed consent and protections for vulnerable populations are also summarized.
Ethical & professional issues in epidemiology
This document discusses several ethical and professional issues in epidemiology. It addresses the importance of legal responsibilities, limitations of practice, and implications of actions for health professionals. It also covers specific issues like outbreak preparedness, research ethics, organ transplantation, bio-banking, immunization, abortion, end of life care, privacy, tuberculosis control, and the ethical challenges of big data and artificial intelligence in health.
Randomised Controlled Trial, RCT, Experimental study
An epidemiological experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups to receive and not receive an experimental preventive or therapetuic procedure, maneuver, or intervention .
Tuskegee study
The Tuskegee Syphilis Study was a clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to observe the natural progression of untreated syphilis in rural African American men in Alabama. Over 600 men infected with syphilis were enrolled in the study under the guise of receiving free health care from the U.S. government, but they were never informed they had syphilis and were intentionally denied effective treatment even after penicillin became the standard treatment in 1947. The study was exposed and ended in 1972 due to public outcry over the grossly unethical treatment of human subjects.
Translational epidemiology
Translational epidemiology aims to effectively transfer new knowledge from epidemiological studies into disease control programs and public health policies. It involves four phases - from scientific discovery to evidence-based guidelines to implementation in health practice and finally to improved population health outcomes. Overcoming challenges such as the lack of collaboration and adequate funding is important to translate basic research findings into real-world benefits for public health.
Vaccine Hesitancy in the United States
Lab meeting presentation concerning vaccine hesitancy in the United States, resulting disease outbreaks and consequences, and recommendations for better public health communication efforts.
EMPHNET-PHE course: Module03 ethical issues in surveillance, screening and ou...
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Anjali icmr ppt
The document summarizes the revised National Ethical Guidelines for Biomedical and Health Research involving Human Participants released by the Indian Council of Medical Research (ICMR) in 2017.
It provides an overview of the history and development of ethical guidelines in India and internationally. The key sections and principles covered in the new guidelines are summarized, including informed consent process, vulnerable groups, responsible conduct of research, and ethical review procedures. The guidelines aim to protect dignity, rights, safety and well-being of research participants according to core ethical principles of respect for persons, beneficence, non-maleficence and justice.
Vaccine Trials
This document outlines the process for vaccine trials from pre-clinical evaluation through post-licensure safety monitoring. It discusses the various phases of vaccine trials including phase I safety/immunogenicity trials, phase II dose-ranging trials, phase III large-scale efficacy/safety trials, and phase IV post-marketing surveillance. It also covers topics like emergency approval, notable past safety issues, and efforts to improve global vaccine safety monitoring. The overall goal is to demonstrate a vaccine's safety, immunogenicity and efficacy through rigorous clinical testing before and after product approval and implementation.
Field trial and community trail.pptx
Field trials involve assessing methods or procedures among individuals or groups in real-world settings to reduce disease risk. They can precisely evaluate single variables but require more subjects and are costly. Community trials allocate whole communities to interventions and focus on changing knowledge and attitudes through education. They are helpful for public health decisions but have risks of selection bias and controls receiving interventions. Both aim to test strategies under natural conditions.
Error, confounding and bias
This document discusses different types of error and bias that can occur in epidemiological studies. It defines random error as occurring due to chance and resulting in imprecise measures, while systematic error or bias results in invalid measures that are not true. Types of bias discussed include selection bias, information bias, and confounding. Selection bias can arise from how cases and controls are selected, while information bias occurs when exposure or disease status is incorrectly classified. The document emphasizes the importance of reducing both random and systematic errors to obtain valid study results.
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The Presentation will take the reader through various ethical issues in biomedical research. It covers topics like The Nuremberg Code, Declaration of Helsinki, Declaration of Geneva, selected code and regulations that guide research with human subjects, etc.
History of bioethics
This document provides a history of the development of bioethics and medical ethics from ancient civilizations to modern times. It describes some of the earliest ethical codes from ancient Egypt, Babylon, India, Greece, Rome, and Islamic and Jewish traditions. It then outlines the progression of medical ethics standards over time, including influential codes and guidelines developed in response to unethical human experimentation, with a focus on the atrocities that occurred in the United States in the 20th century. Key milestones discussed include the Nuremberg Code, Declaration of Helsinki, and Belmont Report.
Randomized controlled trial: Going for the Gold
Dr. Gaurav Kamboj's document discusses the hierarchy of evidence and research designs. It provides background on the history of randomization in research from its first use in 1747 to establish the gold standard of randomized controlled trials (RCTs). The document describes the basic design of RCTs and different types of RCT study designs including parallel, crossover, factorial, and cluster designs. It outlines the basic steps to conduct an RCT including developing a protocol, selecting study populations, random allocation of subjects, intervention/manipulation, follow-up, and outcome assessment.
The Nuremberg Code
The document summarizes the history and key principles of the Nuremberg Code, which was established after World War II in response to unethical medical experiments conducted by Nazi doctors on concentration camp prisoners without consent. The Nuremberg Code set forth 10 ethical principles for human experimentation, including requirements for voluntary and informed consent, that experiments yield socially useful results not obtainable by other means, and that risks to subjects be avoided wherever possible. It had a significant influence on later guidelines for ethical clinical research involving human subjects.
Cross sectional study
This document discusses cross-sectional studies. It defines a cross-sectional study as an observational study that measures exposure and health outcomes in a population at a single point in time, providing a "snapshot" of prevalence. It describes key characteristics, including simultaneously collecting exposure and outcome data, estimating prevalence rather than incidence, and inability to determine temporal relationships between variables. The document outlines advantages as being quick and inexpensive but also limitations such as inability to establish causation.
History of Clinical Trials
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Public health surveillance
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Institutional ethics committee : Roles and Responsibilities
The document discusses the role and responsibilities of an Institutional Ethics Committee (IEC). The main points are:
1. An IEC is an independent body that reviews clinical trials and ensures the ethical treatment of human subjects. It evaluates protocols, informed consent forms, and other aspects of research proposals.
2. The IEC's main responsibilities are to protect participants, ensure universal ethical values are followed, and help develop research that meets local health needs.
3. The IEC reviews documents like protocols, consent forms, recruitment materials, safety information, and investigators' qualifications before research begins and conducts continuing annual reviews. It documents its approval, required modifications, or disapproval of proposed studies in writing.
Bias in clinical research
This is an interesting ppt discussing in detail about bias in clinical research and how to overcome it...
Meta-analysis and systematic reviews
A systematic review is a rigorous analysis of published research on a focused question that collects and summarizes the evidence. It contrasts with an overview, which may include non-research articles and be influenced by other evidence. Meta-analysis uses statistical methods to combine results from multiple studies. To ensure validity, meta-analyses must have a well-defined methodology, including comprehensive searches and duplicate screening and data extraction to reduce bias. Important factors include assessing whether all relevant studies were found and the sources searched, as well as controlling for biases such as from selective data extraction or funding influences.
Ethics in health research
This document discusses ethics in health research. It provides an overview of the origins and principles of ethics, including teleological and deontological perspectives. It then discusses ethics specifically in the context of health research, including how research must be useful and avoid harm. The document outlines several historical examples of unethical human experimentation, such as the Nazi experiments and Unit 731 tests during WWII. It also discusses international efforts to establish ethical guidelines, including the Nuremberg Code, Declaration of Helsinki, and Belmont Report. The core ethical principles of autonomy, beneficence, justice, and respect for the environment are covered. Elements of informed consent and protections for vulnerable populations are also summarized.
Ethical & professional issues in epidemiology
This document discusses several ethical and professional issues in epidemiology. It addresses the importance of legal responsibilities, limitations of practice, and implications of actions for health professionals. It also covers specific issues like outbreak preparedness, research ethics, organ transplantation, bio-banking, immunization, abortion, end of life care, privacy, tuberculosis control, and the ethical challenges of big data and artificial intelligence in health.
Randomised Controlled Trial, RCT, Experimental study
An epidemiological experiment in which subjects in a population are randomly allocated into groups, usually called study and control groups to receive and not receive an experimental preventive or therapetuic procedure, maneuver, or intervention .
Tuskegee study
The Tuskegee Syphilis Study was a clinical study conducted between 1932 and 1972 by the U.S. Public Health Service to observe the natural progression of untreated syphilis in rural African American men in Alabama. Over 600 men infected with syphilis were enrolled in the study under the guise of receiving free health care from the U.S. government, but they were never informed they had syphilis and were intentionally denied effective treatment even after penicillin became the standard treatment in 1947. The study was exposed and ended in 1972 due to public outcry over the grossly unethical treatment of human subjects.
Translational epidemiology
Translational epidemiology aims to effectively transfer new knowledge from epidemiological studies into disease control programs and public health policies. It involves four phases - from scientific discovery to evidence-based guidelines to implementation in health practice and finally to improved population health outcomes. Overcoming challenges such as the lack of collaboration and adequate funding is important to translate basic research findings into real-world benefits for public health.
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Institutional ethics committee : Roles and Responsibilities
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Randomised Controlled Trial, RCT, Experimental study
Randomised Controlled Trial, RCT, Experimental study
Similar to Module05 ethical issues in vaccination
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The epidemic of misinformation about vaccines
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Capstone Presentation - Vaccinating Children
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NEWER & EMERGING VACCINE SYNOPSIS PPT.pptx
This document summarizes a presentation on child health nursing regarding immunization. It discusses how children are the future and immunization protects them from preventable diseases. The presentation reviews the history of immunization and how vaccines have reduced mortality from infectious diseases. It then presents the objectives and hypotheses of a study assessing knowledge of newer vaccines among mothers of under-five children. Key terms are operationally defined and the conceptual framework of health promotion is described.
Ethics and Childhood Vaccination Policy in theUnited States
Ethics and Childhood Vaccination Policy in the
United States
Childhood immunization in-
volves a balance between par-
ents’ autonomy in deciding
whether to immunize their chil-
dren and the benefits to public
healthfrommandatingvaccines.
Ethical concerns about pediatric
vaccination span several public
health domains, including those
of policymakers, clinicians, and
other professionals.
In light of ongoing develop-
ments and debates, we discuss
several key ethical issues con-
cerning childhood immunization
in the United States and de-
scribe how they affect policy
development and clinical prac-
tice. We focus on ethical con-
siderations pertaining to herd
immunity as a community good,
vaccine communication, dis-
missal of vaccine-refusing fam-
ilies from practice, and vaccine
mandates.
Clinicians and policymakers
need to consider the nature
and timing of vaccine-related
discussions and invoke delib-
erative approaches to policy-
making. (Am J Public Health.
2016;106:273–278. doi:10.2105/
AJPH.2015.302952)
Kristin S. Hendrix, PhD, Lynne A. Sturm, PhD, Gregory D. Zimet, PhD, and Eric M. Meslin, PhD, FCAHS
Following the December2014 measles outbreak at
a popular amusement park in
California,1,2 which spread to
other states, Canada, and Mex-
ico, there has been increased
attention to US childhood im-
munization practices. A recent
study attributed the outbreak
to underimmunization,3 and
several policymakers have called
for an end to religious and phil-
osophical (i.e., personal-belief)
exemptions altogether, with the
state of California passing legis-
lation removing the option of
personal-belief exemptions.4,5
Political candidates have
expressed various viewpoints on
vaccination.6 In light of these
developments, we discuss several
key ethical issues concerning
childhood immunization in the
United States and describe how
they affect policy development
and clinical practice. There are
a myriad of ethical issues re-
garding such topics as vaccination
development, administration,
communication, and safety
monitoring. We focus on a few
key ethical issues concerning
childhood immunization in the
United States—what we refer to
as a “vaccine ethics” approach—
and describe how such an
approach affects policy develop-
ment and clinical immunization
practice.
VACCINE ATTITUDES
AND BEHAVIORS
In a time of growing hesita-
tion, uncertainty, and opposition
concerning childhood vaccines,
the developed world is witness-
ing a resurgence of vaccine-
preventable illnesses.7–9 Although
the spread of antivaccine and
vaccine-fear sentiments has be-
come common through social
networks, both online and in
person,10,11 a growing body of
research argues that such senti-
ments are multidimensional and
nuanced.12,13
Although sensible public
policy is often consistent with
public sentiment, there are in-
stances in which empirical data
can give conflicting input about
the ethical acceptability of policy.
In vaccine policy, this is espe ...
Prevention
1) Prevention aims to promote health and safety in communities by slowing the onset of disease through measures like health education, vaccinations, and early diagnosis.
2) There are four levels of prevention: primordial focuses on whole populations, primary targets risk factors, secondary detects disease early, and tertiary manages existing conditions.
3) Successful prevention requires understanding disease causation and risk factors, implementing prophylactic measures for at-risk groups, and continuous evaluation of prevention programs. Going "upstream" to address root causes is most effective.
Running head IMMUNIZATION1IMMUNIZATION2IMMUNIZATION.docx
Running head: IMMUNIZATION
1
IMMUNIZATION
2
IMMUNIZATION
3
Immunization
Mary Jones
IHP-610-X3562 Health Policy and Law
Southern New Hampshire University
01/29/2017
Immunization
This is the process through which a person is made resistant to a certain disease typically by administering a vaccine. This is done in a controlled way so that the body is not put at the risk of contracting the said disease. The process helps the body’s immune system fight of the disease by providing the body's immune system with the skills for handling a certain attack so that, should the same disease attack the body in the future the body's immune system will have the skills to respond appropriately. Exposing the body immune system to a certain disease during immunization helps the body retain the skills/abilities through immunological memory that it can use in the future (Pickering, 2012).
There are different elements of the immune system involved in this process. This is what the immunization improves as a way to ready them for a possible future attack. They include the T cells, B cells, and the B cell antibodies produced. The memory T and B cells are tasked with the quick recovery in the case of a second attack of the same disease.
Forms of Immunization
Active immunization
This happens when one comes naturally into contact with a microbe; the body then takes measures to protect its self, by producing antibodies and other forms of defense systems against this microbe (Tunkel, 2008). When this microbe attacks in the future the body will be ready with the steps it took within the first time it got attacked to eliminate the microbe even faster than before
Passive Immunization
This is the introduction of pre-synthesized elements into the body; these elements are already capable of dealing with a particular foreign element such that the body does not need to produce anything so as to fight the disease in question. Antibodies are the most widely used for passive immunization. Passive immunization produces fast results as the body receives antibodies and only has to apply them to attack a certain disease. The disadvantage of this, however, is that these results are not long lasting. This is because the antibodies used are quickly broken down by the host's body and since the body didn't get to learn how to make more their advantage end the moment the antibodies are gone.
A good example of passive immunization is the transfer of antibodies from mother to fetus during pregnancy. This help protects the fetus from foreign molecules before and shortly after birth. Other examples include harvesting antibodies from animals that were first injected with snake venom to make their bodies produce antibodies that can eliminate the effects of the snake venom, then get these antibodies into the body of a snake bite victim. These transfer of antibodies help the snake bite victim heal from the snake bite but these healing properties end as soon as the body breaks dow ...
Social Vaccine Prevention
Social vaccine refers to comprehensive packages of interventions aimed at preventing diseases and promoting positive behaviors by addressing social determinants of health and social inequities. It differs from medical vaccines in that it focuses on societal and structural factors rather than directly targeting pathogens. Examples include education programs, stigma reduction, promoting gender equality, and legal/policy reforms. Developing an effective social vaccine involves recognizing social and economic root causes of health issues, designing multi-level interventions, and implementing them through community engagement and participation. Proponents argue social vaccines can be highly effective and low-cost public health strategies.
Childhood immunisation: acceptance and advocacy
This document discusses public acceptance of vaccination in Australia. It notes that while most under-vaccination is due to access barriers, a small percentage (2-3%) of parents actively refuse vaccines. These refusers sometimes cluster in certain regions. It emphasizes the importance of understanding different audience concerns, maintaining trust, addressing both access barriers and communication approaches, and supporting health professionals in vaccine discussions. The goal of public health communication should be increasing vaccination rates while acknowledging parental perspectives.
THEORETICAL CONCEPT The Health Belief Model (HBM) is by far the mo.docx
THEORETICAL CONCEPT The Health Belief Model (HBM) is by far the most commonly used theory in health education and health promotion (Glanz, Rimer, & Viswanath, 2008; National Cancer Institute [NCI], 2005). The underlying concept of the HBM is that health behavior is determined by personal beliefs or perceptions about a disease and the strategies available to decrease its occurrence (Hochbaum, 1958). Personal perception is influenced by the whole range of intrapersonal factors affecting health behavior, including, but not limited to: knowledge, attitudes, beliefs, experiences, skills, culture, and religion.
THEORETICAL CONSTRUCTS
The following four perceptions serve as the main constructs of the model: perceived seriousness, perceived susceptibility, perceived benefits, and perceived barriers. Each of these perceptions, individually or in combination, can be used to explain health behavior. More recently, other constructs have been added to the HBM; thus, the model has been expanded to include cues to action, motivating factors, and self-efficacy. PERCEIVED SERIOUSNESS The construct of perceived seriousness speaks to an individual’s belief about the seriousness or severity of a disease. While the perception of seriousness is often based on medical information or knowledge, it may also come from beliefs a person has about the consequences an illness might have on him or her personally. For example, most of us perceive seasonal flu as a relatively minor ailment. We get it, stay home a few days, and get better. However, if you have asthma, contracting the flu could land you in the hospital. In this case, your perception of the flu might be that it is a serious disease. Or, if you are self-employed, having the flu might mean a week or more of lost wages. Again, this would influence your perception of the seriousness of this illness. Perception of seriousness can also be colored by past experience with the illness. No doubt, most people would consider skin cancer a serious disease. However, the perception of serious might be diminished in someone who had a cancerous lesion removed and recovered without much more than a sore area and a Band-Aid for a few days.
PERCEIVED SUSCEPTIBILITY
Personal risk or susceptibility is one of the more powerful perceptions in prompting people to adopt healthier behaviors. The greater the perceived risk, the greater the likelihood of engaging in behaviors to decrease the risk. This is what prompts men who have sex with men to be vaccinated against hepatitis B (de Wit, Vet, Schutten, & van Steenbergen, 2005) and to use condoms in an effort to decrease susceptibility to HIV infection (Belcher, Sternberg, Wolotski, Halkitis, & Hoff, 2005). Perceived susceptibility motivates people to be vaccinated for influenza (Chen, Fox, Cantrell, Stockdale, & Kagawa-Singer, 2007) to use sunscreen to prevent skin cancer, and to floss their teeth to prevent gum disease and tooth loss (Figure 4– 1). It is only logical that when peop ...
Bioethical Determinants of Pandemic Vaccine Allocation Strategies 6.3.08
Bioethical Determinants of Pandemic Vaccine Allocation Strategies 6.3.08Leonard Davis Institute of Health Economics
The document discusses different ethical approaches to allocating limited pandemic vaccine supplies. It analyzes the US DHHS draft guidance approach, which focuses on utilitarianism to protect essential workers, versus other approaches emphasizing beneficence, justice, and global responsibilities. More public discussion is needed to balance these ethical principles and gain acceptance for allocation policies.Health prevention model
The document discusses several models of health prevention including:
- The primary, secondary, and tertiary levels of prevention which focus on health before, during, and after disease.
- Clinical, role performance, and adaptive models which view health based on absence of symptoms, ability to perform roles, and ability to adapt.
- Agent-host-environmental model examining disease causes through interactions.
- High level wellness and holistic health models recognizing multifaceted influences on well-being.
- Nightingale's environment theory viewing health on a continuum influenced by internal and external factors.
- Milio's framework addressing community health determinants and policy.
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Ethical and Human Rights Concerns in Global HealthChapter Fou.docx
Ethical and Human Rights Concerns in Global Health
Chapter Four
Chapter four: Ethical and human rights concerns in global health.
As with any area of health, global health is affected by the issues of ethics and right for sound health outcome. In this chapter we will explore ethical and human rights concerns, some of the central treaties and conversions related to human rights, some historically significant cases in human subject research and key principles for making critical decisions in health research.
1
Failure to respect human rights is often associated with harm to human health
Health research with human subjects puts people at risk for the sake of other people’s health
Health investments must be made in fair ways since resources are limited
The Importance of Ethical and Human Rights Issues in Global Health
Access to the health care is human right and failure to respect this right might causes harm for health. For example, the stigma associated with HIV, TB and leprosy makes it difficult for the patient to obtain necessary health care, it not only cause harm to individual health but as a whole community health even. For example, if a TB patient remains untreated by the health care workers, then that individual could be a source of infection for other people.
Health research with human subject in particular in low income countries where study participants may not have other option to obtain the medication might become a proxy of clinical trial for other people .Lastly, fair decision in health investment is critical because in low income countries where health resources are scare difficult decisions need to be made depending on the priority and severity of disease.
2
The Foundations for Health and Human Rights
Universal Declaration of Human Rights and other legally binding multilateral treaties
Governments are obliged to respect, protect, and fulfill the rights they state
International Bill of Human Rights is the cornerstone for human rights. This bill include couple of documents including the Universal declaration of human rights that was officially declared in 1948, that place obligation on Government to respect , protect, and fulfill the rights of the state.
3
Selected Human Rights
The Rights-Based Approach
Assess health policies, programs, and practices in terms of impact on human rights
Analyze and address the health impacts resulting from violations of human rights when considering ways to improve population health
Prioritize the fulfillment of human rights
In considering human right, first we are going to examine the issue of right based approach. Some global health advocates argue that this approach, which thinks that fulfillment of people’s human right is conducive to their health, should be followed in global health. This means we need to assess health policies, programs or practices in terms of its impact on human right and analyze the health impacts from the perspective of violation of human rights
.
Chapter12
This document discusses several ethical issues that arise during epidemics like AIDS, including a health care provider's duty to treat patients, maintain confidentiality, and determine appropriate testing and treatment approaches. It also examines ethical considerations in treating infected health care workers and conducting experimental research. Globally, questions are raised about distributive justice and the duties of developed nations in responding to epidemics threatening vulnerable populations.
DQ11) N-LHi Class-In 2023 we are will educate about STDs and be aware.docx
DQ1
1)Â N.L
Hi Class,
In 2023 we are will educate about STDs and be aware of how most of them can be transmitted. HIV or human immunodeficiency virus attacks the body’s immune system resulting in a compromised immune system and can result in AIDS or acquired immunodeficiency syndrome if untreated (Centers for Disease Control and Prevention, 2022).  Mandating HIV screening can be tricky depending on where you are mandating people to get tested at. For example, In Urgent care or hospitals, it should be okay to mandate everyone to get tested as a precaution due to the atmosphere and environment one is in. Whereas in a job that doesn’t deal with any exposure it isn’t ethically fair to be exposed to this when there isn’t a reason to be. In my opinion, it should be offered during the other mandated vaccinations like the flu shots and Tuberculosis.
Reference:
Centers for Disease Control and Prevention. (2022, June 30).
About HIV/AIDS
. Centers for Disease Control and Prevention. Retrieved November 28, 2022, from
https://www.cdc.gov/hiv/basics/whatishiv.html
2) E.P
Regarding HIV/AIDS specifically, the duty of confidentiality is nearly ubiquitous in professional codes of conduct. Patients' right to privacy and the public's need to be safe from contagions are in tension with one another. Presumably, only patients themselves will have a full understanding of how their disclosures to third parties will affect their personal, social, and professional life (Rennie et al 2006). Even more so than in other areas of life, the doctor-patient relationship is one in which a person living with HIV/AIDS has a right to confidentiality. Any intentional disclosure of protected information to a third party is a crime. One case in which a doctor divulged his patients' HIV status to a coworker on the golf course without their permission resulted in a court awarding damages to the patients. Confidentiality, as a subset of information privacy, refers to the protection of information shared inside a trusting relationship from being shared outside of that relationship (Knight et al 2014). Only if the person (or institution) to whom confidential information was supplied fails to secure the information or knowingly exposes it to a third party without first party agreement does the right to confidentiality be violated. A breach of privacy, rather than confidentiality, occurs when an unauthorized person accesses patient records or other sensitive information stored in a computer system. No one other than the intended recipient in a confidential connection may be held liable for disclosure of the information.
Reference
Rennie, S., & Behets, F. (2006). Desperately seeking targets: the ethics of routine HIV testing in low-income countries. Bulletin of the World Health Organization, 84, 52-57.
Knight, R., Shoveller, J., Greyson, D., Kerr, T., Gilbert, M., & Shannon, K. (2014). Advancing population and public health ethics regarding HIV testing: a sc.
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Ethical Dilemma Paper
This document discusses the ethical dilemma around whether vaccinations should be mandatory nationwide. It presents perspectives from both sides of the issue. The main argument for mandatory vaccination is that it protects public health by preventing outbreaks through herd immunity. However, others argue it violates personal freedom and medical choice. The document analyzes this dilemma using frameworks like virtue ethics, decision making processes, and nursing codes of ethics. Ultimately it concludes that while neither option is ideal, promoting vaccination through education is preferable to mandatory policies to respect individual rights.
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Module05 ethical issues in vaccination
- 1. Ethical issues in vaccination JPFCM Ghaiath M. A. Hussein MBBS, MHSc. (Bioethics), PhD Researcher Email: ghaiathme@gmail.com JPFCM, Riyadh, KSA 12-16 November, 2017
- 2. Module’s objectives • Identify the ethical issue related to vaccination • Analyse the arguments that support and that reject making vaccination mandatory. • Outline an ethical framework to vaccination in the EMR context 2
- 3. Module’s Outline • Overview on vaccines, vaccination and immunization • Benefits and harms approach to vaccination • Duty to care for others (or not to harm other) • Compulsion and refusal of vaccination
- 4. Vaccine vs. Immunization • A vaccine is a product that produces immunity from a disease and can be administered through needle injections, by mouth, or by aerosol. • A vaccination is the injection of a killed or weakened organism that produces immunity in the body against that organism. • An immunization is the process by which a person or animal becomes protected from a disease. Vaccines cause immunization, and there are also some diseases that cause immunization after an individual recovers from the disease. (Source: http://www.vaccines.gov/basics/index.html)
- 6. Harms & Benefits Individual protection Herd immunity Reduced morbidity & mortality Side effects (local) Long term? Vulnerability Compulsion (lack of freedom?)
- 7. Duty of Care • Do we (as individuals) have duty to care for others not related to us? • Do we (as professionals) have duty to care for others, even if this would threat our own safety?
- 8. Compulsion and refusal of vaccination • Do we (as government) has the right to ‘force’ the people to be vaccinated? Hard Paternalism Soft Paternalism Forcing competent persons to act (or inact) in a certain way without their consent to achieve the public good the interference done on behalf of individuals who are not able to take their decisions properly, Examples?
- 9. References • Dawson, A. 2011, "Vaccination ethics", Public Health Ethics pp. 143-153. • Krantz, I., Sachs, L., & Nilstun, T. 2004, "Ethics and vaccination", Scandinavian Journal of Public Health, vol. 32, no. 3, pp. 172-178. • Omer, S. B., Salmon, D. A., Orenstein, W. A., deHart, M. P., & Halsey, N. 2009, "Vaccine refusal, mandatory immunization, and the risks of vaccine-preventable diseases", New England Journal of Medicine, vol. 360, no. 19, pp. 1981-1988. • Optional/additional readings: • Colgrove, J. 2006, "The ethics and politics of compulsory HPV vaccination", New England Journal of Medicine, vol. 355, no. 23, pp. 2389-2391. • Van Delden, J. J., Ashcroft, R., Dawson, A., Marckmann, G., Upshur, R., & Verweij, M. F. 2008, "The ethics of mandatory vaccination against influenza for health care workers", Vaccine, vol. 26, no. 44, pp. 5562-5566