Readings & Case Review 3
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Ethical Implications of PH Research Methods
READINGS & CASE REVIEW #3
“Ethical Dilemmas in Population-Level Treatment of Lead Poisoning in Zamfara state, Nigeria”
Wurr, C., & Cooney, L. (2014). Ethical dilemmas in population-level treatment of lead poisoning in
Zamfara State, Nigeria.
Public Health Ethics
, 7(3), 298-300.
A.
Read through the case:
“Ethical Dilemmas in Population-Level Treatment of Lead
Poisoning in Zamfara state, Nigeria”
B.
Watch the video clip (~3 min.):
CNN (Nov. 30, 2010): Gold rush triggers deadly lead
poisoning
C.
Read the following three different perspectives on this case study
:
PERSPECTIVE #1:
Segelid, M. J. (2014).
Ethical and Empirical Issues Concerning
Conditional Treatment of Lead Poisoning from Gold Mining in Nigeria
P
ERSPECTIVE #2:
Reid, A. (2014).
Commentary on Zamfara Lead Poisoning
Humanitarian Efforts
PERSPECTIVE #3:
Pringle, J. D. (2014).
The Unprecedented Lead-Poisoning
Outbreak: Ethical
Issues in a Troubling Broader Context
SPECIFIC CASE AND ANALYSIS
ANALYZE THE SITUATION USING ELEMENTS OF THE ETHICAL ANALYSIS
FRAMEWORK: STEP 1:
1.
This case took place in Zamfara State, Nigeria in 2010. Summarize the main problems
happening in the villages. What main industry was blamed for these problems? Why?
2.
The case study article highlights
two
major ethical challenges
in this situation Zamfara State.
What are the two key ethical issues in this case?
(If needed, refer to the headings and sections in the second column on page 2 of the case
study.)
A.
Key ethical issue #1:
Summarize in your own words the ethical dilemma(s). What are the potential harms of
concern with this ethical issue?
Dr. Laura Phipps
UTA, KINE 4351
B.
Key ethical issue #2:
Summarize in your own words the ethical dilemma(s). What are the potential harms of
concern with this ethical issue?
3.
Who are the stakeholders involved? Describe 3-5 stakeholders, their priorities and their
concerns
.
Stakeholders
Priorities
Concerns
4.
What are relevant social and political factors surrounding the affected Nigerian villages that
could influence the context of this case?
Dr. Laura Phipps
UTA, KINE 4351
EVALUATE THE ETHICAL DILEMMA IN NIGERIA IN LIGHT OF THE READINGS:
5.
According to the web article by Resnik and Portier (2015), “Relationships between human
health and the environment raise many ethical, social, and legal dilemmas by forcing people to
choose among competing values.”
A.
Choose an ethically challenging situation that is described in the sections “Framing the
Issue” or “The Science: Environmental Health and Hazards,” or, alternatively, choose a
different ethical dilemma tied to an environmental health issue. What is/are the main
overarching ethical challenge(s) associated with this situation?
B.
Assess this ethically challenging situation in light of the three categories of considerations
highlighted in Resnik’s and Portier’s article. How would you frame the ethical tensions
according to at least
two
of these three categories?
a.
Managing benefits and risks:
b.
Social justice:
c.
Human rights:
6.
Perspective #1
:
Summarize Dr. Selgelid’s arguments regarding the effect that resource availability should have on
MSF’s treatment of the Nigerian children. How much impact do you think resource availability
should have on how much lead poisoning treatment is given to a child? Why? When deciding
resource allocation in this situation, what factors should be considered?
7.
Perspective #2
:
“[T]his creates a conflict about how MSF should respond” (p. 312).
Dr. Reid makes this statement as he highlights the ethical dilemma surrounding the intervention
of a humanitarian organization in the lead-poisoning outbreak.
Explain
in your own words and
evaluate (give your perspective)
on three overarching arguments
Dr. Reid makes in this article regarding the ethical dilemma that could be created when a
humanitarian organization gets involved with treating the children in the lead-poisoning outbreak.
A.
B.
Dr. Laura Phipps
UTA, KINE 4351
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C.
8.
Perspective #3
:
What do you consider to be the most compelling argument Dr. Pringle makes concerning the
ethics of lead treatment for the children when unsafe mining practices continue in the
community? Why do you think this argument is significant?
B.
Dr. Pringle raises the “critical question” of “how so many children came to die from lead
poisoning and how it was left to a humanitarian organization to mount the emergency
response” instead of the government or mining industry. Summarize your viewpoint on this
critical question, based on his arguments.
CONSIDER THE ETHICAL ISSUES CONCERNING CONDITIONAL TREATMENT OF
LEAD POISONING ACCORDING TO THE ETHICAL ANALYSIS FRAMEWORK, STEP 2:
9.
Suppose you were asked to consult with MSF regarding their work in Zamfara State.
Use at least two
article references
to explain why you would you recommend that the MSF
continue
or
not continue
treating the children in Nigeria for lead poisoning. If so, under what
conditions should the treatment take place?
10.
Evaluate your recommendation to MSF according to the four ethical dimensions described in
the Ethical Analysis Framework, Step 2 (listed below).
Recognize that the situation in Nigeria involves a complex ethical dilemma and your
recommendation will likely include both
strengths
and
weaknesses
concerning these four
ethical dimensions. For example, you should be able to evaluate and report if your
recommendation
does
or
does not
demonstrate distributive justice, or if there are special
conditions under which distributive justice could be demonstrated.
When providing an ethical recommendation to a stakeholder, it is important to be
thoughtful and clear about how your recommendation could both
fit the ethical
dimensions
and
fall short
of the ethical dimensions
. MSF workers should be aware of
where they have strong moral ground and where they might need to be prepared to
mitigate potential adverse consequences for certain populations.
Dr. Laura Phipps
UTA, KINE 4351
A.
Utility
:
Does a particular PH action produce a balance of benefits over harms?
B.
Justice
:
Are the benefits and burdens distributed fairly (distributive justice)? Are
members of affected groups able to participate in making decisions (procedural
justice)?
C.
Respect for individual interests and social value
:
Does the PH action respect individual
choices and interests (autonomy, liberty, privacy)?
D.
Respect for professional institutions
:
Does the PH action respect professional roles and
values, such as transparency, honesty, trustworthiness, consensus-building, promise-
keeping, protection of confidentiality, and protection of vulnerable individuals and
communities from undue stigmatization?
Dr. Laura Phipps
UTA, KINE 4351