文章基本信息

标题：Expected Ethical Competencies of Public Health Professionals and Graduate Curricula in Accredited Schools of Public Health in North America
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作者：Lisa M. Lee ; Brandy Wright ; Salaam Semaan 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2013
卷号：103
期号：5
页码：938-942
DOI：10.2105/AJPH.2012.300680
语种：English
出版社：American Public Health Association
摘要：Objectives. We assessed expected ethics competencies of public health professionals in codes and competencies, reviewed ethics instruction at schools of public health, and recommended ways to bridge the gap between them. Methods. We reviewed the code of ethics and 3 sets of competencies, separating ethics-related competencies into 3 domains: professional, research, and public health. We reviewed ethics course requirements in 2010–2011 on the Internet sites of 46 graduate schools of public health and categorized courses as required, not required, or undetermined. Results. Half of schools (n = 23) required an ethics course for graduation (master’s or doctoral level), 21 did not, and 2 had no information. Sixteen of 23 required courses were 3-credit courses. Course content varied from 1 ethics topic to many topics addressing multiple ethics domains. Conclusions. Consistent ethics education and competency evaluation can be accomplished through a combination of a required course addressing the 3 domains, integration of ethics topics in other courses, and “booster” trainings. Enhancing ethics competence of public health professionals is important to address the ethical questions that arise in public health research, surveillance, practice, and policy. Public health as a profession has a long history of expecting ethical behavior by its providers, scientists, and decision-makers. With early influences from medicine and nursing, laboratory science, and epidemiology, to more contemporary disciplines (e.g., behavioral science and engineering), public health consists of diverse professions, 1 each of which contributes unique training, expectations of professional behavior, and discipline-specific codes of ethics. The common link that brings these disparate professionals together is the need for collective effort to improve health through a population focus. 2 Public health’s population focus presents unique ethics considerations that differ from those reflected in biomedicine and clinical care. Interactions between health care providers and patients emphasize the clinician’s obligation to the patient and the patient’s autonomy. Emphasis on the individual presents a challenge to public health professionals whose “patient” is the community or population. Since the early 2000s, at least a dozen public health ethics frameworks offered by scholars and practitioners have discussed the tensions that occur between autonomy and community responsibility. 3 Public health professionals, many of whom are trained in medicine and allied health, understand that ethical challenges arise in the population setting, in public health practice, and public health research. The purpose of this assessment was to assess the expected ethical competencies of public health professionals as reflected in published codes and competencies, review current ethics instruction at schools of public health (SPH), and recommend ways to bridge the gap between what is expected and what is currently taught in graduate level courses.