Call for Cases for a New Publication

Update: The case submission deadline has been extended to January 7, 2013.

Global Perspectives on Public Health Ethics: A Casebook

Summary

Although the practice of public health has always involved consideration of ethical issues, the field of public health ethics as a discipline is a relatively new and emerging area. Few practical training resources for public health practitioners are available, especially resources which consider ethical issues likely to arise in the practice of public health.

The purpose of this call is to assemble a broad range of cases that highlight global perspectives on the ethical challenges of public health and approaches specifically designed for addressing these challenges. The cases will be used to explore differences and similarities in various cultural approaches to the application of ethics to the practice of public health.

Cases should include a background section (up to 700 words) that provides context regarding the public health topic, a description of the case (up to 500 words), up to 5 questions (300 words) to stimulate discussion of the ethical aspects of the case, and references as needed to document sources for the information provided in the background section (not included in word count). Cases will be required to be submitted in English in a Word document using Times New Roman script and 12 point font. Only previously unpublished, original cases will be considered.

Once cases are assembled, the casebook editors will prepare introductory information on public health ethics as well as summary ethical analyses highlighting issues raised by the cases.

Although the target audience for the casebook will be public health practitioners, the casebook format will make it useful for educators who wish to use it in classes or workshops on public health ethics.

Anticipated Timeline

• Notification of intent to develop a case due by December 1, 2012 (not required)
• Cases due by January 7, 2013
• Case review and selection completed by April 1, 2013
• Revision of cases to address peer reviewers comments completed by June 1, 2013
• Development of introduction and case summary sections (to be written by invited authors) completed by September 1, 2013
• Agency clearance and publisher peer review completed by June 1, 2014
• Revisions and finalization of the casebook completed by September 1, 2014
• Anticipated casebook publication expected by December 1, 2014

Objectives for the Casebook

1. Increase awareness and understanding of public health ethics and the value of ethical analysis in public health practice. This includes, but is not limited to, ethical considerations for:
   1. public health policy development, implementation, and evaluation
   2. public health decision making in national and international field settings and training programs
   3. applied public health research
2. Highlight ethical issues and dilemmas that arise in the practice of public health, drawing attention to similarities and differences in cross-cultural perspectives on frequently encountered public health ethics concerns.
3. Create a tool to support instruction, debate, and dialogue regarding public health ethics that delineates approaches specifically designed to address ethical challenges encountered in public health practice.

Audience for the Casebook

The main audience for the casebook will be public health practitioners, including front-line workers, field epidemiology trainers and trainees, managers, planners, and decision makers who have an interest in learning about how to integrate ethical analysis into their day to day public health practice. The casebook will also be useful to schools of public health and public health students as well as to academic ethicists who can use the book to teach public health ethics and distinguish it from clinical and research ethics.

Casebook Editors

The editors for the casebook will be:

• Drue H. Barrett, PhD, Lead, Public Health Ethics Unit, Office of Science Integrity, Office of the Associate Director for Science, Centers for Disease Control and Prevention, Atlanta, GA
• Gail Bolan, MD, Director for the Division of Sexually Transmitted Disease Prevention (DSTDP) within the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB
• Angus Dawson, PhD, Professor of Public Health Ethics, Head of Medicine, Ethics, Society & History, University of Birmingham, UK
• Leonard Ortmann, Public Health Ethicists, Public Health Ethics Unit, Office of Science Integrity, Office of the Associate Director for Science, Centers for Disease Control and Prevention, Atlanta, GA
• Andreas Reis, MD, MSc, Department of Ethics, Equity, Trade and Human Rights, World Health Organization, Genève, Switzerland
• Carla Saenz, PhD, Bioethics Regional Advisor, Pan American Health Organization, Washington DC

The editors will seek input from individuals and organizations with expertise in public health ethics regarding the direction of the overall casebook project, recommendations regarding reviewers, and input on promotion and dissemination plans.

Structure for the Casebook

The book will be organized into chapters that address major public health topics. We expect to include chapters on the following topics, however cases that address other public health topics will be considered:

• Public Health Methods and Approaches (e.g., surveillance, epidemiology, outbreak management, monitoring of data trends, community engagement)
• Resource Allocation and Priority Setting (e.g., allocation of resources during a pandemic, program planning under government austerity measures, prioritization of prevention versus control measures)
• Public Health Research (e.g., informed consent, control arms for clinical trials, sharing research results, community benefit)
• Disease and Injury Prevention (e.g., infection control, vaccination policies, screening approaches, product safety, food regulation and inspection, disaster planning and response)
• Chronic Disease Prevention and Health Promotion (e.g., smoking bans, obesity prevention and control, seat belt laws, urban planning, food and agricultural policy)
• Environmental and Occupational Health (e.g., clean air and water policies, natural radiation, zoonotic diseases, climate change, workplace health screening, worker protections)
• International Collaboration for Global Public Health (e.g., global public goods, international assistance, global governance, global coordination, and information/data sharing between countries, working across jurisdictions)
• Protection of Vulnerable and Marginalized Groups (e.g., social determinants of health, health disparities, health equity, protection of particular vulnerable populations)

The goal is to include at least three cases for each topic area to illustrate different aspects or cultural perspectives of the topic. Additionally, for each topic area there will be a summary ethical analysis that will explore the ethical dimensions of the topic, highlighting the similarities and differences in how the topic is addressed by the different cultural perspectives reflected in the cases. Topics for which there are a sufficient number of submissions may be further subdivided into routine public health practice versus public health practice during emergency conditions. An introductory chapter will provide an overview of public health ethics, distinguish it from clinical and research ethics, and discuss some approaches to case analysis. The summary ethical analysis sections and the introductory materials will be developed either by the casebook editors or by invited authors with knowledge and experience in public health ethics.

Case submissions are encouraged on any topic related to the practice of public health, the development of public health policy, or applied public health research. Cases on cross cutting topics, such as conflicts of interest or professional ethical obligations, also are welcome. The addition of topic areas other than those listed above will be considered, if the number of cases submitted (ideally, at least 3 per topic) permits different cultural perspectives to be illustrated. The final number of cases will depend upon the outcome of the case solicitation process.

Format for Cases

Case submissions (up to 1500 words) should conform to the following template:

• Title (not included in word count) – The title should be no more than two lines and should clearly describe the topic of the case.
• Authors (not included in word count) – Information on authors should include first and last name, professional degrees, position title, and institutional affiliation.
• Corresponding Author (not included in the word count) – One author should be listed as the corresponding author. This should be the author who will remain engaged with the casebook editors until the casebook is finalized and published. Contact information for the corresponding author should include name, address, telephone number, email address, and fax number.
• Case Topic (not included in word count) – Indicate which public health topic the case addresses from the list of potential topics included above under “Structure for the Casebook.” If more than one topic applies, list all appropriate topics in order of priority. If none of the topics apply, indicate which topic would be most appropriate.
• Background (up to 700 words) - The background should include introductory information indicating the case setting, population, and/or intervention in question, together with an account of the relevant scientific evidence, legal/regulatory landscape, and other contextual information sufficient to orient a public health reader not expert in the case topic.
• Case Description (up to 500 words) - The case description should include a concise articulation of a public health situation that raises ethical tensions, challenges or concerns that require a decision or recommendation from public health officials or practitioners (see below for more information about case content).
• Case Questions (up to 300 words) – The case should include 3-5 questions to stimulate discussion about the case.
• References (not included in word count) – References should be used to document sources of factual information or scientific data. References should include full citations listed at the end of the document and references noted in the text by listing the author last name(s) and year of publication in parentheses. (See Springer Basic Reference Style for more information about reference style.) Given the nature of this casebook, extensive reference sections are not expected and the number of references should be no more than 20.
• Acknowledgements (not included in the word count) – All individuals who contributed to the case but who are not included as authors should be acknowledged at the end of the case document. Examples of those who might be acknowledged include a person who provided purely technical assistance or general support for the development of the case.

Click here for an example of the case format and reference style. Case authors are also encouraged to consult one or more of the resources noted at the end of this call for cases for ideas on how to develop a case submission.

Guidelines for the Development of Cases

Cases should be realistic and can be based on an actual event, a composite of several actual events, or a hypothetical event that characterizes a realistic public health ethics concern. If based on actual events, case details should be anonymized for identifying information that could be private, sensitive or disputable by others involved in the case. This can include, but is not limited to removing or anonymizing the names of individuals, communities, or institutions. Public documents pertinent to actual events should be included in the references.

Cases should be written in a narrative style following the headings in the structured template noted above, using plain language. Cases must be submitted electronically in a Word document in English using Times New Roman script and 12 point font. Only original cases that have not been previously published will be considered.

Submissions may be from individuals, teams, or organizations that represent a range of disciplines and/or sectors and may include decision-makers, researchers, frontline workers, community organizations, and/or citizens.

Submissions of cases are encouraged that reflect the following:

• Routine public health practices the raise ethical challenges, for example a reduction in budget that requires a decision about how to prioritize scarce resources or public health practices that raise questions about how to use information collected from surveillance activities to modify individual health behaviors linked to chronic diseases.
• Use of public health practices, methods and tools in emergency settings that raise ethics tensions, such as use of public health interventions for the control of infectious diseases when the interventions may limit individual liberty.
• Public health policies that raise ethical tensions or may have unintended consequences for specific sectors of the public, such as policies regarding limiting exposure to hazardous substances that result in expulsion of populations from specific neighborhoods.
• Public health programs that raise ethical questions about how to best collaborate with partners, including other government sectors, other countries, or the private sector, for example public health programs that rely upon private sector funding.
• Public health research that raises ethical concerns, such as examples of research where there may be questions about the appropriate intervention for subjects in the control arm or how to best engage the community in obtaining consent for the research.

Those interested in submitting a case are encouraged to send a letter of intent that briefly describes the nature of the case topic to PHEthics@cdc.gov by December 1, 2012; however this is not required.

In order to be considered for inclusion in the casebook, cases must be submitted to PHEthics@cdc.gov by January 1, 2013.

Case Selection Criteria

A peer review process will be used to make the selection of cases for inclusion in the casebook. It is anticipated that the peer review process will take approximately three months. The following criteria will be used:

1. Relevance to objectives and intended audience(s) of the casebook (20%)
2. Description of background and context for the case (30%)
3. Articulation of the case (i.e., the extent to which the case clearly describes a realistic ethical challenge, tension or dilemma relevant to the practice of public health, public health policy, or public health research) (30%)
4. Usefulness of the questions for stimulating discussion of the ethical issues raised by the case (20%)

Following peer review, cases will be accepted (with potential for minor modifications), provisionally accepted based on a satisfactory response to comments, or rejected. Authors of accepted cases are expected to remain engaged with the casebook editors until the casebook is finalized and published. Cases may be professionally edited.

Original case contributors will retain authorship of the case and will be appropriately cited in the casebook.

The intent is to submit the casebook to Springer Press for publication as an open access book. Links to the casebook will be included in the casebook agency sponsors’ websites.

For more information, please contact:

Drue Barrett, Ph.D.
Lead, Public Health Ethics Unit
Office of Scientific Integrity
Office of the Associate Director for Science
Centers for Disease Control and Prevention
404-639-4690
DBarrett@cdc.gov

Resources for Development of Cases:

Cash R, Wikler D, Saxena A, Capron, A (eds) (2009) Casebook on ethical issues in international health research. Geneva, Switzerland: World Health Organization. Available at http://www.who.int/rpc/publications/ethics_casebook/en/index.html

Jennings B, Kahn J, Mastroianni A, Parker, LS (eds) (2003) Ethics and public health: model curriculum. Washington DC: Association of Schools of Public Health. Available at http://www.asph.org/document.cfm?page=782

McDougall C (2010) Case studies of ethics during a pandemic. A publication of the National Collaborating Centre for Healthy Public Policy. Available at http://www.ncchpp.ca/docs/Ethics_CaseStudies_EN.pdf

Nuffield Council on Bioethics (2007) Public health: ethical issues. Available at http://www.nuffieldbioethics.org/public-health