Public Health Ethics Training Materials
Proposed Book Title:
The Value of Stories:
Narrative Ethics in Public Health
Public health ethics addresses ethical challenges in public health practice by applying relevant ethical principles and norms. Some of these principles, like respect for individual rights, are common to research ethics, clinical ethics, and bioethics. Some are most relevant to public health, for example, the emphasis on the obligations that arise from the interdependence of people living in communities. This emphasis on interdependence directly follows from public health’s focus on the health of communities and entire populations.
As the field of public health ethics is both relatively new and distinctive, there are few training resources to help practitioners and health officials address ethical challenges likely to arise in public health practice. To address this gap, the Centers for Disease Control and Prevention (CDC) spearheaded the development of a public health ethics casebook, Public Health Ethics: Cases Spanning the Globe. This open access book, published in 2016 by Springer Press, features 40 cases from around the globe and describes a framework for analyzing ethical issues in public health.
To complement the casebook, the editors (Drue Barrett, Leonard Ortmann, and Stephanie Larson) are proposing a collected volume that employs narrative to explore public health ethics. In clinical medicine, authors such as Anne Hudson Jones, Rita Charon, Martha Montello, and Arthur Frank have successfully adopted narrative ethics as an approach. A narrative tells or retells in various forms (written, oral, video, etc.) an original story, which consists of a series of events. In recounting events, narrative edits out, colors, or highlights the events from a particular perspective for particular purposes. A narrative, then, deliberately attempts to shape or revise the story of what actually happened. Narrative also inevitably raises or implies questions about how one should (or should not) think, act, or live, usually in relation to others. Moreover, everyone is familiar, whether through Aesop’s fables or nursery tales, with the notion of the “moral of the story,” the story’s moral lesson. Because a moral dimension is integral to stories, narrative ethics readily combines the domains of storytelling and moral values. Narratives, then, whether drawn from fiction or everyday experiences, help us open up a reflective space to think through ethical questions. As applied to public health, narrative ethics explores stories based in public health practice and research that raise ethical concerns. A selected list of additional resources on narrative ethics is provided at the end of this call for papers.
As our proposed title, “The Value of Stories,” suggests, we are looking for contributions that, among other things, illustrate how stories can illuminate ethical concerns that arise in public health, complement the evidence that epidemiology or surveillance provides, or show how more conventional approaches sometimes fall short of what practitioners need to know in order to develop effective and ethical public health interventions.
The editors will prepare initial chapter(s) describing the field of narrative ethics, the field of public health ethics, including ethical principles relevant to public health practice and research, and how narrative ethics can be used to explore ethical issues in public health practice and research. The remaining chapters will consist of the submitted papers.
The editors will explore potential publishers who have a history of publishing books on the topics of narrative ethics, public health ethics, and public health.
The primary audience for the book are instructors in schools of public health and other academic settings, public health students, and ethicists interested in the fields of public health and narrative ethics. The book may also be of interest to other 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 editors for the book will be:
- Drue H. Barrett, PhD, Lead, Public Health Ethics and Strategy Unit, Office of Scientific Integrity, Office of Science, Centers for Disease Control and Prevention, Atlanta, GA
- Leonard Ortmann, Public Health Ethicist, Public Health Ethics and Strategy Unit, Office of Scientific Integrity, Office of Science, Centers for Disease Control and Prevention, Atlanta, GA
- Stephanie Larson, MA, Doctoral Candidate, English and Bioethics, Emory University, Atlanta, GA
Call for Papers
The purpose of this call is to solicit papers that use some form of narrative (a personal narrative, an autobiography, a poem, a short story, a novel, or other literary work) to illustrate ethical considerations or issues relevant to a specific issue/topic in the practice of public health. Papers could be oriented around a particular disease or public health intervention (e.g., immunizations, directly observed therapy, emergency response), a public health function (e.g., surveillance, assessment, policy development, assurance), or a particular public health method, approach, or service (e.g., research, evaluation, health investigations, education).
The format of the paper should include at least 2 sections: 1) a description of some form of narrative that illustrates an ethical issue in public health practice or research and 2) an analysis or discussion that illustrates the values or the moral lessons of the narrative. The narratives or stories might illustrate positive or negative aspects of public health practice or research. The form of narrative could include, but is not limited to, fiction (e.g., novels) or non-fiction (e.g., memoirs), plays, film, art, television, or graphic novels. If previously published narrative materials are included, authors must document in writing that they have obtained permission from the copyright holder to use the material, prior to final acceptance of the paper.
If you are interested in submitting a paper for inclusion in the book, please submit a short summary (maximum length of 1000 words or 2 single spaced typed pages) that describes the public health ethics topic and how the narrative illustrates an ethical consideration relevant to public health practice and research. Please also include a potential title and list of potential authors (not included in the word length). Submit your short summary by January 18, 2019 to Phethics@cdc.gov.
The editors will review the summaries to ensure that the paper fits the theme of using narrative to explore ethical considerations and to assist with determining the approach for organizing the book contents. For summaries deemed inconsistent with this theme, the editors will work with potential authors to determine if the proposed paper concept can be revised to ensure a better fit with the overall book theme. It is expected that final papers will be approximately 25 double spaced pages (Times New Roman script and 12-point font). Only previously unpublished, original papers will be considered; however, this does not preclude use of previously published examples of narrative if appropriate permission is obtained.
- January 18, 2019 – Submission of the proposed paper summary due.
- March 22, 2019 – Authors notified whether topic is a good fit for the book or whether modification is required.
- September 20, 2019 – Papers due. (If required, internal clearance by the author’s agency should be completed prior to submitting the paper by this due date.)
- January 15, 2020 – Editors will complete review of the papers.
- March 15, 2020 – Authors submit completed revision of the papers, having addressed editor comments.
- May 15, 2020 – Editors will obtain clearance of the book through the CDC Office of Science prior to submitting it to the publisher.
Selected Resources for Additional Information on Narrative Ethics
- This book can be accessed at https://link.springer.com/book/10.1007%2F978-3-319-23847-0.
- See https://www.units.miamioh.edu/technologyandhumanities/nardef.htm for a definition of narrative.
- See The Living Handbook of Narratology (Phelan, 2013)
- Information on ethical principles relevant to public health practice and research can be found at https://www.apha.org/-/media/files/pdf/membergroups/ethics/ethics_brochure.ashx?la=en&hash=1E9425A9C96347E42AC0D6B0D2000AA6A8717C3C
For more information, please contact:
As part of CDC’s ongoing efforts to support state and local health departments, the Public Health Ethics Unit has developed a training manual to be used as a tool to strengthen public health ethics capacity at the local level. The manual includes an introduction to public health ethics, relevant case studies, suggestions for integrating ethics into health departments, and additional resources. The Student version of the manual may be downloaded here; the Facilitator version is available upon request.
GOOD DECISION MAKING IN REAL TIME: PUBLIC HEALTH ETHICS FOR LOCAL HEALTH OFFICIALS (WD4004)
The Centers for Disease Control and Prevention (CDC) and the National Association of County and City Health Officials (NACCHO) announce the availability of a Web-on-Demand e-Learning module, Good Decision Making in Real Time: Practical Public Health Ethics for Local Health Officials.
This Web-on-demand course provides training on the basics of public health ethics and the process of ethical analysis and describes tools and resources for addressing ethical challenges that commonly arise in the practice of public health. The course also explores the complementary nature of public health law and public health ethics, reviews approaches to implementing public health ethics in health departments, and presents a case study to illustrate the steps of applying an ethical analysis to a real-life case scenario.
At the conclusion of the session, the participant will be able to:
- List 3 ways to define the field of public health ethics.
- Describe 2 ways public health ethics and law can work together to address ethical challenges.
- Describe 3 resources for helping public health officials make ethically informed choices.
- List 2 specific ways to integrate ethical considerations into public health decision-making.
- Explore multiple solutions by organizing, prioritizing, and defending each possible solution.
Drue Barrett, PhD; Lead, Public Health Ethics Unit; Office of Scientific Integrity, Office of the Associate Director for Science, Centers for Disease Control and Prevention
Ruth Gaare Bernheim, JD, MPH; Chair, Department of Public Health Sciences, School of Medicine; Co-Director, The Institute for Practical Ethics and Public Life; Professor of Public Health Sciences, Medicine, and Family Medicine; University of Virginia School of Medicine
Alan Melnick, MD, MPH, CPH; Director and Health Officer; Clark County Public Health, Washington
Leonard Ortmann, PhD; Senior Ethics Consultant; Public Health Ethics Unit, Office of Scientific Integrity, Office of the Associate Director for Science, Centers for Disease Control and Prevention
Matthew Penn, JD, MLIS; Director, Public Health Law Program; Office for State, Tribal, Local, and Territorial Support, Centers for Disease Control and Prevention
ORIGINATION DATE: February 10, 2018
EXPIRATION DATE: February 10, 2020
HARDWARE/SOFTWARE: Computer Hardware; Internet connection; Browser; Speakers or headset
TARGET AUDIENCE: Administrators, Advanced Practice Nurses, Certified Health Education, Dentists, Dos, Epidemiologists, Industrial Hygienists, Laboratorians, Licensed Practical/Vocational Nurses, Physicians, Medical Assistants, Health Educators, Pharmacists, Program Managers, Registered Nurses, Veterinarians
PREREQUISITES: Although not a requirement, it would be helpful for the target audience to have a basic introductory level of understanding of the field of public health and the types of activities that local public health departments engage in.
FORMAT: These seminars are recorded webcasts.
CONTACT INFORMATION: Drue Barrett, Public Health Ethics Unit, Office of the Associate Director for Science, (404) 639-4690; email@example.com
CME activities with Joint Providers: This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint providership of the Centers for Disease Control and Prevention and the National Association of County and City Health Officials. The Centers for Disease Control and Prevention is accredited by the (ACCME®) to provide medical education for physicians. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
The Centers for Disease Control and Prevention designates this enduring activity for a maximum of 2.0 AMA PRA Category 1 Credits™.
CNE: The Centers for Disease Control and Prevention is accredited as a provider of Continuing Nursing Education by the American Nurses Credentialing Center’s Commission on Accreditation.
This activity provides 1.9 contact hours.
CEU: The Centers for Disease Control and Prevention is authorized by IACET to offer 0.2 CEU’s for this program.
CECH: Sponsored by the Centers for Disease Control and Prevention, a designated provider of continuing education contact hours (CECH) in health education by the National Commission for Health Education Credentialing, Inc. This program is designed for Certified Health Education Specialists (CHES) and/or Master Certified Health Education Specialists (MCHES) to receive up to 2.0 total Category I continuing education contact hours. Maximum advanced level continuing education contact hours available are 0. CDC provider number 98614.
AAVSB/RACE: This program was reviewed and approved by AAVSB RACE program. 2.0 for hours of continuing education. Participants should be aware that some boards have limitations on the number of hours accepted in certain categories and/or restrictions on certain methods of delivery of continuing education. Please contact the AAVSB RACE program if you have any comments/concerns regarding this program’s validity or relevancy to the veterinary profession.
CPE: The Centers for Disease Control and Prevention is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
This program is a designated event for pharmacists to receive 0.19 CEUs in pharmacy education. The Universal Activity Number is 0387-9999-18-093-H04-P.
Category: This activity has been designated as Knowledge-Based.
Once credit is claimed, an unofficial statement of credit is immediately available on TCEOnline. Official credit will be uploaded within 60 days on the NABP/CPE Monitor.
Top of Page
For Certified Public Health Professionals (CPH)
The Centers for Disease Control and Prevention is a pre-approved provider of Certified in Public Health (CPH) recertification credits and is authorized to offer 2.0 CPH recertification credits for this program.
CDC is an approved provider of CPH Recertification Credits by the National Board of Public Health Examiners. Effective October 1, 2013, the National Board of Public Health Examiners (NBPHE) accepts continuing education units (CEU) for CPH recertification credits from CDC. Please select CEU as your choice for continuing education when registering for a course on TCEOnline. Learners seeking CPH should use the guidelines provided by the NBPHE for calculating recertification credits. For assistance please contact NBPHE at Certified in Public Health.
DISCLOSURE: In compliance with continuing education requirements, all presenters must disclose any financial or other associations with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters as well as any use of unlabeled product(s) or product(s) under investigational use.
CDC, our planners, content experts, and their spouses/partners wish to disclose they have no financial interests or other relationships with the manufacturers of commercial products, suppliers of commercial services, or commercial supporters. Planners have reviewed content to ensure there is no bias.
Content will not include any discussion of the unlabeled use of a product or a product under investigational use.
The Centers for Disease Control and Prevention and the National Association of County and City Health Officials are jointly providing the CNE for this activity.
CDC did not accept commercial support for this activity.
To receive continuing education (CE):
FEES: No fees are charged for CDC’s CE activities.
Below are additional public health ethics cases that can be used in conjunction with the training manual – Good Decision Making in Real Time: Public Health Ethics Training for Local Health Departments:
- Emergency Preparedness: Impact of Regulatory Compliance and Resource Allocation Decisions on Laboratory Capacity
- Ensuring Biosafety/Biosecurity during a Public Health Emergency
- Short-course Zidovudine Compared to What? A Trial to Prevent Mother-to-Infant HIV Transmission
- Unsafe Injections: Duty to Warn?
- Use of Restraint and Physical Force by First Responders: Duty to Investigate and Educate?
- Ethical Considerations for Allocating Medical Countermeasures in an Anthrax Incident
- Policies for Restricting Use of Electronic Nicotine Delivery Systems (ENDS) in Indoor Public Spaces
Public Health Ethics: Cases Spanning the Globe (2016). DH Barrett, LW Ortmann, A Dawson, C Saenz, A Reis, G Bolan (Eds.). Springer Open.
This open access book includes 40 cases that highlight a broad range of ethical issues and dilemmas that arise in the practice of public health. The casebook begins with an introduction to the basic concepts of public health ethics and describes important events that shaped the practice of public health. The cases are organized into chapters that discuss the following topics:
- Resource allocation and priority setting
- Disease prevention and control
- Chronic disease prevention and health promotion
- Environmental and occupational public health
- Vulnerability and marginalized populations
- International collaboration for global public health
- Public health research
You can access this book free of charge at Public Health Ethics: Cases Spanning the Globe.
- Page last reviewed: October 11, 2017
- Page last updated: August 10, 2016
- Content source:
- Office of the Associate Director for Science