As management strategies for groups as well as individuals become an increasingly important part of medical practice, medical education will need to include a greater understanding of ethical principles and practices as well as an increased understanding of public health. Ethics in medical curricula has traditionally focused on physician obligation to individual patients. Incorporating public health principles into medical curricula provides a setting for demonstrating the inter-relationship of ethical practices for both individuals and populations. When viewed in this context, students will become increasingly aware of potential conflicts. In the example of infectious diseases, past ethical concerns have centered around conflicts between mandatory disease reporting to public health agencies and the need for patient confidentiality. New issues in emerging infectious disease may result in conflicts in a physician’s obligation between beneficence and autonomy for the individual and nonmaleficence and justice for the population. The decision whether or not to prescribe medication for an individual patient may contribute to the emergence of antibiotic resistant organisms that may adversely affect entire populations. Other examples include efforts to reduce tobacco use or detect early disease. Increased knowledge about genetic variation in and risk for individuals has the potential to create conflicts between autonomy and beneficence in screening and prevention programs for individuals and populations. Care must be taken to incorporate this information into broad public health messages. We propose using the triangular relationship between ethics, individual patient care, and public health as a model for teaching about many common health care problems.
Learning Objectives: Describe how ethical issues relate to individual and population health issues. Cite two examples
Keywords: Medicine, Ethics
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
The 128th Annual Meeting of APHA