257073 Principles, ethics and budgeting during a time of scarcity

Tuesday, October 30, 2012 : 12:30 PM - 12:50 PM

JP Leider, PhD , Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Jessica Young, MS , Office of Public Health Practice & Training, Johns Hopkins School of Public Health, Baltimore, MD
Beth Resnick, MPH , Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
Despite much theoretical work in how and what type of ethical principles ought to be utilized in public health practice, there is little empirical understanding of how and where ethical principles and concepts actually are utilized, explicitly or implicitly, in practice. This presentation seeks to address this gap in knowledge -- specifically in how ethics is used in budget and priority setting at state health agencies. This mixed-methods project took place in two stages. First, 45 semi-structured interviews were conducted with state public health leaders across six state health agencies. Stage 2 consisted of a survey of all 50 states and DC; we received 207 responses (67% response-rate). In both stages, executives and division/bureau heads served as respondents. Respondents reported three main types of guiding principles and values used in resource allocation decision-making: 1) Specific criteria or goals (e.g. promote prevention, maximize return on investment, protect the vulnerable); 2) Compliance-oriented (e.g., meet mandates, align with political directives, follow federal guidance); and 3) Virtues they wish to exemplify or inspire in others (e.g., honesty, transparency, inspiring leadership). Very few said they actually felt they were explicitly utilizing ethical principles; this may be in part due to a common identification of ‘Ethics' as Professionalism/Compliance Oriented (e.g., professional codes of ethics). This project identifies several opportunities for public health ethics to more directly engage with public health practitioners - namely around perception of what ethical principles are and mean for resource allocation, using a common language, and tool creation for practitioners.

Learning Areas:
Ethics, professional and legal requirements
Program planning
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines
Public health or related research

Learning Objectives:
After this presentation, participants will be able to describe the principles reported by practitioners used while setting budgets and priorities. Participants will also be able to discuss how these principles present in different and varying aspects of the priority setting process.

Keywords: Practice-Based Research, Ethics

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: As part of a team, I conceptualized, conducted and analyzed the research in question, am a doctoral student trained in quantitative and qualitative methods.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.