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課程名稱 |
公共衛生倫理
Public Health Ethics |
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開課學期 |
111-1 |
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授課對象 |
公共衛生學院 健康政策與管理研究所 |
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授課教師 |
吳建昌 |
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課號 |
HPM7002 |
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課程識別碼 |
848 M0020 |
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班次 |
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學分 |
1.0 |
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全/半年 |
半年 |
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必/選修 |
必修 |
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上課時間 |
星期二8,9(15:30~17:20) |
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上課地點 |
公衛201 |
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備註 |
限碩士班以上
總人數上限：100人
外系人數限制：50人 |
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課程簡介影片 |
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核心能力關聯 |
核心能力與課程規劃關聯圖 |
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課程大綱
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課程概述 |
This course aims at introducing students to the field of public health ethics through learning by doing. The first part reviews the basic ethical tenets of public health practices and the brief history of public health. The second part, providing representative readings of public health ethics debates, intends to train the students to use the newly acquired knowledge to make comments on several important public health issues, which include autonomy and paternalism, justice and health, infectious disease, occupational and environmental regulation, genetics and public health.
The PDF file for each session will be uploaded to the course website on the Ceiba about 10 days before the meeting date. During the second part of the course, the questions that the teacher will ask the panel members on a specific session are included in the file for that session. The students are required to think about them and be prepared to interact with the teacher. |
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課程目標 |
At the end of this course students should be able to:
1. describe the nature and scope of public health;
2. compare major theories of public health ethics;
3. identify ethical issues in specific public health events;
4. prepare ethical analysis of public health policy and practice. |
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課程要求 |
This course meets once every two weeks in average, 2 hours per session. For each session students are required to read all assigned readings in advance. On the second part of the course, each student will be assigned to either one of the six panels. Preparing themselves by studying the assigned reading materials and case examples (if any), each panel shall engage in interactions with the teacher at the designated session for the purpose of enhancing learning for all the course participants.
The students shall ask absence according to university regulations if they could not attend a session. The teaching assistant might call the roll from time to time. Those students who actively and constructively participate in class discussion shall be rewarded with increased course grades.
On Dec 27, 2022, each student taking the course has to turn in their term paper in electronic format to Dr. Kevin Chien-Chang Wu’s e-mail address: ccwu88@ntu.edu.tw. The recommended structure of the term paper is as follows:
(1) Locate and describe a public health event in Taiwan or other countries;
(2) Recognize the situation or decision as one that raise ethical issue or dilemma;
(3) Break the ethical issue down to its component part;
(a) Assess the factual information available to the decision maker
(b) Identify the stakeholders in the decision
(c) Identify the values at stake
(d) Identify any relevant ethical, legal or professional guidance
(e) Identify options available
(f) Consider the process of making decision and the value of that process
(4) Conducting critical ethical analysis;
(5) Justify your decision with sound arguments
The term paper, in the electronic format of Microsoft Word or others, should be 1.5-line-spaced, in no. 12 Times New Roman fonts or 新細明體characters. The first page of the term paper should contain the title of the paper and the student’s name, school ID number, e-mail address, and the name of the program or department she or he belongs to. The main text shall not exceed 5,000 words. (Those who write too long and do not have good justifications shall be punished by deduction in their final scores!!) Reference or endnotes should be listed. Plagiarism shall be handled according to the relevant regulations of National Taiwan University. The student shall fail if s/he does not submit the term paper within 3 days after the deadline.
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預期每週課後學習時數 |
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Office Hours |
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指定閱讀 |
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參考書目 |
Recommended Textbook
Bayer R, Gostin LO, Jennings B, and Steinbock B eds., Public Health Ethics: Theory, Policy, and Practice. New York: Oxford University Press, 2007.
Anand S, Peter F, and Sen A eds., Public Health, Ethics, and Equity, Oxford: Oxford University Press, 2006. (An electronic book available at the National Taiwan University Library)
Coughlin, SS, Case Studies in Public Health Ethics, Washington D.C.: American Public Health Association, 2009. (An electronic book available at the National Taiwan University Library)
Beauchamp DE, Steinbock B. Introduction - ethical theory and public health. In: Beauchamp DE, Steinbock B (eds). New Ethics for the Public’s Health. New York: Oxford University Press, 1999.
吳建昌，公共衛生倫理理論與專業倫理準則（專書章節草稿）.
Recommended Websites
Association of Schools of Public Health, Ethics and Public Health Model Curriculum-- http://www.asph.org/document.cfm?page=782
Public Health Ethics-- http://phe.oxfordjournals.org/
American Public Health Association. Public health code of ethics 2019 [Available from: https://www.apha.org/-/media/Files/PDF/membergroups/Ethics/Code_of_Ethics.ashx on May 10, 2022. |
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評量方式
(僅供參考) |
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No. |
項目 |
百分比 |
說明 |
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1. |
Class attendance |
20% |
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2. |
Individual course participation |
20% |
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3. |
Term paper |
60% |
期末報告字數不得超過5,000字 |
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週次 |
日期 |
單元主題 |
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第1週 |
9/6 |
Welcome + Theories and Principles of Public Health Ethics I
Callahan D, Jennings B. Ethics and public health - forging a strong relationship. Am J Public Health 2002; 92:169-76.
Faden, R, Bernstein, J and Shebaya, S, "Public Health Ethics", The Stanford Encyclopedia of Philosophy (Fall 2020 Edition), Edward N. Zalta (ed.), forthcoming URL = .
Beauchamp DE, Steinbock B. Introduction - ethical theory and public health. In: Beauchamp DE, Steinbock B (eds). New Ethics for the Public’s Health. New York: Oxford University Press, 1999, 3-23. (Electronic book available at National Taiwan University Library)
Coughlin, SS. How many principles for public health ethics?. The open public health journal 2008; 1: 8-16. |
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第3週 |
9/20 |
Theories and Principles of Public Health Ethics II
Kass NE. An ethics framework for public health. Am J Public Health 2001; 91:1776-82.
Roberts MJ, Reich MR. Ethical analysis in public health. Lancet 2002; 359:1055-59.
Childress JF, Faden RR, et al.: Public health ethics: mapping the terrain. J Law Med Ethics 2002; 30:170-78.
Turoldo, F. Responsibility as an ethical framework for public health interventions. American Journal of Public Health 2009; 99(7): 1197-1202. |
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第5週 |
10/4 |
Theories and Principles of Public Health Ethics III
Rose G. Sick individuals and sick populations, International Journal of Epidemiology, 1985, 14(1): 32-38.
Marmot M. Social determinants of health inequalities, Lancet, 2005; 365: 1099-1105.
Ruger, JP. Ethics of the social determinants of health. The Lancet, 2004, 364(9439): 1092-1097.
Buchanan, DR. Autonomy, paternalism, and justice: ethical priorities in public health. American journal of public health 2008; 98(1): 15-21.
Fitzpatrick, SJ. Reshaping the ethics of suicide prevention: responsibility, inequality and action on the social determinants of suicide. Public Health Ethics 2018; 11(2): 179-190.
McGuire, AL., et al. Ethical challenges arising in the COVID-19 pandemic: An overview from the Association of Bioethics Program Directors (ABPD) task force. The American Journal of Bioethics 2020; 20(7): 15-27. |
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第7週 |
10/18 |
Autonomy and Paternalism (Panel 1)
Wikler D, Personal and social responsibility for health. In: Public Health Ethics and Equity, 109-134. (Electronic book, available at National Taiwan University Library Electronic Booklist)
Bayer R, Moreno JD. Health promotion: ethical and social dilemmas of government policy. (Health Affairs, 1986, 5(2): 72-85.
Menard, J-F. A ‘nudge’ for public health ethics: libertarian paternalism as a framework for ethical analysis of public health interventions?. Public Health Ethics, 2010, 3.3: 229-238.
Conly S, Coercive paternalism in health care: Against freedom of choice, Public Health Ethics, 2013, 6(3): 241-245.
Studdert, DM, and Hall, MA. "Disease control, civil liberties, and mass testing—calibrating restrictions during the COVID-19 pandemic." New England Journal of Medicine 2020; 338:102-104. |
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第9週 |
11/1 |
Infectious Disease (Panel 2)
Bayer R, Fairchild AL. Surveillance and privacy. Science, 2000, 290(5498): 1898-1899.
Gostin LO, Bayer R, Fairchild AL. Ethical and legal challenges posed by severe acute respiratory syndrome: implications for the control of severe infectious disease threats. JAMA 2003, 290(24): 3229-3237.
Elamin, AN, et al. Ethical issues concerning vaccination requirements. Public Health Reviews, 2012, 34.1: 14.
Mello, MM. Rationalizing vaccine injury compensation. Bioethics, 2008, 22.1: 32-42.
Gostin, LO, Eric A, and Wetter, SA. Responding to COVID‐19: How to Navigate a Public Health Emergency Legally and Ethically. Hastings Center Report 2020; 50(2): 8-12. |
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第11週 |
11/15 |
Environmental and Occupational Health (Panel 3)
Weed, D. Precaution, prevention and public health ethics, Journal of Medicine and Philosophy, 2004, 29(3): 313-332.
Cranor, CC. Regulating Toxic Substances: A Philosophy of Science and the Law, (New York: Oxford University Press, 1993, pp.44-48 [excerpts]). In Public Health Ethics: Theory, Policy, and Practice, 313-318.
Daniels, N. “Doth OSHA protect too much?” (in Daniels, Just Health Care [Cambridge, Cambridge University Press, 1985]), chapter 7 (excerpts), Public Health Ethics: Theory, Policy, and Practice, 327-348.
Resnik, DB, MacDougall, DR, and Smith, EM. Ethical dilemmas in protecting susceptible subpopulations from environmental health risks: Liberty, utility, fairness, and accountability for reasonableness. The American Journal of Bioethics, 2018, 18.3: 29-41.
Galbraith, N, et al. The mental health of doctors during the Covid-19 pandemic. BJPsych bulletin 2020: 1-4. doi:10.1192/bjb.2020.44
Cox, CL. ‘Healthcare Heroes’: problems with media focus on heroism from healthcare workers during the COVID-19 pandemic. Journal of medical ethics 2020; 46(8): 510-513. |
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第13週 |
11/29 |
Justice and Health (Panel 4)
Daniels N, Kennedy BP, Kawachi I. Why justice is good for our health: the social determinants of health inequalities. Daedalus, 1999, 128(4): 215-251.
Deaton A. Policy implications of the gradient of health and wealth. Health Affairs, 2002, 21(2): 13-30.
Marmot, M, et al. Closing the gap in a generation: health equity through action on the social determinants of health. The Lancet, 2008, 372.9650: 1661-1669.
Venkatapuram, S, and Marmot, M. Epidemiology and social justice in light of social determinants of health research. Bioethics, 2009, 23.2: 79-89.
White, DB., and Lo, B. "A framework for rationing ventilators and critical care beds during the COVID-19 pandemic." Jama 2020; 323(18): 1773-1774.
Gray, DM, et al. "COVID-19 and the other pandemic: populations made vulnerable by systemic inequity." Nature Reviews Gastroenterology & Hepatology 2020: 1-3. https://doi.org/10.1038/s41575-020-0330-8 |
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第15週 |
12/13 |
Public health Research ethics (Panel 5)
The Nuremberg Code (1949), accessed at:
https://history.nih.gov/research/downloads/nuremberg.pdf
The Belmont Report (1979) , accessed at : https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html
Council for International Organizations of Medical Sciences, International Ethical Guidelines for Biomedical Research Involving Human Subjects (2016), accessed at:
https://cioms.ch/wp-content/uploads/2017/01/WEB-CIOMS-EthicalGuidelines.pdf
The Declaration of Helsinki (2013), accessed at:
https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
WMA Declaration of Taipei on Ethical Considerations regarding Health Databases and Biobanks (2016), assessed at:
https://www.wma.net/policies-post/wma-declaration-of-taipei-on-ethical-considerations-regarding-health-databases-and-biobanks/
Mittelstadt, BD, Floridi, L. The ethics of big data: current and foreseeable issues in biomedical contexts. Science and Engineering Ethics, 2016, 22.2: 303-341.
臺灣最高行政法院106年判字第54號行政判決
Shah, SK, et al. Ethics of controlled human infection to study COVID-19. Science 2020; 368(6493): 832-834.
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第17週 |
12/27 |
SUBMISSION OF TERM PAPER (Before 23:59:59) |
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