Looking Ahead: Addressing Ethical Challenges in Public Health Practice

Ethical challenges in public health can have a significant impact on the health of communities if they impede efficiencies and best practices. Competing needs for resources and a plurality of values can challenge public health policymakers and practitioners to make fair and effective decisions for their communities. In this paper, the authors offer an analytic framework designed to assist policymakers and practitioners in managing the ethical tensions they face in daily practice. Their framework is built upon the following set of six considerations: determining population-level utility of the proposed action; demonstrating evidence of need and effectiveness of actions; establishing fairness of goals and proposed implementation strategies; ensuring accountability; and, assessing expected efficiencies and costs associated with the proposed action. Together, these considerations create a structured guide to assist decision-makers in identifying potential ethical challenges and in assessing the moral considerations that underlie public health practice - and possibly even, if the conditions are met, reduce the creation of ethical tension. Although the authors'empirical experiences provide the basis for the framework advanced here, their approach remains to be tested and evaluated by public health practitioners.     

Departmental audit committees and governance: Making management and accountability the priority from the top down

Abstract: One of the key policies arising from the Federal Accountability Act 2006 was the requirement for deputy heads to establish “department and agency audit committees.” These committees comprise retired public servants, academics and leaders from the private sector. This policy requires deputy heads to take advice from “outside” advisers for the management of their departments or agencies. This is unprecedented. The author examines the reform antecedents of this policy, key implementation considerations, and what this is likely to mean for management in the federal public service.     

The intellectual legacy of J.E. Hodgetts

Abstract: J.E. (Ted) Hodgetts was influenced by both the political economy approach that he learned at the University of Toronto and by the comprehensive historical method developed by Leonard White, under whom he studied at Chicago. His first great project, Pioneer Public Service, convinced him that responsible government was impossible without responsible public administration. The authors examine how his response to management theories and practices evolved following his participation in the Glassco, Lambert and Gomery commissions. Hodgetts consistently refused the complete separation of politics and administration, and he promoted the use of management techniques to strengthen parliamentary supervision of the public service. The two key components of his legacy are thus a commitment to the democratic values of representative government and the comprehensive study of the internal dynamics of public administration in interaction with the relevant environmental factors.     

Correlation of surnames and Y-chromosome in Central-Brazil

In patrilineal societies, surnames and Y-specific haplotypes and haplogroups are expected to be correlated. This characteristic could help defining an initial pool of suspects in forensic genetics analysis. Here we evaluated this correlation in a sample of Central-Brazilian men. Surnames and Y-SNP haplogroup and Y-STR haplotype were analyzed in 55 pairs of Central-Brazilian men sharing surnames (n = 110). Seven haplogroups and thirty-two haplotypes have been observed, none correlated solely to any of the twenty-eight surnames represented here. In this sample, two men with the same surname showed a chance of 0.41 of sharing a Y-specific haplogroup. This chance is higher for surnames of intermediate frequencies, whereas rare surnames show distinct chances as zero and one. Observed results may be over-estimated due to a predominance of a specific haplogroup (P92R7 = 49%) in the sample, what makes it possible for two men with no coancestry to share this haplogroup. Considering STR, only three pairs of men shared haplotypes. The average difference between the haplotypes in each pair was 2.45 mutational steps. This relatively low correlation is due to some historical and cultural peculiarities of the country, what makes it improper for forensic purposes in Brazil.