Resource Pack Global Health Ethics 2018 Overview This resource pack was curated by the Global Health Education and Learning Incubator at Harvard University to highlight select key resources on the topic of ethics as it relates to global issues of health. Resources in this pack address topics such as the common ethics standards used in clinical and health research and research administration (including public health), bioethics in global health policy decision making, ethical fieldwork and communications in public health across different cultures, sexual and reproductive health ethics, health care justice, and the role of anthropology and religion in shaping questions of ethical principles and practice. The selected multidisciplinary materials may be suitable for students at the undergraduate college and public health graduate school levels. The pack includes basic reads in foundational resources such as international codes, as well as books and chapters, articles and reports, web portals, multimedia, and related teaching materials, including case studies. Learning objectives and supporting materials for use in pedagogy will vary depending on course goals and audience. This resource pack includes: • Basic Reads: Ethical Codes and Research Administration Standards • Reports and Books • Articles, Chapters, and Briefs • Web Portals and Organizations • Multimedia and News • Teaching Materials and Case Studies

This resource pack was developed by Susan R. Holman, MTS, PhD, for the Global Health Education and Learning Incubator at Harvard University in 2018. The Incubator’s educational materials are not intended to serve as endorsements or sources of primary data, and do not necessarily reflect the views of Harvard University. Visit http://repository.gheli.harvard.edu/repository for additional teaching tools and updates. Last updated: 8/10/18.

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Selected Resources – At a Glance

BASIC READS: ETHICAL CODES AND RESEARCH ADMINISTRATION STANDARDS Resource Portal. Federal Policy for the Protection of Human Subjects (Common Rule). U.S. Department of Health & Human Services 1991. https://www.hhs.gov/ohrp/regulations-and- policy/regulations/common-rule/index.html. Resource Portal. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Department of Health, Education, and Welfare, National Commission for the

Protection of Human Subjects of Biomedical and Behavioral Research 1979. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html. Report. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. World Medical Association 1964. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical- principles-for-medical-research-involving-human-subjects. Report. Nuremberg Code. Citation 1947. http://www.unesco.org/new/en/social-and-human- sciences/themes/bioethics/international-bioethics-committee/reports-and-advices. REPORTS AND BOOKS Report. International Bioethics Committee. Report of the IBC on Big Data and Health. United Nations * Educational, Scientific and Cultural Organization 2017. http://www.unesco.org/new/en/social-and-human- sciences/themes/bioethics/international-bioethics-committee/reports-and-advices. Report. WHO Guidelines on Ethical Issues in Public Health Surveillance. World Health Organization 2017.

http://www.who.int/ethics/publications/public-health-surveillance/en. Book. International Ethical Guidelines for Health-Related Research Involving Humans. Council for International Organizations of Medical Sciences, World Health Organization 2016.

https://cioms.ch/shop/product/international-ethical-guidelines-for-health-related-research-involving- humans. Report. Van Bavel B et al. Student Guidelines for Ethical Fieldwork Overseas. Development Studies Association Ireland, Irish Forum for Global Health 2016. https://globalhealth.ie/resources/student-ethical- guidelines. Book. Galarneau C. Communities of Health Care Justice. Rutgers University Press 2016.

https://www.rutgersuniversitypress.org/communities-of-health-care-justice/9780813577661. Report. Global Health Ethics: Key Issues. Global Network of WHO Collaborating Centres for Bioethics,

World Health Organization 2015. http://www.who.int/ethics/publications/global-health-ethics/en. Book. Selgelid M, Rappert B, eds. On the Dual Uses of Science and Ethics: Principles, Practices, and Prospects. Australian National University Press 2013. https://press.anu.edu.au/publications/series/centre- applied-philosophy-and-public-ethics-cappe/dual-uses-science-and-ethics. Book. Davis A et al. Study Guide for Institutional Review Board: Management and Function. Jones &

Bartlett Publishers 2006. http://www.jblearning.com/catalog/0763738662. Book. Bankert E, Amdur R. Institutional Review Board: Management and Function: Second Edition. Jones

& Bartlett Publishers 2005. http://www.jblearning.com/catalog/9780763730499. ARTICLES, CHAPTERS, AND BRIEFS Article. Haddad S et al., eds. Ethics and Global Health. BMC Medical Ethics 2018; 19(Supplement 1).

https://bmcmedethics.biomedcentral.com/articles/supplements/volume-19-supplement-1. Article. Reynolds L, Sariola S. The Ethics and Politics of Community Engagement in Global Health

Research. Critical Public Health 2018; 28(3): 257-268. DOI: https://doi.org/10.1080/09581596.2018.1449598. Article. Hummel P et al. Rapid Qualitative Review of Ethical Issues Surrounding Healthcare for Pregnant Women or Women of Reproductive Age in Epidemic Outbreaks. Epidemiology and Health 2018; 40: e2018003. DOI: http://doi.org/10.4178/epih.e2018003.

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Global Health Ethics: Resource Pack

Article. Fourie C. The Trouble With Inequalities in Global Health Partnerships: An Ethical Assessment. Medicine Anthropology Theory 2018; 5(2): 142-155. http://www.medanthrotheory.org/read/10589/the- trouble-with-inequalities-in-global-health-partnerships. Article. Chapman AR. Evaluating the Health-Related Targets in the Sustainable Development Goals From a Human Rights Perspective. The International Journal of Human Rights 2017; 21(8): 1098-1113. https://doi.org/10.1080/13642987.2017.1348704. Article. Hurlimann T et al. Ethical Issues in the Development and Implementation of Nutrition-Related Public Health Policies and Interventions: A Scoping Review. PLoS One 2017; 13(2). DOI: https://doi.org/10.1371/journal.pone.0186897. Article. Allum N et al. Religion and the Public Ethics of Stem-Cell Research: Attitudes in Europe, Canada,

and the United States. PLoS One 2017; Apr 20. DOI: https://doi.org/10.1371/journal.pone.0176274. Article. Rozier M. Religion and Public Health: Moral Tradition as Both Problem and Solution. Journal of

Religion and Health 2017; 56: 1052-1063. DOI: https://doi.org/10.1007/s10943-017-0357-5. Article. Levin J. Partnerships Between the Faith-Based and Medical Sectors: Implications for Preventive Medicine and Public Health. Preventive Medicine Reports 2016; 4:344- 350.https://www.sciencedirect.com/science/article/pii/S2211335516300845. Article. Kotalik J, Martin G. Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers. American Journal of Bioethics 2016; 16(5): 38-43. https://www.tandfonline.com/doi/full/10.1080/15265161.2016.1159749. Article. Sallans RK. Lessons from a Transgender Patient for Health Care Professionals. AMA Journal of

Ethics 2016; 18(11): 1139-1146. http://journalofethics.ama-assn.org/2016/11/mnar1-1611.html. Chapter. Velji A, Bryant JH. Global Health Ethics. Chapter 21 in Markle W. et al. Understanding Global Health, Second Edition. McGraw-Hill Education 2014. Pages 463-486. https://accessmedicine.mhmedical.com/content.aspx?bookid=710§ionid=46796922#57940501. Article. Washington DA. Critical Race Feminist Bioethics: Telling Stories in Law School and Medical School in Pursuit of “Cultural Competency.” Albany Law Review 2010(72): 961-998. http://commons.law.famu.edu/faculty-research/117. Chapter. Kleinman A. Writing at the Margin: Discourse Between Anthropology and Medicine. Chapter 3: Anthropology of Bioethics. University of California Press 1995. Pages 41-67. http://oxfordindex.oup.com/view/10.1525/california/9780520209657.003.0003. Brief. Emanuel E et al. Research Ethics: How to Treat People who Participate in Research. Clinical Center Department of Bioethics, National Institutes of Health n.d. https://www.bioethics.nih.gov/education/pdf/FNIH_BioethicsBrochure_WEB.PDF. WEB PORTALS AND ORGANIZATIONS Web Portal. Global Health Fieldwork Ethics: Values, Realities, and the Right to Health. Health and Human Rights Journal 2019; 21. https://www.hhrjournal.org/submissions/call-for-submissions-upcoming- issues/#fieldwork. Web Portal. Global Health Ethics. World Health Organization 2018. http://www.who.int/ethics. Resource Portal. Integrating Ethics in Infectious Disease Outbreaks. World Health Organization.

https://extranet.who.int/ethics. Resource Portal. Bioethics Information and Resources. National Institutes of Health Fogarty International

Center 2018. https://www.fic.nih.gov/ResearchTopics/Pages/Bioethics.aspx. Web Portal. National Institutes of Health Department of Bioethics 2018.

https://www.bioethics.nih.gov/home/index.shtml. Resource Portal. National Institutes of Health Clinical Center: Patient Recruitment Ethics in Clinical

Research 2018. https://clinicalcenter.nih.gov/recruit/ethics.html. Web Portal. Presidential Commission for the Study of Bioethical Issues. 2017.

https://bioethicsarchive.georgetown.edu/pcsbi/node/851.html. Resource Portal. Health Care in Danger (HCID) Initiative. International Red Cross and Red Crescent

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Movement 2014. http://healthcareindanger.org/hcid-project. Organization. Council for International Organizations of Medical Sciences. https://cioms.ch. Organization. UNESCO International Bioethics Committee (IBC). http://www.unesco.org/new/en/social-

and-human-sciences/themes/bioethics/international-bioethics-committee. Organization. Harvard University Edmond J. Safra Center for Ethics. https://ethics.harvard.edu. Organization. Tuskegee University National Center for Bioethics in Research and Health Care.

http://tuskegeebioethics.org. Organization. Global Network of WHO Collaborating Centres for Bioethics.

http://www.who.int/ethics/partnerships/global_network/en. Organization. International Association of Bioethics. www.bioethics-international.org. MULTIMEDIA AND NEWS Video. Harvard University Initiative on Health, Religion, and Spirituality: Videos. 2018.

https://projects.iq.harvard.edu/rshm/events-videos. NewsBlog. Sullivan N, Berry N. Good Intentions and Murky Ethics: How Anthropology Matters in Short- Term Global Health Travel. Anthropology News 2017; Nov 3. https://anthrosource.onlinelibrary.wiley.com/doi/10.1111/AN.661. Video. Kleinman A. Caregiving as Moral Experience. Columbia University School of Social Work 2016; Oct

6. https://livestream.com/accounts/3727021/events/6419588/videos/138049950. News Portal. Religion & Ethics Newsweekly: Health and Medicine. 2016.

http://www.pbs.org/wnet/religionandethics/topics/health-and-medicine. Video. Health Care in Danger: Why Medical Ethics Matters. International Committee of the Red Cross 2014. https://www.icrc.org/eng/resources/documents/audiovisuals/video/2014/health-care-in-danger- medical-ethics.htm. Video. Arthur Kleinman Extended Interview. Public Broadcasting Service, Religion & Ethics Newsweekly

2010; Oct 1. https://www.pbs.org/video/religion-ethics-newsweekly-arthur-kleinman-extended-interview. TEACHING MATERIALS AND CASE STUDIES Resource Portal. Certified IRB Professional (CIP). Public Responsibility in Medicine and Research.

https://www.primr.org/Certification/cip. Online Learning. CITI Program—Collaborative Institutional Training Initiative.

https://www.citiprogram.org. Online Learning. Bioethics: The Law, Medicine, and Ethics of Reproductive Technologies and Genetics. * HarvardX, edX. https://www.edx.org/course/bioethics-the-law-medicine-and-ethics-of-reproductive- technologies-and-genetics. Online Learning. Public Health Ethics Training Materials. Centers for Disease Control and Prevention

2018. https://www.cdc.gov/od/science/integrity/phethics/trainingmaterials.htm. Online Learning. Global Health Ethics Student Curriculum. American Medical Student Association 2017.

https://www.amsa.org/advocacy/action-committees/ethics. Teaching Pack. Teaching Pack: Flint, Michigan: Lethal Water. Global Health Education and Learning * Incubator at Harvard University 2017. http://repository.gheli.harvard.edu/repository/collection/teaching- pack-flint-michigan-and-lethal-water. Teaching Case. Pruneski JA. What Should the Victor Do with the Vanquished? Deciding the Fate of * Smallpox. National Center for Case Study Teaching in Science, University at Buffalo 2017. http://sciencecases.lib.buffalo.edu/cs/collection/detail.asp?case_id=912&id=912. Teaching Pack. Teaching Pack: Accidents and Injuries: Lessons From a Stampede. Global Health Education * and Learning Incubator at Harvard University 2017. http://repository.gheli.harvard.edu/repository/collection/teaching-pack-accidents-injuries-lessons. Teaching Cases. Public Health Ethics Case Repository. Centers for Disease Control and Prevention 2017.

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Global Health Ethics: Resource Pack

Teaching Cases. Barrett DH et al, eds. Public Health Ethics: Cases Spanning the Globe. Springer Open 2016.

https://link.springer.com/book/10.1007/978-3-319-23847-0. Teaching Case. Kane N. Medical Tourism at Mountain Insurance Company. Harvard T.H. Chan School of * Public Health 2016. http://caseresources.hsph.harvard.edu/publications/medical-tourism-abc-health-plan- %C2%A0-%C2%A0. Teaching Cases. Aellah G et al. Global Health Research in an Unequal World: Ethics Case Studies From * Africa. Wellcome Trust, CAB International 2016. DOI: http://dx.doi.org/10.1079/9781786390042.0000. Guide/Primer. Global Health Ethics: Key issues. World Health Organization 2015. * http://www.who.int/ethics/publications/global-health-ethics/en. Teaching Case. Gordon R. Who Owns Your Story? Global Health Education and Learning Incubator at * Harvard University, Harvard University 2014. http://repository.gheli.harvard.edu/repository/10692. Teaching Case. Cash R et al., eds. Casebook on Ethical Issues in International Health Research. World * Health Organization 2009. http://www.who.int/rpc/publications/ethics_casebook/en. *indicates resource listed in GHELI's online Repository

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Annotated Bibliography

BASIC READS: ETHICAL CODES AND RESEARCH ADMINISTRATION STANDARDS

Federal Policy for the Protection of Human Subjects (Common Rule) Resource Portal. Federal Policy for the Protection of Human Subjects (Common Rule). U.S. Department of Health & Human Services 1991. https://www.hhs.gov/ohrp/regulations-and-policy/regulations/common-rule/index.html. This website contains the U.S. government’s federal policy standards for protecting human subjects in research conducted in the U.S. today. Also known as the Common Rule, the Federal Policy includes regulations by 15 Federal agencies and departments; the Common Rule pertaining to health and human services are contained in Health and Human Services (HHS) regulations 45 CFR part 46. The Common Rule applies to all grants and programs that receive U.S. Government funding and is a critical reference tool for anyone involved in human subjects research or research administration in the United States.

The Belmont Report Resource Portal. The Belmont Report: Ethical Principles and Guidelines for the Protection of Human Subjects of Research. Department of Health, Education, and Welfare, National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research 1979. https://www.hhs.gov/ohrp/regulations-and-policy/belmont- report/index.html. This resource portal contains the text of and educational material about The Belmont Report, the standard ethics reference document used to guide human subjects research in the United States. The Belmont Report, release in 1979, was created by the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research following the National Research Act of 1974, and outlines the basic ethical principles required in conducting biomedical and behavioral research involving human subjects. The portal also includes an educational video about the report, video interviews with Commission members from the Report’s 25th anniversary in 2004, and links to other reports published by the Commission between 1974 and 1978. The Belmont Report is an important resource for anyone active in research or research administration in the United States.

Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects Report. Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Subjects. World Medical Association 1964. https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical- research-involving-human-subjects. This policy report adopted by the World Medical Association General Assembly in Helsinki, Finland, in 1964, and periodically updated, is a global policy statement of ethical principles for human subjects research, including any research on identifiable human data and material. The Declaration is designed to advise and inform physicians and related health care and medical professionals on ethical decision making in research that involves human subjects.

Nuremberg Code Report. Nuremberg Code. Citation 1947. http://www.unesco.org/new/en/social-and-human- sciences/themes/bioethics/international-bioethics-committee/reports-and-advices. The Nuremberg Code, formulated in 1947 in response to human rights abuses that took place during World War Two, is a set of ten ethical principles designed to guide clinical human subjects research throughout the world. The Code was written by U.S. court judges who presided over the trial of Nazi physicians in August 1947. The Code continues to serve as a global standard reference document in medical research and research administration.

REPORTS AND BOOKS

Report of the International Bioethics Committee of UNESCO (IBC) on Big Data and Health

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Global Health Ethics: Resource Pack

Report. International Bioethics Committee. Report of the IBC on Big Data and Health. United Nations Educational, Scientific and Cultural Organization 2017. http://www.unesco.org/new/en/social-and-human- sciences/themes/bioethics/international-bioethics-committee/reports-and-advices. GHELI repository link: http://repository.gheli.harvard.edu/repository/11900 This report from the International Bioethics Committee of UNESCO (IBC) addresses the topic of big data and health, including issues of autonomy, consent, data protection, governance, etc. It explores a wide range of definitions for big data to set the stage for examining legal regulations, visions, trends, and ethics of use. Using this information as a guideline, the report gives recommendations for big data success. The final draft of the report was adopted by the Committee on September 15, 2017.

WHO Guidelines on Ethical Issues in Public Health Surveillance Report. WHO Guidelines on Ethical Issues in Public Health Surveillance. World Health Organization 2017. http://www.who.int/ethics/publications/public-health-surveillance/en. This report from the World Health Organization (WHO) provides an international framework on ethics in public health surveillance, designed for officials in government agencies, health workers, and policy makers and practitioners in non- governmental organizations (NGOs) and the public sector. Public health surveillance is an important tool for determining morbidity and mortality patterns and causes, but surveillance often raises controversies over privacy and other civil liberties. This framework document outlines 17 guidelines for ethical surveillance approaches. The report would be a useful reference for classroom discussion on public health ethics and global research.

International Ethical Guidelines for Health-Related Research Involving Humans Book. International Ethical Guidelines for Health-Related Research Involving Humans. Council for International Organizations of Medical Sciences, World Health Organization 2016. https://cioms.ch/shop/product/international-ethical- guidelines-for-health-related-research-involving-humans. This free book from the Council for International Organizations of Medical Sciences, produced in collaboration with the World Health Organization, provides practical international guidelines for ethical health-related human subjects research. First published in 1993 and revised in 2002, this book, available as a free pdf, has been updated to include special guidelines for research ethics in low-resource settings. The guidelines can help researchers and health policy and practice experts to evaluate the ethics of a particular research protocol in order to help protect individuals from potential research risks.

Student Guidelines for Ethical Fieldwork Overseas Report. Van Bavel B et al. Student Guidelines for Ethical Fieldwork Overseas. Development Studies Association Ireland, Irish Forum for Global Health 2016. https://globalhealth.ie/resources/student-ethical-guidelines. This report offers a set of guidelines for ethical overseas fieldwork, developed for students by students engaged in research ethics, policies, and programs within selected higher education institutions in Ireland. The guidelines are designed to encourage supervisors, institutions, and participating students to conduct fieldwork that upholds practice standards ensuring responsibility, accountability, protection, respect, conduct, integrity, and competence. Guidelines are focused on international academic fieldwork, particularly related to global health. The document could be a valuable reference guide in classes and training sessions that prepare undergraduate or graduate students for cross- cultural or global experiential learning.

Communities of Health Care Justice Book. Galarneau C. Communities of Health Care Justice. Rutgers University Press 2016. https://www.rutgersuniversitypress.org/communities-of-health-care-justice/9780813577661. This book applies an ethics perspective to community health care justice, arguing that communities must serve as critical moral actors to define and uphold just health policy. The author, a scholar in gender studies, bioethics, and religion, calls for imagining a new framework of just health care, illustrates examples from current health policy, and outlines structural, conceptual, and systemic changes needed to put such an ethical health care framework into practice. A 28-minute online audio, with associated slide presentation based on a seminar held in 2016 at the Wellesley Centers for Women, highlights the book’s key points and would be suitable for undergraduate-level classroom discussion. A two-page author interview in 2017 also provides a short summary of the book’s key themes suitable for

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student discussion. This book is available for purchase through the publisher. Users with academic affiliations may also find the book in their institution’s library.

Global Health Ethics. Key Issues Report. Global Health Ethics: Key Issues. Global Network of WHO Collaborating Centres for Bioethics, World Health Organization 2015. http://www.who.int/ethics/publications/global-health-ethics/en. This report, produced for the World Health Organization (WHO) by the Global Network of the World Health Organization Collaborating Centres for Bioethics, outlines key concepts in health ethics, identifies basic ethical issues related to health and health care, discusses the role of practical strategies to address health ethics, and concludes with a short summary of the role of ethics in the World Health Organization today. The report is designed to help health care providers, policy makers, and researchers to understand ethical challenges in global public health and practical strategies to address them. It would be a useful classroom resource for introductory undergraduate or graduate ethics courses.

On the Dual Uses of Science and Ethics: Principles, Practices, and Prospects Book. Selgelid M, Rappert B, eds. On the Dual Uses of Science and Ethics: Principles, Practices, and Prospects. Australian National University Press 2013. https://press.anu.edu.au/publications/series/centre-applied-philosophy-and- public-ethics-cappe/dual-uses-science-and-ethics. This free online book examines the moral ambiguity of science and technology and the role of ethical analysis in advancing biological science to prevent the deliberate spread of disease. It focuses on “dual use” research, or scientific research that can have both positive/neutral and also potentially negative use and application. The book is part of a series on practical ethics and public policy that connects the arts, humanities, and social sciences with biological science. The book is available for free download and would be suitable for advanced or graduate-level ethics classes in public policy or global health sciences.

Study Guide for Institutional Review Board: Management and Function Book. Davis A et al. Study Guide for Institutional Review Board: Management and Function. Jones & Bartlett Publishers 2006. http://www.jblearning.com/catalog/0763738662. This book serves as a companion study guide to the textbook, Institutional Review Board: Management and Function: Second Edition, designed to help prepare students, members of institutional review boards (IRBs), and administrators in grant administration, including research with human subjects in compliance with federal research regulations. Written by experts in the IRB process, and published in partnership with the Applied Research Ethics Association (ARENA), this book is a core resource that promotes professional development of all who work in human subjects protection. This book is available for purchase through the publisher. Users with academic affiliations may also find the book in their institution’s library.

Institutional Review Board: Management and Function: Second Edition Book. Bankert E, Amdur R. Institutional Review Board: Management and Function: Second Edition. Jones & Bartlett Publishers 2005. http://www.jblearning.com/catalog/9780763730499. This book is the most commonly recommended instructional manual designed to provide a comprehensive reference to institutional review board (IRB) members and administrators with the information they need to run an efficient and effective system of protecting human research subjects, while remaining in compliance with federal research regulations. Written by experts in the IRB process, it is a useful resource that promotes professional development of all who work in human subjects protection. The text includes case studies, sample forms, and sample policy documents. Topics include: Organizing the Office and the IRB Committee, Review Categories, Initial Protocol Review and The Full- Committee Meeting, Informed Consent, Continuing Review, Administrative and Regulatory Issues, Issues Based on Study Population, and IRB Issues Based on Study Design or Category. The Second Edition includes chapters on: IRB Closure of Study Files, Internet Research, Research in Public Schools, Phase I Clinical Trials in Healthy Volunteers, Vulnerability in Research, Balancing the Risks and Potential Benefits, and the Health Insurance Portability and Accountability Act (HIPAA). A separate study guide is available for institutional grant administration training. This book is available for purchase through the publisher. Users with academic affiliations may also find the book in their institution’s library. 8 This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported [email protected] 617-495-8222

Global Health Ethics: Resource Pack

ARTICLES, CHAPTERS, AND BRIEFS

Ethics and Global Health Article. Haddad S et al., eds. Ethics and Global Health. BMC Medical Ethics 2018; 19(Supplement 1). https://bmcmedethics.biomedcentral.com/articles/supplements/volume-19-supplement-1. This special supplement of BMC Medical Ethics consists of 11 articles that directly explore the intersections of ethics and global health in health education. The essays were developed as the result of a joint training program initiative, the Global Health Research Capacity Strengthening Program (GHR-CAPS), an inter-university platform for global health teaching and training that took place between 2009 and 2016. The issue includes the following articles: • Introduction to Ethics and Global Health • A Reflection on the Challenge of Protecting Confidentiality of Participants While Disseminating Research Results Locally • Deconstructing the Notion of “Global Health Research Partnerships” Across Northern and African Contexts • Ethics Beyond Ethics: The Need for Virtuous Researchers • The Ethics of Relationality in Implementation and Evaluation Research in Global Health: Reflections From the Dream-A-World Program in Kingston, Jamaica • Community Involvement in Biomedical Research Conducted in the Global Health Context: What Can be Done to Make it Really Matter? • Differences and Structural Weaknesses of Institutional Mechanisms for Health Research Ethics: Burkina Faso, Palestine, Peru, and the Democratic Republic of the Congo • Right to Health and Social Justice in Bangladesh: Ethical Dilemmas and Obligations of State and Non-State Actors to Ensure Health for Urban Poor • Commodification of Care and its Effects on Maternal Health in the Noun Division (West Region—Cameroon) • Ethical Issues Related to Human Papillomavirus Vaccination Programs: An Example From Bangladesh • Integrated Primary Health Care in Low- and Middle-Income Countries: A Double Challenge

The Ethics and Politics of Community Engagement in Global Health Research Article. Reynolds L, Sariola S. The Ethics and Politics of Community Engagement in Global Health Research. Critical Public Health 2018; 28(3): 257-268. DOI: https://doi.org/10.1080/09581596.2018.1449598. This article summarizes the concept of community engagement as a key component of global health research, including research related to policy, ethics, and technological design. Based on research funded by the Wellcome Trust and the University of Oxford Global Health Bioethics Network, the authors outlines the ethical and philosophical foundations for community engagement and participation in global health, the role of expert knowledge and trust in science, ethics and politics, how researchers engagement relates to power, participant goals, and scientific knowledge, and lessons and implications for future policy and practice. The essay may help undergraduate and graduate students think carefully about how and why they engage with community in any research project.

Rapid Qualitative Review of Ethical Issues Surrounding Healthcare for Pregnant Women or Women of Reproductive Age in Epidemic Outbreaks Article. Hummel P et al. Rapid Qualitative Review of Ethical Issues Surrounding Healthcare for Pregnant Women or Women of Reproductive Age in Epidemic Outbreaks. Epidemiology and Health 2018; 40: e2018003. DOI: http://doi.org/10.4178/epih.e2018003. This article by two researchers affiliated with the World Health Organization (WHO) summarizes results of a rapid literature review on key ethical issues pertinent to pregnancies that occur during epidemics. Identified research discussed considered the ethical challenges that occurred in pregnancy related to HIV, influenza, rubella, Ebola, and cancer, and the authors focus their discussion on potential applications to women exposed to Zika virus. The article might be useful as a model for the value of literature review within graduate-level classroom discussion of ethics in sexual and reproductive health.

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The Trouble With Inequalities in Global Health Partnerships: An Ethical Assessment Article. Fourie C. The Trouble With Inequalities in Global Health Partnerships: An Ethical Assessment. Medicine Anthropology Theory 2018; 5(2): 142-155. http://www.medanthrotheory.org/read/10589/the-trouble-with-inequalities-in- global-health-partnerships. This article draws on medical anthropology and the health sciences to offer a philosophical-ethical analysis of inequalities in global health partnerships today, particularly the inequalities that exist between researchers in the United States and in Africa. The author, a professor of medical ethics and bioethics at the University of Washington, describes several examples of partnered inequalities, considers the inherent ethical challenges they pose, and calls for improved ethical assessments and change.

Evaluating the Health-Related Targets in the Sustainable Development Goals From a Human Rights Perspective Article. Chapman AR. Evaluating the Health-Related Targets in the Sustainable Development Goals From a Human Rights Perspective. The International Journal of Human Rights 2017; 21(8): 1098-1113. https://doi.org/10.1080/13642987.2017.1348704. This article by a leading ethicist and scholar in human rights provides an overview of health targets in the Sustainable Development Goals (SDGs) and assesses them from a human rights perspective. It focuses on the targets for Goal 3, “to ensure healthy lives and promote well-being for all at all ages,” and highlights the relevance of this target to sexual and reproductive health, women’s health, universal health coverage, and access to affordable essential medicines. The article offers a valuable broad approach to how ethics intersects with global health goals and social determinants. The article was part of a special issue of The International Journal of Human Rights on the SDGs and human rights.

Ethical Issues in the Development and Implementation of Nutrition-Related Public Health Policies and Interventions: A Scoping Review Article. Hurlimann T et al. Ethical Issues in the Development and Implementation of Nutrition-Related Public Health Policies and Interventions: A Scoping Review. PLoS One 2017; 13(2). DOI: https://doi.org/10.1371/journal.pone.0186897. This article in PLoS One provides a review of the published peer-review literature on ethical issues that pertain to nutrition-related public health interventions. The authors identified obesity and non-communicable diseases as the nutrition-related topics most frequently and most explicitly discussed in relation to ethics. Other ethical discussion included undernutrition, food safety and food sustainability, breastfeeding, vitamin-mineral supplementation, and food fortification. Nutrition research needs to develop more targeted ethical frameworks that address a complex range of public health contexts and interventions.

Religion and the Public Ethics of Stem-Cell Research: Attitudes in Europe, Canada, and the United States Article. Allum N et al. Religion and the Public Ethics of Stem-Cell Research: Attitudes in Europe, Canada, and the United States. PLoS One 2017; Apr 20. DOI: https://doi.org/10.1371/journal.pone.0176274. This article in PLoS One examines the role of religion in public opinion on stem-cell research in Europe and North America, using survey data from 2005, when such research was highly controversial. Moral acceptability and religious convictions in the U.S. most strongly influenced public ethics in framing policy and regulation than did perceived benefits in Europe and Canada. Stem cell ethics is an example of how public opinion shapes research options and resources for sensitive health-related technologies.

Religion and Public Health: Moral Tradition as Both Problem and Solution Article. Rozier M. Religion and Public Health: Moral Tradition as Both Problem and Solution. Journal of Religion and Health 2017; 56: 1052-1063. DOI: https://doi.org/10.1007/s10943-017-0357-5. This article by a researcher in health management and policy at the University of Michigan explores the moral imperative for public health, with a focus on Jewish and Christian ethics. The author suggests that religious traditions need to consider their moral traditions with intentional attention to prevention and population health.

Partnerships Between the Faith-Based and Medical Sectors: Implications for Preventive Medicine and Public Health Article. Levin J. Partnerships Between the Faith-Based and Medical Sectors: Implications for Preventive Medicine and Public Health. Preventive Medicine Reports 2016; 4:344-350. DOI: https://www.sciencedirect.com/science/article/pii/S2211335516300845. 10 This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported [email protected] 617-495-8222

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This article provides a review of multifaceted interconnections between the faith-based and medical sectors that have evolved over the past several decades in the U.S. The author outlines ten intersecting points, with a focus on primary care, global health, and community-based outreach to underserved populations. The article summarizes legal, political, professional, ethical, and research challenges that remain for faith-based and healthcare professionals who work in these areas.

Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers Article. Kotalik J, Martin G. Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers. American Journal of Bioethics 2016; 16(5): 38-43. https://www.tandfonline.com/doi/full/10.1080/15265161.2016.1159749. This article explores the importance culture plays in shaping ethical issues, with a focus on Native American communities in North America. It considers both bioethics and Aboriginal knowledge through discussion of seven guiding principles (also called the Seven Grandfather Teachings) in Ojibway Native American communities. The authors argue that considering indigenous moral teachings and traditions could improve health care services for the populations of these communities. This article is free to journal subscribers and others with institutional access, and is also available to purchase individually.

Lessons from a Transgender Patient for Health Care Professionals Article. Sallans RK. Lessons from a Transgender Patient for Health Care Professionals. AMA Journal of Ethics 2016; 18(11): 1139-1146. http://journalofethics.ama-assn.org/2016/11/mnar1-1611.html. This article by an educator in LGBTQ health care relates the author’s experiences with health care providers during his transgender transition. Targeted to readers who work in the health care field, the article includes lessons and examples of how health care professionals may be more respectful, responsive, and inclusive to the needs of transgender individuals.

Global Health Ethics Chapter. Velji A, Bryant JH. Chapter 21: Global Health Ethics. Markle W. et al. Understanding Global Health, Second Edition. McGraw-Hill Education 2014. Pages 463-486. https://accessmedicine.mhmedical.com/content.aspx?bookid=710§ionid=46796922#57940501. This book chapter defines global health ethics and its relationship to human rights, culture, poverty, and health. Focusing on medical applications, the authors outline four common principles of ethics—autonomy, beneficence, nonmaleficence, and justice—summarizes the role of religion in global health ethics, and briefly describes short case examples of ethical dilemmas and questions for classroom discussion. The chapter, part of a popular textbook used in undergraduate courses on global health, available free online to subscribing institutions, may be a useful introductory overview for undergraduates or graduate students.

Critical Race Feminist Bioethics: Telling Stories in Law School and Medical School in Pursuit of “Cultural Competency” Article. Washington DA. Critical Race Feminist Bioethics: Telling Stories in Law School and Medical School in Pursuit of “Cultural Competency.” Albany Law Review 2010; 72: 961-998. http://commons.law.famu.edu/faculty-research/117. This article the Albany Law Review considers the intersection of slavery, race, and gender, in the construction of the medical specialty of gynecology in the United States. It offers a feminist perspective on bioethics through a critical discussion of history, science, and technology. The article particularly focuses on the relevance of narrative in legal and medical school education.

Anthropology of Bioethics Chapter. Kleinman A. Writing at the Margin: Discourse Between Anthropology and Medicine. Chapter 3: Anthropology of Bioethics. University of California Press 1995. Pages 41-67. http://oxfordindex.oup.com/view/10.1525/california/9780520209657.003.0003. This chapter provides a classic resource on what bioethics is all about and why it may be significant for ethical questions in medicine and health broadly defined. Written by a psychiatrist and anthropologist renowned for shaping contemporary global health and social justice ethics, the text discusses the anthropology of bioethics as it impacts health care delivery, outlines how anthropology contributes to medical ethics and the culture of bioethics, and the potential of anthropology to advance practical bioethics around the world.

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Research Ethics: How to Treat People who Participate in Research Brief. Emanuel E et al. Research Ethics: How to Treat People who Participate in Research. Clinical Center Department of Bioethics, National Institutes of Health n.d. https://www.bioethics.nih.gov/education/pdf/FNIH_BioethicsBrochure_WEB.PDF. This 15-page brief offers a basic introduction to seven principles for ethical research: social and clinical value, scientific validity, fair subject selection, favorable risk-benefit ratio, independent review, informed consent, and respect for potential and enrolled subjects. Written by the former Chair (1997–2011) of the National Institutes of Health Clinical Center Bioethics Department, the brief is designed for anyone active in clinical research ethics and patient recruitment.

WEB PORTALS AND ORGANIZATIONS

Global Health Fieldwork Ethics: Values, Realities, and the Right to Health Web Portal. Global Health Fieldwork Ethics: Values, Realities, and the Right to Health. Health and Human Rights Journal 2019; 21. https://www.hhrjournal.org/submissions/call-for-submissions-upcoming-issues/#fieldwork. This web page highlights a forthcoming special section of Health and Human Rights Journal, a free online, peer-reviewed publication of the Harvard University FXB Center for Health and Human Rights, which will explore ethical challenges in global health fieldwork. The editorial call for manuscripts highlights how the collection of articles, to be published in 2019, will advance more consistent integration of fieldwork ethics into global health training and discourse, and into research ethics review and oversight.

Global Health Ethics Web Portal. Global Health Ethics. World Health Organization 2018. http://www.who.int/ethics. This website on ethics from the World Health Organization (WHO) provides an online hub for publications and information sources on global health ethics. It includes educational tools from the Global Health Ethics Team, including videos and guidelines on ethical decision making during an infectious disease outbreak, a quiz on the ethics of public health surveillance, the WHO Guidelines on Ethical Issues in Public Health Surveillance, Ethical Issues Associated with Vector-Borne Diseases, information about the WHO Research Ethics Review Committee, and links to international ethical guidelines relevant to health such as the 1964 Declaration of Helsinki.

Integrating Ethics in Infectious Disease Outbreaks Resource Portal. Integrating Ethics in Infectious Disease Outbreaks. World Health Organization 2018. https://extranet.who.int/ethics. This web portal from the World Health Organization (WHO) provides a platform of resources on ethical principles for public health officials and frontline workers engaged in the identification and prevention of infectious diseases. The site outlines key principles that govern decision-making, how to use them, and how to integrate ethics in every aspect of responses to an infectious disease outbreak. Topic sections include Ethics Matters, a video summarizing why ethics are important in epidemiologic responses; Ethics Issues, an illustrated summary of intersections between surveillance and research; Ethics in Action, an online case-based quiz to train viewers on strengthening effective responses; and Resources, with links to checklists, training courses, video materials, WHO publications, other institutional resources, and templates and infographics.

Bioethics Information and Resources Resource Portal. Bioethics Information and Resources. National Institutes of Health Fogarty International Center 2018. https://www.fic.nih.gov/ResearchTopics/Pages/Bioethics.aspx. This website portal provides a collection of resources on research ethics from around the world available from the Fogarty International Center for Advanced Study in the Health Sciences at the National Institutes of Health (NIH). It includes links to teaching tools, career path advice, and online course information for teachers and students, information on regulations, guidelines, and committees for investigators and ethics committees, journals and grant sources for bioethics researchers, and related material available on bioethics in other languages. The site also includes recent bioethics news updates and NIH and other government resources.

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National Institutes of Health Department of Bioethics Web Portal. National Institutes of Health Department of Bioethics 2018. https://www.bioethics.nih.gov/home/index.shtml. This website of the National Institutes of Health (NIH) Department of Bioethics, part of the NIH Clinical Center, provides links to information about the performance of ethical research in and beyond the context of national government funding. The Department offers a fellowship program, courses for clinicians and clinical researchers, publications, and a Bioethics Consultation Service that offers assistance on clinical issues as well as questions that arise in the course of research involving human subjects.

National Institutes of Health Clinical Center: Patient Recruitment Ethics in Clinical Research Resource Portal. National Institutes of Health Clinical Center: Patient Recruitment Ethics in Clinical Research 2018. https://clinicalcenter.nih.gov/recruit/ethics.html. This resource portal provides a summary of the principles, codes, and regulations that serve as mandated standards for ethical clinical research in the United States today, lists and defines seven principles of ethical research, and provides links for searching all ongoing research studies at the National Institutes of Health Clinical Center on a wide range of diseases and conditions.

Presidential Commission for the Study of Bioethical Issues Web Portal. Presidential Commission for the Study of Bioethical Issues. 2017. https://bioethicsarchive.georgetown.edu/pcsbi/node/851.html. This website is an archived site of information on projects, reports, education, news, meetings, blogs, and podcasts from the Presidential Commission for the Study of Bioethical Issues (the Bioethics Commission), an expert group of advisors to and with support of the United States presidents between 2009 and 2017. Available project reports cover topics that included: the ethics of synthetic biology and emerging technologies, sexually transmitted disease (STD) research in Guatemala from 1946 to 1948, privacy in genome sequencing research, review of current rules and regulations to protect participants in human subjects research, safeguarding children in pediatric research, ethical management of incidental and secondary research findings, recommendations for ethics in neuroscience research (Part 1 and Part 2), ethics and Ebola, and bioethics for every generation.

Health Care in Danger (HCID) Initiative Resource Portal. Health Care in Danger (HCID) Initiative. International Red Cross and Red Crescent Movement 2014. http://healthcareindanger.org/hcid-project. This web portal provides links to resources from the Health Care In Danger (HCID) Initiative of the International Red Cross and Red Crescent Movement, launched to address the rising challenge of violence against patients and their health care service providers in settings of armed conflict. The Initiative has launched a common core on ethics, the “Ethical Principles of Health Care in Times of Armed Conflict and Other Emergencies,” in addition to other training manuals, publications, reports, and videos useful for training humanitarian aid and health workers in settings of conflict.

Council for International Organizations of Medical Sciences Organization. Council for International Organizations of Medical Sciences. https://cioms.ch. This international organization, founded in 1949 by the World Health Organization (WHO) and United Nations Educational, Scientific and Cultural Organization (UNESCO), aims to advance public health through health research guidance related to ethics, safety, and medical product development. CIOMS working groups develop consensus guidelines in topical areas that include bioethics, vaccine safety, clinical research in resource-limited settings, and related topics. CIOMS publications on ethics include the 2016 International Ethical Guidelines for Health-Related Research Involving Humans.

UNESCO International Bioethics Committee (IBC) Organization. UNESCO International Bioethics Committee (IBC). http://www.unesco.org/new/en/social-and-human- sciences/themes/bioethics/international-bioethics-committee. This committee of the United Nations Educational, Scientific and Cultural Organization (UNESCO) represents a global forum in bioethics that was created in 1993 to promote reflection, exchange ideas, and encourage action on ethical and legal issues raised by research in the life sciences and their applications. The organization’s web portal describes the

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Committee and highlights related resources such as videos, reports, policy and public statements, and related UNESCO resources.

Harvard University Edmond J. Safra Center for Ethics Organization. Harvard University Edmond J. Safra Center for Ethics. https://ethics.harvard.edu. The Edmond J. Safra Center for Ethics at Harvard University advances teaching and research on ethics related to public life. Launched in 1986, its research, fellowships, and public events reflect ethical concepts on a range of issues that relate to health. Its award-winning Justice, Health, and Democracy Project aims to build and implement a nationwide platform to support programs that redirect low-level drug offenders away from prisons and into social services. The Center works closely with faculty in related programs on ethics at Harvard, such as the Harvard Medical School Center for Bioethics, and is part of the National Ethics Project, in collaboration with several other educational organizations, to examine and redefine ethics pedagogy in undergraduate education across the nation.

Tuskegee University National Center for Bioethics in Research and Health Care Organization. Tuskegee University National Center for Bioethics in Research and Health Care. http://tuskegeebioethics.org. This is the first national center devoted to bioethics that engages sciences, law, humanities, and religious faiths to explore research and medical treatment issues for African Americans and other underserved persons. Launched with grant funds and a presidential apology in 1997 by President Clinton, the Center builds on lessons learned as a result of and from survivors of the Syphilis Study, Tuskegee University, and Tuskegee/Macon County for the U.S. Public Health Service medical experiment in which African American men with syphilis were tracked without being offered treatment over a period of 40 years. The Center’s website offers online resources and narratives that consider ethics and public health, clinical trials, as well as ethics and spirituality. The Center also publishes the Journal of Healthcare, Science and the Humanities.

Global Network of WHO Collaborating Centres for Bioethics Organization. Global Network of WHO Collaborating Centres for Bioethics. http://www.who.int/ethics/partnerships/global_network/en. This organizational network consists of university-based centers around the world that provide expertise and collaboration to advance scientific ethics as part of a World Health Organization (WHO) mandate. The collaborating centers facilitate resource mobilization and strengthen connections and synergies in both low and middle-income countries. Member centers are located in Argentina, Australia, Canada, Chile, Pakistan, Singapore, South Africa, Switzerland, and the United States. The organizational website also links to terms of reference, an annual report, and informational brochure.

International Association of Bioethics Organization. International Association of Bioethics. www.bioethics-international.org. This professional association aims to link persons who work in bioethics and related fields, facilitate intersecting communications, and encourage discussion of issues relevant to bioethics that have cross-cultural implications. Founded in 1992, the International Association of Bioethics sponsors global conferences, and publishes the journal Bioethics. Members connect through international networking groups in Arts and Bioethics, Bioethics Education, Environmental Bioethics, Feminist Approaches to Bioethics, Genetics and Bioethics, Philosophy and Bioethics, Public Health Ethics, and an Ibero-American Network.

MULTIMEDIA AND NEWS

Harvard University Initiative on Health, Religion, and Spirituality: Videos Video. Harvard University Initiative on Health, Religion, and Spirituality: Videos. 2018. https://projects.iq.harvard.edu/rshm/events-videos. This video collection of invited lectures sponsored by the interfaculty Harvard University Initiative on Health, Religion, and Spirituality comprises more than a dozen invited lectures and discussions between health professionals and

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scholars in religion and spirituality within the Harvard medical and public health community since 2014. Ethics and health are explored through discussions about: palliative care, dementia, surgery, end-of-life care, bioethics, psychiatry, mental health, and empirical research in religious practices that impact health. The initiative aims to serve as a research catalyst for an integrated model of spirituality, public health, and patient care, and fosters collaboration across Harvard University and dialogue with spiritual communities. It brings together researchers, scholars, and theologians to ask: How may religion and spirituality in concert with public health and the practice of medicine alleviate illness and promote well-being? The Initiative also serves as one of the co-sponsors for the annual national Conference on Medicine & Religion. Most of the lectures took place within a graduate student and professional setting but are also appropriate for interested undergraduates and students of religious studies and the health humanities.

Good Intentions and Murky Ethics NewsBlog. Sullivan N, Berry N. Good Intentions and Murky Ethics: How Anthropology Matters in Short-Term Global Health Travel. Anthropology News 2017; Nov 3. https://anthrosource.onlinelibrary.wiley.com/doi/10.1111/AN.661. This news article from the American Anthropology Association offers an engaging overview of certain ethical tensions and challenges commonly present in short-term global health travel. The archived article, available to association members or participating member libraries, may be useful in a high school or undergraduate classroom or section debate or discussion.

Caregiving as Moral Experience Video. Kleinman A. Caregiving as Moral Experience. Columbia University School of Social Work 2016; Oct 6. https://livestream.com/accounts/3727021/events/6419588/videos/138049950. This video from the Columbia University School of Social Work presents a lecture by a world-renowned anthropologist and psychiatrist on caregiving in the American health care system, with a particular focus on its moral and emotional aspects. The two-hour video includes one hour of lecture followed by an hour of interactive discussion with an audience of medical providers and social workers.

Religion & Ethics Newsweekly: Health and Medicine News Portal. Religion & Ethics Newsweekly: Health and Medicine. 2016. http://www.pbs.org/wnet/religionandethics/topics/health-and-medicine. This online portal lists and links to news stories and videos from the Public Broadcasting System’s Religion & Ethics Newsweekly series, focusing on topics pertinent to health and medicine. First launched in 1997, the series examines ethical and faith-based dimensions from every major world religion that shape news across a range of topics, include health and medicine, culture and society, ethics, literature and the arts, race, science and technology, and more. In addition to the weekly broadcast, the site also includes transcripts, videos, podcasts, and other resources.

Health Care in Danger: Why Medical Ethics Matters Video. Health Care in Danger: Why Medical Ethics Matters. International Committee of the Red Cross 2014. https://www.icrc.org/eng/resources/documents/audiovisuals/video/2014/health-care-in-danger-medical-ethics.htm. This three-part video from the International Committee of the Red Cross (ICRC) offers short (2-3 minutes each) soundbites on why health care workers need to know both their roles and responsibilities as they work in emergency situations and often face ethical dilemmas and insecurities. Speakers include a physician, a nurse, and a forensic expert. The video series is part of the International Committee of the Health Care in Danger (HCiD) Initiative, launched in 2014 by the International Red Cross and Red Crescent Movement, to address the rising challenge of violence against patients and their health care service providers in settings of armed conflict. The videos include: Health Care in Danger: Why medical ethics matters (Part 1/3), Bruce Eshaya-Chauvin, ICRC Medical Advisor Health Care in Danger: Why medical ethics matters (Part 2/3), Margaret Schaefer, ICRC Hospital Manager Health Care in Danger: Why medical ethics matters (Part 3/3), Morris Binz-Tidball, Head of ICRC Forensic Services

Arthur Kleinman Extended Interview Video. Arthur Kleinman Extended Interview. Public Broadcasting Service, Religion & Ethics Newsweekly 2010; Oct 1. https://www.pbs.org/video/religion-ethics-newsweekly-arthur-kleinman-extended-interview. This video is an 18-minute interview on caregiving with Dr. Arthur Kleinman, the Esther and Sidney Rabb Professor of Anthropology at Harvard University, Professor of Medical Anthropology in Global Health and Social Medicine, and

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Professor of Psychiatry at Harvard Medical School. Kleinman reflects on the moral and ethical experience of providing care for his wife during her terminal illness with Alzheimer’s disease. He argues that caregiving is an essentially religious act and one that aligns with the anthropological concept of participatory observation and presence. For a later essay on this topic, explore his article, Caregiving as Moral Experience, and an online video with the same title.

TEACHING MATERIALS AND CASE STUDIES

Certified IRB Professional (CIP) Resource Portal. Certified IRB Professional (CIP). Public Responsibility in Medicine and Research. https://www.primr.org/Certification/cip. This resource portal from Public Responsibility in Medicine and Research provides educational resources for and information on research ethics training to become a Certified Institutional Review Board (IRB) Professional (CIP). The CIP credential, created in 1999, is a voluntary program that advances and strengthens competence in human research protection by training for investigators and institutional research administrators in the U.S. and around the world. The site outlines the certification process, how to prepare for the CIP exam, links to the CIP Handbook, and occasional updates in research ethics. It is a useful resource for anyone engaged in animal, human subject, social science, or health research regardless of certification status.

CITI Program—Collaborative Institutional Training Initiative Online Learning. CITI Program—Collaborative Institutional Training Initiative. https://www.citiprogram.org. This resource portal of the Collaborative Institutional Training Initiative (CITI) provides peer-reviewed web-based online training, with more than 80 available courses in research ethics, research administration, regulatory oversight, and responsible research conduct for studies in both the social and health sciences, including those who work with laboratory animals or in human subjects research. CITI courses are designed for research professionals and institutional review board (IRB) administrators in the United States and globally, including those preparing to take the Certified IRB Professional (CIP) examination. Learners gain ethical decision making skills suitable to perform, advise, and/or manage research that benefits society while protecting the safety and well-being of research subjects. CITI courses and programs are available free to learners affiliated with member organizations and at a cost to independent learners.

Bioethics: The Law, Medicine, and Ethics of Reproductive Technologies and Genetics Online Learning. Bioethics: The Law, Medicine, and Ethics of Reproductive Technologies and Genetics. HarvardX, edX. https://www.edx.org/course/bioethics-the-law-medicine-and-ethics-of-reproductive-technologies-and-genetics. GHELI repository link: http://repository.gheli.harvard.edu/repository/12537 This free, self-paced HarvardX course provides a foundation for exploring the legal, medical, and ethical questions around reproduction and human genetics. Including interviews with individuals who have used surrogacy and sperm donation, medical experts, bioethicists, and journalists, the course introduces students to the interdisciplinary conversation about the ownership and use of genetic information. This HarvardX course leverages leading legal cases in this field to contextualize the ethical and legal reasoning discussed. edX is an online learning platform that offers free, high-quality courses to learners everywhere. edX was founded by Harvard University and MIT and now partners with more than 90 global members, including leading universities, nonprofit organizations, and research institutions. It offers more than 1,700 “massive open online courses” (MOOCs) on subjects ranging from architecture and art, to engineering and global health, to physics and social sciences. Harvard provides free online courses from across the university through HarvardX.

Public Health Ethics Training Materials Online Learning. Public Health Ethics Training Materials. Centers for Disease Control and Prevention 2018. https://www.cdc.gov/od/science/integrity/phethics/trainingmaterials.htm.

This web portal describes and links a selection of online learning resources in public health ethics and ethical analysis from the Centers for Disease Control and Prevention (CDC). Resources include: A course on “Good Decision Making in Real Time: Public Health Ethics Training for Local Health Departments” that includes an online Student Manual,

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accompanying Facilitator Manual, and five video learning sessions; a repository of seven public health ethics cases; and an open access case book of 40 cases that highlight a diverse range of dilemmas and ethical issues.

Global Health Ethics Student Curriculum Online Learning. Global Health Ethics Student Curriculum. American Medical Student Association 2017. https://www.amsa.org/advocacy/action-committees/ethics. This online learning portal outlines and links to component documents of a global health ethics curriculum designed for medical students who participate in international research. The curriculum, developed within the American Medical Student Association, includes a brief introduction and four pedagogical tools each for pre-departure and post-return workshops, including: facilitators’ guide, student handbook, student evaluation, and student resource guide. An evaluation of the curriculum is also available.

Flint, Michigan: Lethal Water Teaching Pack. Teaching Pack: Flint, Michigan: Lethal Water. Global Health Education and Learning Incubator at Harvard University 2017. http://repository.gheli.harvard.edu/repository/collection/teaching-pack-flint-michigan-and-lethal-water. GHELI repository link: http://repository.gheli.harvard.edu/repository/collection/teaching-pack-flint-michigan-and-lethal- water/resource/11591 This teaching pack is focused on the toxic water crisis in Flint, Michigan, a disaster with profound health implications. A complex network of interrelated factors contributed to the problems in Flint: culture, ethics, society, environment, politics, urban design, economic justice, and governance. The teaching pack is centered on a case study, which outlines the social, economic, health, and policy consequences faced by Flint in the aftermath of a governmental decision to switch the city’s public water supply from Lake Huron to the more corrosive Flint River. The case highlights the role of citizens, scientists, and activists in raising public awareness of the crisis and the toxic long-term effects of lead poisoning on affected children. It also illustrates the challenges and questions such a crisis poses for other communities in the United States and globally. The teaching pack includes an instructor’s note, role play exercise, and discussion guide with an accompanying teaching graphic, all designed to help students understand the interconnected nature of a complex health issue like Flint's poisoned water, and the complexity of addressing it.

What Should the Victor Do With the Vanquished? Deciding the Fate of Smallpox Teaching Case. Pruneski JA. What Should the Victor Do with the Vanquished? Deciding the Fate of Smallpox. National Center for Case Study Teaching in Science, University at Buffalo 2017. http://sciencecases.lib.buffalo.edu/cs/collection/detail.asp?case_id=912&id=912. GHELI repository link: http://repository.gheli.harvard.edu/repository/11538 This case summarizes the history, biology, and bioethics of smallpox. It considers its vaccination, eradication, and the potential of frozen research stocks of the virus to re-infect the world. It describes the cause, effects, symptoms, history of vaccination, successful efforts to achieve worldwide eradication in 1980. The case invites readers to consider decision-making scenarios and apply them to additional study of other infectious diseases for which eradication may be possible. The case is suitable for high school biology, undergraduate courses in microbiology, or a bioethics module. A teaching note and answer key are available separately as password-protected, subscriber-only resources for teachers.

Accidents and Injuries: Lessons From a Stampede Teaching Pack. Teaching Pack: Accidents and Injuries: Lessons From a Stampede. Global Health Education and Learning Incubator at Harvard University 2017. http://repository.gheli.harvard.edu/repository/collection/teaching-pack-accidents- injuries-lessons. GHELI repository link: http://repository.gheli.harvard.edu/repository/collection/teaching-pack-accidents-injuries- lessons/resource/12040 This teaching pack on unintentional accidents and injuries uses a case-based discussion about a stampede at a mass gathering to explore lessons about global health risks and ethical decision making pertinent to humanitarian aid, public health, and emergency medicine with a focus on disaster response. Built around a case study about the fatal stampede in Allahabad, India, during the 2013 Kumbh Mela pilgrimage festival, the pack includes an instructor’s guide, discussion guide, and role-play exercise. Two additional companion resources, an annotated bibliography and a glossary of terms, include resources and terms specific to disaster management, health concerns about water and sanitation, and the

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history of the Kumbh Mela, and may also be used as accompanying materials for the case, Toilets and Sanitation at the Kumbh Mela.

Public Health Ethics Case Repository Teaching Cases. Public Health Ethics Case Repository. Centers for Disease Control and Prevention 2017. https://www.cdc.gov/od/science/integrity/phethics/trainingmaterials.htm. This collection of seven public health ethics cases from the Centers for Disease Control and Prevention (CDC) were designed for training local health department staff in the U.S. The cases may be used individually or to accompany the CDC training manual, Good Decision Making in Real Time Public Health Ethics Training for Local Health Departments. The cases include:

• Emergency Preparedness: Impact of Regulatory Compliance and Resource Allocation Decisions on Laboratory Capacity (n.d.) • Ensuring Biosafety/Biosecurity During a Public Health Emergency (n.d.) • Short-Course Zidovudine Compared to What? A Trial to Prevent Mother-to-Infant HIV Transmission (2012) o Instructor’s Guide o Participant’s Guide • Unsafe Injections: Duty to Warn? (n.d.) • Use of Restraint and Physical force by First Responders: Duty to Investigate and Educate? (2014; Jun 4) • Ethical Considerations for Allocating Medical Countermeasures in an Anthrax Incident (n.d.) • Policies for Restricting Use of Electronic Nicotine Delivery Systems (ENDS) in Indoor Public Spaces (2016; Jul)

Public Health Ethics: Cases Spanning the Globe Teaching Cases. Barrett DH et al, eds. Public Health Ethics: Cases Spanning the Globe. Springer Open 2016. https://link.springer.com/book/10.1007/978-3-319-23847-0. This book of case studies explores how ethics may be practically applied to everyday public health practices. Available for free download, the book distinguishes clinical and research ethics from public health ethics and discusses cases based on real life that may occur in the practice of public health. It may be used as a training resource for public health students, field workers, program administrators, and makers in global health-related programs, as well as academic ethicists. Each of the book’s nine chapters may be downloaded individually to aid classroom use.

Medical Tourism at Mountain Insurance Company Teaching Case. Kane N. Medical Tourism at Mountain Insurance Company. Harvard T.H. Chan School of Public Health 2016. http://caseresources.hsph.harvard.edu/publications/medical-tourism-abc-health-plan-%C2%A0-%C2%A0. GHELI repository link: http://repository.gheli.harvard.edu/repository/11455 This teaching case explores some of the ethical dilemmas associated with medical tourism, the practice of seeking medical care in foreign countries where the quality may be similar but costs much less than the same procedure performed in the patient’s home country. In the case, a summer intern at the nonprofit company Mountain Health Insurance has been tasked to identify the associated ethical issues with medical tourism that the company’s ethics advisory group should consider at their next meeting. What values should the company apply when thinking about its approach to medical tourism? Her findings and recommendations will steer the company’s effort to update their ethical guidelines to reflect emerging ethical challenges in the financing and delivery of health care. In addition to the four- page case, three discussion questions are provided. These questions ask students to reflect on whether the company should develop an insurance product that includes overseas providers for certain services and procedures, the benefits and concerns of developing such products within the context of the company’s mission, and the ethical issues raised by medical tourism. A teaching note is also available free of charge to faculty and may be accessed by request. The case is one in a series of case studies developed by and for the Harvard T.H. Chan School of Public Health Case-Based Teaching and Learning Center.

Global Health Research in an Unequal World: Ethics Case Studies From Africa Teaching Cases. Aellah G et al. Global Health Research in an Unequal World: Ethics Case Studies From Africa. Wellcome Trust, CAB International 2016. DOI: http://dx.doi.org/10.1079/9781786390042.0000. 18 This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported [email protected] 617-495-8222

Global Health Ethics: Resource Pack

GHELI repository link: http://repository.gheli.harvard.edu/repository/12532 This book-length collection of 42 fictionalized cases, published by Wellcome Trust and CAB International, offers a wide range of narratives on everyday ethical dilemmas and challenges that may accompany global health research in places with substantial global, political, and economic inequality. Each story-based case includes discussion questions, suggested group activities, an invitation to reflect on personal experience, further readings, and facilitator notes with learning objectives. Facilitator guidance, templates, and additional resources on using the case studies are also included. The ethical themes addressed in the cases are organized by relational issues—researcher/participant, community and family, institutional, and staff relationships—and a concluding index lists topical themes by alphabetical keyword. The second part of the book explores key perspectives informing the research approach, offers an analysis of the medical research context in Africa, and outlines what anthropology and the social sciences can offer. This case collection is structured to be a user-friendly illustrated resource, suitable for high school or college student classes as well as training opportunities within medical research organizations, universities, collaborative sites, and non- governmental organizations.

Global Health Ethics: Key Issues Guide/Primer. Global Health Ethics: Key issues. World Health Organization 2015. http://www.who.int/ethics/publications/global-health-ethics/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/10533 This primer from the World Health Organization introduces policy makers, health-care providers, and researchers to key ideas in health ethics, and identifies basic ethical issues surrounding public health, health research, clinical health care, health organizations and systems, and global health. The document also describes the role of decision-making frameworks, ethics committees, and various stakeholders in addressing ethical issues in health, and outlines practical strategies.

Who Owns Your Story? Teaching Case. Gordon R. Who Owns Your Story? Global Health Education and Learning Incubator at Harvard University, Harvard University 2014. http://repository.gheli.harvard.edu/repository/10692. GHELI repository link: http://repository.gheli.harvard.edu/repository/10692 This case uses a role play simulation to illustrate ethical implications when research practices violate cultural taboos and norms. In Who Owns Your Story? the Trilanyi—a fictional Native American tribe based on a real community that is not identified or located in the case—is adversely affected by a high prevalence of diabetes. They ask a university professor with whom they have a close relationship to study their tribe, and they agree to give samples of their blood—which they consider sacred—for the study. Tribe members signed a consent form to participate but it was unclear whether they realized that the consent covered the university potentially using their blood for other possible research topics beyond diabetes. Ultimately, the study does not discover that the tribe has a genetic predisposition to diabetes. Years later, however, tribe members learn that their samples had also been used to study topics they considered objectionable. The case is based on true events between the Havasupai tribe and the University of Arizona which ultimately led to a legal suit that was settled out of court. In the case, students are asked to develop and simulate role play negotiations toward an acceptable resolution for all the parties involved. The case includes a companion Teaching Note.

Casebook on Ethical Issues in International Health Research Teaching Case. Cash R et al., eds. Casebook on Ethical Issues in International Health Research. World Health Organization 2009. http://www.who.int/rpc/publications/ethics_casebook/en. GHELI repository link: http://repository.gheli.harvard.edu/repository/10532 This case book, produced by the World Health Organization, offers 64 case studies focused on important ethical issues or challenges associated with planning, conducting, or reviewing health-related research. Topics touch on how research is defined and when ethical committees should be consulted; how studies should be designed to be both scientifically and ethically sound; how to fairly distribute the harms and benefits of a study; ways to ensure that consent to research is voluntary, knowing, and competent; how to identify or define “standard of care”; what the researchers’ and sponsors’ obligations are to a study’s participants and communities; how to handle issues of privacy and confidentiality; and ways to monitor and moderate professional ethical behavior. The collection is primarily designed as a starting point for discussion and reflection in educational programs for researchers, from short workshops to in-service trainings to

19 This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported [email protected] 617-495-8222 Global Health Ethics: Resource Pack

degree or certificate programs. It is accompanied by a teaching guide to aid in integrating the cases into educational programs.

20 This resource is licensed Creative Commons Attribution-Non Commercial-NoDerivs3.0Unported [email protected] 617-495-8222