Description
Do you think it is ethical to use disincentives to change peoples’ health behavior? For example, charging smokers more for life insurance, or fining a person for not wearing a safety belt or motorcycle helmet. Provide a rationale for your response and offer one particular example of a disincentive to change a certain health behavior as part of your response.
P R E S E N T A T I O N
Ethics and Health Education/Promotion
What is the difference between ethics and morality? Your reading assignment describes ethics as “the science of how choices are made or should be made” and morality as “the activity of making choices and of deciding, judging, justifying, and defending those actions or behaviors called moral.” One can easily use the words ethical and moral interchangeably.
To act ethically means bringing meaning and purpose to one’s life. It is a standard by which to live by acting in a manner that is deemed right. It is believed that a person that lives an ethical life is mature, strong, healthy, and has a more developed personality than those who do not live ethically.
Professional Ethics
Professional ethics focuses on actions that are considered right and wrong in the workplace. Moral principles tell professionals what they should do and what they should not do. Professionals are expected to act ethically. Since health educators work closely with people, it is understood that they should act in a professionally ethical manner.
Ethical theories help health educators to decide if a person’s actions are acceptable. They can be categorized as deontological or teleological. Deontological theories define certain actions as good or bad, right or wrong. Teleological theories define the outcomes of those actions as being morally right or wrong suggesting that sometimes one’s actions might be wrong, but the outcome creates a beneficial outcome.
Everyone cannot be in agreement when determining ethics; therefore, it becomes necessary to determine a common moral ground. To help us do this, Thiroux defined five basic principles that can be applied to human morality to help find common moral ground. These principles are:
Value of Life
Goodness (rightness) – includes nonmaleficence and beneficence
Justice (fairness) – include procedural and distributive justice
Truth telling (honesty)
Individual Freedom (equality or autonomy)
Making Ethical Decisions
In the field of health education, it is important to be able to make ethical decisions and determine what is right and what is wrong within given situations. Health educators need to rely on their values, principles and ethical thinking. The textbook provides one example of an ethical decision-making process that is completed in ten steps. You will be working with these ten steps in an assignment!
Step 1: Define the problem, identify the ethical issue, and gather relevant information.
Step 2: Identify who will be affected.
Step 3: Contemplate ultimate goals and ideals.
Step 4: Identify the alternatives (viable courses of action).
Step 5: Consider the consequences of the alternatives.
Step 6: Consider the nature of the alternatives.
Step 7: Reflect on yourself.
Step 8: Reflect on society and the environment.
Step 9: Apply the categorical imperative.
Step 10: Choose an alternative, provide a rationale, act, and monitor the results.
When going through the decision-making process, it is important to understand the context of the situation. Some actions are appropriate in one place, but not another; it is important to learn from past decisions; one should know how the decision relates to oneself; understand how moral decisions impact relationships; aim for noble ideals; do not lose sight of the fact that choices come from concrete events; and make your decisions with appropriate seriousness. The decision-making process applies to the health education profession. You should be able to apply a circumstance to all of the steps described above.
Ethical Issues and Health Education Promotion
Bayles (1989) organized the obligations of professions and professionals common to all. They apply well to health education and promotion:
(1) Obligations and availability of services: Professional services should be available to all citizens.
(2) Obligations between professionals and clients: This includes the professional-client relationship where the professional is honest, competent, loyal, and discreet.
(3) Obligations to third parties: This governs what information can be shared with family members, legal authorities, and peers.
(4) Obligations between professionals and employers: Professionals have obligations to employers which includes process, confidentiality, and professional support.
(5) Obligations to the profession: Includes conducting research, reforming the profession, and maintaining respect for the profession.
Ensuring Ethical Behavior
To ensure ethical behavior, a profession puts guidelines into place. The guidelines are usually created by those who are in professional preparation programs or by those who are already in the profession. If these guidelines are placed in writing, they are normally called a code of ethics. This document is useful for professionals, and it can also be useful for those who seek the services of professionals.
Due to the nature of health education, the health educator is bound to come across ethical issues. The profession of health education has its own code of ethics. The first one was written in 1976. It has been updated and rewritten several times. The most recent one is entitled “Code of Ethics for the Health Education Profession.” There is no formal process to enforce the code of ethics. See if you can locate it on the Web.
The Health Education Specialist: Roles, Responsibilities, Certifications, Advanced Study
Quality Assurance and Credentialing
Credentialing requires that there is a credentialing body. This body has specific standards that it requires a professional preparation program or an individual to possess. Credentialing can be in the form of accreditation, licensure, or certification.
Accreditation is given to a professional preparation program and is given by the credentialing body that has pre-established standards and requirements that the program possesses. Licensure is the permission that a governing body gives to a professional in order to participate in professional activities. Certification is a formal recognition giving to an individual by a professional organization indicating successful completion of established requirements related to the profession.
History of Role Delineation and Certification
Representatives from eight different health education organizations came together to form the Coalition of Health Education Organizations. They worked together to create role delineation for health educators, verified and defined the role of health education, developed curriculum frameworks, and worked towards a certification system. In October 1988, health educators could be certified based on their academic training, work experience, and references. Beginning in 1990, health educators could become certified by taking a certification examination. Health education students are strongly encouraged to sit for the certification exam upon graduation.
In 1996, standards were established that defined the skills needed by an entry-level health educator. These standards were updated by the Competencies Update Program (CUP) in 2005, and the 2010 Health Education Job Analysis Project set new competencies. They are available for review in Appendix B of the textbook.
Program Accreditation
Colleges and universities that train students in professional programs are accredited by recognized professional organizations. Accreditation is defined as “a process by which a recognized professional body evaluates an entire program against predetermined criteria or standards.” Nonaccredited programs may be unattractive to students because most students want to be ensured that they are receiving specific preparations.
Health Education Accreditation
Currently, health education programs are accredited by the following bodies:
National Commission for the Accreditation of Teacher Education (NCATE)
Teacher Education Accreditation Council (TEAC)
Council on Education for Public Health (CEPH)
Society for Public Health Education/American Association for Health Education (SOPHE/AAHE)
Responsibilities of Health Educators
Responsibilities delineate the overall scope of practice for health educators. Each responsibility has anywhere from four to seven competencies. Each competency is subdivided into one to five sub-competencies. The Health Education Job Analysis 2010 is available in Appendix B of the textbook. It lists the responsibilities, competencies, and sub-competencies.
Health educators have seven major responsibilities, including:
Assessing Individual and Community Needs for Health Education - A needs assessment is performed to determine what health problems might exist in a given population and to determine what capacity the population has to engage in the health education activity. This includes skills, resources, agencies, and people.
Plan Health Education Strategies, Interventions, and Programs - This begins with reviewing the health needs of the community, recruiting community representatives, writing specific and measurable objectives, and developing appropriate interventions.
Implement Health Education Strategies, Interventions, and Programs - The Health Educator should have a complete understanding of the population they are serving, in order to effectively implement the program. They should have a variety of educational methods and materials available to them. Once the program is implemented, the health educator is responsible for monitoring the ongoing program.
Conduct Evaluation and Research Related to Health Education - Evaluation of the program for effectiveness is critical to ensure that the program is meeting the stated objectives. This information is collected and analyzed. The results help the health educator to make changes and improve the program.
Administer Health Education Strategies, Interventions and Programs - Developing health education programs requires strong, effective skills in administration and coordination. It is important that the health educator is able to facilitate cooperative work among those involved in the project.
Serve as a Health Education Resource Person - The health educator should have a solid knowledge base and be able to efficiently research information so that they might act as a resource when approached for health information.
Communicate and Advocate for Health and Health Education - Good health educators must be good communicators and feel comfortable teaching individuals and groups of all sizes and educational levels.
Advanced Study in Health Education
Once a student has their bachelor’s degree in health education, they have the option of going on to earn a master’s degree. There are several types from which to choose. These include M. Ed. (Master of Education), M. S. (Master of Science), M. A. (Master of Arts), M.P.H. (Master of Public Health), and M.S. P. H. (Master of Science in Public Health). There is a tremendous amount of variety from school to school and the student that is interested in pursuing advanced study should match the specific aspects of the programs with their career goals.
Critical Thinking
What are examples of a deontological right and wrong and a teleological right and wrong?
Create a scenario where you might find yourself as a health educator. Take yourself through the 10 steps in the decision-making process.
What are some crucial items that you think should be in the Code of Ethics for health educators?
Why is it important to establish competencies?
Why is it important for a professional program to be accredited?
Why might it be important for someone to pursue advanced studies?
Sample Solution