There are numerous ethical issues in epidemiology, from deciding who should receive a vaccine when there is a shortage to the ethical rules researchers should follow in studying disease patterns and trends. As your text emphasizes, all people are interconnected and transmission of disease is one way this is clearly seen. Unfortunately, many diseases today still have certain stigmas attached to them. Recently, in the ebola outbreak in West Africa of 2014, persons who were exposed to the disease were not allowed into certain public places or were shunned from villages.
It is important as the APN to note not only ethical and professional issues, but also how you can be involved in policy to make real change in disease monitoring, outcomes, and resources. This is a professional and ethical obligation you hold as an educated, professional nurse.
Community Resources for Population-Specific Care
The APRN is in a key role in terms of assessing and engaging collaboratively with community resources for population-specific care. It is no longer feasible or realistic for one provider to do all when it comes to caring for individuals and populations. APNs must establish collegial, inter professional partnerships with community agencies and be aware of the resources each community partner offers to promote health and reduce disease chronicity. Community partners can often also facilitate monitoring and follow-up for health risks and disease states for secondary and tertiary preventive initiatives. For example, the Susan Komen foundation offers support and resources to underrepresented or medically disadvantaged women to get mammograms for breast cancer screening.
Ethical-Legal Issues in Epidemiology
As part of their practice role and scope of practice, APRN’s, are expected to provide health promotion and risk reduction and illness prevention for individuals and populations. No longer can APNs focus on individuals; they must practice based on aggregates of populations that share a common characteristic. For example, pregnant teen mothers would be an aggregate sharing the common characteristics of being teens and also being pregnant.
The APN providing care for a pregnant teen is expected to provide primary, secondary, and tertiary prevention to this patient and also to the aggregate population to improve health status, as well as promote quality patient outcomes and safety. APNs are held legally accountable for analyzing epidemiological and biostatistical data in assessment, planning, designing, implementing, and evaluating individual and population health.
One of the primary objectives of epidemiological science is to create public policies and plans to help in the prevention and improve outcomes of disease. Epidemiology is closely tied to research, clinical practice, and public health. Prevention is a key role, as has been demonstrated throughout this course. Sound education, screening tools, decreasing exposures, and understanding the interaction of genetics, environment, and person are critical in prevention. Public policies, such as banning indoor smoking, have made an impact on health outcomes. Sound public policy requires not only initial research and surveillance to assist in creation of sound policy, but ongoing monitoring of cost, outcomes, and impact to ensure that the policy was truly beneficial.