Practicing the Public Good Exploring Ethical Issues in Public Health Practice

Abstract

Everyday ethics refers to the issues and decision-making practitioners are routinely faced with in their daily work. A quantitative, descriptive study examined everyday ethical issues in public health practice. The theoretical framework was based on Jameton's (1984) concepts of moral uncertainty, moral dilemma and moral distress in nursing. Moral distress may have negative consequences that ultimately lead to job dissatisfaction and leaving the profession. This phenomenon has been studied extensively in clinical practice, but comparatively little in public health practice. A questionnaire was administered to employees at the Thunder Bay District Health Unit (TBDHU) in Thunder Bay, Ontario, Canada. This instrument included an extensively-modified moral distress scale (MDS) (Corley, Elswick, Gorman & Clor, 2001) supplemented by questions about demographics, ethics capacity and personal reflection. Altogether, moral problems were reported at low mean frequencies and intensities. Generally, front line providers and managers and supervisors experienced moral problems at higher levels than the sample average. Furthermore, education, membership in a professional association and job experience had a statistically-significant impact on moral problems. Finally, themes of recent moral or ethical dilemmas included: relationships; different interests/perspectives; fairness; knowledge sharing; and personal issues.