Individual Right Versus the Collective Good
Most of the recent successes in improving the public’4 s health has had to address the tension of individual rights versus the collective good. Anti-smoking campaigns and laws banning smoking in public places protect people from the negative health effects of second-hand smoke, yet some believe that they infringe on the individual rights of those who choose to smoke. Requiring childhood immunizations has helped prevent diseases such as polio and measles, but some parents assert that they have the right to decide if being immunized is in the best interest of their children.
This tension also exists in the allocation of scarce resources, from providing adequate staff coverage to making decisions about the amount of health care to provide. Given the nurse’s involvement in policy and health care delivery, it is important to understand the dynamics of this tension, as well as the legal and ethical implications.
To prepare:
When have you encountered a tension between the individual right and the collective good in your nursing practice?
With information from the Learning Resources in mind, consider relatively recent examples of health care policy that demonstrate this tension. For this Discussion, select one example of timely health care policy that allows you to evaluate the tension between individual rights and the collective good. Conduct additional research as necessary using credible websites and the Walden Library.
By tomorrow 04/04/2018 3pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”
Post a cohesive response that addresses the following:
In the first line of your posting, identify a health care policy.
Explain the tension between individual rights and the collective good.
Analyze the ethical and legal considerations of the policy.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
Chapter 13, “Medical Ethics and Rationing of Health Care”
This chapter discusses the four principles of medical ethics—beneficence, malfeasance, autonomy, and justice, and views current health care conditions through these lenses. Distributive justice, allocation of limited health care resources, rationing, and the ethics of health care financing are also examined.
Bae, S., & Brewer, C. (2010). Mandatory overtime regulations and nurse overtime. Policy, Politics & Nursing Practice, 11(2), 99–107.
The authors examine the effect of government regulations on health care issues by studying nurse overtime. They discovered that states with mandatory overtime regulations had higher total RN work hours.
Blum, J. D., & Talib, N. (2006). Balancing individual rights versus collective good in public health enforcement. Medicine & Law, 25(2), 273–281.
This article examines the balance of public good and individual liberty through the examples of policies regarding communicable disease and childhood immunization. The impact of the U.S. Supreme Court Case, Jacobson v. Massachusettson health care policy is discussed.
Pauly, B. (2008). Harm reduction through a social justice lens. International Journal of Drug Policy, 19(1), 4–10.
The author discusses the ethical issue of marginalized groups, such as the homeless, and their barriers to health care. The philosophy of harm reduction and various social justice theories are examined as possible guides to a policy initiative.
Ruger, J. P. (2008). Ethics in American health 2: An ethical framework for health system reform. American Journal of Public Health, 98(1), 1756–1763.
Wieck, K. L., Oehler, T., Green, A., & Jordan, C. (2004). Safe nurse staffing: A win-win collaboration model for influencing health policy. Policy, Politics & Nursing Practice, 5(3), 160–166.
Optional Resources
Fowler, M. (2008). Guide to the code of ethics for nurses: Interpretation and application. M. D. M. Fowler (Ed.). Silver Spring, MD: The American Nurses Association, Inc.
O’Connor, J. C., MacNeil, A., Chriqui, J. F., Tynan, M., Bates, H., & Eidson, S. K. (2008). Preemption of local smoke-free air ordinances: The implications of judicial opinions for meeting national health objectives. Journal of Law, Medicine & Ethics, 36(2), 403–412.
Rogers, E. M., & Peterson, J. C. (2008). Diffusion of clean indoor air ordinances in the southwestern United States. Health Education & Behavior, 35(5), 683–697.
Trentham, M. (2009). Patient abandonment—What is it really? ASBN Update, 13(1).

Appraising the Literature
For the DNP-prepared nurse, it is important to hone skills related to reviewing and evaluating research literature to implement evidence-based practices. As you examine epidemiological research, in particular, it is essential to ask, “What are the strengths and weakness of the research method(s)? Are the data analysis and interpretation sound? Is there any evidence of bias?” This Discussion provides you and your colleagues valuable practice in critically analyzing research literature.
To prepare:
With this week’s Learning Resources in mind, reflect on the importance of analyzing epidemiological research studies.
Critically appraise the Oppenheimer (2010) and Elliott, Smith, Penny, Smith and Chambers (1999) articles presented in the Learning Resources using Appendix A in Epidemiology for Public Health Practice as a guide.
Determine the strengths and weaknesses of the research methods and data analysis of each study.
Ask yourself, “Is any bias evident in either study? What did the researchers do to control for potential bias?”
Finally, consider the importance of data interpretation in epidemiologic literature and the issues that may arise if potential confounding factors are not considered.
By tomorrow 04/05/2018 3pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”
Post a cohesive scholarly response that addresses the following:
1) Appraise the Oppenheimer (2010) and Elliott et al. (1999) articles, summarizing the strengths and weaknesses of each study (see attached files for those articles).
2) Analyze potential sources of bias in each study and suggest strategies for minimizing bias.
3) Suggest possible confounding variables that may have influenced the results of each study.
Required Readings
Friis, R. H., & Sellers, T. A. (2014). Epidemiology for public health practice (5th ed.). Sudbury, MA: Jones & Bartlett.
Chapter 10, “Data Interpretation Issues”
Chapter 15, “Social, Behavioral, and Psychosocial Epidemiology”
Appendix A – Guide to the Critical Appraisal of an Epidemiologic/Public Health Research Article
In Chapter 10, the authors describe issues related to data interpretation and address the main types of research errors that need to be considered when conducting epidemiologic research, as well as when analyzing published results. It also presents techniques for reducing bias. Chapter 15 features psychosocial, behavioral, and social epidemiology. Appendix A includes criteria to consider when reading an empirical journal article.
Elliott, A. M., Smith, B. H., Penny, K., Smith, W. C., & Chambers, W. A. (1999). The epidemiology of chronic pain in the community. The Lancet, 354(9186), 1248–1252.
This article describes an early epidemiologic study on chronic pain. Carefully review this article noting the structure of the research design, assessment and data collection, and analysis strategies. You will refer to this article for Discussion 2. (see attached file)
Oppenheimer, G. M. (2010). Framingham Heart Study: The first 20 years. Progress in Cardiovascular Diseases, 53(1), 55–61.
The Framingham Heart Study is a landmark epidemiologic study that began in the 1940s. The author of this article reviews the history of the Framingham Heart Study and its contribution to population health. As you read this article, consider any sources of bias or potential conflict of interest. You will refer to this article for Discussion 2. (See attached file).
Phillips, C. V., & Goodman, K. J. (2004). The missed lessons of Sir Austin Bradford Hill. Epidemiologic Perspectives & Innovations, 1(3). Retrieved from http://www.biomedcentral.com/1742-5573/1/3
In 1965, Austin Bradford Hill worked on a paper that has become a standard in public health and epidemiologic study about how to make decisions based on epidemiologic evidence. Hill put forth strategies for inferring causation and stressed the need for considering costs and benefits when planning health-promoting interventions. Review this article, which examines how Hill’s strategies are often misused or misinterpreted.
Centers for Disease Control and Prevention. (2011). CDC health disparities and inequalities report—United States, 2011. Morbidity and Mortality Weekly Report, Supplement, (60), 1–114. Retrieved from http://www.cdc.gov/mmwr/pdf/other/su6001.pdf. [Read pages 11–32]
This report consolidates national data on disparities in mortality, morbidity, behavioral risk factors, health care access, preventive health services, and social determinants of critical health problems in the United States by using selected indicators. The required section of reading introduces the social determinants of health and environmental hazards.
World Health Organization. (2011). Social determinants of health. Retrieved from http://www.who.int/social_determinants/en/
According to the World Health Organization, “The social determinants of health are mostly responsible for health inequities—the unfair and avoidable differences in health status seen within and between countries.” This article presents an introduction to social determinants of health.
World Health Organization. (2011). Social determinants of health: Key concepts. Retrieved from http://www.who.int/social_determinants/thecommission/finalreport/key_concepts/en/index.html
This article outlines key concepts related to the social determinants of health.
Healthy People 2020. (2011). Social determinants of health. Retrieved from http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39
This website presents an overview of the social determinants of health and addresses how the information relates to Healthy People 2020.
UCL Institute of Health Equity. (2012). ‘Fair society healthy lives’ (The Marmot Review). Retrieved from http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives-the-marmot-review
Optional Resources
Genaidy, A. M., Lemasters, G. K., Lockey, J., Succop, P., Deddens, J., Sobeih, & Dunning, K. (2007). An epidemiological appraisal instrumental – a tool for evaluation of epidemiological studies. Ergonomics, 50(6), 920–960.
Centers for Disease Control and Prevention. (2011). Social determinants of health. Retrieved from http://www.cdc.gov/socialdeterminants/