Jananee Muralidharan, Shalini G Hegde, Santu Ghosh, Ankita Mondal, MC Arjun, Tinku Thomas, Sunita S Kurpad, Charles Davis, Harshpal S Sachdev, Anura V Kurpad
In response to the continuing high prevalence of anaemia recorded in the National Family Health Survey-5, the Indian government launched a policy for mandatory iron fortification of the rice provided through public nutrition programmes in India. This was done even though a rigorous evidence analysis had already concluded that rice fortification was not effective in preventing anaemia or iron deficiency at the population level. Fortification also poses a potential risk of iron toxicity over time, but there is no stated time period for the policy’s implementation. The risk is particularly high in segments of the population who already have a high habitual iron intake, and who could be exposed to simultaneous fortification in different staples and food commodities along with the ongoing weekly Iron and Folic Acid tablets supplementation programme. Finally, this fortification policy also requires significant additional funding and resources to implement. It is crucial to examine such mandatory health actions, and to weigh the benefits and risks of harm, using the principles of public health ethics.
{"title":"Mandatory fortification of rice in the public distribution system in India: an ethics perspective","authors":"Jananee Muralidharan, Shalini G Hegde, Santu Ghosh, Ankita Mondal, MC Arjun, Tinku Thomas, Sunita S Kurpad, Charles Davis, Harshpal S Sachdev, Anura V Kurpad","doi":"10.20529/ijme.2023.064","DOIUrl":"https://doi.org/10.20529/ijme.2023.064","url":null,"abstract":"In response to the continuing high prevalence of anaemia recorded in the National Family Health Survey-5, the Indian government launched a policy for mandatory iron fortification of the rice provided through public nutrition programmes in India. This was done even though a rigorous evidence analysis had already concluded that rice fortification was not effective in preventing anaemia or iron deficiency at the population level. Fortification also poses a potential risk of iron toxicity over time, but there is no stated time period for the policy’s implementation. The risk is particularly high in segments of the population who already have a high habitual iron intake, and who could be exposed to simultaneous fortification in different staples and food commodities along with the ongoing weekly Iron and Folic Acid tablets supplementation programme. Finally, this fortification policy also requires significant additional funding and resources to implement. It is crucial to examine such mandatory health actions, and to weigh the benefits and risks of harm, using the principles of public health ethics.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"45 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135511656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"An interfaith anthology grounded in everyday challenges in the NICU","authors":"Meera Baindur","doi":"10.20529/ijme.2023.063","DOIUrl":"https://doi.org/10.20529/ijme.2023.063","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"14 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135616136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This paper focuses on the ethical tensions seen in health systems research by researchers owing to their scientific obligations to their research, ethical obligations to study participants, and social obligations to the community. Health systems research differs from other public health research fields in terms of the participants selected, power relations within health systems and the sociopolitical environment. The study seeks to answer the following questions through experiences in health system research. 1. What are the ethical tensions experienced by researchers in field work? 2. How are the existing guidelines used in resolving tensions arising in field work in India? To understand these ethical tensions, the World Health Organization’s Ethical Considerations for Health Policy and Systems Research were applied to research conducted in the health system settings. These tensions faced by researchers are explained through four emerging themes: the researcher’s position in the health system; voluntariness of participation: participation; and social justice.
{"title":"Ethical obstacles in health systems research in India: need for focused guidelines","authors":"Shipra Singh","doi":"10.20529/ijme.2023.062","DOIUrl":"https://doi.org/10.20529/ijme.2023.062","url":null,"abstract":"This paper focuses on the ethical tensions seen in health systems research by researchers owing to their scientific obligations to their research, ethical obligations to study participants, and social obligations to the community. Health systems research differs from other public health research fields in terms of the participants selected, power relations within health systems and the sociopolitical environment. The study seeks to answer the following questions through experiences in health system research. 1. What are the ethical tensions experienced by researchers in field work? 2. How are the existing guidelines used in resolving tensions arising in field work in India? To understand these ethical tensions, the World Health Organization’s Ethical Considerations for Health Policy and Systems Research were applied to research conducted in the health system settings. These tensions faced by researchers are explained through four emerging themes: the researcher’s position in the health system; voluntariness of participation: participation; and social justice.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"24 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135803463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"People with dementia need attention, not drugs","authors":"Dick Bijl","doi":"10.20529/ijme.2023.061","DOIUrl":"https://doi.org/10.20529/ijme.2023.061","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136015151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Musing over ethics","authors":"Ganesh Singh Dharmashaktu","doi":"10.20529/ijme.2023.054","DOIUrl":"https://doi.org/10.20529/ijme.2023.054","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"295 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139321610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This case study discusses the ethical dilemmas faced by the researchers when a woman with disability voluntarily disclosed her experience of intimate partner violence during an in-depth interview on positive mental health and resilience in wheelchair users. The interviewer's role as a researcher and public health professional raised dilemmas relating to the tenets of privacy, confidentiality and nonmaleficence. Professionals working with women with disability and similar vulnerable participants should anticipate such ethical challenges around violence and discrimination that such individuals face, and strive to resolve challenges based on basic ethical tenets within a context-informed approach.
{"title":"Disclosure of intimate partner violence while studying positive mental health in wheelchair users: ethical dilemmas","authors":"Sonu S Babu, Ravi Prasad Varma","doi":"10.20529/ijme.2023.056","DOIUrl":"https://doi.org/10.20529/ijme.2023.056","url":null,"abstract":"This case study discusses the ethical dilemmas faced by the researchers when a woman with disability voluntarily disclosed her experience of intimate partner violence during an in-depth interview on positive mental health and resilience in wheelchair users. The interviewer's role as a researcher and public health professional raised dilemmas relating to the tenets of privacy, confidentiality and nonmaleficence. Professionals working with women with disability and similar vulnerable participants should anticipate such ethical challenges around violence and discrimination that such individuals face, and strive to resolve challenges based on basic ethical tenets within a context-informed approach.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"62 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139321717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Oppenheimer – The complexities of scientific advancement","authors":"George Thomas","doi":"10.20529/ijme.2023.058","DOIUrl":"https://doi.org/10.20529/ijme.2023.058","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"86 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139321678","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The atomic bombing of Hiroshima and Nagasaki 78 years ago changed the concept of the impact of wars. The hope that the level of devastation would make the world think seriously about taking steps to give up the arms race and focus on human welfare did not materialise. The arms race continues unabated. From one nuclear weapons state in 1945, the number has increased to nine. Nearly 13000 nuclear weapons present on earth are enough to extinguish humankind. This has raised serious concern among medical professionals resolving to preserve life and promote health, who are now coming together for the complete abolition of nuclear weapons.
{"title":"Medical professionals’ resistance against the arms race and nuclear weapons","authors":"Arun Mitra","doi":"10.20529/ijme.2022.055","DOIUrl":"https://doi.org/10.20529/ijme.2022.055","url":null,"abstract":"The atomic bombing of Hiroshima and Nagasaki 78 years ago changed the concept of the impact of wars. The hope that the level of devastation would make the world think seriously about taking steps to give up the arms race and focus on human welfare did not materialise. The arms race continues unabated. From one nuclear weapons state in 1945, the number has increased to nine. Nearly 13000 nuclear weapons present on earth are enough to extinguish humankind. This has raised serious concern among medical professionals resolving to preserve life and promote health, who are now coming together for the complete abolition of nuclear weapons.","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"113 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139321302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The data quality debate on Indian surveys should be more responsible","authors":"S. Zadey, Parth Sharma, Pushkar Nimkar","doi":"10.20529/ijme.2023.052","DOIUrl":"https://doi.org/10.20529/ijme.2023.052","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"79 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139321405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Give truth a chance","authors":"GL Krishna","doi":"10.20529/ijme.2023.060","DOIUrl":"https://doi.org/10.20529/ijme.2023.060","url":null,"abstract":"","PeriodicalId":35523,"journal":{"name":"Indian journal of medical ethics","volume":"19 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139321285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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