Mid-term Paper: Case Study
Global Health Ethics: Spring
2024
Instructions
Students are expected to complete a mid-term analysis paper, to be submitted by the
end of week #6 (May 14, 2023 at 11:59pm). The mid-term paper should respond to the case
study and the questions below. The goal of the mid-term paper is to assess how well students
can apply and analyze the ethical and human rights issues from the readings and the lectures.
The best responses will be specific in identifying the relevant principles and frameworks, and
then apply and analyze those principles to the facts in the case study. The strongest papers will
present thoughtful analyses of the application of ethical principles and the human rights
framework to the scenario.
The mid-term paper should be no longer than 1,000 words. As this is a formal paper, it must
have proper referencing and citations. It should also have an introduction, analysis
section and conclusion. The feedback on your mid-term paper should be used to support the
development of your final paper. Please submit through Blackboard.
Global Health Research in Practice
You’re tasked with developing a public health research project at a well-known university in the
US. This project aims to look at the health outcomes of the small Indigenous community living
in the rain forest, the Awali. The Awali live in the country of Amazonia, a middle-income country
in the Americas.
Amazonia has a large population – in total, about 200 million. The population is also diverse – in
terms of demographic breakdown, 40% identify as coming from European descent, 40% are of
mixed race, 10% are of African descent, 8% are of Asian descent and 2% identify as
Indigenous. Most of the population (close to 80%) live in the three main cities of Amazonia. The
country has good health services in urban areas, but service coverage in rural areas remain
uneven. Of note, the national law of Amazonia provides free primary health services for all
citizens.
There is limited information about the health outcomes of the Awali. Traditionally, the Awali
have lived deep within the rain forest – the majority of that community still reside in that area. In
terms of access to health care, the closest health facility is about 20 miles away, and provides
a limited number of basic services. Most Awali community members do not own cars, but rely
instead on an unpredictable public transport system. The road system within the forest is
limited and poorly maintained. The lack of strong road systems has also meant that outsiders
(including prior researchers) have had difficulty accessing the Awali.
Other information to note about the Awali is that: (1) while there are schools in the Awali
community, the quality of education is limited, and (2) there are also limited economic
opportunities within the local areas. Younger Awali community members must move to big cities
for higher education and more employment opportunities.
The Awali are one of many Indigenous communities in Amazonia – only in the past couple of
decades has there been more of a sustained focus on the health and social well-being of
Indigenous communities in the country. You’ve only been able to find one other research study
on health and the Awali – it is from more than 50 years ago and uses research methods that
would not pass Institutional Review Board approval in 2021.
2
You’re at the beginning of your project and have broad discretion in how you want to carry
out the work. You’ve been in touch with various universities in Amazonia, as well as nongovernmental organizations who might be able to collaborate in the study. You’ve made
contact with the Awali community, but are only at the beginning of developing those
relationships.
1) Reflecting upon the readings from class, how would you design this research project
so that it aligns with ethical principles and human rights?
2) What are the right to health considerations for the Awali? Is the government of
Amazonia advancing the right to health for the Awali? Why or why not?
3) As a researcher from the US, what are some additional ethical issues to consider
before starting work in Amazonia?
Discuss at least two.
As a reminder, as this is a formal paper, you are expected to reference and cite relevant
sources to support your responses.
Grading Rubric
Criteria Total Points
Ethics & human rights in research design
Identification of ethical principles
Identification of human rights principles
Application of ethical principles and human rights framework to Awali
case study
35
Right to health of Awali
Identification of right to health considerations
Response to whether government is or is not realizing the right to
health
Explanation of why government is or is not realizing the right to health
25
US-based research considerations
Identification and discussion of at least two ethical
considerations of research
20
Writing (structure, grammar, spelling, syntax, clarity, etc.) 10
Referencing (in-text and bibliography) 10
TOTAL 100
Readings From Class
Barrett, D.H., Ortmann, L.H., Dawson, A., Saenz, C., Reis, A., Bolan, G. (Eds.) (2016). Public Health Ethics: Cases Spanning the Globe. New York: Springer – Chapter 3: Resource Allocation and Priority Setting – https://link.springer.com/chapter/10.1007/978-3-319-23847-0_1
Kaur, G., Prinja, S., Lakshmi, P., Downey, L., Sharma, D., & Teerawattananon, Y. (2019). Criteria used for priority-setting for public health resource allocation in low- and middle-income countries: A systematic review. International Journal of Technology Assessment in Health Care, 35(6), 474-483. doi:http://dx.doi.org.ezproxy2.library.drexel.edu/10.1017/S0266462319000473 (also attached)
McCoy, M., Schmidt, H., Ruger, J., & Danis, M. (2019-11-02). The Role of Public Engagement in Priority-Setting. In Global Health Priority-Setting: Beyond Cost-Effectiveness: Oxford University Press. https://oxford-universitypressscholarship-com.ezproxy2.library.drexel.edu/view/10.1093/oso/9780190912765.001.0001/oso-9780190912765-chapter-16. (also attached)
Emanuel EJ, Persad G, Upshur R, et al. Fair allocation of scarce medical resources in the time of COVID-19. N Engl J Med. 2020;382(21):2049–2055. doi:10.1056/NEJMsb2005114 (attached). https://www.nejm.org/doi/full/10.1056/nejmsb2005114
