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Videos Concepts Unwrapped View All 36 short illustrated videos explain behavioral ethics concepts and basic ethics principles. Concepts Unwrapped: Sports Edition View All 10 short videos introduce athletes to behavioral ethics concepts. Ethics Defined (Glossary) View All 58 animated videos - 1 to 2 minutes each - define key ethics terms and concepts. Ethics in Focus View All One-of-a-kind videos highlight the ethical aspects of current and historical subjects. Giving Voice To Values View All Eight short videos present the 7 principles of values-driven leadership from Gentile's Giving Voice to Values. In It To Win View All A documentary and six short videos reveal the behavioral ethics biases in super-lobbyist Jack Abramoff's story. Scandals Illustrated View All 30 videos - one minute each - introduce newsworthy scandals with ethical insights and case studies. Video Series

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Professional Ethics

Professionals work in a wide variety of settings and across many different industries including business, science, medicine, education, art, and public service.

Many professions have Codes of Conduct that specify ethical behavior and expectations particular to that industry. In addition, professionals must make ethical judgments in their area of specialty that fall outside their specific Code of Conduct.

The resources in this section offer insights that apply to a wide range of professionals as they seek to develop standards of ethical decision-making and behavior in their careers. Often, professionals need to apply moral reasoning to their interactions with co-workers, clients, and the general public to solve problems that arise in their work. Professionals also need to be on lookout for social and organizational pressures and situational factors that could cause them to err, unknowingly, in their ethical judgments and actions.

No profession is free from ethical dilemmas. All professionals will face ethical issues regardless of their career trajectory or the role they play within an organization. While Codes of Conduct are essential, and a good starting point for ethical conduct, they are no substitute for a well-rounded education in behavioral and applied ethics.

Start Here: Videos

Role Morality

Role Morality

Role morality is the tendency we have to use different moral standards for the different roles we play in society.

Bounded Ethicality

Bounded Ethicality

Bounded ethicality explains how social pressures and psychological processes cause us to behave in ways that are inconsistent with our own values.

Being Your Best Self, Part 4: Moral Action

Being Your Best Self, Part 4: Moral Action

Moral action means transforming the intent to do the right thing into reality. This involves moral ownership, moral efficacy, and moral courage.

Start Here: Cases

Freedom vs. Duty in Clinical Social Work

Freedom vs. Duty in Clinical Social Work

What should social workers do when their personal values come in conflict with the clients they are meant to serve?

High Stakes Testing

High Stakes Testing

In the wake of the No Child Left Behind Act, parents, teachers, and school administrators take different positions on how to assess student achievement.

Healthcare Obligations: Personal vs. Institutional

Healthcare Obligations: Personal vs. Institutional

A medical doctor must make a difficult decision when informing patients of the effectiveness of flu shots while upholding institutional recommendations.

Teaching Notes

Begin by viewing the “Start Here” videos. They introduce key topics that commonly emerge in our careers, such as making ethical decisions based on the role we’re playing at work. The four-part video,  Being Your Best Self , describes the four components of ethical decision-making and action. To help strengthen ethical decision-making skills, watch the behavioral ethics videos in the “Additional Videos” section to learn about the psychological biases that can often lead to making poor choices.

Read through these videos’ teaching notes for details and related ethics concepts. Watch the “Related Videos” and/or read the related Case Study. The video’s “Additional Resources” offer further reading and a bibliography.

To use these resources in the classroom, show a video in class, assign a video to watch outside of class, or embed a video in an online learning module such as Canvas. Then, prompt conversation in class to encourage peer-to-peer learning. Ask students to answer the video’s “Discussion Questions,” and to reflect on the ideas and issues raised by the students in the video. How do their experiences align? How do they differ? The videos also make good writing prompts. Ask students to watch a video and apply the ethics concept to course content.

The case studies offer examples of professionals facing tough ethical decisions or ethically questionable situations in their careers in teaching, science, politics, and social services. Cases are an effective way to introduce ethics topics, and for people to learn how to spot ethical issues.

Select a case study from the Cases Series  or find one in the “Additional Cases” section that resonates with your industry or profession. Then, reason through the ethical dimensions presented, and sketch the ethical decision-making process outlined by the case. Challenge yourself (and/or your team at work) to develop strategies to avoid these ethical pitfalls. Watch the case study’s “Related Videos” and “Related Terms” for further understanding.

To use the case studies in the classroom, ask students to read a video’s “Case Study” and answer the case study “Discussion Questions.” Then, follow the strategy outlined in the previous paragraph, challenging students to develop strategies to avoid the ethical pitfalls presented in the case.

Ethics Unwrapped  blogs  are also useful prompts to engage colleagues or students in discussions about ethics. Learning about ethics in the context of real-world (often current) events can enliven conversation and make ethics relevant and concrete. Share a blog in a meeting or class or post one to the company intranet or the class’s online learning module. To spur discussion, try to identify the ethical issues at hand and to name the ethics concepts related to the blog (or current event in the news). Dig more deeply into the topic using the Additional Resources listed at the end of the blog post.

Remember to review video, case study, and blogs’ relevant glossary  terms. In this way, you will become familiar with all the ethics concepts contained in these material. Share this vocabulary with your colleagues or students, and use it to expand and enrich ethics and leadership conversations. To dive deeper in the glossary, watch “Related” glossary videos.

Many of the concepts covered in Ethics Unwrapped operate in tandem with each other. As you watch more videos, you will become more fluent in ethics and see the interrelatedness of ethics concepts more readily. You also will be able to spot ethical issues more easily – at least, that is the hope! It will also be easier to express your ideas and thoughts about what is and isn’t ethical and why. Hopefully, you will also come to realize the interconnectedness of ethics and leadership, and the essential role ethics plays in developing solid leadership skills that can advance your professional career.

Additional Videos

  • Self-serving Bias
  • Moral Equilibrium
  • Conflict of Interest
  • In It To Win: The Jack Abramoff Story
  • In It To Win: Jack & Framing
  • In It To Win: Jack & Rationalizations
  • In It To Win: Jack & Self-Serving Bias
  • In It To Win: Jack & Role Morality
  • In It To Win: Jack & Moral Equilibrium
  • Intro to GVV
  • GVV Pillar 1: Values
  • GVV Pillar 2: Choice
  • GVV Pillar 3: Normalization
  • GVV Pillar 4: Purpose
  • GVV Pillar 5: Self-Knowledge & Alignment
  • GVV Pillar 6: Voice
  • GVV Pillar 7: Reasons & Rationalizations
  • Obedience to Authority
  • Loss Aversion
  • Intro to Behavioral Ethics
  • Moral Muteness
  • Moral Myopia
  • Being Your Best Self, Part 1: Moral Awareness
  • Being Your Best Self, Part 2: Moral Decision Making
  • Being Your Best Self, Part 3: Moral Intent
  • Legal Rights & Ethical Responsibilities

Additional Cases

Liberal arts & fine arts.

  • A Million Little Pieces
  • Approaching the Presidency: Roosevelt & Taft
  • Pardoning Nixon

Science & Engineering

  • Retracting Research: The Case of Chandok v. Klessig
  • Arctic Offshore Drilling

Social Science

  • The CIA Leak
  • Edward Snowden: Traitor or Hero?
  • The Costco Model
  • The Collapse of Barings Bank
  • Teaching Blackface: A Lesson on Stereotypes
  • Cyber Harassment
  • Cheating: Atlanta’s School Scandal

Communication & Journalism

  • Dr. V’s Magical Putter
  • Limbaugh on Drug Addiction
  • Reporting on Robin Williams
  • Covering Yourself? Journalists and the Bowl Championship
  • Sports Blogs: The Wild West of Sports Journalism?
  • Cheney v. U.S. District Court
  • Negotiating Bankruptcy
  • Patient Autonomy & Informed Consent
  • Prenatal Diagnosis & Parental Choice

Public Policy & Administration

  • Gaming the System: The VA Scandal
  • Krogh & the Watergate Scandal

Stay Informed

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Doha Declaration

Education for justice.

  • Agenda Day 1
  • Agenda Day 2
  • Agenda Day 3
  • Agenda Day 4
  • Registration
  • Breakout Sessions for Primary and Secondary Level
  • Breakout Sessions for Tertiary Level
  • E4J Youth Competition
  • India - Lockdown Learners
  • Chuka, Break the Silence
  • The Online Zoo
  • I would like a community where ...
  • Staying safe online
  • Let's be respectful online
  • We can all be heroes
  • Respect for all
  • We all have rights
  • A mosaic of differences
  • The right thing to do
  • Solving ethical dilemmas
  • UNODC-UNESCO Guide for Policymakers
  • UNODC-UNESCO Handbooks for Teachers
  • Justice Accelerators
  • Introduction
  • Organized Crime
  • Trafficking in Persons & Smuggling of Migrants
  • Crime Prevention & Criminal Justice Reform
  • Crime Prevention, Criminal Justice & SDGs
  • UN Congress on Crime Prevention & Criminal Justice
  • Commission on Crime Prevention & Criminal Justice
  • Conference of the Parties to UNTOC
  • Conference of the States Parties to UNCAC
  • Rules for Simulating Crime Prevention & Criminal Justice Bodies
  • Crime Prevention & Criminal Justice
  • Engage with Us
  • Contact Us about MUN
  • Conferences Supporting E4J
  • Cyberstrike
  • Play for Integrity
  • Running out of Time
  • Zorbs Reloaded
  • Developing a Rationale for Using the Video
  • Previewing the Anti-Corruption Video
  • Viewing the Video with a Purpose
  • Post-viewing Activities
  • Previewing the Firearms Video
  • Rationale for Using the Video
  • Previewing the Human Trafficking Video
  • Previewing the Organized Crime Video
  • Previewing the Video
  • Criminal Justice & Crime Prevention
  • Corruption & Integrity
  • Human Trafficking & Migrant Smuggling
  • Firearms Trafficking
  • Terrorism & Violent Extremism
  • Introduction & Learning Outcomes
  • Corruption - Baseline Definition
  • Effects of Corruption
  • Deeper Meanings of Corruption
  • Measuring Corruption
  • Possible Class Structure
  • Core Reading
  • Advanced Reading
  • Student Assessment
  • Additional Teaching Tools
  • Guidelines for Stand-Alone Course
  • Appendix: How Corruption Affects the SDGs
  • What is Governance?
  • What is Good Governance?
  • Corruption and Bad Governance
  • Governance Reforms and Anti-Corruption
  • Guidelines for Stand-alone Course
  • Corruption and Democracy
  • Corruption and Authoritarian Systems
  • Hybrid Systems and Syndromes of Corruption
  • The Deep Democratization Approach
  • Political Parties and Political Finance
  • Political Institution-building as a Means to Counter Corruption
  • Manifestations and Consequences of Public Sector Corruption
  • Causes of Public Sector Corruption
  • Theories that Explain Corruption
  • Corruption in Public Procurement
  • Corruption in State-Owned Enterprises
  • Responses to Public Sector Corruption
  • Preventing Public Sector Corruption
  • Forms & Manifestations of Private Sector Corruption
  • Consequences of Private Sector Corruption
  • Causes of Private Sector Corruption
  • Responses to Private Sector Corruption
  • Preventing Private Sector Corruption
  • Collective Action & Public-Private Partnerships against Corruption
  • Transparency as a Precondition
  • Detection Mechanisms - Auditing and Reporting
  • Whistle-blowing Systems and Protections
  • Investigation of Corruption
  • Introduction and Learning Outcomes
  • Brief background on the human rights system
  • Overview of the corruption-human rights nexus
  • Impact of corruption on specific human rights
  • Approaches to assessing the corruption-human rights nexus
  • Human-rights based approach
  • Defining sex, gender and gender mainstreaming
  • Gender differences in corruption
  • Theories explaining the gender–corruption nexus
  • Gendered impacts of corruption
  • Anti-corruption and gender mainstreaming
  • Manifestations of corruption in education
  • Costs of corruption in education
  • Causes of corruption in education
  • Fighting corruption in education
  • Core terms and concepts
  • The role of citizens in fighting corruption
  • The role, risks and challenges of CSOs fighting corruption
  • The role of the media in fighting corruption
  • Access to information: a condition for citizen participation
  • ICT as a tool for citizen participation in anti-corruption efforts
  • Government obligations to ensure citizen participation in anti-corruption efforts
  • Teaching Guide
  • Brief History of Terrorism
  • 19th Century Terrorism
  • League of Nations & Terrorism
  • United Nations & Terrorism
  • Terrorist Victimization
  • Exercises & Case Studies
  • Radicalization & Violent Extremism
  • Preventing & Countering Violent Extremism
  • Drivers of Violent Extremism
  • International Approaches to PVE &CVE
  • Regional & Multilateral Approaches
  • Defining Rule of Law
  • UN Global Counter-Terrorism Strategy
  • International Cooperation & UN CT Strategy
  • Legal Sources & UN CT Strategy
  • Regional & National Approaches
  • International Legal Frameworks
  • International Human Rights Law
  • International Humanitarian Law
  • International Refugee Law
  • Current Challenges to International Legal Framework
  • Defining Terrorism
  • Criminal Justice Responses
  • Treaty-based Crimes of Terrorism
  • Core International Crimes
  • International Courts and Tribunals
  • African Region
  • Inter-American Region
  • Asian Region
  • European Region
  • Middle East & Gulf Regions
  • Core Principles of IHL
  • Categorization of Armed Conflict
  • Classification of Persons
  • IHL, Terrorism & Counter-Terrorism
  • Relationship between IHL & intern. human rights law
  • Limitations Permitted by Human Rights Law
  • Derogation during Public Emergency
  • Examples of States of Emergency & Derogations
  • International Human Rights Instruments
  • Regional Human Rights Instruments
  • Extra-territorial Application of Right to Life
  • Arbitrary Deprivation of Life
  • Death Penalty
  • Enforced Disappearances
  • Armed Conflict Context
  • International Covenant on Civil and Political Rights
  • Convention against Torture et al.
  • International Legal Framework
  • Key Contemporary Issues
  • Investigative Phase
  • Trial & Sentencing Phase
  • Armed Conflict
  • Case Studies
  • Special Investigative Techniques
  • Surveillance & Interception of Communications
  • Privacy & Intelligence Gathering in Armed Conflict
  • Accountability & Oversight of Intelligence Gathering
  • Principle of Non-Discrimination
  • Freedom of Religion
  • Freedom of Expression
  • Freedom of Assembly
  • Freedom of Association
  • Fundamental Freedoms
  • Definition of 'Victim'
  • Effects of Terrorism
  • Access to Justice
  • Recognition of the Victim
  • Human Rights Instruments
  • Criminal Justice Mechanisms
  • Instruments for Victims of Terrorism
  • National Approaches
  • Key Challenges in Securing Reparation
  • Topic 1. Contemporary issues relating to conditions conducive both to the spread of terrorism and the rule of law
  • Topic 2. Contemporary issues relating to the right to life
  • Topic 3. Contemporary issues relating to foreign terrorist fighters
  • Topic 4. Contemporary issues relating to non-discrimination and fundamental freedoms
  • Module 16: Linkages between Organized Crime and Terrorism
  • Thematic Areas
  • Content Breakdown
  • Module Adaptation & Design Guidelines
  • Teaching Methods
  • Acknowledgements
  • 1. Introducing United Nations Standards & Norms on CPCJ vis-à-vis International Law
  • 2. Scope of United Nations Standards & Norms on CPCJ
  • 3. United Nations Standards & Norms on CPCJ in Operation
  • 1. Definition of Crime Prevention
  • 2. Key Crime Prevention Typologies
  • 2. (cont.) Tonry & Farrington’s Typology
  • 3. Crime Problem-Solving Approaches
  • 4. What Works
  • United Nations Entities
  • Regional Crime Prevention Councils/Institutions
  • Key Clearinghouses
  • Systematic Reviews
  • 1. Introduction to International Standards & Norms
  • 2. Identifying the Need for Legal Aid
  • 3. Key Components of the Right of Access to Legal Aid
  • 4. Access to Legal Aid for Those with Specific Needs
  • 5. Models for Governing, Administering and Funding Legal Aid
  • 6. Models for Delivering Legal Aid Services
  • 7. Roles and Responsibilities of Legal Aid Providers
  • 8. Quality Assurance and Legal Aid Services
  • 1. Context for Use of Force by Law Enforcement Officials
  • 2. Legal Framework
  • 3. General Principles of Use of Force in Law Enforcement
  • 4. Use of Firearms
  • 5. Use of “Less-Lethal” Weapons
  • 6. Protection of Especially Vulnerable Groups
  • 7. Use of Force during Assemblies
  • 1. Policing in democracies & need for accountability, integrity, oversight
  • 2. Key mechanisms & actors in police accountability, oversight
  • 3. Crosscutting & contemporary issues in police accountability
  • 1. Introducing Aims of Punishment, Imprisonment & Prison Reform
  • 2. Current Trends, Challenges & Human Rights
  • 3. Towards Humane Prisons & Alternative Sanctions
  • 1. Aims and Significance of Alternatives to Imprisonment
  • 2. Justifying Punishment in the Community
  • 3. Pretrial Alternatives
  • 4. Post Trial Alternatives
  • 5. Evaluating Alternatives
  • 1. Concept, Values and Origin of Restorative Justice
  • 2. Overview of Restorative Justice Processes
  • 3. How Cost Effective is Restorative Justice?
  • 4. Issues in Implementing Restorative Justice
  • 1. Gender-Based Discrimination & Women in Conflict with the Law
  • 2. Vulnerabilities of Girls in Conflict with the Law
  • 3. Discrimination and Violence against LGBTI Individuals
  • 4. Gender Diversity in Criminal Justice Workforce
  • 1. Ending Violence against Women
  • 2. Human Rights Approaches to Violence against Women
  • 3. Who Has Rights in this Situation?
  • 4. What about the Men?
  • 5. Local, Regional & Global Solutions to Violence against Women & Girls
  • 1. Understanding the Concept of Victims of Crime
  • 2. Impact of Crime, including Trauma
  • 3. Right of Victims to Adequate Response to their Needs
  • 4. Collecting Victim Data
  • 5. Victims and their Participation in Criminal Justice Process
  • 6. Victim Services: Institutional and Non-Governmental Organizations
  • 7. Outlook on Current Developments Regarding Victims
  • 8. Victims of Crime and International Law
  • 1. The Many Forms of Violence against Children
  • 2. The Impact of Violence on Children
  • 3. States' Obligations to Prevent VAC and Protect Child Victims
  • 4. Improving the Prevention of Violence against Children
  • 5. Improving the Criminal Justice Response to VAC
  • 6. Addressing Violence against Children within the Justice System
  • 1. The Role of the Justice System
  • 2. Convention on the Rights of the Child & International Legal Framework on Children's Rights
  • 3. Justice for Children
  • 4. Justice for Children in Conflict with the Law
  • 5. Realizing Justice for Children
  • 1a. Judicial Independence as Fundamental Value of Rule of Law & of Constitutionalism
  • 1b. Main Factors Aimed at Securing Judicial Independence
  • 2a. Public Prosecutors as ‘Gate Keepers’ of Criminal Justice
  • 2b. Institutional and Functional Role of Prosecutors
  • 2c. Other Factors Affecting the Role of Prosecutors
  • Basics of Computing
  • Global Connectivity and Technology Usage Trends
  • Cybercrime in Brief
  • Cybercrime Trends
  • Cybercrime Prevention
  • Offences against computer data and systems
  • Computer-related offences
  • Content-related offences
  • The Role of Cybercrime Law
  • Harmonization of Laws
  • International and Regional Instruments
  • International Human Rights and Cybercrime Law
  • Digital Evidence
  • Digital Forensics
  • Standards and Best Practices for Digital Forensics
  • Reporting Cybercrime
  • Who Conducts Cybercrime Investigations?
  • Obstacles to Cybercrime Investigations
  • Knowledge Management
  • Legal and Ethical Obligations
  • Handling of Digital Evidence
  • Digital Evidence Admissibility
  • Sovereignty and Jurisdiction
  • Formal International Cooperation Mechanisms
  • Informal International Cooperation Mechanisms
  • Data Retention, Preservation and Access
  • Challenges Relating to Extraterritorial Evidence
  • National Capacity and International Cooperation
  • Internet Governance
  • Cybersecurity Strategies: Basic Features
  • National Cybersecurity Strategies
  • International Cooperation on Cybersecurity Matters
  • Cybersecurity Posture
  • Assets, Vulnerabilities and Threats
  • Vulnerability Disclosure
  • Cybersecurity Measures and Usability
  • Situational Crime Prevention
  • Incident Detection, Response, Recovery & Preparedness
  • Privacy: What it is and Why it is Important
  • Privacy and Security
  • Cybercrime that Compromises Privacy
  • Data Protection Legislation
  • Data Breach Notification Laws
  • Enforcement of Privacy and Data Protection Laws
  • Intellectual Property: What it is
  • Types of Intellectual Property
  • Causes for Cyber-Enabled Copyright & Trademark Offences
  • Protection & Prevention Efforts
  • Online Child Sexual Exploitation and Abuse
  • Cyberstalking and Cyberharassment
  • Cyberbullying
  • Gender-Based Interpersonal Cybercrime
  • Interpersonal Cybercrime Prevention
  • Cyber Organized Crime: What is it?
  • Conceptualizing Organized Crime & Defining Actors Involved
  • Criminal Groups Engaging in Cyber Organized Crime
  • Cyber Organized Crime Activities
  • Preventing & Countering Cyber Organized Crime
  • Cyberespionage
  • Cyberterrorism
  • Cyberwarfare
  • Information Warfare, Disinformation & Electoral Fraud
  • Responses to Cyberinterventions
  • Framing the Issue of Firearms
  • Direct Impact of Firearms
  • Indirect Impacts of Firearms on States or Communities
  • International and National Responses
  • Typology and Classification of Firearms
  • Common Firearms Types
  • 'Other' Types of Firearms
  • Parts and Components
  • History of the Legitimate Arms Market
  • Need for a Legitimate Market
  • Key Actors in the Legitimate Market
  • Authorized & Unauthorized Arms Transfers
  • Illegal Firearms in Social, Cultural & Political Context
  • Supply, Demand & Criminal Motivations
  • Larger Scale Firearms Trafficking Activities
  • Smaller Scale Trafficking Activities
  • Sources of Illicit Firearms
  • Consequences of Illicit Markets
  • International Public Law & Transnational Law
  • International Instruments with Global Outreach
  • Commonalities, Differences & Complementarity between Global Instruments
  • Tools to Support Implementation of Global Instruments
  • Other United Nations Processes
  • The Sustainable Development Goals
  • Multilateral & Regional Instruments
  • Scope of National Firearms Regulations
  • National Firearms Strategies & Action Plans
  • Harmonization of National Legislation with International Firearms Instruments
  • Assistance for Development of National Firearms Legislation
  • Firearms Trafficking as a Cross-Cutting Element
  • Organized Crime and Organized Criminal Groups
  • Criminal Gangs
  • Terrorist Groups
  • Interconnections between Organized Criminal Groups & Terrorist Groups
  • Gangs - Organized Crime & Terrorism: An Evolving Continuum
  • International Response
  • International and National Legal Framework
  • Firearms Related Offences
  • Role of Law Enforcement
  • Firearms as Evidence
  • Use of Special Investigative Techniques
  • International Cooperation and Information Exchange
  • Prosecution and Adjudication of Firearms Trafficking
  • Teaching Methods & Principles
  • Ethical Learning Environments
  • Overview of Modules
  • Module Adaption & Design Guidelines
  • Table of Exercises
  • Basic Terms
  • Forms of Gender Discrimination
  • Ethics of Care
  • Case Studies for Professional Ethics
  • Case Studies for Role Morality
  • Additional Exercises
  • Defining Organized Crime
  • Definition in Convention
  • Similarities & Differences
  • Activities, Organization, Composition
  • Thinking Critically Through Fiction
  • Excerpts of Legislation
  • Research & Independent Study Questions
  • Legal Definitions of Organized Crimes
  • Criminal Association
  • Definitions in the Organized Crime Convention
  • Criminal Organizations and Enterprise Laws
  • Enabling Offence: Obstruction of Justice
  • Drug Trafficking
  • Wildlife & Forest Crime
  • Counterfeit Products Trafficking
  • Falsified Medical Products
  • Trafficking in Cultural Property
  • Trafficking in Persons
  • Case Studies & Exercises
  • Extortion Racketeering
  • Loansharking
  • Links to Corruption
  • Bribery versus Extortion
  • Money-Laundering
  • Liability of Legal Persons
  • How much Organized Crime is there?
  • Alternative Ways for Measuring
  • Measuring Product Markets
  • Risk Assessment
  • Key Concepts of Risk Assessment
  • Risk Assessment of Organized Crime Groups
  • Risk Assessment of Product Markets
  • Risk Assessment in Practice
  • Positivism: Environmental Influences
  • Classical: Pain-Pleasure Decisions
  • Structural Factors
  • Ethical Perspective
  • Crime Causes & Facilitating Factors
  • Models and Structure
  • Hierarchical Model
  • Local, Cultural Model
  • Enterprise or Business Model
  • Groups vs Activities
  • Networked Structure
  • Jurisdiction
  • Investigators of Organized Crime
  • Controlled Deliveries
  • Physical & Electronic Surveillance
  • Undercover Operations
  • Financial Analysis
  • Use of Informants
  • Rights of Victims & Witnesses
  • Role of Prosecutors
  • Adversarial vs Inquisitorial Legal Systems
  • Mitigating Punishment
  • Granting Immunity from Prosecution
  • Witness Protection
  • Aggravating & Mitigating Factors
  • Sentencing Options
  • Alternatives to Imprisonment
  • Death Penalty & Organized Crime
  • Backgrounds of Convicted Offenders
  • Confiscation
  • Confiscation in Practice
  • Mutual Legal Assistance (MLA)
  • Extradition
  • Transfer of Criminal Proceedings
  • Transfer of Sentenced Persons
  • Module 12: Prevention of Organized Crime
  • Adoption of Organized Crime Convention
  • Historical Context
  • Features of the Convention
  • Related international instruments
  • Conference of the Parties
  • Roles of Participants
  • Structure and Flow
  • Recommended Topics
  • Background Materials
  • What is Sex / Gender / Intersectionality?
  • Knowledge about Gender in Organized Crime
  • Gender and Organized Crime
  • Gender and Different Types of Organized Crime
  • Definitions and Terminology
  • Organized crime and Terrorism - International Legal Framework
  • International Terrorism-related Conventions
  • UNSC Resolutions on Terrorism
  • Organized Crime Convention and its Protocols
  • Theoretical Frameworks on Linkages between Organized Crime and Terrorism
  • Typologies of Criminal Behaviour Associated with Terrorism
  • Terrorism and Drug Trafficking
  • Terrorism and Trafficking in Weapons
  • Terrorism, Crime and Trafficking in Cultural Property
  • Trafficking in Persons and Terrorism
  • Intellectual Property Crime and Terrorism
  • Kidnapping for Ransom and Terrorism
  • Exploitation of Natural Resources and Terrorism
  • Review and Assessment Questions
  • Research and Independent Study Questions
  • Criminalization of Smuggling of Migrants
  • UNTOC & the Protocol against Smuggling of Migrants
  • Offences under the Protocol
  • Financial & Other Material Benefits
  • Aggravating Circumstances
  • Criminal Liability
  • Non-Criminalization of Smuggled Migrants
  • Scope of the Protocol
  • Humanitarian Exemption
  • Migrant Smuggling v. Irregular Migration
  • Migrant Smuggling vis-a-vis Other Crime Types
  • Other Resources
  • Assistance and Protection in the Protocol
  • International Human Rights and Refugee Law
  • Vulnerable groups
  • Positive and Negative Obligations of the State
  • Identification of Smuggled Migrants
  • Participation in Legal Proceedings
  • Role of Non-Governmental Organizations
  • Smuggled Migrants & Other Categories of Migrants
  • Short-, Mid- and Long-Term Measures
  • Criminal Justice Reponse: Scope
  • Investigative & Prosecutorial Approaches
  • Different Relevant Actors & Their Roles
  • Testimonial Evidence
  • Financial Investigations
  • Non-Governmental Organizations
  • ‘Outside the Box’ Methodologies
  • Intra- and Inter-Agency Coordination
  • Admissibility of Evidence
  • International Cooperation
  • Exchange of Information
  • Non-Criminal Law Relevant to Smuggling of Migrants
  • Administrative Approach
  • Complementary Activities & Role of Non-criminal Justice Actors
  • Macro-Perspective in Addressing Smuggling of Migrants
  • Human Security
  • International Aid and Cooperation
  • Migration & Migrant Smuggling
  • Mixed Migration Flows
  • Social Politics of Migrant Smuggling
  • Vulnerability
  • Profile of Smugglers
  • Role of Organized Criminal Groups
  • Humanitarianism, Security and Migrant Smuggling
  • Crime of Trafficking in Persons
  • The Issue of Consent
  • The Purpose of Exploitation
  • The abuse of a position of vulnerability
  • Indicators of Trafficking in Persons
  • Distinction between Trafficking in Persons and Other Crimes
  • Misconceptions Regarding Trafficking in Persons
  • Root Causes
  • Supply Side Prevention Strategies
  • Demand Side Prevention Strategies
  • Role of the Media
  • Safe Migration Channels
  • Crime Prevention Strategies
  • Monitoring, Evaluating & Reporting on Effectiveness of Prevention
  • Trafficked Persons as Victims
  • Protection under the Protocol against Trafficking in Persons
  • Broader International Framework
  • State Responsibility for Trafficking in Persons
  • Identification of Victims
  • Principle of Non-Criminalization of Victims
  • Criminal Justice Duties Imposed on States
  • Role of the Criminal Justice System
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University Module Series: Integrity & Ethics

Module 12: integrity, ethics and law.

ethics case study classes

  This module is a resource for lecturers  

Case studies.

Choose one or more of the following case studies and lead a discussion which allows students to address and debate issues of integrity, ethics and law. If time allows, let the students vote on which case studies they want to discuss.

For lecturers teaching large classes, case studies with multiple parts and different methods of solution lend themselves well to the group size and energy in such an environment. Lecturers can begin by having students vote on which case study they prefer. Lecturers could break down analysis of the chosen case study into steps which appear to students in sequential order, thereby ensuring that larger groups stay on track. Lecturers may instruct students to discuss questions in a small group without moving from their seat, and nominate one person to speak for the group if called upon. There is no need to provide excessive amounts of time for group discussion, as ideas can be developed further with the class as a whole. Lecturers can vary the group they call upon to encourage responsive participation.

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Ethics in the Classroom

  • Posted April 19, 2016
  • By Leah Shafer

Ethics in the Classroom

Ethical dilemmas abound in education. Should middle school teachers let a failing eighth-grade student graduate, knowing that if she’s held back, she’ll likely drop out? Should a private school principal condone inflated grades? Should an urban district pander to white, middle-class families — at the expense of poor, minority families — in order to boost the achievement of all schools?

Teachers, principals, superintendents, and education policymakers face questions such as these every day. And for many, amid the tangle of conflicting needs, disparate perspectives, and frustration over circumstances, lies the worry that discussing an ethical dilemma with colleagues will implicate you as not knowing how to make the right choice — or as already having made the wrong one.

Educational philosopher Meira Levinson and doctoral student Jacob Fay take up these challenges in the new book Dilemmas of Educational Ethics: Cases and Commentaries . In detailing the moral predicaments that arise in schools, the researchers also provide a framework for educators to discuss their own dilemmas with colleagues, opening the door to making these conversations more common.

The Case of the Failing Eighth Grader

The book presents six detailed case studies of common educational dilemmas, each accompanied by commentaries of varying viewpoints. Written by a range of practitioners — from classroom teachers to district leaders to African American Studies professors to philosophers — these commentaries each dissect the cases differently, introducing new solutions and new ways to consider what is “right.”

In the first case study, middle schools teachers debate whether to allow a failing eighth grade student to graduate, knowing that she’s both unprepared for ninth-grade coursework but also likely to drop out if she’s held back. Despite having lived in three different foster homes in the past year and having her brother die from a gunshot wound, the student, Ada, put forth enormous amounts of effort to raise her grades — until recently, when she grew discouraged. While the district provides an alternative school for struggling students, the teachers rule it out immediately; it’s known as a flat-out school-to-prison pipeline.

The commentaries on this case, and on the other five, range from providing concrete solutions to proposing total reconsiderations of the situation to suggesting that the whole system change. Classroom teacher Melissa Aguirre, for instance, says that the school should retain Ada in order to uphold its standards, but she also comments that this case shows why it’s necessary to make “competency-based” education, and not just “age-based,” a norm for all. Sigal Ben-Porath , an education and political science professor, notes that high-poverty schools are more likely to define students solely by academic standards, and disregarding noncognitive skills. She writes that Ada should be recognized as a complex person and consulted in the decision on whether she should matriculate to ninth grade.

Others provide more abstract interpretations. Willie "J.R." Fleming, a human rights advocate, explains that the circumstances Ada is living under could be defined as an armed conflict or a war zone. As a response to Ada’s dilemma, the writer imagines appropriate alternative schooling that will allow Ada to heal and thrive. Deputy superintendent Toby Romer, explains that the teachers in this case are focused on “worse-case scenarios”; by dismissing the alternative school as too dangerous, he explains, they have ruled-out any possibility of it working for diligent students like her. Ideally, he says, the teachers would make decisions on how the system is supposed to work, rather than on how it does.

A Powerful Problem-Solving Tool

Ada’s story does not lend itself to one solution; instead, it provokes a whirlwind of feelings and reactions. So how can this case, and the five others in the book, assist teachers in considering their own ethical dilemmas — and in reaching viable solutions?

Case studies offer a safe way for educators to begin recognizing and discussing ethical dilemmas they may face in their own work, since no real person is implicated. “We hope that by reading and talking about the cases and commentaries, professional communities can become more practiced and comfortable in having these sorts of discussions, so that when their own particular dilemmas arise, they have the cases and a language to be able to speak about what it is they’re struggling with in their own practice,” says Fay.

The cases also give educators a chance to consider diverse perspectives. “Right now, our conversation in the United States about education policy and practice is so polarized, and so dismissive of the other side,” explains Levinson. “Both wrap themselves up in the mantle of social justice, and they refuse to recognize that in fact, both sides may really care deeply about equity, opportunity, and social justice, and just have different ways to try to achieve those goals.” Because the cases, and especially the commentaries, delve into different viewpoints, they may allow educators to better understand where the other side is coming from — and how to work with them.

Along the same lines, says Levinson, “the commentaries also provide some guidance for how you can think through the cases. They model that you can have disparate views among people of good intent, and they model that that might happen because you are coming at it from a different experiential perspective.”

Eventually, Levinson envisions the discussion of ethical dilemmas as common professional development in schools. If teachers and principals have enough practice discussing case studies of morally unclear situations, they might become more prepared to discuss their own. “You can imagine that, over time, educators themselves being able to say to their colleagues, ‘Here’s my case, here’s my dilemma, I would really appreciate hearing you talk through it.’”

Additional Resources

  • Read Dilemmas of Educational Ethics , edited by Meira Levinson and Jacob Fay.
  • Read a short essay by Levinson on the intellectually challenging nature of education.

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Ethics Case Studies & Education Resources

ACP ethics education resources cover a broad range of issues in clinical ethics, professionalism, teaching, research, health care delivery, and other topics. Each resource can be used as a learning activity and completed for free CME/MOC credits as indicated or used as a teaching tool.

  • Ethics Case Studies for CME/MOC
  • Ethics Manual Activity for CME/MOC
  • Position Paper Activities for CME/MOC

Additional Ethics Case Studies

Acp ethics case study series.

Each case study draws on an ethical challenge encountered by physicians in everyday practice, teaching or research. Free CME/MOC credits are available from ACP’s Online Learning Center. Free CME/MOC credits are available for completion of case studies on Medscape as indicated (a free Medscape login is required for access and completion).

  • Ethics, Professionalism, Physician Employment and Health Care Business Practices CME/MOC
  • Show Codes, Slow Codes, Full Codes, or No Codes: What Is a Doctor to Do? CME/MOC
  • When Resources Are Limited During a Public Health Catastrophe: Nondiscrimination and Ethical Allocation Guidance CME/MOC
  • Patient Prejudice? The Patient Said What?... and What Comes Next CME/MOC
  • Lab Results Reporting, Ethics, and the 21st Century Cures Act Rule on Information Blocking CME/MOC
  • Physician Suicide Prevention: The Ethics and Role of the Physician Colleague and the Healing Community CME/MOC
  • Ethics, Electronic Health Record Integrity and the Patient-Physician Relationship CME/MOC
  • Ethics, Professionalism, and the Physician Social Media Influencer CME/MOC
  • Professional Attire and the Patient-Physician Relationship CME/MOC
  • When the Family Caregiver Is a Physician: Negotiating the Ethical Boundaries CME/MOC
  • ”Doctor, Can’t You Just Phone a Prescription In?” and Other Ethical Challenges of Telemedicine Encounters CME/MOC
  • Serving as an Expert Witness: Is there a Duty? CME  

Ethics Manual (CME/MOC)

The ACP Ethics Manual is the core of College ethics policy. The seventh edition examines issues in medical ethics, reflecting on the ethical tenets of medicine and their application to emerging challenges while also revisiting older issues that are still very pertinent. It helps physicians be prepared to deal with ethical challenges: to identify and reaffirm the fundamentals of medical ethics—such as the patient-physician relationship—and apply principles and reasoned arguments in resolving dilemmas and in debate about ethics topics.

A 25-question quiz module on the seventh edition of the Ethics Manual is available for up to 10 AMA PRA Category 1 Credits TM and MOC Points. The activity is free for ACP members and Annals subscribers.

Annals of Internal Medicine offers the following CME/MOC activity for ACP members and Annals subscribers:

  • Ethical and Professionalism Implications of Physician Employment and Health Care Business Practices (Ann Intern Med. published online 15 March 2021) CME/MOC

Additional position papers cover a broad range of health care ethics issues and can be used as a teaching tool.

  • Pandemic Treatment Resource Allocation Ethics and Nondiscrimination
  • Confidentiality and Privacy: Beyond HIPAA to Honey, Can We Talk?  
  • Secret Recordings of Office Visits by Patients  
  • Addressing a Colleague's Unprofessional Behavior During Sign-Out  
  • Patient Requests for Specific Care: 'Surely You Can Explain to My Insurer That I Need Boniva?'  
  • Maintaining Medical Professionalism Online: Posting of Patient Information  
  • Banning Harmful Health Behaviors as a Condition of Employment: Where There's Smoke There's Fired?  
  • Addressing a Colleague's Sexually Explicit Facebook Post  
  • Wellness Programs and Patient Goals of Care  
  • Resident Duty Hours: To Hand Over or Gloss Over?
  • When an Aging Colleague Seems Impaired  
  • Preventive Health Screening, Ethics and the Cognitively Impaired Patient  
  • Stewardship of Health Care Resources: Allocating Mechanical Ventilators During Pandemic Influenza  
  • Copied and Pasted and Misdiagnosed (or Cloned Notes and Blind Alleys)  
  • Stewardship of Health Care Resources: Responding to a Patient’s Request for Antibiotics
  • Who Should Get What? Mammography and the Stewardship of Health Care Resources  
  • Patient/Physician/Family Caregiver Relationships: When the Family Caregiver Is a Physician  
  • Physician Work Stoppages and Political Demonstrations -- Economic Self-Interest or Patient Advocacy? Where Is the Line?  
  • To Be or Not to Be: Should I Serve as an Expert Witness?  
  • Author! Author! Who Should Be Named in a Published Study? An Ethics Case Study  
  • The Difficult Patient: Should You End the Relationship? What Now? An Ethics Case Study  
  • Dealing with the "Disruptive" Physician Colleague  
  • Must You Disclose Mistakes Made by Other Physicians?
  • Providing Care to Undocumented Immigrants
  • Twenty-eight additional case studies are published in the book  Ethical Choices: Case Studies for Medical Practice (2nd edition)

For more information on these and other educational content, please contact Lois Snyder Sulmasy, JD, at  [email protected]  or at 215-351-2835.

Ethics Sessions at Internal Medicine Meeting 2020

April 23 – 25, 2020, Los Angeles, CA

Sponsored by the Ethics, Professionalism & Human Rights Committee (EPHRC)

  • Ethical Case Challenges: Precision Medicine and Genetics in Primary Care
  • Ethics Year in Review
  • Spirituality in End-of-Life Care: What is the Physician’s Role?
  • Practical Palliative Care: Managing Pain at the End of Life

Ethics education sessions on different topics are offered at the annual Internal Medicine Meeting each year. Information on past Internal Medicine Meeting ethics sessions is available upon request at [email protected] .

Attending the Internal Medicine Meeting is an excellent way to fulfill your state CME relicensure requirements. The ethics sessions may fulfill specific CME content requirements of your state’s licensure renewal. Letters of participation documenting attendance are available online .

For more information on these and other educational content, please contact Lois Snyder Sulmasy, JD, at [email protected] or at 215-351-2835.

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Discussion Tools: Case Studies

Instructional tools that promote active, participatory learning are widely recognized as the most effective way to engage trainees, convey knowledge, develop skills, and change attitudes.

What is Research Ethics

Why Teach Research Ethics

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Descriptions of educational settings , including in the classroom, and in research contexts.

Case Studies

Other Discussion Tools

Information about the history and authors of the Resources for Research Ethics Collection

Case studies are a tool for discussing scientific integrity. Although one of the most frequently used tools for encouraging discussion, cases are only one of many possible tools. Many of the principles discussed below for discussing case studies can be generalized to other approaches to encouraging discussion about research ethics. Cases are designed to confront readers with specific real-life problems that do not lend themselves to easy answers. Case discussion demands critical and analytical skills and, when implemented in small groups, also fosters collaboration (Pimple, 2002). By providing a focus for discussion, cases help trainees to define or refine their own standards, to appreciate alternative approaches to identifying and resolving ethical problems, and to develop skills for analyzing and dealing with hard problems on their own. The effective use of case studies is comprised of many factors, including:

  • appropriate selection of case(s) (topic, relevance, length, complexity)
  • method of case presentation (verbal, printed, before or during discussion)
  • format for case discussion (Email or Internet-based, small group, large group)
  • leadership of case discussion (choice of discussion leader, roles and responsibilities for discussion leader)
  • outcomes for case discussion (answers to specific questions, answers to general questions, written or verbal summaries)

It should be noted that ethical decision-making is a process rather than a specific correct answer. In this sense, unethical behavior is defined by a failure to engage in the process of ethical decision-making. It is always unacceptable to have made no reasonable attempt to define a consistent and defensible basis for conduct.  

Leading Case Discussions

For the sake of time and clarity of purpose, it is essential that one individual have responsibility for leading the group discussion. As a minimum, this responsibility should include:

  • Reading the case aloud.
  • Defining, and re-defining as needed, the questions to be answered.
  • Encouraging discussion that is "on topic".
  • Discouraging discussion that is "off topic".
  • Keeping the pace of discussion appropriate to the time available.
  • Eliciting contributions from all members of the discussion group.
  • Summarizing both majority and minority opinions at the end of the discussion.

How should cases be analyzed?

Many of the skills necessary to analyze case studies can become tools for responding to real world problems. Cases, like the real world, contain uncertainties and ambiguities. Readers are encouraged to identify key issues, make assumptions as needed, and articulate options for resolution. In addition to the specific questions accompanying each case, readers might consider the following questions:

  • Who are the affected parties (individuals, institutions, a field, society) in this situation?
  • What interest(s) (material, financial, ethical, other) does each party have in the situation? Which interests are in conflict?
  • Were the actions taken by each of the affected parties acceptable (ethical, legal, moral, or common sense)? If not, are there circumstances under which those actions would have been acceptable? Who should impose what sanction(s)?
  • What other courses of action are open to each of the affected parties? What is the likely outcome of each course of action?
  • For each party involved, what course of action would you take, and why?
  • What actions could have been taken to avoid the conflict?

If consensus is not possible, then written or oral summaries should reflect majority and minority opinions.  

Is there a right answer?

ACCEPTABLE SOLUTIONS: Most problems will have several acceptable solutions or answers, but it will not always be the case that a perfect solution can be found. At times, even the best solution will still have some unsatisfactory consequences. UNACCEPTABLE SOLUTIONS: While more than one acceptable solution may be possible, not all solutions are acceptable. For example, obvious violations of specific rules and regulations or of generally accepted standards of conduct would typically be unacceptable. However, it is also plausible that blind adherence to accepted rules or standards would sometimes be an unacceptable course of action.

  • Bebeau MJ with Pimple KD, Muskavitch KMT, Borden SL, Smith DH (1995): Moral Reasoning in Scientific Research: Cases for Teaching and Assessment . Indiana University.
  • Elliott D, Stern JE (1997): Research Ethics - A Reader. University Press of New England, Hanover, NH.
  • Ellison, Karin and Karin Wellner. (2013) Research, Ethics, and Society Cases: Discussion Guide , Online Ethics Center.
  • The Case Method , Center for Innovation in Teaching & Learning, University of Illinois at Urbana-Champaign
  • Herreid CF: National Center for Case Study Teaching in Science, State University of New York at Buffalo. This comprehensive site offers methodology, a case study collection, case study teachers, workshops, and links to additional resources.
  • Korenman SG, Shipp AC (1994): Teaching the Responsible Conduct of Research through a Case Study Approach: A Handbook for Instructors. Association of American Medical Colleges, Washington, DC.
  • Macrina FL (2005): Scientific Integrity: An Introductory Text with Cases. 3rd edition, American Society for Microbiology Press, Washington, DC.
  • National Academy of Sciences (2009): On Being a Scientist: Responsible Conduct in Research . 3rd Edition. Publication from the Committee on Science, Engineering, and Public Policy, National Academy of Sciences, National Academy of Engineering, and Institute of Medicine. National Academy Press, Washington DC.
  • Penslar RL, ed. (1995): Research Ethics: Cases and Materials. Indiana University Press, Bloomington, IN.
  • Pimple, KD (2002): Using Case Studies in Teaching Research Ethics
  • Pimple KD (2002): Using Small Group Assignments in Teaching Research Ethics
  • Schrag B, ed. (1996-2007): Graduate Research Ethics: Cases and Commentaries , Volumes 1-7, Association for Practical and Professional Ethics, Bloomington, Indiana.  

The Resources for Research Ethics Education site was originally developed and maintained by Dr. Michael Kalichman, Director of the Research Ethics Program at the University of California San Diego. The site was transferred to the Online Ethics Center in 2021 with the permission of the author.

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This material is based upon work supported by the National Science Foundation under Award No. 2055332. Any opinions, findings, and conclusions or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation.

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Normative case studies, empirically-informed case studies center on real-world dilemmas of educational ethics confronting educators and policy makers. these cases allow for meaningful ethical reflection that encourages mutual understanding and a shared language for discussing ethical challenges. >>, discussion protocols, discussion protocols help structure conversations about ethical dilemmas. additional resources tailored to particular case studies allow for a deeper dive into particular issues. >>, news about educational justice, connect with other educators and educational researchers working on challenges of educational ethics. read about what's going on locally and nationally. >>, here's what's new with jis, recent case studies, remaking the grade: a district's quest for equitable homework policy, snapshot: in this case study,  arlington, va, faced criticism from teachers and parents when the district announced a plan to make homework more equitable by eliminating deadlines and other requirements. how..., caught in the web: educational risks and rewards of online learning, snapshot : online learning can offer many educational benefits for both students and teachers, but how much online learning is too much should this principal apply for a..., latest news, multimedia case "promotion vs. retention" wins 2021 international e-learning award.

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O'Mathúna D, Iphofen R, editors. Ethics, Integrity and Policymaking: The Value of the Case Study [Internet]. Cham (CH): Springer; 2022. doi: 10.1007/978-3-031-15746-2_1

Cover of Ethics, Integrity and Policymaking

Ethics, Integrity and Policymaking: The Value of the Case Study [Internet].

Chapter 1 making a case for the case: an introduction.

Dónal O’Mathúna and Ron Iphofen .


Published online: November 3, 2022.

This chapter agues for the importance of case studies in generating evidence to guide and/or support policymaking across a variety of fields. Case studies can offer the kind of depth and detail vital to the nuances of context, which may be important in securing effective policies that take account of influences not easily identified in more generalised studies. Case studies can be written in a variety of ways which are overviewed in this chapter, and can also be written with different purposes in mind. At the same time, case studies have limitations, particularly when evidence of causation is sought. Understanding these can help to ensure that case studies are appropriately used to assist in policymaking. This chapter also provides an overview of the types of case studies found in the rest of this volume, and briefly summarises the themes and topics addressed in each of the other chapters.

1.1. Judging the Ethics of Research

When asked to judge the ethical issues involved in research or any evidence-gathering activity, any research ethicist worth their salt will (or should) reply, at least initially: ‘It depends’. This is neither sophistry nor evasive legalism. Instead, it is a specific form of casuistry used in ethics in which general ethical principles are applied to the specifics of actual cases and inferences made through analogy. It is valued as a structured yet flexible approach to real-world ethical challenges. Case study methods recognise the complexities of depth and detail involved in assessing research activities. Another way of putting this is to say: ‘Don’t ask me to make a judgement about a piece of research until I have the details of the project and the context in which it will or did take place.’ Understanding and fully explicating a context is vital as far as ethical research (and evidence-gathering) is concerned, along with taking account of the complex interrelationship between context and method (Miller and Dingwall 1997 ).

This rationale lies behind this collection of case studies which is one outcome from the EU-funded PRO-RES Project. 1 One aim of this project was to establish the virtues, values, principles and standards most commonly held as supportive of ethical practice by researchers, scientists and evidence-generators and users. The project team conducted desk research, workshops and consulted throughout the project with a wide range of stakeholders (PRO-RES 2021a ). The resulting Scientific, Trustworthy, and Ethical evidence for Policy (STEP) ACCORD was devised, which all stakeholders could sign up to and endorse in the interests of ensuring any policies which are the outcome of research findings are based upon ethical evidence (PRO-RES 2021b ).

By ‘ethical evidence’ we mean results and findings that have been generated by research and other activities during which the standards of research ethics and integrity have been upheld (Iphofen and O’Mathúna 2022 ). The first statement of the STEP ACCORD is that policy should be evidence-based, meaning that it is underpinned by high-quality research, analysis and evidence (PRO-RES 2021b ). While our topic could be said to be research ethics, we have chosen to refer more broadly to evidence-generating activities. Much debate has occurred over the precise definition of research under the apparent assumption that ‘non-research projects’ fall outside the purview of requirements to obtain ethics approval from an ethics review body. This debate is more about the regulation of research than the ethics of research and has contributed to an unbalanced approach to the ethics of research (O’Mathúna 2018 ). Research and evidence-generating activities raise many ethical concerns, some similar and some distinct. When the focus is primarily on which projects need to obtain what sort of ethics approval from which type of committee, the ethical issues raised by those activities themselves can receive insufficient attention. This can leave everyone involved with these activities either struggling to figure out how to manage complex and challenging ethical dilemmas or pushing ahead with those activities confident that their approval letter means they have fulfilled all their ethical responsibilities. Unfortunately, this can lead to a view that research ethics is an impediment and burden that must be overcome so that the important work in the research itself can get going.

The alternative perspective advocated by PRO-RES, and the authors of the chapters in this volume, is that ethics underpins all phases of research, from when the idea for a project is conceived, all the way through its design and implementation, and on to how its findings are disseminated and put into practice in individual decisions or in policy. Given the range of activities involved in all these phases, multiple types of ethical issues can arise. Each occurs in its own context of time and place, and this must be taken into account. While ethical principles and theories have important contributions to make at each of these points, case studies are also very important. These allow for the normative effects of various assumptions and declarations to be judged in context. We therefore asked the authors of this volume’s chapters to identify various case studies which would demonstrate the ethical challenges entailed in various types of research and evidence-generating activities. These illustrative case studies explore various innovative topics and fields that raise challenges requiring ethical reflection and careful policymaking responses. The cases highlight diverse ethical issues and provide lessons for the various options available for policymaking (see Sect.  1.6 . below). Cases are drawn from many fields, including artificial intelligence, space science, energy, data protection, professional research practice and pandemic planning. The issues are examined in different locations, including Europe, India, Africa and in global contexts. Each case is examined in detail and also helps to anticipate lessons that could be learned and applied in other situations where ethical evidence is needed to inform evidence-based policymaking.

1.2. The Case for Cases

Case studies have increasingly been used, particularly in social science (Exworthy and Powell 2012 ). Many reasons underlie this trend, one being the movement towards evidence-based practice. Case studies provide a methodology by which a detailed study can be conducted of a social unit, whether that unit is a person, an organization, a policy or a larger group or system (Exworthy and Powell 2012 ). The case study is amenable to various methodologies, mostly qualitative, which allow investigations via documentary analyses, interviews, focus groups, observations, and more.

At the same time, consensus is lacking over the precise nature of a case study. Various definitions have been offered, but Yin ( 2017 ) provides a widely cited definition with two parts. One is that a case study is an in-depth inquiry into a real-life phenomenon where the context is highly pertinent. The second part of Yin’s definition addresses the many variables involved in the case, the multiple sources of evidence explored, and the inclusion of theoretical propositions to guide the analysis. While Yin’s emphasis is on the case study as a research method, he identifies important elements of broader relevance that point to the particular value of the case study for examining ethical issues.

Other definitions of case studies emphasize their story or narrative aspects (Gwee 2018 ). These stories frequently highlight a dilemma in contextually rich ways, with an emphasis on how decisions can be or need to be made. Case studies are particularly helpful with ethical issues to provide crucial context and explore (and evaluate) how ethical decisions have been made or need to be made. Classic cases include the Tuskegee public health syphilis study, the Henrietta Lacks human cell line case, the Milgram and Zimbardo psychology cases, the Tea Room Trade case, and the Belfast Project in oral history research (examined here in Chap. 10 ). Cases exemplify core ethical principles, and how they were applied or misapplied; in addition, they examine how policies have worked well or not (Chaps. 2 , 3 and 5 ). Cases can examine ethics in long-standing issues (like research misconduct (Chap. 7 ), energy production (Chap. 8 ), or Chap. 11 ’s consideration of researchers breaking the law), or with innovations in need of further ethical reflection because of their novelty (like extended space flight (Chap. 9 ) and AI (Chaps. 13 and 14 ), with the latter looking at automation in legal systems). These case studies help to situate the innovations within the context of widely regarded ethical principles and theories, and allow comparisons to be made with other technologies or practices where ethical positions have been developed. In doing so, these case studies offer pointers and suggestions for policymakers given that they are the ones who will develop applicable policies.

1.3. Research Design and Causal Inference

Not everyone is convinced of the value of the case study. It must be admitted that they have limitations, which we will reflect on shortly. Yet we believe that others go too far in their criticisms, revealing instead some prejudices against the value of the case (Yin 2017 ). In what has become a classic text for research design, Campbell and Stanley ( 1963 ) have few good words for what they call the ‘One Shot Case Study.’ They rank it below two other ‘pre-experimental’ designs—the One-Group Pretest–Posttest and the Static-Group Comparison—and conclude that case studies “have such a total absence of control to be of almost no scientific value” (Campbell and Stanley 1963 , 6). The other designs have, in turn, a baseline and outcome measure and some degree of comparative analysis which provides them some validity. Such a criticism is legitimate if one prioritises the experimental method as the most superior in terms of effectiveness evidence and, as for Campbell and Stanley, one is striving to assess the effectiveness of educational interventions.

What is missing from that assessment is that different methodologies are more appropriate for different kinds of questions. Questions of causation and whether a particular treatment, policy or educational strategy is more effective than another are best answered by experimental methods. While experimental designs are better suited to explore causal relationships, case studies are more suited to explore “how” and “why” questions (Yin 2017 ). It can be more productive to view different methodologies as complementing one another, rather than examining them in hierarchical terms.

The case study approach draws on a long tradition in ethnography and anthropology: “It stresses the importance of holistic perspectives and so has more of a ‘humanistic’ emphasis. It recognises that there are multiple influences on any single individual or group and that most other methods neglect the thorough understanding of this range of influences. They usually focus on a chosen variable or variables which are tested in terms of their influence. A case study tends to make no initial assumptions about which are the key variables—preferring to allow the case to ‘speak for itself’” (Iphofen et al. 2009 , 275). This tradition has sometimes discouraged people from conducting or using case studies on the assumption that they take massive amounts of time and lead to huge reports. This is the case with ethnography, but the case study method can be applied in more limited settings and can lead to high-quality, concise reports.

Another criticism of case studies is that they cannot be used to make generalizations. Certainly, there are limits to their generalisability, but the same is true of experimental studies. One randomized controlled trial cannot be generalised to the whole population without ensuring that its details are evaluated in the context of how it was conducted.

Similarly, it should not be assumed that generalisability can adequately guide practice or policy when it comes to the specifics of an individual case. A case study should not be used to support statistical generalizations (that the same percentage found in the case will be found in the general public). But a case study can be used to expand and generalize theories and thus have much usefulness. It affords a method of examining the specific (complex) interactions occurring in a case which can only be known from the details. Such an analysis can be carried out for individuals, policies or interventions.

The current COVID-19 pandemic demonstrates the dangers of generalising in the wrong context. Some people have very mild cases of COVID-19 or are asymptomatic. Others get seriously ill and even die. Sometimes people generalise from cases they know and assume they will have mild symptoms. Then they refuse to take the COVID-19 vaccine, basically generalising from similar cases. Mass vaccination is recommended for the sake of the health of the public (generalised health) and to limit the spread of a deadly virus. Cases are reported of people having adverse reactions to COVID-19 vaccines, and some people generalise from these that they will not take whatever risks might be involved in receiving the vaccine themselves. It might be theoretically possible to discover which individuals WILL react adversely to immunisation on a population level. But it is highly complex and expensive to do so, and takes an extensive period of time. Given the urgency of benefitting the health of ‘the public’, policymakers have decided that the risks to a sub-group are warranted. Only after the emergence of epidemiological data disclosing negative effects of some vaccines on some individuals will it become more clear which characteristics typify those cases which are likely to experience the adverse effects, and more accurately quantify the risks of experiencing those effects.

Much literature now points to the advantages and disadvantages of case studies (Gomm et al. 2000 ), and how to use them and conduct them with adequate rigour to ensure the validity of the evidence generated (Schell 1992 ; Yin 2011 , 2017 ). At the same time, legitimate critiques have been made of some case studies because they have been conducted without adequate rigor, in unsystematic ways, or in ways that allowed bias to have more influence than evidence (Hammersley 2001 ). Part of the problem here is similar to interviewing, where some will assume that since interviews are a form of conversation, anyone can do it. Case studies have some similarities to stories, but that doesn’t mean they are quick and easy ways to report on events. That view can lead to the situation where “most people feel that they can prepare a case study, and nearly all of us believe we can understand one. Since neither view is well founded, the case study receives a lot of approbation it does not deserve” (Hoaglin et al., cited in Yin 2017 , 16).

Case studies can be conducted and used in a wide range of ways (Gwee 2018 ). Case studies can be used as a research method, as a teaching tool, as a way of recording events so that learning can be applied to practice, and to facilitate practical problem-solving skills (Luck et al. 2006 ). Significant differences exist between a case study that was developed and used in research compared to one used for teaching (Yin 2017 ). A valid rationale for studying a ‘case’ should be provided so that it is clear that the proposed method is suitable to the topic and subject being studied. The unit of study for a case could be an individual person, social group, community, or society. Sometimes that specific case alone will constitute the actual research project. Thus, the study could be of one individual’s experience, with insights and understanding gained of the individual’s situation which could be of use to understand others’ experiences. Often there will be attempts made at a comparison between cases—one organisation being compared to another, with both being studied in some detail, and in terms of the same or similar criteria. Given this variety, it is important to use cases in ways appropriate to how they were generated.

The case study continues to be an important piece of evidence in clinical decision-making in medicine and healthcare. Here, case studies do not demonstrate causation or effectiveness, but are used as an important step in understanding the experiences of patients, particularly with a new or confusing set of symptoms. This was clearly seen as clinicians published case studies describing a new respiratory infection which the world now knows to be COVID-19. Only as case studies were generated, and the patterns brought together in larger collections of cases, did the characteristics of the illness come to inform those seeking to diagnose at the bedside (Borges do Nascimento et al. 2020 ). Indeed case studies are frequently favoured in nursing, healthcare and social work research where professional missions require a focus on the care of the individual and where cases facilitate making use of the range of research paradigms (Galatzer-Levy et al. 2000 ; Mattaini 1996 ; Gray 1998 ; Luck et al. 2006 ).

1.4. Devil’s in the Detail

Our main concern in this collection is not with case study aetiology but rather to draw on the advantages of the method to highlight key ethical issues related to the use of evidence in influencing policy. Thus, we make no claim to causal ‘generalisation’ on the basis of these reports—but instead we seek to help elucidate ethics issues, if even theoretical, and anticipate responses and obstacles in similar situations and contexts that might help decision-making in novel circumstances. A key strength of case studies is their capacity to connect abstract theoretical concepts to the complex realities of practice and the real world (Luck et al. 2006 ). Ethics cases clearly fit this description and allow the contextual details of issues and dilemmas to be included in discussions of how ethical principles apply as policy is being developed.

Since cases are highly focussed on the specifics of the situation, more time can be given over to data gathering which may be of both qualitative and quantitative natures. Given the many variables involved in the ‘real life’ setting, increased methodological flexibility is required (Yin 2017 ). This means seeking to maximise the data sources—such as archives (personal and public), records (such as personal diaries), observations (participant and covert) and interviews (face-to-face and online)—and revisiting all sources when necessary and as case participants and time allows.

1.5. Cases and Policymaking

Case studies allow researchers and practitioners to learn from the specifics of a situation and apply that learning in similar situations. Ethics case studies allow such reflection to facilitate the development of ethical decision-making skills. This volume has major interests in ethics and evidence-generation (research), but also in a third area: policymaking. Cases can influence policymaking, such as how one case can receive widespread attention and become the impetus to create policy that aims to prevent similar cases. For example, the US federal Brady Law was enacted in 1993 to require background checks on people before they purchase a gun (ATF 2021 ). The law was named for White House Press Secretary James Brady, and his case became widely known in the US. He was shot and paralyzed during John Hinckley, Jr.’s 1981 assassination attempt on President Ronald Reagan. Another example, this time in a research context, was how the Tuskegee Syphilis Study led, after its public exposure in 1971, to the US Department of Health, Education and Welfare appointing an expert panel to examine the ethics of that case. This resulted in federal policymakers enacting the National Research Act in 1974, which included setting up a national commission that published the Belmont Report in 1976. This report continues to strongly influence research ethics practice around the world. These examples highlight the power of a case study to influence policymaking.

One of the challenges for policymakers, though, is that compelling cases can often be provided for opposite sides of an issue. Also, while the Belmont Report has been praised for articulating a small number of key ethical principles, how those principles should be applied in specific instances of research remains an ongoing challenge and a point of much discussion. This is particularly relevant for innovative techniques and technologies. Hence the importance of cases interacting with general principles and leading to ongoing reflection and debate over the applicable cases. At the same time, new areas of research and evidence generation activities will lead to questions about how existing ethical principles and values apply. New case studies can help to facilitate that reflection, which can then allow policymakers to consider whether existing policy should be adapted or whether whole new areas of policy are needed.

Case studies also can play an important role in learning from and evaluating policy. Policymakers tend to focus on practical, day-to-day concerns and with the introduction of new programmes (Exworthy and Peckam 2012 ). Time and resources may be scant when it comes to evaluating how well existing policies are performing or reflecting on how policies can be adapted to overcome shortcomings (Hunter 2003 ). Effective policies may exist elsewhere (historically or geographically) and be more easily adapted to a new context instead of starting policymaking from scratch. Case studies can permit learning from past policies (or situations where policies did not exist), and they can illuminate various factors that should be explored in more detail in the context of the current issue or situation. Chaps. 2 , 3 and 5 in this volume are examples of this type of case study.

1.6. The Moral Gain

This volume reflects the ambiguity of ethical dilemmas in contemporary policymaking. Analyses will reflect current debates where consensus has not been achieved yet. These cases illustrate key points made throughout the PRO-RES project: that ethical decision-making is a fluid enterprise, where values, principles and standards must constantly be applied to new situations, new events and new research developments. The cases illustrate how no ‘one point’ exists in the research process where judgements about ethics can be regarded as ‘final.’ Case studies provide excellent ways for readers to develop important decision-making skills.

Research produces novel products and processes which can have broad implications for society, the environment and relationships. Research methods themselves are modified or applied in new ways and places, requiring further ethical reflection. New topics and whole fields of research develop and require careful evaluation and thoughtful responses. New case studies are needed because research constantly generates new issues and new ethics questions for policymaking.

The cases found in this volume address a wide range of topics and involve several disciplines. The cases were selected by the parameters of the PRO-RES project and the Horizon 2020 funding call to which it responded. First, the call was concerned with both research ethics and scientific integrity and each of the cases addresses one or both of these areas. The call sought projects that addressed non-medical research, and the cases here address disciplines such as social sciences, engineering, artificial intelligence and One Health. The call also sought particular attention be given to (a) covert research, (b) working in dangerous areas/conflict zones and (c) behavioral research collecting data from social media/internet sources. Hence, we included cases that addressed each of these areas. Finally, while an EU-funded project can be expected to have a European focus, the issues addressed have global implications. Therefore, we wanted to include cases studies from outside Europe and did so by involving authors from India and Africa to reflect on the volume’s areas of interest.

The first case study offered in this volume (Chap. 2 ) examines a significant policy approach taken by the European Union to address ethics and integrity in research and innovation: Responsible Research and Innovation (RRI). This chapter examines the lessons that can be learned from RRI in a European context. Chapter 3 elaborates on this topic with another policy learning case study, but this time examining RRI in India. One of the critiques made of RRI is that it can be Euro-centric. This case study examines this claim, and also describes how a distinctively Indian concept, Scientific Temper, can add to and contextualise RRI. Chapter 4 takes a different approach in being a case study of the development of research ethics guidance in the United Kingdom (UK). It explores the history underlying the research ethics framework commissioned by the UK Research Integrity Office (UKRIO) and the Association of Research Managers and Administrators (ARMA), and points to lessons that can be learned about the policy-development process itself.

While staying focused on policy related to research ethics, the chapters that follow include case studies that address more targeted concerns. Chapter 5 examines the impact of the European Union’s (EU) General Data Protection Regulation (GDPR) in the Republic of Croatia. Research data collected in Croatia is used to explore the handling of personal data before and after the introduction of GDPR. This case study aims to provide lessons learned that could contribute to research ethics policies and procedures in other European Member States.

Chapter 6 moves from policy itself to the role of policy advisors in policymaking. This case study explores the distinct responsibilities of those elevated to the role of “policy advisor,” especially given the current lack of policy to regulate this field or how its advice is used by policymakers. Next, Chap. 7 straddles the previous chapters’ focus on policy and its evaluation while introducing the focus of the next section on historical case studies. This chapter uses the so-called “race for the superconductor” as a case study by which the PRO-RES ethics framework is used to explore specific ethical dilemmas (PRO-RES 2021b ). This case study is especially useful for policymakers because of how it reveals the multiple difficulties in balancing economic, political, institutional and professional requirements and values.

The next case study continues the use of historical cases, but here to explore the challenges facing innovative research into unorthodox energy technology that has the potential to displace traditional energy suppliers. The wave power case in Chap. 8 highlights how conducting research with integrity can have serious consequences and come with considerable cost. The case also points to the importance of transparency in how evidence is used in policymaking so that trust in science and scientists is promoted at the same time as science is used in the public interest. Another area of cutting-edge scientific innovation is explored in Chap. 9 , but this time looking to the future. This case study examines space exploration, and specifically the ethical issues around establishing safe exposure standards for astronauts embarking on extended duration spaceflights. This case highlights the ethical challenges in policymaking focused on an elite group of people (astronauts) who embark on extremely risky activities in the name of science and humanity.

Chapter 10 moves from the physical sciences to the social sciences. The Belfast Project provides a case study to explore the ethical challenges of conducting research after violent conflict. In this case, researchers promised anonymity and confidentiality to research participants, yet that was overturned through legal proceedings which highlighted the limits of confidentiality in research. This case points to the difficulty of balancing the value of research archives in understanding conflict against the value of providing juridical evidence to promote justice. Another social science case is examined in Chap. 11 , this time in ethnography. This so-called ‘urban explorer’ case study explores the justifications that might exist for undertaking covert research where researchers break the law (in this case by trespassing) in order to investigate a topic that would remain otherwise poorly understood. This case raises a number of important questions for policymakers around: the freedoms that researchers should be given to act in the public interest; when researchers are justified in breaking the law; and what responsibilities and consequences researchers should accept if they believe they are justified in doing so.

Further complexity in research and evidence generation is introduced in Chap. 12 . A case study in One Health is used to explore ethical issues at the intersection of animal, human and environmental ethics. The pertinence of such studies has been highlighted by COVID-19, yet policies lag behind in recognising the urgency and complexity of initiating investigations into novel outbreaks, such as the one discussed here that occurred among animals in Ethiopia. Chapter 13 retains the COVID-19 setting, but returns the attention to technological innovation. Artificial intelligence (AI) is the focus of these two chapters in the volume, here examining the ethical challenges arising from the emergency authorisation of using AI to respond to the public health needs created by the COVID-19 pandemic. Chapter 14 addresses a longer term use of AI in addressing problems and challenges in the legal system. Using the so-called Robodebt case, the chapter explores the reasons why legal systems are turning to AI and other automated procedures. The Robodebt case highlights problems when AI algorithms are built on inaccurate assumptions and implemented with little human oversight. This case shows the massive problems for hundreds of thousands of Australians who became victims of poorly conceived AI and makes recommendations to assist policymakers to avoid similar debacles. The last chapter (Chap. 15 ) draws some general conclusions from all the cases that are relevant when using case studies.

1.7. Into the Future

This volume focuses on ethics in research and professional integrity and how we can be clear about the lessons that can be drawn to assist policymakers. The cases provided cover a wide range of situations, settings, and disciplines. They cover international, national, organisational, group and individual levels of concern. Each case raises distinct issues, yet also points to some general features of research, evidence-generation, ethics and policymaking. All the studies illustrate the difficulties of drawing clear ‘boundaries’ between the research and the context. All these case studies show how in real situations dynamic judgements have to be made about many different issues. Guidelines and policies do help and are needed. But at the same time, researchers, policymakers and everyone else involved in evidence generation and evidence implementation need to embody the virtues that are central to good research. Judgments will need to be made in many areas, for example, about how much transparency can be allowed, or is ethically justified; how much risk can be taken, both with participants’ safety and also with the researchers’ safety; how much information can be disclosed to or withheld from participants in their own interests and for the benefit of the ‘science’; and many others. All of these point to just how difficult it can be to apply common standards across disciplines, professions, cultures and countries. That difficulty must be acknowledged and lead to open discussions with the aim of improving practice. The cases presented here point to efforts that have been made towards this. None of them is perfect. Lessons must be learned from all of them, towards which Chap. 15 aims to be a starting point. Only by openly discussing and reflecting on past practice can lessons be learned that can inform policymaking that aims to improve future practice. In this way, ethical progress can become an essential aspect of innovation in research and evidence-generation.

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PRO-RES is a European Commission-funded project aiming to PROmote ethics and integrity in non-medical RESearch by building a supported guidance framework for all non-medical sciences and humanities disciplines adopting social science methodologies. This project has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No 788352. Open access fees for this volume were paid for through the PRO-RES funding.

Open Access This chapter is licensed under the terms of the Creative Commons Attribution 4.0 International License ( ), which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license and indicate if changes were made.

The images or other third party material in this chapter are included in the chapter's Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the chapter's Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder.

  • Cite this Page O’Mathúna D, Iphofen R. Making a Case for the Case: An Introduction. 2022 Nov 3. In: O'Mathúna D, Iphofen R, editors. Ethics, Integrity and Policymaking: The Value of the Case Study [Internet]. Cham (CH): Springer; 2022. Chapter 1. doi: 10.1007/978-3-031-15746-2_1
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  • Judging the Ethics of Research
  • The Case for Cases
  • Research Design and Causal Inference
  • Devil’s in the Detail
  • Cases and Policymaking
  • The Moral Gain
  • Into the Future

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ethics case study classes

When Sophie Huttner was 16 years old, she labored over an ethical dilemma. Her small class at Kent Place School in New Jersey was discussing a case study that concerned a woman who was thinking of leaving her disabled husband; caring for his injuries was devouring the woman’s every moment, and the couple’s affection for each other had fizzled. Was it ethically wrong for her to leave him?

“The case made me realize that the value I placed on individual autonomy would often conflict with other values that I also thought important, like loyalty and integrity,” Huttner said. At the time, she was involved in her first serious relationship, and the case and ensuing discussion touched on the very questions she was mulling in her personal life.

“When you give kids and teenagers the space to explore ethical dilemmas, this can be very powerful for students,” said Jana M. Lone, director of the Center for Philosophy for Children at the University of Washington, which brings introductory philosophy to schoolkids in the Seattle area. Central to ethics education is teaching kids the skills to make sound decisions: to search for and evaluate their assumptions, to excavate the reasons behind those assumptions, to examine without prejudice another’s opinion and to make a thoughtful decision with confidence.

“There’s more hunger for this kind of training now,” Lone said. “The most recent political polarization, the shifting news cycle—which makes us less engaged with people who think differently—has made it more imperative,” she added. Kids, too, sense the ugly divisions in society. “Teenagers and kids recognize that they live in a fractured world, and it’s troubling to them,” Lone said.

Though sought after, ethics classes are largely absent from schools. Also, teachers’ freedom to migrate into wide-ranging conversations that might veer into ethics have been curbed by standardized testing and curriculum requirements. This is despite research that shows teenagers’ ability to make ethical decisions—to see problems from multiple view points, and to consider the potential harm to others that a decision can cause—is underdeveloped. In the most recent survey of teenage ethics done by the Josephson Institute, for example, just 49% percent of the 23,000 teenagers surveyed reported never cheating on a test in school. A 2014 analysis by the Making Caring Common Project at Harvard University found that a majority of teenagers value happiness and personal success more than concern for others.

Teaching ethics to children and teenagers

The Ethics Institute* at Kent Place School is devoted solely to teaching ethics to primary and secondary school students, said Karen Rezach, the institute’s director. “There are so many ethics institutes at the university level, but none at our level,” she said. Like Lone, Rezach thinks kids and teenagers long for ethical guidance. “We’re trying to teach them how to exist in this world,” she said.

Children at Kent Place are introduced to ethics in fifth grade, during what would otherwise be a health and wellness class. Rezach engages the students in simple case studies and invites them to consider the various points of view. She also acquaints them with the concept of right vs. right—the idea that ethical dilemmas often involve a contest between valid but conflicting values. “It’s really, really, really elementary,” she said.

In middle and upper school, the training is more structured and challenging. At the core of this education is a simple framework for ethical decision-making that Rezach underscores with all her classes, and which is captured on a poster board inside school. Paired with this framework is a collection of values that students are encouraged to study and explore. The values and framework for decision-making are the foundation of their ethics training.

ethics case study classes

Once a month, all middle school students grapple with an ethics case study during advisory that’s been written for their grade. Sixth-graders, for example, wrestled with a case about “Emma”, who wasn’t invited to Jane’s party but who saw pictures of the festivities on Instagram. The students then discussed various questions: How might Emma feel when she sees the Instagram photo? What is Jane’s responsibility in this case? What values influence the way you think about this scenario? Though the case studies reflect real-life problems the kids have encountered, the stories are told in the third person, which frees them to talk openly, Rezach said.

Two elective courses on ethics for seventh- and eighth-graders explore deeper quandaries while pressing students to understand the values reflected in those views. In one case study they discussed, “Allison” enters a coffee shop wearing a T-shirt with a swastika, which clearly offends other customers. What should the manager do? How does one balance the right to freedom of expression with the rights of the community? “In this situation, as in all ethical dilemmas, the students have to weigh the benefit and the harm,” Rezach said. She draws connections to books they’re reading in English class, brings up related news stories, and asks students to think of and share ethical quandaries they’ve encountered.

For homework, students study critical historical documents, like the Constitution and Bible, and identify the values that suffuse the work. In another assignment, they prepare a two-minute oral presentation on a principle that matters deeply to them. Some will read a poem, or sing a song, or produce a video that reflects that value. Once the presentations end, Rezach pairs up students with conflicting ideals—compassion versus justice, for example—and asks them to write a case study together.

ethics case study classes

High school students interested in ethics have other ways to learn. Fourteen kids meet weekly after school on an ethics bowl team, which competes nationally against other schools. In bioethics class, an elective, students explore a particular ethical problem related to a single theme—such as “Environment and Health,” this year’s subject—then present and defend their position at a spring symposium. The ethics club is launching an Instagram account, @ethicseverywhere , which will pose an idea or dilemma for all student followers to reflect on. And during the summer, students can apply for shorter programs, one on the ethical issues surrounding science and technology and the other on ethics in business.

Impact on students

Research suggests that ethics training improves academic performance. Children in Scotland who had been taught to think about ethical decision-making and the responsibilities of citizenship showed improved reasoning abilities. A study in Australia showed that young students who took part in a class on “dialogue-based ethical inquiry” were better able to evaluate and construct reasoned, ethical arguments. Standardized test scores for children who studied “collaborative philosophical enquiry”—a variant of ethics training— went up in verbal, nonverbal, and quantitative reasoning. And a small study conducted by researchers at Penn State revealed that even preschoolers can engage with and learn from simple ethical instruction.

Academic benefits aside, students at Kent Place involved in ethics training relish the open-ended conversations with peers along with the chance to reflect on what matters to them. “I love discussing these things with other people, and hearing other points of view, especially on controversial topics,” said Alexandra Grushkin, an eighth-grader. The value she selected that’s most dear to her is integrity. “I believe you’re a good person if you have integrity,” she explained. In her class presentation, she shared a quote by author Lynne Namka that reflected this value. Alexandra was matched with a student who chose loyalty, and the two crafted a case study that captured the tension between these principles: What does a student do when she spots her close friend cheating in a school competition?

Encouraged at home to listen to others’ opinions, Alexandra said that she’s better able now to understand the ideals that undergird beliefs and to articulate her own positions. “It has changed the way I approach conflict—and most things, actually,” she said. “With ethics, I’ve learned that there are a lot of different sides to everything.” What Alexandra’s mother, Trisha, welcomes in this training is the open-mindedness it provokes, as well as the instruction it provides in how to converse calmly. “There’s a humility that comes with this ethical framework that will serve them well for the rest of their lives,” she said.

Rezach believes that students benefit from an ethics education in many ways. “For the first time in their lives, they’re allowed to think for themselves—without someone telling them what to think,” she said, adding “It’s like you’ve taken the lid off the top of their minds.” For teenagers who often struggle with confidence and identity, these debates on ethics free them to test their values in an abstract, unthreatening way. Exploring conflicts from different points of view—and striving to understand the value behind an opinion—also makes them more empathetic to others. “I see them grow in their ability to see somebody else’s perspective,” Rezach said. Having to identify and defend their decision is also critical, she added. Ordinarily, students she encounters avoid making decisions because they fear they’ll get it wrong. “Being able to make a decision and articulate why—that’s huge!” she said. “And being respectful to a person who doesn’t agree—that’s huge.”

Rezach writes the case studies, teaches the classes and overseas all the extracurricular ethics programs. She has also consulted with about 100 other middle- and high schools that want to bring this discipline back to their communities. “It can’t be a one and done,” Rezach said about how to build an ethical student body. “You have to infuse it into current programs—in classes and after school,” she added.

Now a college freshman, Sophie Huttner said she continues to apply the analytical frameworks she absorbed in her ethics training to her studies at Yale. “My ethics education, above all, has functioned as a mirror, allowing me to reflect on my own values and those held by my community,” she said. “Because I have had the chance to consider at length the ethical concepts most important to me, I have become a better judge of my own actions.”

*Linda Flanagan serves on the  advisory board of the Ethics Institute, for which she receives no financial compensation.  

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Resources for Educators & Students

A light snow falls on the Abraham Lincoln statue in front of Bascom Hall at the University of Wisconsin-Madison during winter on Dec. 28, 2015. (Photo by Jeff Miller/UW-Madison)


Ethics in a Nutshell  provides an overview of ethics and journalism ethics. It identifies the major approaches to ethics and models of ethical reasoning. The nature of ethics, range of ethics, theoretical and applied ethics, and types of theories are discussed.

Soon to be legacy, rows of card catalogue drawers are pictured in the Memorial Library at the University of Wisconsin-Madison on March 29, 2012. in May 2012, the library will remove the last of its card catalogues, completing a quarter-century transition to an online record system for books, journals and more. One row of built-in cases will remain as part of a historic display. More than 100 cases are being sold through UW Surplus With A Purpose (SWAP), and 6,700 drawers of cards are being recycled. (Photo by Jeff Miller/UW-Madison)


Digital Media Ethics  deals with the distinct ethical problems, practices and norms of digital news media. Digital news media includes online journalism, blogging, digital photojournalism, citizen journalism and social media. It includes questions about how professional journalism should use this ‘new media’ to research and publish stories, as well as how to use text or images provided by citizens.

Lake Mendota and the University of Wisconsin-Madison campus, including Alumni Park and the Memorial Union Terrace, are pictured in an early morning aerial taken from a helicopter on Oct. 23, 2018. (Photo by Bryce Richter /UW-Madison)


Global Media Ethics  addresses development of a comprehensive set of principles and standards for the practice of journalism in an age of global news media. New forms of communication are reshaping the practice of a once parochial craft serving a local, regional or national public.

On Dec. 2, 2010, international correspondent for the New York Times Anthony Shadid (center) speaks to a group of journalism students in a Vilas Hall classroom at the University of Wisconsin-Madison. Shadid is a UW-Madison alumnus and two-time Pulitzer Prize winner. (Photo by Bryce Richter / UW-Madison)


The Shadid Curriculum draws from the journalism of those who have won or been named a finalist of the Anthony Shadid Award for Journalism Ethics, and encourages student journalists to place themselves in the position of making difficult journalistic decisions.

Teaching Ethics

Logo for the "Media Ethics Division" of the Association for Educators of Journalism and Mass Communication

These teaching resources, which are compiled by the Media Ethics Division of the AEJMC (Association for Education in Journalism and Mass Communication), cover a broad range of materials for teaching media or journalism ethics, including advertising, public relations and entertainment ethics.

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Ethics Case Studies

The APS Ethics Case Studies are a series of case studies on ethical issues that can arise in the course of doing physics research. Many of the studies are accompanied by discussion. These case studies are intended to be an educational resource for researchers, mentors, and students.

Ethics Activity & Discussion Guides

APS has formatted the ethics case studies for courses and seminars on ethics education. The Teacher Edition includes an activity and discussion guide.

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The National Science Foundation requires institutions to provide training in the responsible and ethical conduct of research to undergraduates, graduate students, and postdoctoral researchers participating in funded research projects. The APS Ethics Case Studies can help provide physics-relevant, rather than generic, ethics training. NSF Responsible Conduct of Research Requirements

APS Task Force on Ethics Education

The ethics case studies were prepared by a special APS Task Force on Ethics Education to promote discussion of these issues. They are based on the views of the task force members, and should not be considered to be the views of APS as a whole. Background on APS Task Force on Ethics Education


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Ethics Case Study

Ethics Case Study: Five Types of Case Studies You Shouldn’t Miss Out On!

The General Studies IV paper of the UPSC Mains Exams mainly focuses on the three parts, i.e. Integrity, Aptitude, and Ethics. GS IV paper has two sections, Section A and Section B. Section B is based on an ethics case study and holds a weightage of 125 marks.

As a UPSC aspirant, you must write appropriate ethical answers to all the case studies asked. It is of utmost importance that you focus on some of the frequently appearing case studies on ethical issues, as this is a major category.

Business Ethics Case Studies


XYZ Limited is a multinational company which carries out a variety of businesses. This company is generating multiple jobs and also holds a large share base. To grow its branches, it has decided to develop a business in an undeveloped area. Being energy adept this project will save 15% of the production costs.

The government policy of no payment of tax for 5 years for those who invest in undeveloped areas goes hand in hand. But this project will disturb the natural habitat as well. So the residential people started protests. The company tried to manage the issue by making them understand the importance and benefits of this project. Despite all efforts of the company, the people residing in this area opted for the judiciary.

  • What are the problems involved in this situation?
  • What steps can be taken to satisfy the demands of the company and people who stay there?

Engineering Ethics Cases


An engineer gets employment in the prestigious chemical industry. The pay from this company is also decent. Within a short span, he discovers a kind of waste that has a high amount of toxicity, is dismissed in the nearby river illegally. This is causing many health-related issues for the people consuming this river water nearby.

He informs his fellow workers about this issue, but they suggest to be quiet. On one hand, he is the only working man in his family and can’t risk his job. On the other, his fellow mates’ suggestion feels wrong as the people are suffering from the consumption of toxic water. You seem an advisable person to him, so he asks for your help.

  • What conflicts can you bring up for making him understand that being silent is not a correct option?
  • What type of conduct will you suggest to him and why?

Also Read :  Best Books for UPSC Mains Exam Preparation: Here’s the UPSC Books List You were Looking For

Ethical Case Studies in Education


Currently, you are a Development Officer at a district level. Recently there has been a dispute in one of the villages of your district. The senior groups in this village do not want girls to go out of their houses to study, as it is unsafe. As per them, girls should marry at an early age with less education. The competition is increasing, and male employment is declining due to young girls thinking about their individuality, taking steps for education and freedom.

The situation is heated. Everyday discussions are around these issues. One day you are informed that girls were molested while returning from schools. This led to another huge argument. After fighting their guts, the seniors decided not to send girls to schools and avoid other families who send their girls to study.

  • What action would you take to ensure safety and assure the education of these girls?
  • How would you handle the patriarchal approach of the senior generation and spread a word of peace in the village? How would you deal with the senior generation’s patriarchal approach, and spread a word of peace in the village?

Professional Ethics Case Study


A staff member junior to you took a leave on account of her mother’s illness. She joined again a few days ago. Her mother is old as well as very sick. She has been handling both her mothers’ care adjustments and her job at the same time. At times she has to leave the workplace early or arrive late. This created extra pressure on her co-workers as well. You are the manager of this company.

One of her male co-workers stated that she is a female and should stay at home rather than work, which added more stress on her shoulders.

  • As a manager, how would you handle the workload suspended on other co-workers?
  • How would you use your professional integrity to correct the male co-worker?

Ethics in Finance Case Study


You are a chief officer in a ministry. As a result, you are allowed to take all the important decisions related to construction and road development. The ministry is all set to announce a huge road consignment. Ample care was taken by the officials to use government land majorly and to make less usage of private land. Also, with minimum deforestation, the road plan was finalized.

At the same time, one of the related ministers insisted that you must change the roadways in such a way that comes closer to his huge farmhouse. He also promises to buy a plot legally in your name after this realignment of this road. But this realignment project will cause a burden on government finances. Many agricultural lands fall under this realignment of the road. Also, hundreds of trees would be demolished for the same.

  • What would you do in such a situation?
  • What are the areas of arguments and improvements in this situation?
  • What is your responsibility as a servant of the public?

The format in the above case studies is usually what is asked in Section B of the GS IV paper in the UPSC Exams. These case studies are of great significance and carry huge weightage in the civil service exams. Along with these case studies, many case studies like nonprofit ethics case study and administration ethics case study also have a good amount of weightage.

You must focus intensively on case studies on ethical issues to score brilliantly in your UPSC exams. Your answers should contain ethical terms and an appropriate approach. Practising various kinds of ethics case studies regularly for IAS will keep you intact with the approach you have to maintain. It will also develop a useful skill to write productive and efficient case study answers.

We here at UPSC Pathshala will keep bringing you important content related to UPSC exams. Stay updated with our regular blogs to come across useful tips, tricks, strategies, and suggestions for UPSC exams.

Also Read :  Sanjeev Newar’s UPSC Results Data Analysis Explained: Facts, Real Issue and Share of Reservation

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Original research article, maternal dietary patterns and acute leukemia in infants: results from a case control study in mexico.

ethics case study classes

  • 1 Consejo Nacional de Humanidades, Ciencias y Tecnologías (CONAHCYT), Mexico City, Mexico
  • 2 Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
  • 3 Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
  • 4 Unidad de Investigación Médica en Epidemiología Clínica, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
  • 5 Servicio de Hematología Pediátrica, Hospital General “Gaudencio González Garza”, CMN “La Raza”, IMSS, Mexico City, Mexico
  • 6 Departamento de Hemato-Oncología, Hospital Infantil de México Federico Gómez, Secretaria de Salud (SSA), Mexico City, Mexico
  • 7 Servicio de Oncología, Hospital Pediátrico Moctezuma, Secretaría de Salud de la Ciudad de México (SSCDMX), Mexico City, Mexico
  • 8 Servicio de Hematología, UMAE Hospital de Pediatría, CMN “Siglo XXI”, IMSS, Mexico City, Mexico
  • 9 Servicio de Hematología, Instituto Nacional de Pediatría (INP), SSA, Mexico City, Mexico
  • 10 Servicio de Onco-Pediatría, Hospital Juárez de México, SSA, Mexico City, Mexico
  • 11 Servicio de Hematología Pediátrica, Hospital General de México, SSA, Mexico City, Mexico
  • 12 Servicio de Hematología Pediátrica, CMN “20 de noviembre”, Instituto de Seguridad Social al Servicio de los Trabajadores del Estado (ISSSTE), Mexico City, Mexico
  • 13 Servicio de Hematología Pediátrica, HGR No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” IMSS, Mexico City, Mexico
  • 14 Servicio de Pediatría, Hospital Pediátrico de Tacubaya, SSCDMX, Mexico City, Mexico
  • 15 Servicio de Cirugía Pediátrica, Hospital General “Gaudencio González Garza”, CMN “La Raza”, IMSS, Mexico City, Mexico
  • 16 Servicio de Cirugía Pediátrica, Hospital General Regional (HGR) No. 1 “Dr. Carlos Mac Gregor Sánchez Navarro” IMSS, Mexico City, Mexico
  • 17 Servicio de Pediatría, Hospital General de Zona Regional (HGZR) No. 25 IMSS, Mexico City, Mexico
  • 18 Coordinación Clínica y Pediatría, Hospital Pediátrico de Coyoacán, SSCDMX, Mexico City, Mexico
  • 19 Hospital Pediátrico de Iztapalapa, SSCDMX, Mexico City, Mexico
  • 20 Hospital General “Dr. Gustavo Baz Prada”, Instituto de Salud del Estado de México (ISEM), Estado de México, Mexico
  • 21 Coordinación Clínica y Pediatría del Hospital General de Zona 76 IMSS, Mexico City, Mexico
  • 22 Coordinación Clínica y Pediatría, Hospital General “La Perla” ISEM, Estado de México, Mexico
  • 23 Coordinación Clínica y Pediatría, HGR No. 72 “Dr. Vicente Santos Guajardo”, IMSS, Mexico City, Mexico
  • 24 Coordinación Clínica y Pediatría del Hospital General de Zona 68, IMSS, Mexico City, Mexico
  • 25 Coordinación Clínica y Pediatría del Hospital General de Zona 71, IMSS, Mexico City, Mexico
  • 26 Servicio de Cirugía Pediátrica, HGR 1° Octubre, ISSSTE, Mexico City, Mexico
  • 27 Hospital Regional “General Ignacio Zaragoza”, ISSSTE, Mexico City, Mexico
  • 28 Delegación Regional Estado de México Oriente, IMSS, Estado de México, Mexico
  • 29 Hospital General de Ecatepec “Las Américas”, ISEM, Estado de México, Mexico
  • 30 Laboratorio de Biología Molecular de las Leucemias, Unidad de Investigación en Genética Humana, UMAE, Hospital de Pediatría, CMN “Siglo XXI”, IMSS, Mexico City, Mexico
  • 31 Laboratorio de Genética, Hospital de Pediatría, Centro Médico Nacional (CMN) Siglo-XXI, Instituto Mexicano del Seguro Social (IMSS), Mexico City, Mexico
  • 32 Laboratorio de Innovación y Medicina de Precisión, Núcleo A, Instituto Nacional de Medicina Genómica (INMEGEN), Mexico City, Mexico
  • 33 Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico

Background: Childhood cancer is the leading cause of disease-related mortality among children aged 5–14 years in Mexico, with acute leukemia being the most common cancer among infants. Examining the overall dietary patterns allows for a comprehensive assessment of food and nutrient consumption, providing a more predictive measure of disease risk than individual foods or nutrients. This study aims to evaluate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in Mexican infants.

Methods: A hospital-based case–control study was conducted, comparing 109 confirmed acute leukemia cases with 152 age-matched controls. All participants (≤24 months) were identified at hospitals in Mexico City between 2010 and 2019. Data on a posteriori dietary patterns and other relevant variables were collected through structured interviews and dietary questionnaires. Multivariate logistic regression was employed to estimate the association between maternal dietary patterns during pregnancy and the risk of acute leukemia in infants.

Results: The “Balanced & Vegetable-Rich” pattern, characterized by a balanced consumption of various food groups and higher vegetable intake, exhibited a negative association with acute leukemia when compared to the “High Dairy & Cereals” Pattern (adjusted odds ratio [OR] = 0.51; 95% confidence interval [CI]: 0.29, 0.90). We observed that mothers who gave birth to girls and adhered to a healthy dietary pattern during pregnancy exhibited significantly lower odds of their children developing AL compared to those who gave birth to boys [OR = 0.32 (95% CI 0.11, 0.97)]. Our results underscore the significance of maternal nutrition as a modifiable factor in disease prevention and the importance of prenatal health education.

1. Introduction

In Mexico, childhood cancer is the first cause of death by disease in children aged 5–14 years and the sixth among those under five. It represents almost 70% of the total burden of disease in these age groups ( 1 ). Acute Leukemia (AL) is the most common cancer among children and adolescents around the world. Among Hispanic children, the incidence of AL is the highest compared with other neoplasms in Caucasian and African American and is more frequent in males than among females ( 2 ). In spite that this disease represents a low proportion of cancer cases in the total population, it causes the highest number of years of life potentially lost (YLL) due to premature death.

AL etiology is largely unknown. However, experimental evidence show that translocations are initiating events that occur early in utero and are present in a substantial proportion of childhood AL. Clonal markers in leukemic cells and clonotypic fusion gene sequences in neonatal blood spots, have been observed in monozygotic twins, in whom only one of them develops the disease ( 3 ). These findings underscore the need to examine potential risk factors in the fetal environment, such as maternal diet. Diet may yield protective and/or negative effects leading to cancer, not only through the intake of diverse dietary components that take part in epigenetic processes such as: DNA methylation, histone modifications, noncoding RNAs in fetus but also, as a vehicle for carcinogenic compounds, like N-nitroso precursors, that cross transplacental barrier ( 4 ).

Evidence suggests that the size and growth rate of the fetus during gestation may play a role in the development of leukemia. For example, some studies have shown that children who are born small for gestational age may have a higher risk of developing leukemia ( 5 ). It is thought that a slower growth rate during gestation may increase the risk of certain genetic mutations that can lead to the development of leukemia. Some studies have reported that maternal nutrition effects on fetal growth and development may differ between male and female fetuses ( 6 ). However, there is limited evidence on the differential effects of maternal dietary patterns on leukemia risk in boys and girls.

Early epidemiological studies focused on AL and maternal diet evaluation of a single nutrient and/or food. Further studies evidenced the role of food groups on AL development. In this way, there is available evidence regarding the negative association between maternal consumption of folic acid and protein with AL, respectively ( 7 ), as well as the consumption of fruits, vegetables, fish, shellfish, beans, and beef ( 8 ). In contrast to the observed relationship with the consumption of chocolate, wine, coffee, and processed meats, which are dietary inhibitors of the nuclear enzyme topoisomerase II, as well as sugars and syrups ( 9 ). Individual components of the diet interact with each other, so this approach of evaluating dietary components one by one has gradually evolved to the evaluation of dietary patterns.

Because of the complexity of diets, the overall effects (antagonic or synergistic) of various nutrients and foods that are consumed simultaneously, may only be assessed through the identification of dietary patterns ( 10 ), which depend on culture and availability of foods in each population and are not necessarily replicated throughout different countries. Research on dietary patterns in Latin American populations is scarce, and its possible relationship with childhood AL is null.

Our aim was to evaluate the association between maternal dietary patterns during pregnancy and AL in Mexican infants and to explore if this association differs by sex.

2. Materials and methods

During the period of 2010 to 2019, a clinical based case–control study was carried out in Mexico City and State of Mexico. The study population comprised children that were identified in 9 public secondary and tertiary public hospitals. The protocol was approved by the Mexican Institute of Social Security (IMSS) IRB with number 2010-785-064.

Eligible cases were children up to 24 months of age with acute leukemia (AL), which was confirmed with bone marrow smears and histochemical tests (myeloperoxidase, sudan black B reaction, esterases, periodic Schiff reaction (PAS) and acid phosphatase) and immunophenotype. In total, 237 eligible cases were identified and 110 accepted to participate, yielding a response rate of 47.8%. Not participating children included: 11 which denied participation and 116 did not have complete dietary information.

2.2. Controls

Cases were sex and 1:1 age matched (±12 months) with a child (control) attending to any of the ambulatory surgery services from the same health institution where the cases were gathered (IMSS, Secretary of Health, Secretary of Health of Mexico City, State of Mexico Institute of Health, Institute of Security and Social Services for State Workers). In total, 276 eligible controls were identified, of which 24 did not agree to participate (response rate of 91.3%) leaving 252 controls whose diagnoses were: circumcision (%), hernioplasty, orchiopexy, tonsillectomy, intoxication, first and second level burns.

2.3. Interviews

Mothers gave informed consent to participate in a face-to-face interview in the hospitals. Previously trained personnel gathered information regarding the family sociodemographic characteristics, child reproductive history, parents’ alcohol, and tobacco consumption as well as maternal diet during pregnancy.

2.4. Maternal diet

Dietary maternal intake, during pregnancy, was obtained through a food frequency questionnaire (FFQ). This instrument contained 116 items including foods, beverages, and local dishes. The reproducibility of this questionnaire was previously evaluated in Mexican women, to whom it was applied twice at an interval of 1 year, while its validity was estimated using a 24-h diet recall at 3-month intervals as a reference. The details of this validation have been published ( 11 ).

According to the methodology suggested by Willett et al. ( 12 ) the FFQ includes 10 response options for frequency of consumption ranging from “never” to “6 or more times a day,” as well as predetermined portions for each food as follows: a glass (e.g., milk and wine), cup (for yogurt, some fruits and vegetables, tea, juices, alcoholic and non-alcoholic beverages), a spoon (e.g., oils, sour cream, sauces and nuts), a slice (e.g., cheese, some fruits and meats), a plate (e.g., legumes and local dishes) and a piece (e.g., some fruits and breads).

Total energy content in foods and local dishes was obtained from nutritional composition tables of the United States Department of Agriculture (USDA 2007, 2017–2018) that include a wide variety of foods similar to those consumed in the study area. For the few foods that were not found in the USDA tables, such as tejocote (a local fruit), we used the reference tables of the National Institute of Medical Sciences and Nutrition “Salvador Zubirán” ( 13 ). Only two foods (soy juice and soy beer) were not found in neither food data sources.

Energy consumption was estimated by adding the caloric intake from foods and local dishes. Due to the fact, that some fruits and vegetables are only consumed during certain seasons of the year, their energy intake was weighted according to their availability in the market, for example, only 50% of the kcal of plums were considered, as they are available for 6 months of the year ( 14 ).

Up to this phase, one case was eliminated, because the estimated total energy intake was less than 525 kcal, which corresponds to less than 2 standard deviations of the daily intake observed in pregnant Mexican women and may not represent a valid biological value ( 15 ). Therefore, the final sample size of this report was 109 cases and 252 controls.

2.4.1. Dietary patterns

We derived dietary patterns from 22 food groups and 8 isolated foods. Food groups were created according to their similarity in the content of macro and micronutrients (e.g., fat, carbohydrates, protein, vitamins, sodium); sugar (added or not) or type of fat (saturated or vegetal); otherwise, foods were included as isolated items (atole, corn, corn tortilla, egg, poultry, avocado, dehydrated cranberries and soy sauce).

To derive dietary patterns we used 2 different approaches: Cluster analysis and factor analysis. For cluster analysis, we used food groups and foods in portions per day and their energy percentage contribution. Through the K-means method, we ran 6 cluster solutions and selected one that contained 2 non-overlapping clusters. As a result, each individual belonged to only one cluster that we named Balanced & Vegetable-Rich or High Dairy & Cereals.

We further determined the factor loadings of each food group, using factor analysis ( 14 ). We orthogonally rotated the factors (varimax rotation) to keep them uncorrelated and to improve their interpretation. After assessment of graphic analysis and interpretability, we retained factors with eigenvalues >1.5. We defined each factor by a subset of at least 5 food groups with an absolute loading ≥0.2 ( 16 ).

We estimated each pattern by summing the personal intake of the food groups weighted by their corresponding loading factor. We derived 3 dietary patterns named High Saturated Fats & Sugars, Moderate Meat & Cereals and Balanced & Vegetable-Rich. With this analysis, each participant receives a score for each pattern identified.

2.5. Statistical analysis

Mother, father, and child characteristics were compared between cases and controls using Chi square, one-way ANOVA ( Table 1 ).

Table 1 . General characteristics of the study subjects.

The association between maternal dietary patterns and AL was assessed using unconditional multivariate logistic regression models. Covariates were selected based on two criteria. Firstly, we included covariates that exhibited significant differences between the cases and controls. These covariates encompassed factors such as institution, breastfeeding, age at pregnancy, education (both maternal and paternal), smoking before and during pregnancy, iron and vitamin consumption, drug use for genital infection, and the age of the father. Secondly, we incorporated covariates based on a causal directed acyclic graph (DAG) approach, which considered variables such as age at pregnancy, state of residence, person/room ratio, breastfeeding, iron and vitamin supplementation, tobacco and alcohol use, and maternal education. Detailed information regarding the covariates can be found in Supplementary Figure 1 .

Using as a reference category the “High Dairy & Cereals” cluster, we estimated the odds ratio for AL among individuals belonging to the “Balanced & Vegetable-Rich” cluster. We created tertiles based on the dietary pattern score distributions among controls. We estimated the odds ratios for LA comparing tertile 3 and 2 versus tertile 1, respectively. We also stratified the adjusted models and estimated the dietary pattern x sex interaction adding the respective multiplicative term.

We performed tests for linear trends using the continuous dietary pattern scores. We used p  < 0.05 as a cutoff for significance.

We conducted our analysis using STATA, version 13 and Daggity v3.0.

In order to ensure comparability between the study groups, we carefully controlled for the distribution of children’s age and sex, which was similar across all groups. Comparative analysis revealed that mothers of children with AL exhibited lower alcohol intake during pregnancy, lower person/room ratios and lower intakes of iron during pregnancy compared to mothers of healthy children. Moreover, children diagnosed with AL were reported to have a higher birthweight compared to controls (see Table 1 ).

Through cluster analysis, we identified two distinct dietary patterns, labeled as ‘High Dairy & Cereals’ and ‘Balanced & Vegetable-Rich.’ Both patterns included food groups such as ‘other fruits’ and ‘other vegetables.’ However, the ‘High Dairy & Cereals’ cluster stood out for its higher consumption of cereals, dairy products, and eggs, whereas the ‘Balanced & Vegetable-Rich’ cluster was characterized by a higher intake of allium vegetables and corn tortillas.

Additionally, factor analysis yielded three major dietary patterns: (1) ‘Balanced & Vegetable-Rich,’ which was characterized by high consumption of fruits, allium vegetables, other vegetables, and legumes, and low consumption of pastries and refined cereals; (2) ‘High Saturated Fats & Sugars,’ which exhibited high consumption of saturated fats, refined cereals, canned products, corn tortillas, and sodas, and low consumption of whole grain cereals, seafood, and dairy products; and (3) ‘Moderate Meat & Cereals,’ which showed high consumption of processed meat, red meat, poultry, and refined cereals, and low consumption of dairy, fruits, and legumes. The factor-loading matrixes for these dietary patterns explained a total variance of 20.3% (see Table 2 ).

Table 2 . Food groups consumption (portions/day) according to dietary patterns using cluster and factor analysis in the study sample (cases = 109, controls = 252).

Our analysis unveiled a notable inverse association between the ‘Balanced & Vegetable-Rich’ dietary pattern and the risk of developing Acute Leukemia (AL). While adjusting for various influencing factors, including institution, breastfeeding, age at pregnancy, parental education, smoking habits before and during pregnancy, iron and vitamin consumption, drug use for genital infections, age of the father, and paternal alcohol consumption, the ‘Balanced & Vegetable-Rich’ pattern demonstrated odds ratios (OR) of 0.51 (95% CI, 0.29, 0.90) in the cluster analysis. In the factor analysis, assessing different levels of adherence (T3 vs. T1) to the same dietary pattern (‘Balanced & Vegetable-Rich’), the OR was 0.47 (95% CI, 0.24, 0.91).

We observed that mothers who gave birth to girls and adhered to the ‘Balanced & Vegetable-Rich’ dietary pattern had significantly lower odds of their children developing AL compared to those who gave birth to boys. This difference was evident in both cluster and factor analyses. Cluster analysis demonstrated odds ratios (OR) of 0.40 (95% CI: 0.17, 0.94) for mothers following a ‘Balanced & Vegetable-Rich’ pattern, while mothers of boys had OR of 0.64 (95% CI: 0.2, 1.47). There is a significant interaction between the “Balanced & Vegetable-Rich” dietary pattern and the sex of infants in relation to the risk of AL (P for interaction 0.020). Similarly, factor analysis showed OR of 0.32 (95% CI: 0.11, 0.97) for mothers of girls adhering to a ‘Balanced & Vegetable-Rich’ pattern, in contrast to OR of 0.49 (95% CI: 0.19, 1.23) for mothers of boys, also showing a statistical significant pattern x sex interaction (0.037).

The ‘Moderate Meat & Cereals’ pattern was found to have an inverse association with the development of AL, with an OR of 0.28 (95% CI: 0.11, 0.97). This suggests that a higher intake of the ‘Moderate Meat & Cereals’ pattern is associated with reduced odds of AL. Notably, this association was significant overall ( Table 3 ).

Table 3 . Association between acute leukemia and dietary patterns.

4. Discussion

To our knowledge, this is the first study to examine childhood AL and dietary patterns in a sample of pregnant women in Mexico. Using two different approaches, we found two similar ‘Balanced & Vegetable-Rich.’ patterns, characterized by high consumption of foods included in the following groups: fruits, vegetables, allium, legumes, and low intake of refined sugars and cereals that were negatively associated with AL. These ‘Balanced & Vegetable-Rich.’ patterns were inversely and significantly associated with AL only among girls. In contrast, we found a positive but not significant relationship between AL and a pattern characterized by saturated fats and cereals.

There is no previous evidence on maternal dietary patterns and childhood leukemia, and the scarce information on food groups is inconclusive. According to a recent meta-analysis ( 8 ), a challenge in this area is to have information on comparable food groups across studies. In this context, for example, two studies included in a recent meta-analysis reported an inverse relationship between the consumption of fruits (OR: 0.81, 95% CI: 0.67–0.99), vegetables (OR: 0.51, 95% CI: 0.28, 0.94); and legumes (OR: 0.76, 95% CI: 0.62–0.94) with AL. Our results confirmed those associations in spite that there might be some different foods within the groups.

Several biological mechanisms have been implicated, as fruits and vegetables contain micronutrients that exert a protective action against leukemogenesis. Antioxidants, in particular vitamin A (retinoid acid), C (ascorbic acid) and E, as well as carotenoids are known to protect against oxidative damage of lipids, lipoproteins and DNA ( 4 ). Carotenoids have been shown to enhance DNA repair and have a positive effect on immune function, cell transformation and differentiation ( 4 ). Ascorbic acid can inhibit the in vitro proliferation of leukemic cells ( 4 ), while vitamin A plays a prominent role in the induction of terminal differentiation of lymphoid and myeloid blasts and in the inhibition of their clonogenic growth ( 4 ). In addition, direct and dose–response cytotoxic effects against leukemic cells have been suggested through selective regulation of cell cycle proteins for a variety of flavonoids present in most green leafy vegetables.

The consumption of allium vegetables, mainly garlic, onion, and leeks has not been studied regarding AL. Extensive experimental research has consistently shown the anticarcinogenic potential of allyl sulfides and flavonoids in relation to colon, gastric (particularly quercetin which is present abundantly in onion) and found that these compounds promote inhibition of mutagenesis, modulation of enzyme activities, inhibition of DNA adduct formation, free-radical scavenging, and effects on cell proliferation and tumor growth ( 17 – 22 ). However, epidemiological findings have not been conclusive. Previous meta-analyses have shown that high consumption of allium vegetables might be inversely associated with gastric and colorectal cancer ( 23 , 24 ) Moreover a worldwide pooled analysis, reported an inverse association between allium vegetables intake and gastric cancer ( 25 ). In our sample we found an inverse relationship that warrant further attention since it could be possible that some of these mechanisms were the same for childhood AL.

Likewise, our results are consistent with the findings of studies that have suggested a positive association with sugar and refined grains, a study conducted in greek population, found that the odds of AL were higher with increased maternal intake of sugars and syrups (OR, 1.32; 95% CI, 1.05–1.67) ( 26 ). The potential mechanisms supporting the positive association between sugars and cancer, have already been discussed and include adiposity and insulin signaling pathway disruption, hormonal imbalances, inflammation, oxidative stress, DNA damage, and alteration of gene expression ( 27 ). Nevertheless, further research is needed to elucidate the relationship between AL and sugar intake.

The study of meat and processed meat consumption related to childhood cancer has been of interest since the 1990s. A more recent study, found that children who regularly ate cured meat (more than once a week) had a 74 percent greater chance of developing acute leukemia ( 28 ). Meat contains nitrosamines which have been classified as a type 1 carcinogen ( 29 ). Consumption of cured/smoked meat leads to the formation of carcinogenic N-nitroso compounds in the acidic stomach ( 30 ). Due to the high heterogeneity among the few epidemiological studies, a conclusion of the relationship between processed meats intake and AL is not currently stated. Our results do not suggest an association between meat and AL, consistently with the study by Ross et al. and in contrast to other studies. Since lack of statistical power may be and explanation for this, this question warrants further research.

The lower OR observed for mothers of girls following the ‘Balanced & Vegetable-Rich’ dietary pattern and the statistically significant pattern x sex interaction suggest that this dietary regimen may have a more pronounced protective effect against AL in female offspring. While the gender-specific differences in the impact of maternal healthy dietary patterns on leukemia risk are apparent in our findings, the exact biological mechanisms underlying these distinctions remain complex and not yet fully understood. Several biological factors could contribute to these gender-specific associations. One such factor is the influence of sex hormones, which play a vital role in the development and function of the immune system. Estrogens, for example, are known to have immunomodulatory effects and may affect the immune response against leukemic cells. Epigenetic modifications represent another plausible mechanism. Maternal diet during pregnancy can influence epigenetic changes in the developing fetus. These modifications can affect gene expression and cellular function, potentially contributing to variations in leukemia risk. Moreover, the immune system and its response to dietary patterns may differ between the sexes. It’s known that immune responses are inherently different in males and females due to differences in immune cell populations, immune regulatory pathways, and the expression of various immune-related genes ( 31 ).

A comprehensive review and meta-analysis, spanning 38 studies, published by Blanco-López ( 32 ) et al. in 2023, shed light on the role of maternal dietary factors in childhood acute leukemia. Notably, it highlighted a reduced risk of acute lymphoblastic leukemia with increased maternal fruit consumption, while heightened coffee intake was associated with an elevated risk. These findings are consistent with the results of our study. However, to craft effective population-level prevention strategies, further research, especially from high-quality cohort studies, is crucial for identifying causal factors in this complex landscape of childhood leukemia etiology.

Several limitations of this study should be considered to interpret our results. The extrapolation of our results is limited, since we had a low participation rate within the cases, and we did not have enough information from the children who did not participate to assess the representativeness of our sample. On the other hand, the maternal dietary information was not blinded to the case–control child status, however it is highly unlikely that the mothers reported, differentially between the groups, a pattern with a specific direction to be associated with AL. Nevertheless, since the collection of data on maternal nutrition during pregnancy took place around 3 years after birth, we cannot rule out the possibility of nondifferential measurement error, which translates into attenuation of the associations reported in this paper. As in all observational studies, confounding cannot be ruled out, therefore we adjusted for potentially confounding variables which were chosen after a careful analysis with the Daggity software (directed acyclic graph, Supplementary Figure 1 ). It’s important to acknowledge that we did not have access to data on certain well-established risk factors for AL, such as exposure to pesticides or infections, which could have served as potential confounding variables.

An additional limitation of our study is that we did not explore the potential influence of genetic factors in the Mexican population. Genetic epidemiology could provide valuable insights, as the genetic architecture of Mexican individuals may play a role in the observed associations. Future research could benefit from incorporating genetic analyses to comprehensively investigate the interplay between genetic predisposition and maternal dietary patterns in childhood leukemia risk.

Our findings suggest that a dietary pattern during pregnancy characterized by the high consumption of fruits, allium vegetables, other vegetables, and legumes and low in pastries and refined cereals may be associated with reduced odds of AL, mainly in girls. Further prospective studies with more detailed diet and biomarker assessments are necessary to confirm our findings, to elucidate potential mechanisms that explain the effect of the maternal dietary patterns according to infant sex. The results of this study emphasize the importance of promoting healthy maternal dietary patterns during pregnancy for the long-term health of the offspring.

Data availability statement

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

Ethics statement

The studies involving humans were approved by Comisión Nacional de Investigación Científica. The studies were conducted in accordance with the local legislation and institutional requirements. Written informed consent for participation in this study was provided by the participants’ legal guardians/next of kin.

Author contributions

PM-A: Formal analysis, Methodology, Writing – original draft. ED-G: Formal analysis, Methodology, Writing – review & editing. MP-S: Data curation, Funding acquisition, Project administration, Writing – review & editing. LE-H: Data curation, Validation, Writing – review & editing. ED-A: Data curation, Validation, Writing – review & editing. JT-N: Data curation, Validation, Writing – review & editing. KS-L: Data curation, Validation, Writing – review & editing. RP-A: Data curation, Validation, Writing – review & editing. MV-A: Data curation, Validation, Writing – review & editing. RE-E: Data curation, Validation, Writing – review & editing. MM-M: Data curation, Validation, Writing – review & editing. AG-Á: Data curation, Validation, Writing – review & editing. LR-V: Data curation, Validation, Writing – review & editing. JD-H: Data curation, Validation, Writing – review & editing. JM-G: Data curation, Validation, Writing – review & editing. AC-E: Data curation, Validation, Writing – review & editing. ML-C: Data curation, Validation, Writing – review & editing. SM-S: Data curation, Validation, Writing – review & editing. JR-G: Data curation, Validation, Writing – review & editing. NH-P: Data curation, Validation, Writing – review & editing. JF-B: Data curation, Validation, Writing – review & editing. JP-G: Data curation, Validation, Writing – review & editing. MR-V: Data curation, Validation, Writing – review & editing. DT-V: Data curation, Validation, Writing – review & editing. JO-D: Data curation, Validation, Writing – review & editing. AM-R: Data curation, Validation, Writing – review & editing. LG-C: Data curation, Validation, Writing – review & editing. CA-H: Data curation, Validation, Writing – review & editing. JF-L: Data curation, Validation, Writing – review & editing. JN-E: Data curation, Validation, Writing – review & editing. MM-R: Data curation, Validation, Writing – review & editing. HR-V: Data curation, Validation, Writing – review & editing. DD-R: Data curation, Validation, Writing – review & editing. SJ-M: Data curation, Validation, Writing – review & editing. JM-A: Data curation, Funding acquisition, Investigation, Supervision, Writing – review & editing. LL-C: Conceptualization, Supervision, Writing – original draft, Writing – review & editing.

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. The present study was funded by CONAHCYT. Grant number: SALUD 2010-01-141026.

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

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Supplementary material

The Supplementary material for this article can be found online at:

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Keywords: dietary patterns, pediatric cancer, acute leukemia, leukemia, maternal diet, case–control

Citation: Muñoz-Aguirre P, Denova-Gutiérrez E, Pérez-Saldivar ML, Espinoza-Hernández LE, Dorantes-Acosta EM, Torres-Nava JR, Solís-Labastida KA, Paredes-Aguilera R, Velázquez-Aviña MM, Espinosa-Elizondo RM, Miranda-Madrazo MR, González-Ávila AI, Rodríguez-Villalobos LR, Dosta-Herrera JJ, Mondragón-García JA, Castañeda-Echevarría A, López-Caballero MG, Martínez-Silva SI, Rivera-González J, Hernández-Pineda NA, Flores-Botello J, Pérez-Gómez JA, Rodríguez-Vázquez MA, Torres-Valle D, Olvera-Durán JÁ, Martínez-Ríos A, García-Cortés LR, Almeida-Hernández C, Flores-Lujano J, Núñez-Enriquez JC, Mata-Rocha M, Rosas-Vargas H, Duarte-Rodríguez DA, Jiménez-Morales S, Mejía-Aranguré JM and López-Carrillo L (2023) Maternal dietary patterns and acute leukemia in infants: results from a case control study in Mexico. Front. Nutr . 10:1278255. doi: 10.3389/fnut.2023.1278255

Received: 16 August 2023; Accepted: 30 October 2023; Published: 13 November 2023.

Reviewed by:

Copyright © 2023 Muñoz-Aguirre, Denova-Gutiérrez, Pérez-Saldivar, Espinoza-Hernández, Dorantes-Acosta, Torres-Nava, Solís-Labastida, Paredes-Aguilera, Velázquez-Aviña, Espinosa-Elizondo, Miranda-Madrazo, González-Ávila, Rodríguez-Villalobos, Dosta-Herrera, Mondragón-García, Castañeda-Echevarría, López-Caballero, Martínez-Silva, Rivera-González, Hernández-Pineda, Flores-Botello, Pérez-Gómez, Rodríguez-Vázquez, Torres-Valle, Olvera-Durán, Martínez-Ríos, García-Cortés, Almeida-Hernández, Flores-Lujano, Núñez-Enriquez, Mata-Rocha, Rosas-Vargas, Duarte-Rodríguez, Jiménez-Morales, Mejía-Aranguré and López-Carrillo. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Lizbeth López-Carrillo, [email protected] ; Juan Manuel Mejía-Aranguré, [email protected]

This article is part of the Research Topic

Dietary Patterns in Cancer Prevention and Survival

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Brain Fog: New Study Examines Causes of This Long COVID Symptom

Neuropsychiatric symptoms of Long COVID , including brain fog , inability to concentrate, and headache, have puzzled researchers and clinicians, who are hunting for those symptoms’ causes. A new study found that neuroinflammation and blood-brain-barrier dysfunction are not likely drivers of the symptoms, giving researchers more clues in their quest to uncover what actually may be the culprit.

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Scientists have proposed many potential causes of the neuropsychiatric symptoms—including damage of the blood vessels in the brain, ongoing brain inflammation, and lingering viral infection. This study is the first time researchers have tested a large cohort of people living with Long COVID for spinal fluid markers of brain inflammation and blood-brain-barrier dysfunction. The researchers published their findings in JAMA Network Open on November 10 , and the outcome is significant even with the negative finding.

“Our study suggests that interventions that are aimed at quieting brain inflammation likely won’t help people with Long COVID,” says Shelli Farhadian, MD, PhD , assistant professor of medicine (infectious diseases) at Yale School of Medicine (YSM) and first author of the study.

For many years, Farhadian and Serena Spudich, MD , Gilbert H. Glaser Professor of Neurology and senior author, have been studying neurological abnormalities caused by human immunodeficiency virus (HIV) infection. An important way to assess this is through cerebrospinal fluid (CSF), which offers a window into the brains of living people. “It’s the only part of the central nervous system that’s easily accessible,” says Farhadian. “It can and has already told us a lot about the brain and people living with other infections and inflammatory diseases like multiple sclerosis, HIV, and Parkinson’s disease.” Researchers can look at proteins and cells in the spinal fluid to see if there is any neurological dysfunction, including abnormal immune activity or blood-brain-barrier impairment.

Researchers analyze cerebrospinal fluid and blood for signs of dysfunction

Beginning in late 2020, the team began enrolling participants with self-reported neurological or psychiatric Long COVID symptoms. Many of the patients were enrolled in the YSM Department of Neurology’s neuroCOVID clinic . The researchers had to rely on the self-reporting of symptoms because there are no established diagnostic criteria for Long COVID.

As a control, researchers were able to use CSF and blood samples that predated COVID-19. “It’s increasingly difficult to find people who have never had COVID-19,” says Farhadian. “The CDC estimates that over 90 percent of people by this point have been infected.” But fortunately, over the past decade, Farhadian and Spudich were already enrolling healthy people from the New Haven community as volunteers to donate blood samples and CSF as research volunteers. Their team was able to use these samples collected before the pandemic as a control.

Our study suggests that interventions that are aimed at quieting brain inflammation likely won’t help people with Long COVID. Shelli Farhadian, MD, PhD

All participants in the experimental cohort consented to give blood samples and underwent a lumbar puncture to collect CSF. Using these samples, researchers measured levels of inflammatory proteins called cytokines, immune cells, and neopterin, another marker of inflammation. They also evaluated the CSF-to-blood albumin ratio, which indicates blood-brain-barrier integrity. “We chose these markers because they’ve previously been found to be elevated in other neuroinflammatory conditions,” says Farhadian.

The researchers did not find any significant differences between the experimental and control groups, suggesting that neuroinflammation and blood-brain-barrier dysfunction are unlikely to be the causes of neuropsychiatric symptoms associated with Long COVID. Now, the team can turn its attention to other potential causes of Long COVID and eventually home in on those that are supported by scientific evidence. “It’s been two years since the pandemic, and it’s time to reassess what we know and don’t know about Long COVID so that we can focus our efforts on finding a solution,” says Farhadian. “We were really lucky that our participants were generous in agreeing to enroll in our study.”

Ongoing Long COVID research at Yale will evaluate other possible causes of brain fog

Farhadian and Spudich now plan to focus on other hypotheses that may reveal the biological underpinnings of neuropsychiatric symptoms of Long COVID. They will do this by leading translational research conducted through the COVID Mind Study at Yale , Specifically, the team will study whether lingering viral infection of the central nervous system plays a role in symptoms.

Other research led by Lindsay McAlpine, MD , instructor in the division of neurological infections and global neurology and co-author of the neuroinflammation and blood-brain-barrier study, is assessing structural and vascular brain abnormalities. “We still don’t understand what’s causing neurological Long COVID,” says Farhadian. “But our hope is that with more studies, we can start to eliminate some of the possibilities and zero in on some of the others.”

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  • Shelli Farhadian, MD, PhD Assistant Professor of Medicine (Infectious Diseases); Assistant Professor, Epidemiology of Microbial Diseases
  • Serena Spudich, MD, MA Gilbert H. Glaser Professor of Neurology; Affiliated Faculty, Yale Institute for Global Health; Division Chief, Neurological Infections & Global Neurology; Co-Director, Yale Center for Brain & Mind Health

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Justice Department Secures $25 Million Landmark Agreement with Apple to Resolve Employment Discrimination Allegations Based on Citizenship Status

The Justice Department announced today that it has secured a landmark agreement with Apple Inc. (Apple) to resolve allegations that Apple illegally discriminated in hiring and recruitment against U.S. citizens and certain non-U.S. citizens whose permission to live in and work in the United States does not expire.

Under the agreement, Apple is required to pay up to $25 million in backpay and civil penalties, the largest award that the department has recovered under the anti-discrimination provision of the Immigration and Nationality act (INA).

“Creating unlawful barriers that make it harder for someone to seek a job because of their citizenship status will not be tolerated,” said Assistant Attorney General Kristen Clarke of the Justice Department’s Civil Rights Division. “This resolution reflects the Civil Rights Division’s commitment to ending illegal discriminatory employment practices.”

The settlement agreement resolves the department’s determination that Apple violated the INA’s anti-discrimination requirements during Apple’s recruitment for positions falling under the permanent labor certification program (PERM). The PERM program is administered by the U.S. Department of Labor and the U.S. Department of Homeland Security. It allows employers to sponsor workers for lawful permanent resident status in the United States after completing recruitment and meeting other program requirements. Any U.S. employer that utilizes the PERM program cannot illegally discriminate in hiring or recruitment based on citizenship or immigration status.

The department’s investigation, which started in February 2019, found that Apple engaged in a pattern or practice of citizenship status discrimination in recruitment for positions it hired through PERM, and that the company’s unlawful discrimination prejudiced U.S. citizens, U.S. nationals, lawful permanent residents, and those granted asylum or refugee status. These less effective recruitment practices deterred protected workers from applying to positions that Apple preferred to fill instead with PERM beneficiaries.

Specifically, the department’s investigation found that Apple did not advertise positions Apple sought to fill through the PERM program on its external job website, even though its standard practice was to post other job positions on this website. It also required all PERM position applicants to mail paper applications, even though the company permitted electronic applications for other positions. In some instances, Apple did not consider certain applications for PERM positions from Apple employees if those applications were submitted electronically, as opposed to paper applications submitted through the mail. These less effective recruitment procedures nearly always resulted in few or no applications to PERM positions from applicants whose permission to work does not expire.  

Pursuant to the $25 million agreement, Apple is required to pay $6.75 million in civil penalties and establish an $18.25 million back pay fund for eligible discrimination victims. The agreement also requires Apple to ensure that its recruitment for PERM positions more closely matches its standard recruitment practices.

Specifically, Apple will be required to conduct more expansive recruitment for all PERM positions, including posting PERM positions on its external job website, accepting electronic applications, and enabling applicants to PERM positions to be searchable in its applicant tracking system. Apple has implemented some of these measures after the department opened its investigation. Additionally, Apple will train its employees on the INA’s anti-discrimination requirements and be subject to departmental monitoring for the three-year period of the agreement.

The Civil Rights Division’s Immigrant and Employee Rights Section (IER) is responsible for enforcing the INA’s anti-discrimination provision. This law prohibits discrimination based on citizenship status and national origin  in hiring, firing or recruitment or referral for a fee;  unfair documentary practices ; and  retaliation and intimidation . Learn more about IER’s work and how to get assistance through this brief video or watch an on-demand presentation . Find more information on how employers can avoid discrimination when hiring and recruiting on IER’s website .  

Workers who have questions about this settlement can contact IER at 1-888-473-3897 or [email protected] . The public can get more information about how to get help from IER by visiting IER’s  English  and  Spanish  websites. Subscribe for  email updates  from IER.

View the settlement agreement here.

View Attachment A here.

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