In the Heitman & McKeiran 2003 case study, Stillwater Springs finds itself challenged by the threat of its old lead mines used for over a century and residents unaware of the danger (p. 126). Because the new elementary school and residences were built to attract more people, the town’s economic needs juxtapose those of the residents (p. 126). They illuminate problems of informed consent and treating persons with dignity and respect (PHLS, 2002, p. 5). It also negates the a person’s right to health in its fullest measure (Hietman & McKeiran, 2003, p. 127)
Yet, residents discover Stillwater’s history, its lead mines and the threat it poses through a resident led health education campaign (Heitman & McKeiran, 2002, p. 126). Revealing the correlation between old lead mines, ground and groundwater contamination and chronic and irreversible health conditions in populations affected by such, 300 signatures are collected for the state lead abatement director (p. 126, 127). Although town business owners and officials vehemently oppose any attention and investigation and the lead abatement director does not have the resources to address this for another five years, something must be done (p. 127). However, the director also knows that many communities will ask for similar services, all of which lie beyond the program’s budget and resource capacities (p. 127).
On one hand, the lead abatement director and Stillwater officials have an ethical duty to the residents in accordance with prevention (PHLS, 2002, p. 7). Since the threats and their potentiality are well-documented, they should provide assessment and/or screening, especially since damage is often symptom-free (Heitmann & McKeiran, 2003, p. 126). At the very least, the director and the local health departments should establish and implement a lead health education and screening program to address uninformed consent and problems with the physical and social environment (PHLS, 2002, p. 7). This also confers dignity. Even as the state director lacks the resources to fully eradicate the problem for five years and the proposed solution is not the best or the most ethical, it is the most effective, efficient and ethical one given resource scarcity.
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