| Course | NU733 Ethics, Policy, and Advocacy for Population Health |
|---|---|
| Unit | Unit 3 |
| Paper type | Ethical framework paper |
| Length | About 1,090 words, 6 pages double-spaced |
| Format | APA 7 student paper |
| School | Purdue University Global |
| Program | Doctor of Nursing Practice (DNP) |
| Updated | September 2026 |
Free sample paper for NU733 Unit 3
Six Questions for a Clearance Protocol: Applying Kass's Public Health Ethics Framework to Composite Port Hadley's Encampment Clearances, and Why Principlism Was Set Aside
[Student Name]
Purdue University Global
NU733: Ethics, Policy, and Advocacy for Population Health
Unit 3 Ethical Framework Paper
[Instructor Name]
[Date]
Port Hadley, its protocol and figures are composite; numbers are bracketed placeholders.
The Protocol
Port Hadley's clearance protocol is set out in a [two]-page administrative memo. When the city manager orders a clearance under the camping ordinance, police post a notice [24] hours in advance, and a public works crew removes tents and belongings at the stated time. The written justification cites sanitation and the risk of infectious disease, most recently the hepatitis A cluster at the riverside site. The protocol does not provide for storage of belongings, does not require an offer of shelter, and does not involve health staff. In [2024], the city carried out [19] clearances under this protocol.
Why Kass and Not Principlism
Principlism, with its four principles of autonomy, doing good, avoiding harm and justice, was developed chiefly to guide decisions between clinicians and individual patients (Beauchamp & Childress, 2019). A clearance protocol is a different kind of decision. It is made by a government for a population, it affects people who did not consent to it and may never meet the decision maker, and its benefits and burdens fall on different groups. Principlism can be stretched to cover such cases, but its concepts, especially autonomy and consent, fit awkwardly when the issue is a public program rather than a treatment choice.
Public health ethics developed partly in response to that gap. Childress and colleagues described public health as concerned with the health of populations and proposed conditions under which public health measures that infringe on individual interests can be justified (Childress et al., 2002). Kass offered a practical framework of six questions designed for evaluating public health programs and policies (Kass, 2001). It fits this case because it asks about goals, effectiveness, burdens, alternatives, fairness and balance, which are the questions a city should ask before adopting a protocol. I use it alone, in its own order, so that each question gets full attention.
Question 1: What Are the Public Health Goals?
The memo names two: reducing the spread of infectious disease in encampments and improving sanitation in public spaces. Both are legitimate public health goals. Kass emphasizes that the goal should be expressed in terms of reduced morbidity or mortality, not only in terms of improved order. The protocol's goals partly meet this: disease reduction is a health goal, while cleaner parks are mainly about public space.
Finding: the protocol has legitimate public health goals, though one of its two stated goals is not primarily about health.
Question 2: How Effective Is the Program in Achieving Its Goals?
Here the protocol fails. Clearing a site disperses its residents but does not end their homelessness, their lack of sanitation, or their exposure to infection. After the riverside clearance, the outreach team spent three weeks finding displaced residents to complete their hepatitis A vaccinations, and some were never found; the protocol thus interrupted the most effective disease control measure then under way. Research on repeated displacement projects increases in overdose deaths, serious infections and hospitalizations among people who inject drugs (Barocas et al., 2023). The city has no data showing that clearances reduced infections.
Finding: the protocol's effectiveness in reducing disease is unproven and may be negative.
A protocol justified by infection control that scatters the people being vaccinated fails the test its own justification sets.
Question 3: What Are the Known or Potential Burdens?
The burdens fall mainly on the people displaced: loss of tents, identification and medications; disruption of health care, including vaccination and treatment for opioid use disorder; exposure to cold after losing shelter; and the stress and stigma of removal. Some burdens fall on the outreach team and the county hospital. The protocol's memo names none of them.
Finding: the burdens are substantial, fall mostly on an already vulnerable group, and are not acknowledged in the protocol.
Question 4: Can Burdens Be Minimized? Are There Alternatives?
Here the protocol fails again. Several burdens could be reduced at little cost: storing belongings for a period, completing medical care such as vaccine series before clearance, having a health worker present, and offering shelter before removal. Alternatives also exist, such as bringing sanitation to the site, which directly addresses the stated goal. Kass's framework asks whether the least burdensome effective option has been chosen, and the protocol does not consider any alternative.
Finding: burdens could be reduced substantially, and less burdensome alternatives were not considered.
Question 5: Is the Program Implemented Fairly?
Clearances are concentrated at sites near downtown businesses and parks, while encampments in less visible places are rarely cleared. That pattern suggests that complaints, not health risk, drive enforcement. The people affected are disproportionately Black, older and disabled, as later units show, so uneven enforcement may compound existing inequities.
Finding: implementation appears driven by visibility and complaints rather than health risk, raising concerns about fairness.
Question 6: How Can Benefits and Burdens Be Fairly Balanced?
Kass suggests that when a program imposes burdens, its justification must be stronger, and that the process of deciding should be open and include those affected. The protocol was adopted without public comment and without the views of people experiencing homelessness or the health workers who serve them. A fairer balance would require a revised protocol that states expected health benefits, names burdens, adopts the measures that reduce them and is developed with the people affected.
Finding: the balance is not currently fair, but a revised protocol could make it so.
Summary of Findings
The protocol meets the first question in part, fails the second and fourth, reveals serious concerns under the third and fifth, and could meet the sixth only if revised. The two failures carry the most weight, because they go to whether the protocol should exist in its current form at all: the protocol cannot show that it achieves its health goal, and it ignores ways to reduce its burdens.
Conclusion
Kass's framework shows that Port Hadley's clearance protocol is weakest where it matters most: its effectiveness and its failure to minimize burdens. A revised protocol would bring sanitation first, finish medical care before any clearance, store belongings and involve health staff. The next units examine the population affected, the state law that constrains the city, and the people with power to change the protocol.
References
Barocas, J. A., Nall, S. K., Axelrath, S., Pladsen, C., Boyer, A., Kral, A. H., Meehan, A. A., Savinkina, A., Peery, D., Bien, M., Agnew-Brune, C., Goldshear, J., Chiang, J., Linas, B. P., Gonsalves, G., Bluthenthal, R. N., & Mosites, E. (2023). Population-level health effects of involuntary displacement of people experiencing unsheltered homelessness who inject drugs in US cities. JAMA, 329(17), 1478-1486. https://doi.org/10.1001/jama.2023.4800
Beauchamp, T. L., & Childress, J. F. (2019). Principles of biomedical ethics (8th ed.). Oxford University Press.
Childress, J. F., Faden, R. R., Gaare, R. D., Gostin, L. O., Kahn, J., Bonnie, R. J., Kass, N. E., Mastroianni, A. C., Moreno, J. D., & Nieburg, P. (2002). Public health ethics: Mapping the terrain. Journal of Law, Medicine & Ethics, 30(2), 170-178. https://doi.org/10.1111/j.1748-720X.2002.tb00384.x
Kass, N. E. (2001). An ethics framework for public health. American Journal of Public Health, 91(11), 1776-1782. https://doi.org/10.2105/AJPH.91.11.1776
NU733 Unit 3 instructions, in plain terms
In Unit 3 you test a public health program or policy against a named ethical framework. Expect to describe the program, explain why you chose the framework, apply each of its elements in turn, reach a finding for each, and summarize what the analysis shows. Many sections use Kass's framework, while others allow Childress and colleagues' conditions or another public health ethics approach. Expect something near 2,200 words. Faculty reward a framework chosen for a stated reason, each element applied with evidence from the case, findings stated plainly, and a conclusion that points to what should change. Describe any framework you set aside accurately before explaining why it fits this case poorly.
How this NU733 Unit 3 example is built
The paper opens with the protocol from the city's memo and the number of clearances carried out. A section explains why principlism fits a population program awkwardly and why public health ethics, and Kass in particular, fits better. Six sections follow Kass's questions in order: legitimate goals, one only partly about health; unproven and possibly negative effectiveness, with evidence on displacement; unacknowledged burdens; burdens that could be reduced and alternatives never considered; enforcement driven by visibility; and a balance that could be fair only if revised. The highlighted sentence captures the effectiveness failure. A summary identifies the two decisive failures, and the conclusion lists what a revised protocol would include.
Where the points sit in the NU733 Unit 3 rubric
Framework papers are typically marked on the choice and explanation of the framework, application, use of evidence, findings and conclusions. The choice criterion rewards an accurate description of the framework and a reason for choosing it, including why another was set aside. Application is judged element by element, with each question answered from the case rather than in general terms. Evidence earns credit when the analysis draws on data or research, for example about the effects of displacement. Findings should be stated plainly for each element. The conclusion scores well when it follows from the findings and says what should change. Clear headings that follow the framework's own order help a grader track each element quickly.
NU733 Unit 3 help: mistakes that cost points
A common weakness is a long summary of the framework followed by a thin, one-paragraph application. Another is using several frameworks briefly, so none is applied properly. Some papers declare a program unethical without testing it against each element. Others ignore evidence on effectiveness, which is often where a program fails. Many students treat principlism as irrelevant without describing it accurately. And conclusions often condemn the program without proposing what would fix it. Choose one framework, explain why, answer each of its questions from the facts of your case, write a one-line finding after each, and end with the changes those findings require.
Get an NU733 Unit 3 example written to your instructions
Which framework has your section assigned for Unit 3, and which program or policy will it test? Pass those on with the instructions and rubric. A free first custom sample, prepared to those specifications within 24-48h, applies that framework in its authors' own terms and reaches a verdict it can defend. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
More NU733 papers and DNP samples
- NU733 Unit 1: Issue Analysis, Homelessness Deaths
- NU733 Unit 2: Discussion Post, Costs of a Clearance
- NU733 Unit 4: Population Profile
- NU733 Unit 5: Statute Analysis
- NU733 Unit 6: Policy Brief
- NU733 Unit 7: Seminar Reflection
- NU733 Unit 8: Stakeholder Power Map
- NU733 Unit 9: Advocacy Letter
- NU733 Unit 10: Position Paper
- NU713 Unit 3: Measurement Critique, ADI and PRAPARE
- NU703 Unit 3: Boyer Scholarship Model Application
NU733 Unit 3 questions, answered
What are Kass's six questions?
In her 2001 American Journal of Public Health article, Nancy Kass asks what the program's public health goals are, how effective it is at achieving them, what its known or potential burdens are, whether those burdens can be minimized or alternatives exist, whether it is implemented fairly, and how its benefits and burdens can be fairly balanced. They are meant to be worked through in order.
Could Childress and colleagues' framework be used instead?
Yes. Their 2002 paper in the Journal of Law, Medicine and Ethics sets out general moral considerations and five conditions for overriding them, asking whether a measure is effective, proportionate and necessary, whether it infringes as little as possible, and whether it can be publicly justified. It suits questions about when a program may limit liberty. Choose whichever your section names, and apply it fully rather than borrowing a condition or two.
Is it acceptable to reject principlism entirely?
Rejecting it for this purpose is acceptable if you explain why, and describing it accurately first is essential. Principlism remains a strong framework for clinical decisions. The argument in a population health paper is usually that its principles strain when benefits and burdens fall on different people and no single patient's consent is at stake.
Where can I find a free NU733 Unit 3 sample paper?
The complete NU733 Unit 3 ethical framework paper is on this page, with the protocol, why principlism was set aside, Kass's six questions each with a finding, a summary and a conclusion on revision, plus four references. A framework paper on your own program can be requested.
Which of Kass's questions does the protocol fail in NU733 Unit 3?
The second and fourth. The city cannot show that clearances reduce disease, and they scattered a vaccine series; and burdens could be reduced by storage, finishing care first and offering shelter, while alternatives such as bringing sanitation were never considered.