Using the case-study methodology to teach ethics to public health students

This article uses the case-study methodology as a strategy to facilitate examination of ethical principles that underlie developmental risk research carried out among adolescents. Description of the ethical dilemmas that arose during the implementation of a longitudinal randomized controlled trial is presented along with discussion guidelines. As youth were being enrolled and the trial was being conducted, it was noted that a small but significant number had responded "yes" to a question on suicidal ideation. After review by the Institutional Review Boards overseeing the trial, it was decided that confidentiality had to be breached. A revised protocol was implemented explicitly stating that confidentiality would be broken if a youth reported suicidal ideation. The number of youth reporting suicidal ideation after the consent form was amended decreased significantly. Presentation of this research by use of the case study method sensitizes students to issues that arise at the intersection of disease prevention and health promotion intervention research.