Ethical Challenges in Community Health 

Bioethics in Community Health: 
Understanding Ethical Challenges of Community Health Centers

Funder: Greenwall Foundation, Making A Difference Program

This national study of nonprofit community health centers in the United States will learn about and describe the nature and extent of ethical challenges arising in primary care clinics serving diverse low-income communities facing health care barriers. Community health providers have few places to turn for bioethical analysis and guidance on the practice challenges that keep them up at night. The project builds on prior Hastings Center research on ethical challenges in immigrant health and arising in Federal Qualified Health Centers (FQHCs) participating in genomics research and responding to Covid-19.

Through its engaged research process and its products, this new study will strengthen and inform ongoing bioethics-community health collaboration that supports community health providers and advances trustworthy health care, inclusive research, and equitable health policy.

The Hastings Center’s quantitative research and dissemination partner in this project, the Institute for Community Health (ICH), is a nonprofit consulting organization with a mission to improve community health through planning and assessment, participatory evaluation, applied research, and data services. ICH’s Leah Zallman Center for Immigrant Health Research was established in memory of the late Leah Zallman, a primary care physician and preeminent researcher on immigrant health. Dr. Zallman served as research director at ICH and took part in The Hastings Center’s 2018 convening on building systems of safety in health care for immigrant patients and their families.


The study will use survey, interview, and analytical methods. It will take place from September 1, 2022-February 29, 2024. 

Project Team

  • Carolyn Neuhaus, PhD, Principal Investigator; Research Scholar, The Hastings Center
  • Nancy Berlinger, PhD, Co-Principal Investigator; Research Scholar, The Hastings Center
  • Johanna Crane, PhD, Co-Investigator/Interview Director; Associate Professor, Alden March Bioethics Institute, Albany Medical College
  • Onesky Aupont, MD, MPH, PhD, Co-Investigator/Survey Director; Senior Research and Evaluation Scientist, Institute for Community Health (ICH)
  • Jessica Santos, PhD, Senior Advisor-Survey; Director, Leah Zallman Center for Immigrant Health Research, ICH
  • Ranjani Paradise, PhD, Senior Advisor-Survey; Director of Evaluation, ICH
  • Sofia Ladner, MPH, Project Manager-Survey; Research and Evaluation Project Manager, ICH
  • Aashna Lal, BA, Project Manager; Project Manager & Research Assistant, The Hastings Center


Berlinger, Nancy. “Bioethics in Community Health.” Hastings Center Report 52, no. 4 (2022). https:/doi/10.1002/hast.1399. Abstract: What keeps community health providers up at night? And how should bioethics evolve to meet the needs of these providers? Hastings Center research scholar Nancy Berlinger introduces a new project and line of research and public-facing work at The Hastings Center to explore ethical challenges that arise in primary and preventative health care for medically underserved communities, where ethical challenges often reflect the health consequences of social inequalities.

Download the article.