Arts and Humanities Commons^™

Medical Expertise, Patient Expertise, And Surrogate Decision Making: The Importance Of Co-Deliberation In Medical Decision-Making, Lindsey Grossheim

Theses

In biomedicine, there are many cases where a patient is incapacitated and unable to make their medical decisions. Often, these patients have no declared decision-maker. This thesis explores solutions which promote these patients’ ability to receive beneficent care and have a respect for their autonomy by proposing a requirement for co-deliberation between a medical professional (medical expert) and someone who knows the patient well (patient expert). This thesis studies a case and applies three solutions: one where each expert has full authority and a final solution where the two experts co-deliberate. Co-deliberation is a conversation between the two experts to …

Ethical Considerations Regarding Paternalism In Medicine, Lola Holcomb

Richard T. Schellhase Essay Prize in Ethics

Paternalism and autonomy are typically conceptualized as opposing theoretical frameworks. With respect to medical ethics, autonomy is practiced by the patient when he/she has liberty and control over his/her own medical matters, and his/her opinions supersede those of the physician. Paternalism is practiced by the physician when he/she restricts the patient’s autonomy (sometimes against the patient’s will) to promote health and well-being while discouraging undesirable behaviors. This paper details and analyzes a number of cases of medical paternalism in practice, both from the past and in the present day, with the purpose of examining associated ethical considerations. Attention is given …

Disease Mongering: How Sickness Sells, Vanessa C. Iroegbulem

Augustana Center for the Study of Ethics Essay Contest

“Disease mongering” is the practice of widening diagnostic boundaries of an illness and promoting their public awareness to expand the markets for treatment and to increase profits. This tactic typically used by pharmaceutical companies, medical equipment manufacturers, insurance companies, and even some doctors and patient groups, has become a great concern. Disease mongering has since increased in parallel with “medicalization,” which attempts to label normal human conditions as medical problems, thus becoming the subject of medical study, diagnosis, prevention, or treatment. This paper first seeks to examine how an increasing amount of life’s natural conditions and ailments are being seen …

Grey’S Anatomy As Philosophy: Ethical Ambiguity In Shades Of Grey, Kimberly S. Engels Phd, Katie Becker

Faculty Works: PHI (2010-2021)

Grey’s Anatomy focuses on the personal and professional life of protagonist Meredith Grey. Throughout the long series, a consistent theme is that the audience is confronted with moral dilemmas in Meredith’s professional work with patients as well as in her personal life. Grey’s decision-making often breaks professional protocol in order to do what she believes is best for her patients and those close to her. We argue that Grey’s approach to morality is representative of Simone de Beauvoir’s approach in The Ethics of Ambiguity. In this text, Beauvoir argues that an existentialist ethic must reject a childlike approach to …

Immunotherapy: Therapy Vs. Enhancement, Mariah Daly

Honors Program Theses

The battle against cancer is a long-standing struggle that has resulted in new information and the development of novel medical technologies. Current research aims to figure out a way to reprogram cells and bodily mechanisms to eliminate those cells that are cancerous without destroying healthy cells in the process. Methods which use the body’s own mechanisms, such as immunotherapy, have shown and continue to show potential for specifically targeting cancer cells. Adoptive T cell therapy is one form of immunotherapy that has gained significant attention and focus in the field. Therapies improve conditions up to the normal state of being, …

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

Baker Scholar Projects

It is a seldom-discussed fact that English-speakers in America enjoy a quality of health care that is not necessarily afforded to non-native speakers receiving care at the same facilities. Policy regarding what is required of health institutions in terms of translation services is exceedingly vague, and implementation of this policy is inconsistent. This lack of guidance makes it possible for many patients needing interpreters to fall through the cracks. This project will examine current policy guiding interpretive services in the U.S., and will recommend more specific guidelines that would improve quality of care for limited English proficiency individuals. This project …

Policy Of Current Hospital Translation Services And Recommendations For Future Adjustments For Spanish-Speaking Patients, Isidora Rose Beach

Chancellor’s Honors Program Projects

No abstract provided.

Before The Birth Of Bioethics: The Shaping Of Physicians’ Ethics In Canada, 1940-1970, Maureen Muldoon

The Canadian Society for Study of Practical Ethics / Société Canadienne Pour L'étude De L'éthique Appliquée — SCEEA

Students who study bioethics today usually learn very little about the medical ethics of physicians prior to the 1970’s. The practices of earlier physicians are often characterized as being paternalistic and lacking in respect for patient autonomy and justice. Yet just as the emergence of bioethics was shaped by social context, so was the medical ethics that preceded it.

This paper is a work in “descriptive ethics,” which explores the de facto morality of physicians roughly between 1940 and 1970. De facto morality refers to the profession’s officially endorsed standards as stated in its codes of ethics and related documents, …

Narrative Medicine And Health Care Ethics: Religious And Literary Approaches To Patient Identity And Clinical Practice, Tara Flanagan Tracy

Dissertations

This dissertation examines practices of narrative medicine and moral identity for end-of-life patients, with special attention given to Aristotle's Poetics and the work of Paul Ricoeur. While noting the genuine value of narrative medicine for clinicians, I examine the limits of self-narration for patients who are unable to offer a linear, coherent narrative of their lives due to cognitive deficits such as Alzheimer's disease. Nevertheless, the premise of narrative medicine, that being a close reader of texts can develop the ability to attend closely to patients, remains useful. When the sources used in narrative medicine are expanded to include those …

Assessing Decision-Making Capacity After Severe Brain Injury, Andrew Peterson

Electronic Thesis and Dissertation Repository

Severe brain injury is a leading cause of death and disability. Following severe brain injury diagnosis is difficult and errors frequently occur. Recent findings in clinical neuroscience may offer a solution. Neuroimaging has been used to detect preserved cognitive function and awareness in some patients clinically diagnosed as being in a vegetative state. Remarkably, neuroimaging has also been used to communicate with some vegetative patients through a series of yes/no questions. Some have speculated that, one day, this method may allow severely brain-injured patients to make medical decisions. Yet, skepticism is rife, due in part to the inherent difficulty of …

Closed Cases? - The Mentioning Of Medical Errors In Doctors' Memoirs, Angelika Potempa

Philosophy Faculty Publications and Presentations

The concession of errors in the pursuit of the art of medicine, where mishaps can lead to deleterious consequences is at the center of this paper. The social costs of medical errors and a professional culture with a strong tradition of self-regulation and shielding itself via a more or less permeable “Wall of Silence” make the issue not only interesting but keep it timely. The focus is on how and within what framework medical errors are admitted in the memoirs of American doctors. The times remembered reach from the 1950s and 1960s to the present.

Killing And Letting Die: The Irrelevant Distinction, Sarah Beth Shaw

Honors College Theses

The object of this essay is to explain why the distinctions made in euthanasia between killing vs. letting die and willingness to kill vs. unwillingness to kill are not relevant to real life euthanasia cases. The specific purpose of the research is to isolate the relevant factor for debate when discussing the morality of euthanasia. It begins with a brief examination of some vocabulary that is commonly used when discussing euthanasia. Following this is a quick overview of what the word euthanasia meant in the ancient Greco-Roman world compared to what it means in the modern vernacular. I use an …

Personhood, Harm And Interest: A Reply To Alberto Giubilini And Francesca Minerva, Matthew Beard, Sandra Lynch

Philosophy Papers and Journal Articles

In the article ‘After-birth abortion: why should the baby live?’ arguments are made in favour of the moral permissibility of intentionally killing newborn infants, under particular conditions. Here we argue that their arguments are based on an indefensible view of personhood, and we question the logic of harm and interest that informs their arguments. Furthermore, we argue that the conclusions here are so contrary to ordinary moral intuitions that the argument and conclusions based upon it—including those which defend more mainstream methods of abortion—should be treated with immediate suspicion.

Bioethics In Canada, Charles Weijer, Anthony Skelton, Samantha Brennan

Samantha Brennan

This comprehensive introduction to bioethical issues emphasizes Canadian policies, issues, and scholars. Using the human lifespan as an organizing narrative, Bioethics in Canada explores ethical theories through a diverse selection of readings discussing traditional and cutting-edge topics in the field.

Readership : Bioethics in Canada is a core text for bioethics courses, generally offered in second- or third-year through philosophy departments at Canadian universities.

http://www.oupcanada.com/catalog/9780195440157.html

Consuming Direct-To-Consumer Genetic Tests: The Role Of Genetic Literacy And Knowledge Calibration, Yvette E. Pearson, Yuping Liu-Thompkins

Philosophy Faculty Publications

As direct-to-consumer marketing of medical genetic tests grows in popularity, there is an increasing need to better understand the ethical and public policy implications of such products. The complexity of genetic tests raises serious concerns about whether consumers possess the knowledge to make sound decisions about their use. This research examines the effects of educational intervention and feedback on consumers' genetic literacy and calibration -- the gap between consumers' actual knowledge and how much they think they know. The authors find that consumers' genetic knowledge was generally low and that people tended to underestimate their knowledge level. Furthermore, consumers' perceived …

Ethical Issues Posed By Cluster Randomized Trials In Health Research, Charles Weijer, Jeremy Grimshaw, Monica Taljaard, Ariella Binik, Robert Boruch, Jamie Brehaut, Allan Donner, Martin Eccles, Antonio Gallo, Andrew Mcrae, Raphael Saginur, Merrick Zwarenstein

Charles Weijer

The cluster randomized trial (CRT) is used increasingly in knowledge translation research, quality improvement research, community based intervention studies, public health research, and research in developing countries. However, cluster trials raise difficult ethical issues that challenge researchers, research ethics committees, regulators, and sponsors as they seek to fulfill responsibly their respective roles. Our project will provide a systematic analysis of the ethics of cluster trials. Here we have outlined a series of six areas of inquiry that must be addressed if the cluster trial is to be set on a firm ethical foundation: 1. Who is a research subject? 2. …

On The Scope Of A Professional’S Right Of Conscience, David Lefkowitz

Philosophy Faculty Publications

Under what conditions, if any, do medical professionals enjoy a right of conscience? That is, when must a just state accommodate a physician’s, pharmacist’s, or other medical professional’s refusal to provide legally and professionally sanctioned services to which she morally objects; for example, by enacting laws that enable her to do so without fear of losing her job or her professional privileges? Recent assertions by several pharmacists of a right to conscientiously refuse to fill prescriptions for the so-called morning-after pill, and by a California fertility doctor of a right to conscientiously refuse to provide fertility treatment to a lesbian, …

Conceptual Problems In Research Ethics, Charles Weijer

Charles Weijer

This poster addresses these issues:
• What good is medical research?
• What is owed to the study subject?
• When is research risk acceptable?
• How should we conduct research in developing countries?
• How should we conduct research involving communities?

Ethical Considerations In The Conduct Of Vaccine Trials In Developing Countries, Charles Weijer, C. Lanata, C. Plowe

Charles Weijer

No abstract provided.

Deep Ecology And End-Of-Life Care, Paul Carrick

Philosophy Faculty Publications

Physicians and nurses caring for terminally ill patients are expected to center their moral concerns almost exclusively on the needs and welfare of the dying patient and the patients family. But what about the relationship of traditional medical ethics to the emerging new theories of environmental ethics, like deep ecology? As we glide into the twenty-first century, can anyone seriously doubt that the mounting global concerns of environmental ethics will eventually influence the ethics of medicine too?

For example, suppose physicians were to integrate the core values of an ecocentric environmental ethic like deep ecology into contemporary North American norms …

Helsinki Discords: Fda, Ethics, And International Drug Trials, Jonathan Kimmelman, Charles Weijer, Eric Meslin

Charles Weijer

No abstract provided.

Introduction, Oonagh Corrigan, John Mcmillan, Charles Weijer

Charles Weijer

This introductory chapter begins with a brief explanation of the impetus behind the book as well as its objectives. It then discusses the history of consent and the challenges for informed consent. An overview of the subsequent chapters is presented.

Ethics And Schizophrenia, A. Rudnick, Charles Weijer

Charles Weijer

No abstract provided.

Politics, Risk, And Community In The Maya Icbg Case, Fern Brunger, Charles Weijer

Charles Weijer

No abstract provided.

Revisiting The Ethics Of Hiv Prevention Research In Developing Countries, Charles Weijer, Guy Leblanc

Philosophy Presentations

Issues: We present key aspects of our paper, commissioned by UNAIDS in 2005, entitled, “Revisiting the ethics of HIV prevention research in developing countries.” In 2004 and 2005 we witnessed the closure or suspension of three international clinical trials testing tenofovir in the prevention of HIV infection in high risk groups due to the failure to provide free treatment to those who seroconvert during the conduct of the study. We examine critically moral claims for the provision of treatment to those who seroconvert in HIV prevention trials and ask whether it is a matter of moral obligation or moral negotiation? …

Revisiting The Ethics Of Hiv Prevention Research In Developing Countries, Charles Weijer, Guy Leblanc

Charles Weijer

Issues: We present key aspects of our paper, commissioned by UNAIDS in 2005, entitled, “Revisiting the ethics of HIV prevention research in developing countries.” In 2004 and 2005 we witnessed the closure or suspension of three international clinical trials testing tenofovir in the prevention of HIV infection in high risk groups due to the failure to provide free treatment to those who seroconvert during the conduct of the study. We examine critically moral claims for the provision of treatment to those who seroconvert in HIV prevention trials and ask whether it is a matter of moral obligation or moral negotiation? …

Protecting Communities In Research: From A New Principle To Rational Protections, Ezekiel Emanuel, Charles Weijer

Charles Weijer

No abstract provided.

Evaluating Risks Of Non-Therapeutic Research In Children, Paul Miller, Charles Weijer

Charles Weijer

No abstract provided.

Bioethics In Social Context, Edited By Barry Hoffmaster, Charles Weijer

Charles Weijer

No abstract provided.

Ethical Issues In Palliative Care Research, Neil Macdonald, Charles Weijer

Charles Weijer

No abstract provided.