Bioethics and Medical Ethics Commons^™

Early Onset Colorectal Cancer: Research, Trends & Challenges, Sarah E. Smith

Capstone Showcase

Early onset colorectal cancer (EOCRC) incidence and mortality are rising in a global trend, contrasting with improvements seen in late-onset colorectal cancer (LOCRC). EOCRC appears to differ in presentation, histology, and pathology from LOCRC painting concerns of a more aggressive tumor profile. With incidence steadily climbing, there is still lacking awareness and guidance on screening for EOCRC. This article aims to provide background on EOCRC including epidemiology, risk factors, and traits, as well as to explore methods for adjusting provider screening criteria to combat this concerning trend.

Bioethics And A Theology Of Vulnerability, Carrie Oneil-Smith

Obsculta

This essay looks at how a theology of vulnerability can contribute to ethical decision-making in an increasingly secular society. Relationality, power dynamics and scriptural justifications are considered, as well as early contributions made to this nascent field of Christian thought. This essay was written for a class on Health Care Ethics taught by Dr. Mary Ann Kish.

Ambivalence At 10 000 Feet, Marc Perlman

HCA Healthcare Journal of Medicine

The transition from medical neophyte to seasoned physician is a gradual process spanning the course of many years. However, there are various milestones throughout the experience that capture increases in decision-making capacity and responsibility, such as the switch from pre-clinical to clinical medical education. Medical students in their clinical years are endowed with an abundance of knowledge from their pre-clinical years and are just beginning to synthesize and apply that information to patient care. “Ambivalence at 10 000 Feet” captures a reflection of a third-year medical student on the theoretical decision to provide emergency medical care in the absence of …

At The End Of Life: Conceptualizing Human Dignity And Assisted Suicide Debates In Contemporary Germany, Edith-Marie Green

Honors Theses

As medicine improves and breakthroughs on cures for illnesses formerly thought deadly continue to develop, the global population continues to age. This has introduced new concerns about aging and end-of-life health care. One proposed end-of-life healthcare solution is assisted suicide, although the practice is not without its controversies. The case of assisted suicide in Germany is of particular interest for a variety of reasons, and the practice has not had an easy path there. A series of debates in 2015 led to the practice being banned, but that ban was overturned in 2020 by Germany’s Constitutional Court. While assisted suicide …

Impact Of A Multifaceted Intervention On Physicians' Knowledge, Attitudes And Practices In Relation To Pharmaceutical Incentivisation: Protocol For A Randomised Control Trial, Muhammad Naveed Noor, Mishal Khan, Afifah Rahman-Shepherd, Amna Rehana Siddiqui, Sabeen Sharif Khan, Iqbal Azam, Sadia Shakoor, Rumina Hasan

Department of Pathology and Laboratory Medicine

Introduction: In settings where the private sector constitutes a larger part of the health system, profit-gathering can take primacy over patients' well-being. In their interactions with pharmaceutical companies, private general practitioners (GPs) can experience the conflict of interest (COI), a situation whereby the impartiality of GPs' professional decision making may be influenced by secondary interests such as financial gains from prescribing specific pharmaceutical brands.
Methods and analysis: This study is a randomised controlled trial to assess the impact of a multifaceted intervention on GPs' medical practice. The study sample consists of 419 registered GPs who own/work in private clinics and …

Discussing The Injustice Of The Covid-19 Vaccine Pass Imposed On Medical Consultation In Public Hospitals In Hong Kong, Fung Kei Cheng

Journal of Health Ethics

The COVID-19 pandemic has devastated public health, economy and social life all over the world, especially wherever a vaccine pass scheme has been implemented. Many countries have begun to relax schedules to return to normal activities. In contrast, Hong Kong continues to tighten the utilisation of a vaccine pass for medical services in order to boost vaccination rates. Such a practice not only significantly challenges ethical and operative concerns but also threatens health equity and social justice for healthcare decision-makers and practitioners, consequently hurting public health and community well-being. This discussion analyses the various arguments, reviews vaccine hesitancy and suggests …

Understanding The Role Of Race In American Medicine, Fariel C. A. Lamountain

Honors Theses

Long running inequity in health care and outcomes in the United States stem from failure to acknowledge the underlying role of the Transatlantic slave trade as it manifests in all facets of American society and commerce. This paper focuses specifically on the American medical system and its foundations to understand the precursors to generational trends in lack of access to healthcare and poor health for Black communities. This paper uses a three-pronged approach to understand the racist cycle of inequity, highlighting the history and origins of racism in American medicine, personal accounts and statistical evidence of inequity, and community and …

Biomedical Ethics In The Medical School Curriculum: Lessons Learned From The Holocaust, Emma Flanagan

College Honors Program

The Holocaust, the murder of 6 million Jews, is the only medically-santioned genocide. This thesis explores the roles of Nazi doctors in the planning, organizing, and implementation of the organized mass murder of European Jewry. Given the German medical community’s complicity, it is imperative that physicians today are well informed about their profession’s history of involvement in the Holocaust. In addition, and by way of contrast, a study of the moral challenges faced by doctors imprisoned in concentration camps or in the ghettos of Nazi-occupied Europe might serve to better prepare physicians for future ethical dilemmas. In a survey of …

Adolescent Medical Decisionmaking Rights: Reconciling Medicine And Law, Doriane Lambelet Coleman, Philip M. Rosoff

Faculty Scholarship

Dennis Lindberg came into his aunt’s care when he was in the 4th grade because his parents struggled with drug addiction and could not provide for him. At thirteen, he was baptized in his aunt’s faith as a Jehovah’s Witness. Just days after he turned fourteen, on November 6, he was diagnosed with acute lymphoblastic leukemia.

The prognosis was that Dennis had a 75% chance of cure with standard oncology treatment. Consistent with the requirements of his new faith, however, Dennis told his doctors, “I do not want to be treated if the requirement is that I would have to …

The Bioethical Implications Of Genetic Screening Programs For Rare Diseases, Ellie Pitcher, Jeremy Mccallum

Honors Thesis

In the United States, there are currently thirty-five hereditary medical disorders that the Department of Health and Human Services recommends for newborn screening. The early diagnosis of these disorders is critical to the health and well-being of affected individuals. There are many more rare genetic diseases that would benefit from early diagnosis, but which do not symptomatically present until late in life or have low penetrance. Some of these genetic diseases are extremely dangerous, and would massively benefit from the early diagnosis that accompanies newborn screening in the United States. Here the benefits and risks associated with early screening for …

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 …

Turning Passion Into Purpose: A Journey To Medicine Through Global Health, Laurenie Louissaint Md

Family Medicine

No abstract provided.

Ethics Of The Advance Euthanasia Directive: Death Within Dementia, Isabella Braga

Honors Program Theses

By the year 2050, over 131.5 million people worldwide will have dementia. While many dementia patients seek euthanasia as a means of maintaining dignity and autonomy, they are in a difficult position: because physician-assisted euthanasia is administered by a medical professional, in current medical practice, the dementia patient must be euthanized while she is of sound mind. She thus sacrifices years of fulfilled, compos mentis living. With an advance euthanasia directive, the patient can designate a brightline of dementia past which she would like to be euthanized. She would be able to live out her compos mentis years, and have …

The Knockdown Of Rab8 And Rab11 Proteins On The Trafficking Of Dengue Virus And The Philosophical Implications On Public Health, Maddie Labor

Regis University Student Publications (comprehensive collection)

Honors thesis

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, …

"Farewell" To Prognosis In Shared Decision-Making, Robert F. Johnson

Peer Reviewed Articles

Whether because of a cultural pattern or personal preference, palliative care clinicians encounter persons approaching the end of life who wish to limit or forego prognostic information relating to their situation. This scenario has received attention in a recent motion picture as well as a newly available advance directive modification—the Prognosis Declaration form. The ordinary expectation for end-of-life shared decision-making with a capable person is clinician disclosure of the best effort at prognostic assessment. The optimal match between the expressed values, goals, and preferences of the person with available clinician expertise is hopefully achieved. For the clinician, a person’s choice …

The Role Of Compassion In Medical Ethics And Its Reintegration In Modern Practice, Hannah E. Borchers

Senior Honors Theses

Compassion has been an integral part of medical ethics since its origins, but as medicine progressed, compassion slowly disappeared from practice. The development of any industry results from many complex factors, but the decline of compassion in medicine can be largely attributed to the evolution of technology and role of medical ethics committees. Change is not always negative, but in this case, medicine neglected one of its foundational principles. This is seen by analyzing the history and progression of medical ethics and its four pillars. Plato and Aristotle defined justice in Greek philosophy, Hippocrates used the concept of non-maleficence in …

Medical And Ethical Issues And Latter-Day Saints, Kevin J. Black

Kevin J. Black, MD

Behind The Mask Of Morality: (E)Urochristian Bioethics And The Colonial-Racial Discourse, Jennifer L. Mccurdy

Electronic Theses and Dissertations

The discipline of bioethics is insufficient and ineffective in addressing the persistent issues of racism and racial inequalities in healthcare. A minority of bioethicists are indeed attentive to issues such as implicit bias, structural racism, power inequalities, and the social determinants of health. Yet, these efforts do not consider the colonial-racial discourse -- that racism is an instrument of eurochristian colonialism, and bioethics is a product of that same colonial worldview. Exposing mainstream bioethicists to the work of anti-colonial scholars and activists would provide bioethicists a framework through which they would be better equipped to address issues of race through: …

The Ethics Of An Unlicensed Medical Practitioner, Charles C. Escott

Writing Across the Curriculum

For option A of this assignment, the prompt is that Harry, a manufacturer of medical equipment and an avid reader of medical textbooks, has developed a program that will allow its users to self-diagnose and self-treat their ailments, without a doctor’s help. Harry wants to sell his program to “ordinary folk” as a replacement for consulting licensed medical practitioners. An important point here is that Harry is not licensed to practice medicine and has only read books on the subject. The posed question is whether or not his program should be published (from an ethical standpoint—not necessarily a profit-driven one). …

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.

Going Beyond ‘Do No Harm’: A Critical Annotation, Robert F. Johnson

Peer Reviewed Articles

The Op-Ed article in the New York Times (November 4th, 2016), “On Assisted Suicide, Going Beyond Do No Harm” by Haider Javed Warraich provided an articulate and timely plea for more widespread availability and application of physician-assisted dying, or “suicide”, as part of end-of-life medical care. While this profound intervention should be considered by physicians and others as an option for those able to express their wishes at the end-of-life, it must be considered in the context of the ethical principles appropriate for all health care interventions and recognized for its limited role in the overall approach to compassionate care …

Commentary: Care Is A Noun And A Verb, Peter G. Holub

Internet Journal of Allied Health Sciences and Practice

Care is a living word that binds us to our patients and to each other. The desire to care for others is the motivation for everything we do. Whether healthcare system or health care provider or health-care reform, the singular mission is patient care. The motto for healthcare is Cum scientia caritas (Latin for scientific knowledge applied with care). The only challenge to this most rudimentary tenet for caring depends on how we define care.

Healer, Witness, Or Double Agent? Reexamining The Ethics Of Forensic Psychiatry, Matthew U. Scherer

Journal of Law and Health

In recent years, psychiatrists have become ever more prevalent in American courtrooms. Consequently, the issue of when the usual rules of medical ethics should apply to forensic psychiatric encounters has taken on increased importance and is a continuing topic of discussion among both legal and medical scholars. A number of approaches to the problem of forensic psychiatric ethics have been proposed, but none adequately addresses the issues that arise when a forensic encounter develops therapeutic characteristics. This article looks to the rules governing the lawyer-client relationship as a model for a new approach to forensic psychiatric ethics. This new model …

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 …

Healing Powers; An Examination Of Medical Ethics, Benevolent Lies, And The Doctor-Patient Relationship In Late Eighteenth-Century Britain, Rosa Dale-Moore

Honors Program Theses

This paper will discuss foundational thought for the practice of medical ethics in the context of Dr. Thomas Percival, a physician in late eighteenth century Britain, and his work in which he introduced a code of medical ethics in an attempt to correct the imbalance of values used by physicians in their medical practices and to codify medical ethics as a practice in the Manchester Infirmary.

Antecedent Law And Ethics Of Aid In Dying, Alan Meisel

Articles

Scholarly discussion of physician aid in dying – physicians actively aiding patients in ending their lives – has noticeably increased in recent years. While conversations and examinations of end-of-life treatment have been ongoing for decades, the antecedent law and ethics of aid in dying that have developed in the United States have recently moved into the spotlight. In this essay, written for a symposium at Quinnipiac School of Law, the author takes his audience on a brief journey through the history of end-of-life decision-making in the U.S., beginning with the early days of the Karen Quinlan case in 1976 and …

The Pedagogical Significance Of The Bush Stem Cell Policy: A Window Into Bioethical Regulation In The United States (President George W. Bush, Fifth Anniversary Essay Collection), O. Carter Snead

O. Carter Snead

The enormous significance of the Bush stem cell funding policy has been evident since its inception. The announcement of the policy on August 9, 2001 marked the first time a U.S. president had ever taken up a matter of bioethical import as the sole subject of a major national policy address. Indeed, the August 9th speech was the President's first nationally televised policy address of any kind. Since then, the policy has been a constant focus of attention and discussion by political commentators, the print and broadcast media, advocacy organizations, scientists, elected officials, and candidates for all levels of office …