Bioethics and Medical Ethics Commons^™

Volume 3 Editorial, Daniel Brannan

Dialogue & Nexus

No abstract provided.

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

Making Sex Work For The State : The Policing Of Sex Work In The United States., Madeline A Clabough

College of Arts & Sciences Senior Honors Theses

This thesis analyzes the ways that sex work is regulated within the United States, and analyze the ways that regulation is shaped by contemporary feminist discourse. To do so, it analyzes the ways in which sex workers have been and pathologized since the 19th century, and address the ways that these conceptualizations have been incorporated into the legal regulation of sex workers. Finally, this thesis will look to contemporary practices in the state regulation of sex workers, and argue that the relationship between neoliberalism, the carceral state, and what has come to be termed “carceral feminism” operate in conjunction to …

Dying For A Diagnosis: The Impact Of Racial Discrimination In Healthcare, Danielle Owusu

Senior Theses

Previous studies have found that healthcare providers are affected by unconscious racial bias, reducing the quality of care and outcomes for African American patients (Yearby, 2010). This undergraduate study hypothesized when healthcare providers show more empathy, they provide higher quality care to their patients. Since African Americans face more discrimination on average, their chances for quality care is lower. Results reveal a positive correlation between empathy from healthcare providers and care administered to patients; furthermore, they reveal no significance found in discrimination of African American patients compared to other races. The study consisted of 93% female participants, which affects the …

Illegitimate Bodies In Legitimate Times: Life, Liberty And The Pursuit Of Movement, Brian Culp

Faculty and Research Publications

Drawing on Michel Foucault’s concepts of state racism and biopower, the author of the 26th Delphine Hanna Lecture presents several claims: (a) that the idea of the illegitimate outsider in Western world governments like the United States has largely been influenced by ancient Greek ideals, (b) that a host of policies and intentional actions by power brokers create derision and hierarchies between “old” and “new” immigrant groups, and (c) neoliberal ideology couched in actions that aim “to protect the state” is nothing more than a recoding of traditional racist rhetoric that expands systemic racism. The author identifies the capabilities approach, …

Concurrent Surgery And Informed Consent, Andrew M. Weller

College Honors Program

This thesis seeks to construct an ethical course of action for concurrent surgery, a practice brought into the public eye by The Boston Globe, which argued against allowing one attending surgeon to oversee two cases on separate patients in different operating rooms. First, the common morality and its four main principles relevant to biomedical ethics will be described which will be subsequently used to show that concurrent surgery is allowed according to non-violation of the principle of non-maleficence through current empirical evidence, and supported by the principle of beneficence and justice. Next, the principle of respect for autonomy will be …

Removable Discontinuity: Crispr, Gene Drives, And Bioethics, Emily Dunnahoe

Undergraduate Research Conference

This paper questions whether bioethical scrutiny has been devoted to the ethical dilemmas that have arisen with advancements of CRISPR-Cas 9 gene editing techniques, particularly its use in conjunction with gene drive applications. Therefore, the trend of genetic research using both gene drives and CRISPR-Cas 9 systems must be established, while also simultaneously observing the trend of bioethical scholarly works. The tabulation of all articles from 2012 to 2015 from selected genetic journals yielded a significant increase in articles relating to CRISPR, while no articles were found in their selected bioethical counterparts for the same period. Similarly, no significant CRISPR/gene …

The Ethical Viability Of In Vitro Fertilization, Jack Hamilton

Dialogue & Nexus

In vitro fertilization is considered from multiple ethical positions and whether or not it is limited to disease prevention or used for genetic enhancement. The first can be in line with most ethical theories provided time and resources are allowed for the technology to be provided for all. The latter seems to devalue humans and remove compassion for the disenfranchised.

Passive Euthanasia, Jennifer Hulett, Madeline Peterson

Dialogue & Nexus

The controversy of passive euthanasia (e.g. the withholding or withdrawing of life-sustaining treatments in patients that are either disabled or terminally ill) has been long-debated because, it has been argued, passive euthanasia violates the physician’s Hippocratic Oath to do no harm to the patient. This withholding or withdrawal can include one or more of the following: ventilators, feeding tubes, and life support. In this paper we will explore the major debate points of passive euthanasia in light of four ethical theories: utilitarianism, virtue ethics, Kantian, and evolutionary ethics.

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.

Children’S Exposure To Environmental Toxins: Socioeconomic Factors And Subsequent Effects On Mental Health And Function, Dorothy L. Mcleod

Center for the Human Rights of Children

The physical environment in which children live, including the air they breathe and the water they drink, has a profound influence on their development. While children need many chemicals and nutrients to physically grow and develop normally, others, such as those deemed environmental toxins (e.g. pesticides, lead, mercury, and illicit substances) act instead as a threat to healthy development. These chemicals may have highly toxic effects, and while they are a threat to all individuals, they affect infants and children most severely. In order to provide an introduction to the issue of toxin exposure and mental health outcomes, to highlight …

The Unifying Power Of Education, Keagan Potts, Jenji Learn

Center for the Study of Ethics in Society Papers

• Without Expertise or Experience: Philosophizing When Your Students Know You Know Nothing
• Segregated Students — Segregated Society: The Primacy of Education in Ending Hate
• Combatting Emerging Resegregation: Teaching Those in Power to Empower

Genomic Contraindications For Heart Transplantation., Danton S. Char, Gabriel Lázaro-Muñoz, Aliessa Barnes, David Magnus, Michael J. Deem, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

Genome sequencing raises new ethical challenges. Decoding the genome produces new forms of diagnostic and prognostic information; however, the information is often difficult to interpret. The connection between most genetic variants and their phenotypic manifestations is not understood. This scenario is particularly true for disorders that are not associated with an autosomal genetic variant. The analytic uncertainty is compounded by moral uncertainty about how, exactly, the results of genomic testing should influence clinical decisions. In this Ethics Rounds, we present a case in which genomic findings seemed to play a role in deciding whether a patient was to be listed …

Application Of Default Rules To Address Financial Conflicts Of Interest In Academic Medical Centers, Joanna K. Sax

Joanna K Sax

A recent report issued from the Institute of Medicine contains an extensive analysis of financial conflicts of interest (FCOIs) in biomedical science. In brief, an FCOI exists when a profit-seeking motive either unduly influences or appears to influence an academic scientist’s primary obligations. The cornerstone of current policy to address FCOIs at academic medical centers (AMCs) is disclosure; however, disclosure does not appear to appropriately regulate, manage, or eliminate FCOIs.

Although the relationships between intramural scientists and industry and extramural scientists and industry may be structurally different, they both can lead to FCOIs that threaten scientific integrity. Overall, the NIH …

Corporate Social Responsibility In The Health Care Sector, Dina Siniora

Graduate Student Research Symposium

The challenge for the health care sector is to continually explore ways to ensure that the welfares of individual patients remain the utmost primacy and simultaneously promote health care equity via corporate socially responsible activities (CSR). There is an essential need to truly embrace CSR and ethical principles that would promote equal distribution of health care resources. Relevant CSR activities would be achieved by making the most significant health problems in a given society a priority of health care organizations. CSR in health care applied to hospitals and pharmaceutical companies should promote shared values and common ethical principles in new …

Ethical Concerns When Minors Act As Standardized Patients., Erwin Jiayuan Khoo, Robert Schremmer, Douglas S. Diekema, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations governing medical research and into child labor laws. But there are no similar guidelines for minors' work in medical education. This article addresses the question of whether there should be rules. Should minors be required to give their informed consent or assent? Are there certain practices that could cause harm for the children who become SPs? We present a controversial case and ask a …

Communicating Through A Brain-Computer Interface: Towards The Assessment Of Quality Of Life In Minimally Conscious And Covertly Aware Vegetative State Patients, Jasmine Tung

Electronic Thesis and Dissertation Repository

Neuroimaging has been utilized to establish communication, using a brain-computer interface, with select patients with severe brain injuries and profound communication impairments. Due to the severe injuries sustained by these patients, traditional techniques used to develop quality of life instruments cannot be used. The Aware Study used a novel approach to establish the key dimensions for assessing the quality of life of patients who can only communicate using this sophisticated technology. Consensus methodology was employed, with the assistance of a multidisciplinary panel of experts, to collectively decide which dimensions are essential for the inclusion in a quality of life instrument …

Quietly Conscious: A Discussion Of Fetal Personhood And Abortion, Gabriella Graziani

Exigence

This document examines the Abortion debate by specifically discussing fetal personhood. The author first summarizes the history of the abortion debate and asserts that the argument over life at conception is a not a new concept. The author further addresses the number of abortions compared to live births in the Fredericksburg area, making sure to promote the serious nature of this problem. By first exploring the concept of fetal pain, it is concluded that though there is not scientific certainty on the topic, some scientist assert that it could be an emerging problem if more study was put into the …

Donation After Brain Circulation Determination Of Death, Anne L. Dalle Ave, James L. Bernat

Dartmouth Scholarship

Background:

The fundamental determinant of death in donation after circulatory determination of death is the cessation of brain circulation and function. We therefore propose the term donation after brain circulation determination of death [DBCDD].

Results:

In DBCDD, death is determined when the cessation of circulatory function is permanent but before it is irreversible, consistent with medical standards of death determination outside the context of organ donation. Safeguards to prevent error include that: 1] the possibility of auto-resuscitation has elapsed; 2] no brain circulation may resume after the determination of death; 3] complete circulatory cessation is verified; and 4] the cessation …

Newborn Sequencing In Genomic Medicine And Public Health., Jonathan S. Berg, Pankaj B. Agrawal, Donald B. Bailey, Alan H. Beggs, Steven E. Brenner, Amy M. Brower, Julie A. Cakici, Ozge Ceyhan-Birsoy, Kee Chan, Flavia Chen, Robert J. Currier, Dmitry Dukhovny, Robert C. Green, Julie Harris-Wai, Ingrid A. Holm, Brenda Iglesias, Galen Joseph, Stephen F. Kingsmore, Barbara A. Koenig, Pui-Yan Kwok, John Lantos, J Steven Leeder, Megan A. Lewis, Amy L. Mcguire, Laura V. Milko, Sean D. Mooney, Richard B. Parad, Stacey Pereira, Josh E. Petrikin, Bradford C. Powell, Cynthia M. Powell, Jennifer M. Puck, Heidi L. Rehm, Neil Risch, Myra Roche, Joseph T. Shieh, Narayanan Veeraraghavan, Michael S. Watson, Laurel K. Willig, Timothy W. Yu, Tiina Urv, Anastasia L. Wise

Manuscripts, Articles, Book Chapters and Other Papers

The rapid development of genomic sequencing technologies has decreased the cost of genetic analysis to the extent that it seems plausible that genome-scale sequencing could have widespread availability in pediatric care. Genomic sequencing provides a powerful diagnostic modality for patients who manifest symptoms of monogenic disease and an opportunity to detect health conditions before their development. However, many technical, clinical, ethical, and societal challenges should be addressed before such technology is widely deployed in pediatric practice. This article provides an overview of the Newborn Sequencing in Genomic Medicine and Public Health Consortium, which is investigating the application of genome-scale sequencing …