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Introduction, David Barnard PH.D., J.D. 2017 Oregon Health & Science University

Introduction, David Barnard Ph.D., J.D.

Reflections on Healthcare Management

Introduction message about the essays collected from the “Ethics in Healthcare Organizations” course offered by the OHSU School of Medicine’s Division of Management as part of the Healthcare MBA Program. A course taught by Drs. David Pollack, Jeanne Enders, and Ruth Ann Tsukuda, which exposes students to several frameworks for the analysis of the ethical aspects of health policy and research, organizational behavior, and clinical care.


Bioethics Of Information Disclosure Across Cultures: "Don't Talk With Her About Her Condition", Christina Li 2017 Oregon Health & Science University

Bioethics Of Information Disclosure Across Cultures: "Don't Talk With Her About Her Condition", Christina Li

Reflections on Healthcare Management

Healthcare providers are routinely faced with the bioethical challenges of information disclosure across cultures. This paper analyzes the case study “Don’t Talk with Her about Her Condition” (Center for Ethics in Health Care at OHSU; See Appendix A). The impact of full, partial, or non-disclosure of information to a patient greatly varies in different cultural contexts. While information disclosure emphasizes patient autonomy and informed decision-making, it also can be controversial to improving patient safety. In some cultures, the disclosure of a negative diagnosis or prognosis can pose significant risk to the patient’s health, so the patient family takes ...


Ethical Issues In Cancer Clinical Trials, Rosemary Makar M.D. 2017 Oregon Health & Science University

Ethical Issues In Cancer Clinical Trials, Rosemary Makar M.D.

Reflections on Healthcare Management

Results from cancer clinical trials make valuable contributions to medical care for cancer patients. Two important ethical dilemmas in these trials are respect for individual autonomy and distributive justice. This paper explores the history of clinical trials and discusses these ethical dilemmas citing specific examples. Although there has been significant progress in these ethical issues, future review and legislation of the process will continue to improve and solidify ethical aspects of cancer clinical trials.


The Ethics Of Universal Health Care In The United States, Michael Meyer 2017 Oregon Health & Science University

The Ethics Of Universal Health Care In The United States, Michael Meyer

Reflections on Healthcare Management

Close examination of ethical arguments both for and against universal health care in the United States should lead Americans to choose universal coverage over opposing alternatives. While the number of Americans without health insurance has dropped significantly due to the passage of the Affordable Care Act, nearly 30 million Americans remain without health coverage and experience limited access to health care. This considerable figure should be of tremendous moral concern, as studies have shown that tens of thousands of Americans die each year due to this lack of health coverage. Additionally, universal health coverage would promote fairness, equality and greater ...


Access To Health Care Coverage In The United States: Rationing People Rather Than Services, Leah Vasquez 2017 Oregon Health & Science University

Access To Health Care Coverage In The United States: Rationing People Rather Than Services, Leah Vasquez

Reflections on Healthcare Management

Access to health care coverage in the United States is far from equitable and raises many ethical questions related to fairness. Access refers to the ease in which an individual in need of medical services is able to obtain them. Under the framework of bioethics, issues surrounding access to health care coverage fall primarily under the principle of justice as it pertains to fairness, entitlement to and equitable distribution of resources (Trotochaud, 2006). Within the U.S. health care system, access to health insurance is the most critical factor for determining one’s access to health care services.


Moral Courage, Jennifer Teeples 2017 Oregon Health & Science University

Moral Courage, Jennifer Teeples

Reflections on Healthcare Management

“Moral Courage means doing the right thing in the face of your fears” (Manji, 2016). It is not often a regular topic when discussing the complicated relationships between doctors, patients, administrators, and nurses. However, it is a topic that has the ability to have a substantial impact on the patient experience, cost of healthcare, and morale. Through creating a culture that embraces and encourages moral courage, we can improve the patient experience and create a more positive, collaborative workplace.


Priority Access To Care In The Emergency Department, James A. Heilman M.D. 2017 Oregon Health & Science University

Priority Access To Care In The Emergency Department, James A. Heilman M.D.

Reflections on Healthcare Management

“Very important persons” (VIPs), “friends of physicians” and Emergency Department (ED) staff and family members often receive care in front of other patients who may be critically ill waiting for care in the ED lobby. This paper explores the organizational ethics of these three select groups of patients who often obtain priority access to care in the busy ED. A specific case is provided to highlight the challenges of these complicated encounters. The organizational ethics are then explored and potential solutions are identified. This is an important ethical and operational issue that requires exploration by emergency department and hospital leaders ...


Investigation Of Abuse Allegations In Hospitals: An Ethical Dilemma, Todd M. Warlik RN 2017 Oregon Health & Science University

Investigation Of Abuse Allegations In Hospitals: An Ethical Dilemma, Todd M. Warlik Rn

Reflections on Healthcare Management

Abuse of patients by healthcare workers is an issue of serious concern for every hospital and healthcare facility. These investigations present a serious challenge to healthcare administrators in that they present a unique ethical dilemma: how to balance to concerns and safety of patients with the obligation of ensuring justice and fairness for employees. This paper attempts to dissect this issue through case example and analysis.


Machine Intelligence And Medical Ethics, Paul Wilkens 2017 Oregon Health & Science University

Machine Intelligence And Medical Ethics, Paul Wilkens

Reflections on Healthcare Management

The practice of medicine increasingly relies on machine intelligence. Most of the existing technology functions as tools to support human activity, but some emerging uses are much more complex. Automation of complicated tasks requires greater autonomy and better decision-making skills. When lives are on the line, decisions made by machine intelligence must conform to the highest standards of utility and ethical behavior. We discuss some of the near-future medical applications of machine intelligence, and how we can ensure the ethical operation of these devices. We conclude with a review of ethical philosophies that might be used to inform machine medical ...


Clinical & Organizational Ethical Considerations In Determining Death And Its Role In Organ Donation, Corey R. White D.O. 2017 Oregon Health & Science University

Clinical & Organizational Ethical Considerations In Determining Death And Its Role In Organ Donation, Corey R. White D.O.

Reflections on Healthcare Management

In 1981 the United States Uniform Determination of Death Act (UDDA) expanded the legally recognized forms of death to either (1) the irreversible cessation of circulatory and respiratory functions, or (2) the irreversible cessation of all functions of the entire brain. The second and new definition is most commonly referred to as death by neurological criteria or brain death. Both cardiopulmonary and brain death are intricately linked to organ transplantation, and the supply of organs. In the US, donation after brain death is the source of the majority of organs. It is also more likely to result in multiple transplantable ...


The "Research Triple Aim": Ethics As A Policy Driver For Funding Medical Research, Tim Burdick M.D., MSC 2017 Oregon Health & Science University

The "Research Triple Aim": Ethics As A Policy Driver For Funding Medical Research, Tim Burdick M.D., Msc

Reflections on Healthcare Management

Just as the allocation of limited healthcare resources is an ethics issue, we can say the same of the finite dollars spent by the federal government on biomedical research. Misappropriated and wasted money delays improving the lives of those afflicted with disease. From this, we conclude quickly that research dollars should be distributed and used in ways that meet ethical tests including that of distributive justice. Policy levers, a common and effective means of pushing national activities in a desired direction, could be targeted to achieve a more ethical approach to how we allocate research funding in the US.

One ...


Challenges And Facilitators Of Recruitment: Lessons Learned From Conducting A Focused Ethnography In A Vulnerable Rural Population, Debra Kramlich, Rebecca Kronk, Karen Jakub 2017 Duquesne University

Challenges And Facilitators Of Recruitment: Lessons Learned From Conducting A Focused Ethnography In A Vulnerable Rural Population, Debra Kramlich, Rebecca Kronk, Karen Jakub

The Qualitative Report

The purpose of this article is to describe the challenges and facilitators of recruitment encountered in an ethnographic dissertation study of rural women with substance use disorders during the perinatal period. While the study is being conducted in the hospital setting post-delivery, potential participants who meet inclusion criteria are identified by practitioners through a number of perinatal practices within a wide geographic area as well as by inpatient social workers. Recruitment in this vulnerable and often socially disadvantaged population has been found to be challenging with regard to ethical approval, participant eligibility and availability, practice changes, and discrepancies in the ...


Grandparenting In Selected West African Countries: Implications For Health And Hygiene Behaviours In The Household, Joshua Oyeniyi Aransiola Dr, Akanni Ibukun Akinyemi Dr, Ambrose Akinlo Dr, Funmi Togonu-Bickesteeth Prof. 2017 Obafemi Awolowo University, Ile-Ife, Nigeria.

Grandparenting In Selected West African Countries: Implications For Health And Hygiene Behaviours In The Household, Joshua Oyeniyi Aransiola Dr, Akanni Ibukun Akinyemi Dr, Ambrose Akinlo Dr, Funmi Togonu-Bickesteeth Prof.

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

This is a descriptive study of the health and hygiene behaviors of grandparents who are the primary caregivers of their grandchildren in four West African countries, Ghana, Liberia, Nigeria, and Sierra Leone. The article utilizes data from each country’s most recent Demographic and Health Survey (DHS). The study identified 20,841 households where grandparents were primary caregivers. As expected, most of these households are in Nigeria given their population exceeds the collective population of the other three West African countries. However, the number of grandfamilies in Ghana, Sierra Leone and Liberia is still worrisome for their population size. In ...


Caregiving Among Community-Dwelling Grandparents In Jamaica, Julian GM McKoy Davis, Douladel Willie-Tyndale, Kathryn Mitchell-Fearon, Desmalee Holder-Nevins, Kenneth James, Denise Eldemire-Shearer 2017 University of the West Indies, Mona

Caregiving Among Community-Dwelling Grandparents In Jamaica, Julian Gm Mckoy Davis, Douladel Willie-Tyndale, Kathryn Mitchell-Fearon, Desmalee Holder-Nevins, Kenneth James, Denise Eldemire-Shearer

GrandFamilies: The Contemporary Journal of Research, Practice and Policy

Grandparents play invaluable caregiving roles in the general upbringing of grandchildren. The objective of the present study is to provide a profile of grandparents providing care to co-resident grandchildren younger than 18 years old in Jamaica. A subsample of 451 grandparents providing care to co-resident grandchildren under than 18 years old was derived from a larger nationally-representative community-based study of 2943 older adults residing in Jamaica. Data pertaining to caregiving, demography, health, socioeconomic status, and social participation were analysed using bivariate and multivariate analyses. Seventy one percent of grandparents were involve in regular care of their grandchildren. Hypertension (65.9 ...


Population Pharmacokinetic And Pharmacodynamic Analysis Of Buprenorphine For The Treatment Of Neonatal Abstinence Syndrome, Jason N. Moore, PharmD, Marc Gastonguay, Susan C. Adeniyi-Jones, MD, David E. Moody, Walter K. Kraft, MD, FACP 2017 Thomas Jefferson University

Population Pharmacokinetic And Pharmacodynamic Analysis Of Buprenorphine For The Treatment Of Neonatal Abstinence Syndrome, Jason N. Moore, Pharmd, Marc Gastonguay, Susan C. Adeniyi-Jones, Md, David E. Moody, Walter K. Kraft, Md, Facp

Department of Pharmacology and Experimental Therapeutics Posters

Neonatal abstinence syndrome (NAS) is a condition affecting newborns exposed to an opioid in utero. Symptoms of NAS include excessive crying, poor feeding, and disordered autonomic control. Up to 2/3 of infants will require pharmacologic therapies to reach symptom control. Opioids including morphine and methadone are the current first-line treatments. Buprenorphine is being investigated as a treatment of NAS. The purpose of this analysis was to evaluate the pharmacokinetics (PK) and pharmacodynamics (PD) of BUP in infants with NAS.

Poster presented at American Society for Clinical Pharmacology and Therapeutics (ASCPT) 2017 Annual Meeting, March 15-18, 2017 in Washington DC.


Umccts Newsletter, February 2017, UMass Center for Clinical and Translational Science 2017 University of Massachusetts Medical School

Umccts Newsletter, February 2017, Umass Center For Clinical And Translational Science

UMass Center for Clinical and Translational Science Newsletter

This is the February 2017 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.


Umccts Newsletter, January 2017, UMass Center for Clinical and Translational Science 2017 University of Massachusetts Medical School

Umccts Newsletter, January 2017, Umass Center For Clinical And Translational Science

UMass Center for Clinical and Translational Science Newsletter

This is the January 2017 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.


Umccts Newsletter, December 2016, UMass Center for Clinical and Translational Science 2017 University of Massachusetts Medical School

Umccts Newsletter, December 2016, Umass Center For Clinical And Translational Science

UMass Center for Clinical and Translational Science Newsletter

This is the December 2016 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.


Umccts Newsletter, November 2016, UMass Center for Clinical and Translational Science 2017 University of Massachusetts Medical School

Umccts Newsletter, November 2016, Umass Center For Clinical And Translational Science

UMass Center for Clinical and Translational Science Newsletter

This is the November 2016 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.


Umccts Newsletter, October 2016, UMass Center for Clinical and Translational Science 2017 University of Massachusetts Medical School

Umccts Newsletter, October 2016, Umass Center For Clinical And Translational Science

UMass Center for Clinical and Translational Science Newsletter

This is the October 2016 issue of the UMass Center for Clinical and Translational Science Newsletter containing news and events of interest.


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