Medicine and Health Sciences Commons^™

Emulating Future Neurotechnology Using Magic, Jay A. Olson, Mariève Cyr, Despina Z. Artenie, Thomas Strandberg, Lars Hall, Matthew L. Tompkins, Amir Raz, Petter Johansson

Psychology Faculty Articles and Research

Recent developments in neuroscience and artificial intelligence have allowed machines to decode mental processes with growing accuracy. Neuroethicists have speculated that perfecting these technologies may result in reactions ranging from an invasion of privacy to an increase in self-understanding. Yet, evaluating these predictions is difficult given that people are poor at forecasting their reactions. To address this, we developed a paradigm using elements of performance magic to emulate future neurotechnologies. We led 59 participants to believe that a (sham) neurotechnological machine could infer their preferences, detect their errors, and reveal their deep-seated attitudes. The machine gave participants randomly assigned positive …

The Ethical Imperative Of Inclusion In Healthcare Innovation: Scaling And Sustaining Digital Health Equity, Lukas E. Chandler

Electronic Theses and Dissertations

The COVID-19 pandemic revealed the harm of digital health exclusion. Excluded groups could not benefit from virtual care due to device access gaps, broadband connectivity, and digital and language literacy levels. A lack of engagement with historically excluded populations in digital health innovation is an ethical harm and a maleficent form of social exclusion. Digital tools in healthcare delivery represent more than just a strategy for promoting health equity; they signify an opportunity to address health inequities in the health technology design process.

The historical focus of healthcare ethics on bedside decision-making issues largely explains why the field lacks concerted …

Moral Status And The Oversight Of Research Involving Chimeric Animals, Patricia Marshall, Kaitlynn P. Craig

Faculty Scholarship

The use of nonhuman animals in research has long been a source of bioethical and scientific debate. We consider the oversight and use of nonhuman animals in chimeric research. We conducted interviews with twelve members of embryonic stem cell research oversight committees, nine members of institutional animal care and use committees, and fourteen scientists involved in human–nonhuman-animal chimeric research in different areas of the United States. Interviews addressed animal welfare and conceptual issues associated with moral status and humanization of nonhuman animals that contain human cells. Our findings suggest that concepts of enhanced moral status and consciousness are not very …

Renal Replacement Therapy Could Be Initiated In Patients With Severe Aki, Regardless Of Age And Critical Condition, El Hussain Shamsa

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Meersch M, Küllmar M, Schmidt C, et al. Long-Term Clinical Outcomes after Early Initiation of RRT in Critically Ill Patients with AKI. J Am Soc Nephrol. Mar 2018;29(3):1011-1019. https://doi.org/10.1681/asn.2017060694

for a critically ill elderly patient with severe acute kidney injury.

Nursing Considerations For Post-Traumatic Amnesia After A Traumatic Brain Injury, Hannah Grant

Senior Honors Theses

A period known as post-traumatic amnesia (PTA) often follows a traumatic brain injury (TBI). PTA is characterized by anterograde and retrograde amnesia, confusion, disorientation, and agitation. The duration and severity of PTA is a key indicator of the long-term prognosis after a TBI, so proper assessment and nursing care of a PTA patient is crucial. TBIs range from mild to severe, but primarily affect the fronto-temporal lobes. In PTA, both neural lesions and white matter damage within the parahippocampal region can cause PTA. A nurse must perform a thorough assessment of a TBI patient, but, since PTA is a key …

Ethical And Moral Imperatives Of 2022, Sheila P. Davis Phd

Journal of Health Ethics

Editor's introduction to the Journal of Health Ethics vol. 18, no. 2

Intra-Skeletal Variation In Stable Isotopes Through Non-Destructive Approaches: Applications Of The Patterns Of Skeletal Remodeling To Biological Anthropology, Armando Anzellini

Doctoral Dissertations

Stable isotope analysis is a well-established method in biological anthropology used to deliver data on residence, diet, and life history. Samples for these analyses are often collected from the diaphyses of long bones with an assumption of an expected rate of turnover between five and ten years, depending on the skeletal element. However, the biological foundations of this assumption are still uncertain, especially concerning the intra-skeletal and intra-element variation of isotopic signatures that may relate to patterns of remodeling. Exploring these gaps in intra-element isotopic variation requires fine-grained work using multiple bones from multiple individuals, but such work is limited …

Psychiatric Medications: Does Education Affect Medication Prescriptions?, Surina M. Narine, Mary D. Ramos, Sarah Chu

Symposium of Student Scholars

Background: There is a lack of research on racial challenges among underrepresented adolescents regarding prescription drug use for mental illnesses. Purpose: This study addressed the following question: In adolescent minorities, how does education about racial disparity and culture affect the stigma and number of prescriptions written for psychiatric medications? This evidence-based practice project aimed to identify if racial awareness directly impacts the amount of psychiatric medication prescribed for adolescent minorities. Methods: Literature reviews analyzed qualitative and quantitative data to provide correlating information on racial disparities and psychotropic medications. This study examined the following possible factors for decreased prescribed drugs within …

Maid (Medical Assistance In Dying) And Meaning: An Exploration Of The Experience And Ability To Make Meaning Through Involvement In A Maid-Specific Bereavement Group, The Synergistic Potential Of Covid-19 And Maid, And The Impact Of Healthcare Providers Relationships From The Perspective Of Relational Ethics On The Legacy Of Maid-Involved Families Into Their Bereavement, Allyson Van Kessel

Electronic Thesis and Dissertation Repository

MAiD became legally accessible to Canadians with a grievous and irremediable illness in June of 2016. As I write in 2023, MAiD has been expanded to include patients who do not have a foreseeable death, with anticipated inclusion of those with mental illness as a sole underlying medical condition (MI-SUMC) in 2024. As MAiD now accounts for over 3% of all deaths annually in Canada, there is a growing impetus to explore ways by which MAiD practice can be improved and care can be extended to the family members following the death of a patient.

A hospital in southwestern Ontario …

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 …

Impact Of Moral Injury On Work Performance In Nurses Following The Covid-19 Surges, Annette Callis, Trisha Saul, Ross Bindler

Articles, Abstracts, and Reports

Background

Moral Injury (MI) was defined by Jonathan Shay in 1994 as committing acts that betray one’s moral compass in high-stakes situations, while under the authority of another, that severely affect one’s well-being. MI was measured solely in the military prior to the COVID pandemic.

Aims

1.Explore the relationship between moral injury (MI) and perceived work performance in hospital nurses following the pandemic surges. 2. Determine relationships between MI and select participant demographics and between work performance and select demographics.

Sample

A convenience sample of 191 nurses from seven Southern California Hospitals participated in the study from March to June …

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 …

Applying Lessons Learned: Nursing Facility Administrators’ Operational And Ethical Challenges During Covid-19, Mary Eleanor R. Wickersham

Journal of Health Ethics

Operational and ethical challenges for nursing homes across the United States during the COVID-19 pandemic were daunting, that experience perhaps only a forecast of future epidemics that nursing home administrators and operators may face. This article describes administrator-identified challenges and focuses on how nursing homes might learn from their experiences by increasing flexibility to meet evolving needs, improving quality assurance and disaster planning, using ethics policies and ethical decision-making processes to work through difficult decisions, and leading the way in creating new policies that will make nursing home care safer and more appropriate for patients with ever changing needs.

Theory Building As Integrated Reflection: Understanding Physician Reflection Through Human Communication Research, Medical Education, And Ethics, Andrea Vicini, Ashley P. Duggan, Allen F. Shaughnessy

Journal of Health Ethics

Grounded in a presupposition that a single explanatory framework cannot fully account for the expansive learning processes that occur during medical residency, the article examines developing physicians’ reflective writing from three disciplinary lenses. The goal is to understand how the multi-dimensional nature of medical residency translates into assembling educational experiences and constructing meaning that cannot be fully explained through a single discipline. An interdisciplinary research team across medical education, communication, and ethics qualitatively analyzed reflective entries (N=756) completed by family medicine residents (N=33) across an academic year. Results provide evidence for moving toward an integrated thematic explanation across disciplines. The …

Should Health Systems Share Genetic Findings With At-Risk Relatives When The Proband Is Deceased? Interviews With Individuals Diagnosed With Lynch Syndrome, Jessica Ezzell Hunter, Jennifer L. Schneider, Alison J. Firemark, James V. Davis, Sara Gille, Pamala A. Pawloski, Su-Ying Liang, Victoria Schlieder, Alanna Kulchak Rahm

Journal of Patient-Centered Research and Reviews

Purpose: Genetic information has health implications for patients and their biological relatives. Death of a patient before sharing a genetic diagnosis with at-risk relatives is a missed opportunity to provide important information that could guide interventions to minimize cancer-related morbidity and mortality in relatives.

Methods: We performed semi-structured interviews with individuals diagnosed with Lynch syndrome at 1 of 4 health systems to explore their perspectives on whether health systems should share genetic risk information with relatives following a patient’s death. An inductive, open-coding approach was used to analyze audio-recorded content, with software-generated code reports undergoing iterative comparative analysis by a …

Wellness Review 2022, Part 1, Martin Huecker, Brian A. Ferguson, Jacob Shreffler

Journal of Wellness

Introduction: This article represents the first of a two-part assessment of 2022 literature addressing wellness in healthcare professionals published from January 1, 2022 to June 30, 2022.

Methods: Three editors conducted a similar keyword search in Pubmed, also adding manually curated articles. Focusing chiefly on clinical trials and other prospective research, we settled on a final 25 significant papers focusing on wellness in medical professionals to include in this review.

Literature Review: Recent literature into HCW wellness continues to describe burnout factors and COVID-19 impact, but includes more resilience-targeting interventions and systematic reviews of trials seeking bolstering of well-being. Subsections …

On Conflict, Brenden Huynh

be Still

Conflict

In the past, I’ve always been one to avoid conflict. Conflict always had a negative connotation in my mind. I did whatever I could to avoid it. Because of my aversion to conflict, I have had to compromise my time and my efforts in numerous situations. I’ve held my tongue to prevent problems; but sometimes, this would lead to even more. This has affected me all my life, whether its a friend who said something I wasn’t fond of or a waitress that messed up my order, I almost never said anything simply to avoid conflict. Last year, I …

Medical Ethics: How Resource Distribution Affects The Decision Making Of Doctors In Rural India: An Explorative And Comparative Study In Jamkhed, Maharashtra, Jared Yee

Independent Study Project (ISP) Collection

Using rural Mahrasthra as a case study, I was able to explore the medical ethics and common dilemmas that occur in Rural India. Through a collection of interviews and articles, I was able to piece together my understanding of some common ethical challenges that India faces, emphasizing ones that were unique to the location and circumstance. Using observations I made through my work in the hospital, I learned that limited resources effects all sides of ethics in the medical field, with a signficinant effect on economics, hospital structure, and clinical protocol. In an attempt to source the aspects of Indian …

Surveying The Stigma: How The Plhiv Stigma Index Acts As A Validated Framework To Measure Healthcare Discrimination And How It Can Be Adapted To Quantify Mental Health Stigma, Keeley Lariviere

Independent Study Project (ISP) Collection

The PLHIV Stigma Index is an ongoing, international study conducted by and for people living with HIV to measure the stigmatization that people living with HIV experience. As a model that has been proven successful in translating to targeted advocacy campaigns, this paper theorizes on how this Stigma Index could be broadened to capture other aspects of healthcare discrimination. With a growing demand for mental health support and a critically underdeveloped mental healthcare framework, understanding the stigma and discrimination that exist for people living with depression is a good place to start. Using mixed methods analysis from existing literature and …

Informed Consent For Placebo-Controlled Trials: Do Ethics And Science Conflict?, Hope A Feldman, James A Feldman, Charles C Miller, Garrett Walsh, Jon E Tyson

Faculty and Staff Publications

The use of a placebo has been considered the best method for controlling bias in a prospective randomized clinical trial and provides the most rigorous test of treatment efficacy for evaluating a medical therapy. Placebos commonly produce clinically important effects particularly in studies where the primary outcomes are subjective. Yet the potential beneficial or harmful effects of placebos are often not addressed in designing a clinical trial, calculating the sample size, seeking consent, or interpreting clinical trial results. In this manuscript, we use an actual study to indicate three approaches that might be considered in seeking informed consent for placebo-controlled …

An Analysis Of Clinical Research Enrollment Decisions In Post-Ebola Guinea, Alisha Kabani

Undergraduate Student Research Internships Conference

In the aftermath of the West Africa Ebola outbreak, many grew familiar with the term “Ebola business”, a phrase serving as a shorthand for an assemblage of practices and possibilities that stood for the profitability potential of the deadly Ebola virus in the country. This is the backdrop for a CIHR-funded qualitative study aimed at advancing the understanding of whether and how those approached for clinical research post-Ebola, experienced those invitations and associated benefits.

My role consisted of supporting the analysis and expanding evidence-based understanding of when and on what basis, participants in foreign-funded and remunerated studies in high poverty …

Ethical Oversight Of Roles & Relationships In Treatment & Research In Advanced Disease States, Alexa Vercelli

Electronic Theses and Dissertations

There is often ethical analysis focusing solely on the care of the patient by the physician or on the protection of the research participant by the clinical investigator, but those two are often overlapping. By paralleling the analysis of treatment and research, it emphasizes the specific ethical approaches necessary for individuals facing advanced diseases states in the separate roles of being a patient or participant. It also gives guidance to the complexity of the ethics surrounding medical professionals who float between the roles of treating physicians and clinical investigators. As individuals with advanced disease states are considered a vulnerable population …

Respecting The Ethical Tension Between Surveillance And Privacy In Promoting Public Health And Disease Management, Kamal Althobaiti

Electronic Theses and Dissertations

The recognition of the need to undertake surveillance and to protect privacy is well established. However, the continually changing circumstances and fast-paced development of healthcare today requires a continuing need to respect this ethical tension between surveillance and privacy. Hence, this dissertation is to respect the ethical tension between surveillance and privacy in promoting public health and disease management. This dissertation investigates the ethics of conducting public health surveillance, including the challenges associated with obtaining consent and protecting data from unauthorized access. The dissertation will focus on the ethical consequences of big data, including issues associated with obtaining informed consent, …

Ethical Implications Of Covid-19 Surveillance In Karnataka Using Nancy Kass Framework, Apurva Jain, Lakshya Arora

Journal of Health Ethics

Numerous public health hurdles, including pandemics such as COVID-19, have led to concerns about community health practices in relation, necessitating the application of an ethical perspective. International research ethics guidelines are only used in a restricted range of contexts of public health. As a result, a variety of frameworks have been established to assist ethical analysis of public health concerns. In this study, we have used the Nancy Kass framework for analyzing COVID-19 surveillance in Karnataka state of India, which is a six-step approach that can assist public health practitioners in evaluating the ethical consequences of interventions, policy initiatives, services, …

Reciprocity And Priority Allocation System For Organ Transplant: An Ethical Analysis, Gordon Wong, Chong Ho Yu

Journal of Health Ethics

How to increase the supply of organs donations for transplant is a critical issue in healthcare. Although recently xenotransplantation has received much publicity, it may be years before this becomes clinically viable. The Reciprocity and Priority Allocation (RPA) System currently used in Israel and a few other countries may be a reasonable approach to increase organ donation in the foreseeable future. For this approach to be accepted by the public, a robust analysis on its ethical implications is needed. This paper applies two formal ethics frameworks to analyze the implication of the RPA system.

Chronic Poetics: A Waiting Room Of One's Own, Madeleine Simmons

Electronic Theses, Projects, and Dissertations

This article explores chronic poetics, through my personal lens I take readers on a walk- through of poetry and the discussions surrounding chronic illnesses. I examine the current state of chronic illness and the nuances to its discussion. I analyze chronic illness in the context of disability studies, and touch on the tensions of categorizing chronic illness as a disability. As well as how to best navigate reading chronic poetics, as poets engage in new territories as they form a new language to describe their circumstances. While analyzing multiple poems from different authors, I explore why specifically the vessel of …

Ethical Considerations Of Telehealth: Access, Inequity, Trust, And Overuse, Monica O'Reilly-Jacob, Andrea Vicini, Ashley P. Duggan

Journal of Health Ethics

In the U.S. healthcare system, telehealth is increasingly present and demands ethical assessment. On the one hand, telehealth increases access to healthcare services for some at-risk populations (e.g., people suffering from mental illness and addictions) and in specific contexts (e.g., rural). On the other hand, telehealth widens the digital divide and can lead to overuse of services. Furthermore, because it is still unclear how telehealth influences trust between patients and primary care clinicians, connecting relationship science and human communication research can inform critical reasoning. Finally, healthcare policy is advancing toward the wide adoption of telehealth. Hence, it is urgent to …

Financial Incentives And Healthcare: A Critique Of Michael Sandel, Mark Peacock

Journal of Health Ethics

The use of financial incentives in healthcare calls for ethical examination. Michael Sandel's influential work represents such examination and is subject to critical analysis in this paper. Sandel focuses on monetary payments to persuade patients to lose weight, give up smoking etc. but also on the much-discussed case of giving drug addicts money in return for their consent to be sterilized. He offers two separate objections to financial incentives, one based on coercion, the other on corruption. I argue that Sandel's corruption objection to commodification is insufficient to ground the objection he has to financial incentives in healthcare. Whatever strength …

Evaluating Burnout, Secondary Traumatic Stress, And Sleep Disturbances In Healthcare Professionals During A Global Pandemic, Laura K. Miller, Sarah Pehlke

Journal of Wellness

Introduction: For healthcare workers, the COVID-19 pandemic resulted in increased workload, work related stress and patient acuity potentially leading to burnout, secondary traumatic stress (STS), and sleep disruptions. This study aims to assess the prevalence of burnout and STS symptoms, as well as sleep disturbances among healthcare personnel working in the United States during the pandemic.

Methods: Healthcare workers from all disciplines and settings in the United States completed a cross-sectional survey about work and personal characteristics from January 20-March 1, 2021. Participants reported on symptoms of burnout, STS, and sleep disruptions.

Results: A total of 360 participants in the …

Pharmacists Role In Preventing Drug Abuse, Renae L. Wilson

College of Pharmacy Student Research

In 2019, there were approximately 332,000 pharmacists active in the US workforce, Data USA, 2019. A survey of 1,700 American adults, discovered, that 34% of Americans still rely on healthcare providers such as pharmacists, for information in relation their health, KRC Research, 2018. Pharmacists are one of the three most trusted health care professions and were found to be the second most trusted source for health information by Americans in 2005. Blendon et al., 2006 found, that information from pharmacist was trusted by 67%, of participants in their survey. One of the oaths pledged by pharmacist is, ‘ …