Medicine and Health Sciences Commons^™

The Ethical And Validity Conundrum In Epilepsy Research In Lmic Settings, Pauline Samia, Adeel Shah, Archana Patel, Philip Olielo, Lionel Mudave, Samson Gwer

Brain and Mind Institute

In the last few decades, research in epilepsy has significantly improved understanding of risk factors and etiologies associated with epilepsy, promoting greater access to interventions and medications that have improved health-related outcomes for patients. However, these advances and benefits are not being felt evenly on a global scale due to significant inequalities in access to and utilization of research resources and expertise in Low-and Middle-Income Countries (LMICs).

To promote effective research output, and advance evidence-based practices; the context, disease burden, and challenges that hinder good research need to be re-defined and addressed. This is key in facilitating implementation of coherent …

Infertility: An Evaluation Of Treatment Modalities And Ethical Considerations, Elise Ferenczy

Senior Honors Theses

This thesis reviews a variety of options for treatment of infertility, along with ethical considerations for each. The basis for ethical concerns will be primarily a biblical worldview, as the goal is to support Christian couples in decisions regarding infertility treatment. The biblical worldview is outlined to provide readers with an understanding of its core principles, and the Bible is used as the primary source for ethical discussion. The most common etiologies of infertility are outlined, followed by treatment modalities grouped by category. While some modalities present very few ethical concerns, others require careful consideration in many regards. Many of …

Meeting, Moving, Mastering - A Text Analysis Of The Aesthetic Attractions Of 'Wild Swimming', Dagmar Dahl, Åsa I. Bäckström

International Journal of Aquatic Research and Education

Why are people fascinated by swimming in nature? This article addresses the aesthetic experiences of wild swimming as expressed by five wild swimming authors in their books. Drawing from aesthetic philosophy, we analyze the ways in which the appeal of wild swimming is described on three levels: the allure of water in the environment, the sensory encounter between water and the body, and the experience of moving in water. Furthermore, with reference to Seel’s concept of nature aesthetics (1996), the experience of wild swimming is analyzed in terms of contemplation, correspondence, and imagination. We can conclude that the special intensity …

Reflections On The Use Of Patient Records: Privacy, Ethics, And Reparations In The History Of Psychiatry, Jonathan Sadowsky

Faculty Scholarship

One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in …

Comparing Levels Of Situational Empathy Based On Medium Of Exposure To Covid-19 Mortality Information And Proximity To Others, Beth Durkin

Honors Projects

In response to the COVID-19 pandemic, many people expressed a lax attitude to the policies put in place to keep the public safe despite the high risk of infection and its devastating effects on health across the United States. It is possible that this response may be partially due to a “numbness to numbers,” a phenomenon that describes diminished empathy for a large group of people experiencing a negative event (eg. COVID-19). The present study explored the relationship between levels of situational empathy and the medium of exposure to COVID-19 mortality information (eg. personal story or fact sheet) in an …

Where Do We Draw The Line? The Ethical Dilemma Involved In Genetic Engineering And Gene Therapy, Amber Schrag

Senior Honors Theses

Genetic engineering and gene therapy are greatly disputed in our time. With the advancement of technology, one has the power to manipulate genes in the body, which raises the questions: What is our role in this? Is there a limit to this power, or should there be? This paper reviews the uses of this technology and evaluates the ethics from a scientific and Biblical point of view. It is concluded that using gene therapy to help cure diseases is very beneficial in both the scientific and Biblical realm as it is restoring individuals back to health and wholeness.

The Ethical Challenges Of Newborn Screening Programs In The United States, Devin Donovan

Senior Theses

Newborn screening programs have been mandated throughout the United States since the 1960s, and technological advancements have allowed for their evolution into the essential public health entities they are today (Arnold 558). These programs screen newborns for a variety of congenital and genetic conditions in all states, but each state varies in conditions screened and policies for collecting and using samples. Residual blood spots are a key component of these programs because they are often used for secondary purposes, such as for quality assurance and public health or biomedical research (Botkin et al. 121). Ethical challenges have arisen related to …

Ethics And Epidemiology Workshop Report: Towards Ethics-Informed Epidemiology And Epidemiology-Informed Ethics, Zoe Ritchie, Brendan T. Smith Phd, Maxwell J. Smith Phd

Health Studies Publications

Two key groups of researchers have worked in parallel to advance health equity—one on the descriptive component (those in public health sciences, e.g., epidemiologists) and one on the normative component (those in the humanities and social sciences, e.g., philosophers and ethicists). Yet a significant gulf exists between their respective research. Consequently, advances in thinking regarding the philosophical underpinnings and normative requirements of health equity have been largely divorced from the design of public health interventions that seek to reduce health inequities. As a consequence, public health interventions aiming to advance health equity may fail to target the most appropriate populations …

Woman-Centred Ethics: A Feminist Participatory Action Research [Journal Article], Kate Buchanan, Sadie Geraghty, Lisa Whitehead, Elizabeth Newnham

Research outputs 2022 to 2026

Introduction: Contemporary ethical issues in the maternity system are nuanced, complex and layered. Medicalisation and the reported rise in incidence of mistreatment and birth trauma, has been described as unethical. Some authors suggest bioethical principles are limited in terms of guiding everyday care of pregnancy and birth. There is currently no known published research which explores what birthing people say is ethical. Aims: This study sought to explore women's experience of maternity care from an ethical perspective. Method: A Feminist Participatory Action Research (FPAR) was conducted over three years, in two phases. A Community Action Research Group (CARG) was formed …

Genetic Enhancement Of The Inevitable, Varun Kota

Mako: NSU Undergraduate Student Journal

The invention of CRISPR-CAS9 allows one to edit the genome easily. As a result, many are excited by the potential breakthroughs in medical applications. Others worry that the development of this technology will lead to genetic enhancement, the modification of a set of genes toward a non-therapeutic end goal. After reviewing the philosophical and ethical literature regarding genetic enhancement it became apparent that there was a lack of specificity. Often, the arguments portrayed genetic enhancement as an unbelievable process. In reality, the effects of genetic enhancement are far tamer. The folly in these discussions lies in the notion that traits …

To Publish Or Not To Publish Phd Parts Before Its Completion Is Also An Ethical Question, Christos Melidis

Health Sciences

No Abstract for this article type.

Architectural Design Of A Blockchain-Enabled, Federated Learning Platform For Algorithmic Fairness In Predictive Health Care: Design Science Study, Xueping Liang, Juan Zhao, Yan Chen, Eranga Bandara, Sachin Shetty

VMASC Publications

Background: Developing effective and generalizable predictive models is critical for disease prediction and clinical decision-making, often requiring diverse samples to mitigate population bias and address algorithmic fairness. However, a major challenge is to retrieve learning models across multiple institutions without bringing in local biases and inequity, while preserving individual patients' privacy at each site.

Objective: This study aims to understand the issues of bias and fairness in the machine learning process used in the predictive health care domain. We proposed a software architecture that integrates federated learning and blockchain to improve fairness, while maintaining acceptable prediction accuracy and minimizing overhead …

Dementia And The Fragility Of Self: Navigating Ethical Considerations In Medical Decision-Making, Grace Sauers

Scripps Senior Theses

As the global population ages, the incidence of degenerative memory disorders such as Alzheimer's and dementia is expected to rise. The frequency of complex medical decision-making challenges for these patients will subsequently increase. It is now common practice for patients to provide advance directives outlining the care they wish to receive; in the case they are deemed incompetent to perform adequate decision making. However, patients with dementia occasionally express wishes contrary to those stated in their advance directives. This divergence creates ambiguity about which wishes should be honored and for who those wishes are being honored for. I aim to …

Ada Constitution & Bylaws (2023), American Dental Association

Constitution & Bylaws

The ADA Commons Constitution & Bylaws archival collection comprises printed issues of the American Dental Association's Constitution and Bylaws. The collection also includes the ADA Charter and the ADA Code of Ethics issued 1924-1946.

Physical Restraint In Older People: A Statement From The Early Career Network Of The International Psychogeriatric Association, Mustafa Atee, Claire V. Burley, Victor A. Ojo, Agboola J. Adigun, Hayoung Lee, Daniel J. Hoyle, Olufisayo Elugbadebo, Tomas Leon

Research outputs 2022 to 2026

The International Psychogeriatric Association (IPA) has expressed significant concerns over the use of physical restraints in older people across diverse aged care settings. Following an extensive analysis of the available literature, the IPA's Early Career Network (ECN) has formulated a collection of evidence-based recommendations aimed at guiding the use of physical restraints within various care contexts and demographic groups. Physical restraints not only infringe upon human rights but also raise significant safety concerns that adversely impact the physical, psychological, social, and functional well-being of older adults. Furthermore, their effectiveness in geriatric settings remains inadequate. Given these considerations, the IPA and …

Medical Ethics Principles Underscore Advocating For Human Papillomavirus Vaccine, C Mary Healy, Lara S Savas, Ross Shegog, Rebecca Lunstroth, Sally W Vernon

Student and Faculty Publications

Studies have consistently shown that vaccination rates against human papillomavirus (HPV) lag far behind other adolescent vaccinations recommended at the same age, resulting in exposing adolescents to unnecessary future risk of infection, and genital and head and neck cancers. Studies also have demonstrated that a major barrier to vaccination is lack of a strong provider recommendation. Factors that providers offer for failing to give a strong recommendation range from perception that the child is not at risk or the need to explain that the vaccine is not mandated (lack of equity and justice) or respect for parental autonomy. We look …

An Ethics Assessment Model For Teaching Global Health Program And Policy Implementation, Valerie Oji, Cheryl Knight, Renuka Mahatara, Vicki Oladoyin

Journal of Global Awareness

This mixed-method study surveyed and interviewed 60 High Income Country (HIC) US citizens/immigrants and Low-to-Middle-Income-Country (LMIC) citizens of African heritage on their perceptions of mental health services in African communities for implementation and research planning. In this study, ethics was a core emergent theme for global health initiatives and challenges, including political will for ethical change, community gatekeepers, level of government involvement, community-wide participation, public-private sector collaboration, health literacy and education, transparency, continuous monitoring, and consequences for ethical infractions. Based on our findings, we propose an active teaching and learning methodology of problem-based (PBL) and team-based learning (TBL) with multi-level …

Harnessing The Nursing And Midwifery Workforce To Boost Australia's Clinical Research Impact, Marion Eckert, Claire M. Rickard, Deborah Forsythe, Kathleen Baird, Judith Finn, Andrea Gilkison, Richard Gray, Caroline S.E. Homer, Sandy Middleton, Stephen Neville, Lisa Whitehead, Greg R. Sharplin, Samantha Keogh

Research outputs 2022 to 2026

For the Medical Research Future Fund (MRFF) to achieve its full impact, it is necessary for health practitioners to be trained and reliably funded to deliver research and translation alongside their clinical work. We offer insight into current systems, concerns and suggestions as this applies to clinical research in nursing and midwifery. Nurses and midwives globally have a long record of delivering high quality clinical research that improves care and outcomes. An analysis of four landmark nursing-led studies in the United States illustrates the value-adding potential of such research: for every grant dollar, the return on investment ranged from $202 …

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 …

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 …

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 …

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, …

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 …

Exploring Moral Permissibility Of Nurse Participation In Limited Resuscitation, Felicia Stokes

Electronic Theses and Dissertations

This dissertation offers a novel approach to support nurses when they face conflict between clinicians and families or alternate decision-makers over potentially inappropriate end-of-life goals of care. This dissertation will provide a normative analysis of the moral permissibility of limited resuscitation, with arguments supported by analyses of families’ and nurses’ perspectives and actions in the EoL decision-making process. Limited resuscitation is a cardiopulmonary resuscitation effort where full pharmacologic and mechanical intervention is not used, or the length of the resuscitative effort is shortened. It is typically associated with deception because it is performed without the knowledge of patients and families. …

Narrative Authority: A Narrative-Based Multicultural Ethics To Overcome Western Biases In The Current Models Of Care, Fahmida Hossain

Electronic Theses and Dissertations

Technological advances and globalization are transforming healthcare dramatically. But unfortunately, current medical practices remain blind to their multicultural patients’ varied worldviews and norms, especially in the West. As a result, patients often find themselves isolated, anxious, and resentful.

All the humanistic models in the current literature view the individual as a unique and autonomous being and, in turn, provide practices to access and recognize the patient’s personhood. These models—Narrative Medicine, Narrative Ethics, and Ethics of Care—attempt to catch sight of the individual, the person’s situation, and some semblance of the person’s story before diagnosing or offering prescriptions. However, all these …

Undergraduate Holocaust Education And Biomedical Ethics: What's The Connection?, Tatiana Thompson

Psychology Department Student Scholarship

This poster represents the research results of two studies used to examine Holocaust education in undergraduate colleges and universities.

Ethical Sensitivity Of Padis Care Among Critical Care Nurses: A Mixed Methods Study, Denise Waterfield

Theses & Dissertations

Critically ill patients often experience distressful and impactful symptoms and conditions that include pain, agitation/sedation, delirium, immobility, and sleep disruption (PADIS). The presence of PADIS can affect recovery and long-term patient outcomes. An integral part of critical care nursing is PADIS prevention, assessment, and management. To better understand the complexities of PADIS care, two reviews of the literature were completed. The first is an integrative review of the use of PADIS assessment tools by critical care nurses. The second is a qualitative systematic review of the literature on the integration of care ethics and nursing workload. Ethical sensitivity of everyday …

The Ethics Of Masking During A Pandemic, Mason Bennett

Philosophy Undergraduate Honors Theses

The COVID-19 pandemic has been disastrous, approaching a million deaths in the United States alone, and has demonstrated the world’s lack of preparation for a severe airborne virus. Countermeasures to infection are important to implement in order to lessen loss of life, but also must be justified and shown to be ethical. A countermeasure which is especially viable is wearing masks because of their high efficacy in preventing disease transmission compared to their relatively low restriction of liberty; studies have shown that mask wearing effectively impairs the spread of airborne pathogens and creates little physical or social harm. I argue …

Cpr-Directive Conversations In The Emergency Department: The Opinion Of Elderly Patients, Kelvin H. Kramp Dr., Rutger De Hond, Mirwais Mehrab, Martijn Van Hooft, Roger A.P.A. Hessels

Journal of Geriatric Emergency Medicine

Background: The average age of patients admitted to the emergency department (ED) continues to rise. Many face difficult discussions about cardiopulmonary resuscitation (CPR) and end-of-life decisions.

Objectives: This study aimed to determine which healthcare professionals elderly patients admitted via the ED preferred to discuss their CPR-directive with and their opinion about the ED as a setting for discussing their CPR-directive.

Methods: A mixed-methods study with an explanatory sequential design was conducted. A questionnaire was administered to 100 patients >65 years of age admitted to nursing wards via the ED that had a CPR-directive conversation during admission 24-48 hours earlier. Patients …

Protect Your Patients And Yourself: The Complete And Honest Medical History, Mitchell Gardiner Dmd

The Journal of the Michigan Dental Association

This feature article emphasizes the critical role of obtaining a complete and honest medical history in dental practice. Reflecting on the evolution of clinicians' diligence since dental school, the article underscores the potential risks associated with inadequate medical histories. The legal and ethical responsibilities in gathering comprehensive patient information are highlighted, emphasizing the impact on patient well-being and the dentist's vulnerability to legal challenges. The complexities of patients' truthfulness, especially regarding sensitive topics, are discussed, urging clinicians to establish trust for accurate disclosures. The article concludes with practical recommendations, stressing the ongoing need for thorough medical history reviews and the …