Medicine and Health Sciences Commons^™

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.

The Divergence Of Medical Ethics And State Laws Regarding Life Sustaining Treatment, Hannah Vandusen, Jason A. Wasserman

Posters

INTRODUCTION
Research reveals that cardiopulmonary resuscitation (CPR) rarely leads to prolonged survival in patients with chronic illnesses in whom death is expected in the relative near-term. There is strong ethical consensus favoring a physician’s right to refuse to provide CPR when it is physiologically futile or medically inappropriate. State laws governing medical treatment, however, sometimes diverge from this guidance. This study examines laws related to life sustaining treatment, analyzing both physician and surrogate authority in decision making about resuscitation orders in the national context.

Ethics Of Euthanasia And Physician Assisted Suicide, Kathryn Halloran

Honors Senior Capstone Projects

No abstract provided.

International Medical Service Trips: Colonialist Roots And Ethics Of Global Health Today, Lorenzo Patti

Regis University Student Publications (comprehensive collection)

Service trips have become a relatively common part of society today. People in both the professional and academic world often jump at the opportunity to be able to travel through the lens of learning or working. Service trips are framed as excursions to help marginalized communities, in reality, the trips end up being more about tourism and travel. Despite the attractive façade of medical service, its harmful impact is evident when examining it further. Medical trips often fall into two categories, voluntourism and capacity building. Voluntourism has a number of flaws, which cause long-term detrimental effects to the communities visited …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

Health For All: Using Utilitarianism To Require Childhood Vaccinations, Hannah Vercellotti

Augustana Center for the Study of Ethics Essay Contest

In the last few decades, many parents have chosen not to vaccinate their children against serious infectious diseases. In seeking exemptions, they often cite conflicting religious beliefs and fear of risks. Using the principle of utilitarianism, this paper argues that despite parents' cited religious beliefs and concerns about risks, state laws should require all children to get vaccinated unless doing so would cause direct harm to the child’s health. Adopting this mandate would ensure that the maximum number of people would benefit from immunity to serious and deadly diseases.

From Witch Hunts To Autoantibodies: Overcoming Psychogenic Stigma To Uncover The Molecular Cause Of Autoimmunity, Emma Hainstock

Regis University Student Publications (comprehensive collection)

Due to the frequency of misdiagnosis of autoimmune diseases and their disproportionate incidence in women, my thesis explores historical misconceptions about autoimmune conditions which could have lingered in society to impede their diagnoses today. Antiphospholipid Antibody Syndrome (APS) and Anti-NMDA Receptor Encephalitis (ANRE) are the conditions I focused on, as both diseases can cause complex neurologic symptoms such as hallucinations and memory loss, which in combination with the fact that they are disproportionately suffered by women, have caused physicians in the past to misdiagnose patients as either hysteric or demonically possessed. I explore antiphospholipid antibody syndrome and anti-NMDA receptor encephalitis’s …

Should Doctors Take Into Account Human Races? A Medical Ethics Approach, Gabriel Andrade

Journal of Health Ethics

Racial discrimination has some very harmful social effects. But, can discrimination in medicine lead to good outcomes? This is an emerging question in medical ethics. It is undoubtedly true that some individuals are more genetically prone to some diseases than others. But, we should not rush to judgment, and believe that race may be a good guide in order to discover what diseases an individual is more susceptible to. Illnesses such as sickle cell-anemia and Tay Sachs disease have long been thought to have a racial correspondence. This is in fact not true. There have also been attempts to prescribe …

Moral Distress And The Health Care Organization, Andy Kondrat

Dissertations

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress.

In …

Review Of "Truly Human Enhancement: A Philosophical Defense Of Limits ", James Mcbain

Faculty Submissions

Review of "Truly Human Enhancement: A Philosophical Defense of Limits" by Nicholas Agar.

Ovaries, Testicles, And Uteruses, Oh My! Regulating Reproductive Tissue Transplants, Valarie K. Blake

William & Mary Journal of Race, Gender, and Social Justice

This article will explore key regulatory and ethical challenges presented by reproductive tissue transplants (RTTs) as they are currently developing, recognizing that additional issues may reveal themselves as the technologies progress. Part I of this article will begin with a discussion of the current status of the technology, including the results and status of animal and human experiments for all three types of transplants. Part II will explore the demand for RTTs—who might consider such a transplant and why RTTS might be considered by some patients as more favorable than other reproductive options. Part III will explore the different regulatory …

The Disavowed Curriculum: Understanding Student's Reasoning In Professionally Challenging Situations, Shiphra Ginsburg, Glenn Regehr, Lorelei Lingard

Lorelei Lingard

CONTEXT: Understanding students' perceptions of and responses to lapses in professionalism is important to shaping students' professional development. OBJECTIVE: Utilize realistic, standardized professional dilemmas to obtain insight into students' reasoning and motivations in "real time." DESIGN: Qualitative study using 5 videotaped scenarios (each depicting a student placed in a situation which requires action in response to a professional dilemma) and individual interviews, in which students were questioned about what they would do next and why. SETTING: University of Toronto. PARTICIPANTS: Eighteen fourth-year medical students; participation voluntary and anonymous. MAIN OUTCOME MEASURE: A model to explain students' reasoning in the face …

Context, Conflict, And Resolution: A New Conceptual Framework For Evaluating Professionalism, Shiphra Ginsburg, Glenn Regehr, Rose Hatala, Nancy Mcnaughton, Alice Frohna, Brian Hodges, Lorelei Lingard, David Stern

Lorelei Lingard

No abstract provided.

Before The White Coat: Perceptions Of Professional Lapses In The Pre-Clerkship, Shiphra Ginsburg, Natasha Kachan, Lorelei Lingard

Lorelei Lingard

BACKGROUND: It has been shown that the professional development of clinical clerks is influenced by their experiences of unprofessional behaviour, but the perceptions of pre-clerkship students have received relatively little attention. Our purpose was to develop a greater contextual understanding of the situations in which pre-clerkship students encounter professional challenges, and to investigate what pre-clerkship students consider to be professional lapses in these situations.

METHODS: We conducted 4 focus groups (n = 22 students); transcripts were analysed by 3 researchers using grounded theory.

RESULTS: Pre-clerkship students reported lapses in the areas of communicative violation, role resistance, objectification, accountability and harm, …

To Be And Not To Be: The Paradox Of The Emerging Professional Stance, Shiphra Ginsburg, Glenn Regehr, Lorelei Lingard

Lorelei Lingard

PURPOSE: Understanding how students resolve professional conflict is essential to teaching and evaluating professionalism. The purpose of this study was to refine an existing coding structure of rationalizations of student behaviour, and to further our understanding of students' reasoning strategies in the face of perceived professional lapses.

METHODS: Anonymous essays were collected from final year medical students at two universities. Each essay included a description of a specific professional lapse, and a consideration of how the lapse was dealt with. Essays were analysed using grounded theory. The resulting coding structure was applied using NVivo software.

RESULTS: Twenty essays, containing 147 …

Medical Ethics: A Slow But Sustained Revolution In Pakistan’S Healthcare, Muhammad Shahid Shamim, Muhammad Shahzad Shamim

Section of Neurosurgery

No abstract provided.

Medical Conscience And The Policing Of Parenthood, Richard F. Storrow

William & Mary Journal of Race, Gender, and Social Justice

As state and local anti-discrimination provisions become more and more comprehensive, physicians who refuse to treat patients for reasons of sexual orientation or marital status are beginning to face legal liability. Increasingly, physicians are invoking codes of medical ethics alongside more familiar constitutional law claims in support of their claim to insulation from legal liability. This Article explores what medical ethics has to say about physicians who, for sincerely held religious reasons, refuse to treat patients for reasons of sexual orientation or marital status. The issue is explored through the lens of a case recently decided by the California Supreme …

Critically Appraising Qualitative Research, Ayelet Kuper, Lorelei Lingard, Wendy Levinson

Lorelei Lingard

No abstract provided.

Ethics Of Surgical Training In Developing Countries, Kevin Ramsey, Charles Weijer

Charles Weijer

The practice of surgical trainees operating in developing countries is gaining interest in the medical community. Although there has been little analysis about the ethical impact of these electives, there has been some concerns raised over the possible exploitation of trainees and their patients. An ethical review of this practice shows that care needs to be taken to prevent harm. Inexperienced surgeons learning surgical skills in developing countries engender greater risk of violating basic ethical principles. Advanced surgical trainees who have already achieved surgical competence are best qualified to satisfy these ethical issues. All training programs need to develop a …

Developing A Research Ethics Consultation Service: Fostering Responsive And Responsible Clinical Research, Larry I. Palmer, Joseph J. Fins

Popular Media

Although clinical ethics has become a central, and welcome, component of the health care landscape, research ethics consultation services are still uncommon. Indeed, the usual approach to ethical concerns in research with human subjects has been primarily a regulatory one. Nonetheless, ethical problems also arise in the context of research and thus collaborations between investigators and research ethicists are as essential as those between physicians and clinical ethicists. The authors argue that the use of research ethics consultation services can be of benefit to clinical scientists, bioethicists, research institutions, and research subjects. Such services can increase sensitivity among researchers to …

Response - Jay Katz: From Harms To Risks, Larry I. Palmer

Faculty Publications

No abstract provided.

A Death In The Family: Reflections On The Terri Schiavo Case, Charles Weijer

Charles Weijer

No abstract provided.

The Secret Kappa Lambda Society Of Hippocrates (And The Origin Of The American Medical Association's Principles Of Medical Ethics), Charles T. Ambrose

Microbiology, Immunology, and Molecular Genetics Faculty Publications

This paper relates the neglected history of an idealistic, secret medical fraternity which existed briefly in Lexington, Kentucky, during the first half of the 19th century. It was created for students in the Medical Department at Transylvania University, the fifth US medical school, founded in 1799. One goal of the fraternity was to counter the widespread dissension and often violent quarrels among doctors that characterized American medicine of that period. And to that end, it was among the first to promote Thomas Percival's code of medical ethics in this country. Branches of the fraternity were established in Philadelphia and New …

Moral Callings And The Duty To Have Children: A Response To Jeff Mitchell, James Mcbain

Faculty Submissions

Jeff Mitchell argues that the good reason for having children is that parenthood is a “moral calling” and that one should heed the call out of a sense of duty and responsibility for the good of society. I argue such a “moral calling” account is mistaken, first, in that Mitchell problematically assumes the “basic intuition” is mistaken and, second, it fails to provide the epistemic conditions for the warranted belief that one would probably make a good parent (a central consideration of Mitchell’s). Thus, such a “moral calling” rationale for the having of children is not superior to rationales that …

Will The Real Charles Fried Please Stand Up?, Paul Miller, Charles Weijer

Charles Weijer

In response to the preceding commentary by Jerry Menikoff in this issue of the Journal, the authors argue that Fried's central concern is not that randomized clinical trials (RCTs) are conducted without consent, but rather that various aspects of the design and conduct of RCTs are in tension with physicians' duties of personal care to their patients. Although Fried does argue that the existence of equipoise cannot justify failure to obtain consent from research subjects, informed consent by itself does not supplant ill subjects' rights to personalized judgment and care embodied in Fried's equipoise.

The Ethics Of Placebo-Controlled Trials, Charles Weijer, Kathleen Glass

Charles Weijer

No abstract provided.

Minimal Risk And Its Implications, Charles Weijer

Charles Weijer

No abstract provided.

Misrepresenting Research: Commentary, Charles Weijer

Charles Weijer

No abstract provided.

Benefit-Sharing And Other Protections For Communities In Genetic Research, Charles Weijer

Charles Weijer

No abstract provided.

Clinical Equipoise And Not The Uncertainty Principle Is The Moral Underpinning Of The Randomised Controlled Trial, Charles Weijer, Stanley Shapiro, Kathleen Glass

Charles Weijer

No abstract provided.