Bioethics and Medical Ethics Commons^™

"First, Do No Harm": Ethical Failures And Preventive Solutions In The United States Pharmaceutical System - A Narrative Review, Rebekah R. Bailey

Honors Theses

The United States pharmaceutical system is highly advanced but faces growing ethical concerns related to drug development and marketing, overprescription, and high drug costs. This thesis examines how pharmaceutical marketing, regulatory practices, and prescribing behaviors may conflict with the ethical principle of “first, do no harm.”

Using a narrative review of interdisciplinary literature in public health, medical ethics, and applied ethics, this thesis analyzes patterns in drug development, marketing strategies, and regulatory oversight. The findings suggest that ethical issues are systemic, driven by commercial incentives, inconsistent regulatory standards, and an increasing reliance on pharmaceutical solutions. These factors contribute to overmedicalization, …

Expanding Expanded Access: A Case Of Onc201 And The Ethical Limitations Of Compassionate Use, Ava C. Hutchings

Honors Theses

This study examines the ethical and structural limitations of the Expanded Access program in the United States, with particular focus on its application to terminal pediatric illness. Although the program is intended to provide patients with life-threatening conditions access to investigational therapies outside of clinical trials, its effectiveness in serving critically ill children remains uncertain. This program is analyzed through careful consideration of regulatory review and ethical theory. Key policies governing Expanded Access are examined alongside scholarly discussions of pediatric autonomy and parental authority.

A case study of ONC201, a now-approved investigational drug, is used to illustrate how Expanded Access …

Values-Based Clinical Ethics: A New Model Of Health And Ethics Consultation For Patients Suffering In Extremis, Adam Trainer

Electronic Theses and Dissertations

This dissertation argues that contemporary clinical ethics is inadequately equipped to support patients suffering in extremis because it relies on an insufficiently discriminating account of health and a constrained model of moral reasoning. Drawing on Bernard Lonergan, it reconceives health as an emergent, multi-layered, heuristic notion shaped by biological, psychological, social, and existential goods. On that basis, it critiques principlism’s global applicability thesis and the undergirding claim that its principles form part of the common morality, arguing that this justificatory structure is philosophically insufficient and practically limited for clinical ethics in cases marked by profound suffering, moral plurality, and normative …

Statistical Inference Is Not Moral Reasoning: The Case Against Ai On Hospital Ethics Boards, Elan J. Haronian

Seaver College Research And Scholarly Achievement Symposium

As generative AI becomes more integrated in healthcare, it seems inevitable that AI will eventually be used on hospital ethics committees. However, before implementation, their roles need careful consideration. Although AI promises to reduce costs, increase efficiency, and reduce human workloads, there are important ways in which it is limited, especially when human emotion and connection are crucial, as in clinical ethics boards.

In this paper, I highlight several problems preventing AI from being useful on hospital ethics boards. These include issues of opaque reasoning (the “black box” problem), liability, transparency, privacy, and consent. While there are proposed frameworks for …

The Racial Politics Of Early Dentistry And The Terrible “Toothache Blues”, Bronwen Mcveigh Phd

Journal of the American College of Dentists

In interwar America, the relatively young profession of dentistry was developing rapidly. As the government, health institutions, and social organizers focused more intently on notions of national wellness, questions about how to achieve a healthy smile—and what a healthy smile should look like—proliferated. Groups like the National Dental Association worked to establish rigorous standards of technique, define ethical behavior, and encourage dentists to develop business acumen, yet the surprising proliferation of blues songs about dubious dentists tricking unassuming clients, or about fraught love affairs allegorized by disastrous dental exams, highlights the equivocal nature of many developments in early dentistry.

This …

The Mouth As A Mirror: A Parent- Hygienist’S Ethical Reflections On Oral Healthcare And Pompe Disease, Anika Atkins Ma, Rdh

Journal of the American College of Dentists

This reflective narrative explores the ethical tensions and emotional realities of a dental hygienist who is also the parent of a child with Pompe disease. Drawing from personal experience and care ethics philosophy, the author examines how traditional clinical frameworks—centered on autonomy, beneficence, and protocol— often fall short when addressing the needs of medically fragile children. The piece weaves in the work of care ethicists and pastoral ministry to embrace the philosophy of caregiving as presence, to suggest that oral healthcare must evolve to include responsiveness, context, and relationship-based decision-making. Through the dual lens of provider and parent, the narrative …

J Am Coll Dent 2026 92 2a

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care. The unexpectedly strong response to the call …

J Am Coll Dent 2026 92 2b

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care.

The unexpectedly strong response to the call …

How Dentists Can Remain Advisors Of Merit To Their Patients, Daniel L. Orr Ii, Dds, Ms (Anesth), Phd, Jd, Md, Facd (Nevada Section Chair)

Journal of the American College of Dentists

This article examines how members of the dental profession can sustain their longstanding reputation as trusted advisors amid declining public confidence in major institutions. Grounded in ethical principles, informed consent, and professional self-regulation, dentistry has historically ranked among the most trusted professions. The discussion explores challenges to credibility, including media scrutiny, concerns about anesthesia safety, controversial treatment hesitancy, and debates over community water fluoridation. Emphasizing the concept of the “advisor of merit,” the author argues that continued trust depends on truthful communication, transparency about risks, respect for patient autonomy, and freedom from conflicts of interest in clinical and public health …

Ethical Dilemmas Surrounding Community Water Fluoridation, Roopwant Kaur, Herminio Perez, Mark Moss

Journal of the American College of Dentists

Since the 1950s, community water fluoridation (CWF) has stood as a cornerstone of dental public health. However, a growing amount of public scrutiny necessitates reflection on the ethical basis for coming to a firm position on the topic. Aside from CWF, fluoride in the form of ingestible supplements has recently been identified as a concern by the US Food and Drug Administration. Indeed, it is challenging to wade through the facts, opinions, misinformation, and policy shifts. This article examines the ethical dilemmas that surround CWF through the lens of the American Dental Association (ADA) Principles of Ethics and Code of …

J Am Coll Dent 2025 92 1

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

The Contribution Of Catholic Compromise Principles In Global Health, Scott N. Helstad

Electronic Theses and Dissertations

The Roman Catholic tradition has developed comprehensive ethical principles to address complex practical scenarios that encounter foundational value compromises. These are referred to as compromise principles and they have both a narrow and a broad focus. Narrowly, these compromise principles are critical for Catholic healthcare organizations in the United States with regard to the guidelines of the US Bishops in their Ethical and Religious Directives for Catholic Health Care Services. More broadly, these compromise principles are relevant in the secular realm regarding global health. This dissertation examines these varying perspectives, hence its title, “The Contribution of Catholic Compromise Principles …

Hospital Organizations’ Obligation To Promote Spiritual Well-Being Among Nurses: Development Of A Normative Ethical Argument, Michael Jordan

Electronic Theses and Dissertations

This dissertation presents an innovative strategy to promote the support of nurses' spirituality within hospital organizations. By focusing on the spiritual well-being of nurses by hospital organizations, with a natural extension into nursing schools, the approach aims to enhance nurse’s ability to protect their own spirituality, provide comprehensive spiritual care to patients, and increase nurse moral resilience. By investing in nurses' spirituality and spiritual growth, hospitals can potentially increase job satisfaction among nursing staff, improve patient care outcomes, and create a more holistic healing environment for both nurses and patients. As the nursing shortage continues and the number of nurses …

The Ethical Imperative Of The Renewal Of Virtue Within The Moral Community Of Catholic Healthcare, Amanda Altobell

Electronic Theses and Dissertations

Catholic healthcare is one of the largest nonprofit organizations and providers in the United States, offering medical care to many diverse communities. The fundamental mission of Catholic healthcare is to bring about Christ’s healing ministry and live out the fundamental principle of caring for the vulnerable in pursuit of the common good. However, there have been many missteps, not only due to a more polarized and secular community but also to scandals and conflict due to previous hierarchical and rules-based anthropology that often misses the person's lived experience. Therefore, this dissertation will argue that for Catholic healthcare to survive the …

The Conservative Approach To Informed Consent: The Evidentiary Model And An Antidote To The Problem Of Framing Effects In Medical Decision-Making, James D. Polk

Honors Theses

Since the latter part of the 20th century, there has been a gradual but significant shift of the doctor-patient relation from paternalism to a more patient-centric approach. As such, informed consent – the legal and moral requirement that a physician fully disclose relevant details to their patient and gain their consent – is a central doctrine to patient-centric care. Gone are the days of the doctor governing the patient: the patient is now considered a valuable and important decision-maker. Achieving informed consent is the foundation of patient centric medicine. Therefore, it is of the utmost importance that philosophical consideration be …

The Ethical Imperative Of Leadership In Dentistry, Mike Graham, Toni M. Roucka Rn, Dds, Ma, Facd

Journal of the American College of Dentists

Leadership is one of the four pillars of the American College of Dentists, taking its place alongside excellence, ethics, and professionalism. Leadership in dentistry carries an inherent ethical responsibility to uphold the trust and well-being of those who depend on us—our patients, our teams, and the community. When leaders in our field exercise their influence, they wield significant power over patient outcomes, industry standards, and public health policy. With this influence comes an imperative to act ethically, to ensure that decisions are guided by a commitment to care, integrity, and the best interests of those we serve. At the heart …

Breaking Down The Silos: Dentistry’S Ethical Responsibility As A Partner In Healthcare, Toni M. Roucka Rn, Dds, Ma, Facd, Scott Tomar Dmd, Drph, Facd

Journal of the American College of Dentists

The Ethics Summit, Breaking Down the Silos: Dentistry’s Ethical Responsibility as a Partner in Healthcare, was held on September 12-13, 2024, in Rockville, Maryland. Sponsored by the American College of Dentists Foundation (ACDF) and the Santa Fe Group (SFG), this issue of the JACD is dedicated to the proceedings of that important event.

The Ethical Contributions Of Nudges To Healthcare, Ian Doherty

Electronic Theses and Dissertations

“The Ethical Contributions of Nudges to Healthcare” examines the ethical use, implications, and rationale for using nudges in healthcare. The use of nudges in healthcare are being empirically examined. This leaves much to be examined from the ethical perspective. To examine the ethical perspective, the dissertation lays out how nudges interact with and enhance the biomedical principles of autonomy and beneficence. The dissertation then turns to clinical ethics. Nudges, more specifically the framing effect, are paired with trust in the patient-physician relationship to discern how best to aid a patient in his or her medical decision-making. The dissertation then investigates …

The Contribution Of Pope Francis’ Integral Ecology To Global Ethics, Salvatore Enzo Del Brocco

Electronic Theses and Dissertations

The defense of the dignity and inviolability of human life has always gained prominence in the doctrine of the Catholic Church. With Pope Francis' concept of integral ecology, Catholic bioethics is expanded to a broader understanding. His vision of integral ecology, global bioethics, and solidarity emphasizes the interconnectedness of all things and the importance of caring for one another and the planet. It calls us to recognize our common humanity and to work together for the common good by facing the numerous emerging problems of our times, which threaten the dignity of human life and the future life of the …

Abortion: Analysis Of The Bioethical And Metaphysical Standpoint, Lauren Kovarick

Richard T. Schellhase Essay Prize in Ethics

The antagonistic relationship between a mother and their unborn child creates the controversial topic of abortion. With massive moral implications and consequences associated, education on the laws and reasoning is significant to determine the direction of society. To analyze the ethics of abortion, the bioethical and metaphysical debate must be considered. With the former, the four principles of bioethics are used in healthcare practice to break down an ethical concern. On the metaphysical side, the life-status and rights of the fetus are acknowledged. With this topic, it is important not to argue in favor of one position, but instead have …

Bioethics And A Theology Of Vulnerability, Carrie Oneil-Smith

Obsculta

This essay looks at how a theology of vulnerability can contribute to ethical decision-making in an increasingly secular society. Relationality, power dynamics and scriptural justifications are considered, as well as early contributions made to this nascent field of Christian thought. This essay was written for a class on Health Care Ethics taught by Dr. Mary Ann Kish.

Algorithmic Bias: Causes And Effects On Marginalized Communities, Katrina M. Baha

Undergraduate Honors Theses

Individuals from marginalized backgrounds face different healthcare outcomes due to algorithmic bias in the technological healthcare industry. Algorithmic biases, which are the biases that arise from the set of steps used to solve or analyze a problem, are evident when people from marginalized communities use healthcare technology. For example, many pulse oximeters, which are the medical devices used to measure oxygen saturation in the blood, are not able to accurately read people who have darker skin tones. Thus, people with darker skin tones are not able to receive proper health care due to their pulse oximetry data being inaccurate. This …

The Integration Of Catholic Mission And Ethics In Contributing To A Good Death, Noah Dimas

Electronic Theses and Dissertations

Catholic healthcare ethics exists within a morality that is under regular heavy scrutiny. This is furthered by the healthcare space itself becoming more secular as the greater society itself moves beyond the religious origins of healthcare. However, this does not have to be relegated to a negative. Rather, this can become a strong call to action for Catholic healthcare to rally together and advocate for itself in the wider healthcare space. This is especially true as these challenges to the Catholic moral-ethical framework begin to question the presence of both Catholic and religious healthcare as whole. These challenges, if left …

The Ethics Of Governance Of Data Analytics In Healthcare, Andrew Harrington

Electronic Theses and Dissertations

Recent literature and studies on data governance usually focus on data ethics and governance from a specific country or industry, which has been mostly business, without considering the larger global impact that is affected. Data is a worldwide asset; thus, its implications and considerations should be viewed as such. Hence, this dissertation attempts to incorporate this view by weaving together topics in healthcare, such as the blending of finance and delivery, data governance at the micro and macro levels, data analytics in healthcare, ethics of AI and information management, and technology’s impact on end-of-life practices. Through highlighting these areas of …

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …

The Hermeneutics Of Nudging: The Reciprocity Between Transhumanism And Nudging, Ian Doherty

Graduate Student Research Symposium

This paper investigates and evaluates the implications of nudging someone toward transhumanism. Transhumanism offers a path to alleviate suffering and transcend our physical and mental limitations. Transhumanist technologies consist of alterations like genetic modification, neural implants, and molecular nanotechnology. These technologies are meant to give people full morphological freedom over their bodies. Although transhumanism remains a largely unknown movement, this is where nudge theory can help raise its prominence. Nudge theory aims to help people make better choices, and aid them in making better decisions related to their health and lifestyle. If paired correctly, transhumanism seems to be a perfect …

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 …

Heightened Technology In The Care Of Type 1 Diabetes: An Ethical Symbiosis?, Susanna Larsen

OUR Journal: ODU Undergraduate Research Journal

This paper explores the common negative consequences and ethical issues associated with the evolving medical technology used in the care of Type 1 diabetes. In this paper, I will discuss the ethical impacts of technology on diabetic youth: their view of self, their mechanical requirements, and their health priorities. In order to define the scope of the issues, I will use the following intellectual tools: feminist theory, care ethics, and philosophical discussions of control. This paper will also outline some possible solutions to these ethical issues.

Redefining Paternalistic Practices In Women’S Health: How Dysfunctional Trust Relationships Impact Medical Autonomy Of Female Patients In The Contemporary Clinical Setting, Lauren K. O'Dell

Theses and Dissertations--Philosophy

Utilizing Trudy Govier’s (1997) conception of social trust, this dissertation will provide a framework for understanding trust in healthcare relationships and highlight some of the ways that unequal power distribution and dependency, poorly defined roles, and institutions complicate trust between women and their providers. This framework will also explain how distrust, especially prejudicial distrust, leads to paternalistic attitudes on the part of providers. Paternalism limits patient autonomy because medical autonomy is constitutively relational. This means that insofar as distrust causes paternalism, it also damages autonomy. Through negative outcomes, this lack of autonomy can cause patients to distrust healthcare, which can …

The Ethical Basis For Student-To-Student Training In Dentistry, Larry E. Jenson Dds, Ma, Joel M. White Dds, Ms

Journal of the American College of Dentists

This article will focus on the most ethically contentious student-to student training practice: local anesthesia administration. We will examine the factors that contribute to a broader understanding of the ethical issues involved and introduce a framework that will help to clarify these issues. We have identified six stakeholders in this issue: the student-as-patient, the student-as-student, the university, the faculty, the general public and the profession.