Bioethics and Medical Ethics Commons^™

Dimensional Welfare Beyond Pain: Extending The Precautionary Principle In Birch’S “The Edge Of Sentience”, Willa M. Lane, Nicola S. Clayton

Animal Sentience

Birch's (2024) The Edge of Sentience identifies sentience candidates primarily through the pain-focused LSE Criteria. Yet, as Birch himself notes in Proposal 17, sentience is not pain. We argue that statutory welfare protections must therefore reach beyond pain, and that the right tool for doing so is Birch et al.’s (2020) dimensionality framework, which characterises conscious experience across five domains. Used together, the LSE Criteria establish that welfare is at stake, while the dimensionality framework maps what is at stake beyond pain to provide a taxon-specific profile of where captivity impoverishes experience. We apply this approach to invertebrate welfare and …

Justice, Autonomy, Beneficence, And Non-Maleficence: The Global Failure To Heed Ethical Mandates In Birth Spaces, Julia Dees

Richard T. Schellhase Essay Prize in Ethics

Respectful and safe care in all birthing spaces has long been an ideal that global communities fail to meet. Birthing people are disrespected, physically or emotionally harmed, or left to completely fend for themselves during a period of extreme emotional and medical vulnerability. Historically, autonomy especially has been ignored in birthing spaces with medical trends like the twilight sleep, where women were drugged into a state of unconsciousness during birth (Taylor, 2023), demonstrating the desire of western medicine, in particular, to reduce birthing people to bystanders in their own birth. While birth trends and medical treatments have changed throughout time, …

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 Ethics Of Gene Editing Hereditary Deafness, Jasmine Borie

Richard T. Schellhase Essay Prize in Ethics

Gene editing has been a hot topic of interest in the field of science, and many gene editing solutions for heritable diseases are in the works. In most cases, gene editing is done with good intentions, but there are some instances where it would not be favorable for reasons that may not be inherently obvious to everyone. Several forms of deafness and hearing loss can be inherited, meaning that it can be passed down from parent to offspring. Curing hereditary deafness using gene editing may seem like a good idea, but it can lead to unintentional discrimination and further stigmatization …

Classic Philosophers On Modern Issues: The Ethics Of Germline Editing, Grace O. Decostanza

Richard T. Schellhase Essay Prize in Ethics

The prospect of using CRISPR-Cas-9 technology to edit human embryos in a process called germline editing has the potential to irreparably change the world as we know it. Many pose the question: if you could save your child from having a disease, would you? But I argue that is not the only—or even, real—question we should be asking. Instead, I ask you, should we be changing humanity as we know it in ways that elude even our foremost scientists? Should we decide what disabilities make people not worth being people? Should we introduce a technology knowing full well that it …

An In-Depth Review Of Euthanasia-Related Practices, Arguments For/Against Them, And Proposed Solutions For Their Most Glaring Legal/Ethical Problems, Macon Plecha

Williams Honors College, Honors Research Projects

This paper’s goal is to cover the topic of euthanasia-related practices at great length. Terminology, history, and current programs around the world are discussed first, with the last point covering a wide geographical range: Colombia, Japan, Israel, and Africa, to name a few outside of the Western world standard. Arguments for and against euthanasia-related practices are explored. Within these arguments, several pressing legal and ethical issues arise, and the most severe of these are expanded on through the offering of potential solutions: how to handle stand-alone psychiatric cases, how to improve advanced directives and poor reporting rates, and how to …

The Excessive Cost Of Health: An Analysis Of Pharmaceutical Accessibility Issues In The United States, Henry Woodman Curtis

Electronic Theses & Dissertations (2024 - present)

Compared to the rest of the world, the United States has one of the worst-performing health care systems. While this is influenced by our hospital systems and clinical care in certain contexts, one of the biggest culprits for our poor ratings is the cost and availability of prescription medications. We pay more than any comparable country for the exact same medications and have a harder time actually accessing them. In this dissertation, I aim to analyze how individuals, companies, and governmental agencies have responded to various instances of high-cost or low-availability prescription medications. To begin, I examine pharmaceutical patenting practices …

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 …

Healthcare For Undocumented People In America, Richard Pazer

Graduate Student Research Symposium

Millions of undocumented people live in America and roughly a million have entered every year since 2021. This is a hot-button issue in mainstream politics for a variety of reasons. However, there is an issue that tends to get overlooked which is their health care. In most states, undocumented people do not qualify for healthcare coverage of any kind. This leaves them reliant on EMTALA and emergency departments (ED). Through an examination of the various state and federal policies that pertain to undocumented people’s healthcare coverage, we can see that these people are in desperate need of assistance. It becomes …

Animal Personality And Sentience As Distinct Concepts, Mark Briffa

Animal Sentience

Owens et al (2024) discuss how knowledge of both animal personality and sentience in target populations can be leveraged to enhance wildlife conservation programmes. In this commentary I expand on the distinction between these two concepts. Behavioural differences should be considered broadly across conservation programmes, not just those involving species deemed sentient.

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 …

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 …

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 …

Defining And Exploring Animal Sentience, Andrew N. Rowan, Joyce M. D'Silva Mrs, Ian J.H. Duncan, Nicholas Palmer

Animal Sentience

One of the commentaries on the target article notes that "animal sentience" is difficult to define operationally. This response to the commentaries develops a working, usable definition of animal sentience and examines the relationships between animal emotions and sentience.

The Ethics Surrounding Do-It-Yourself Hormone Replacement Therapy, Ted Studt

Richard T. Schellhase Essay Prize in Ethics

Healthcare is often a complicated issue to navigate, and sadly it gets no easier for those who are transgender. Gender-affirming healthcare can be incredibly tough to attain, both within and outside the United States. Research found that trans citizens in the US were less likely to be insured and more likely to experience barriers to access than cis citizens. In April and May 2021, laws were signed into effect in Arkansas and Tennessee targeting hormone replacement therapy (HRT) and puberty blockers, specifically banning such medicines being given to individuals under 18. As a result, many transgender citizens turn to online …

Righting Health Policy: Bioethics, Political Philosophy, And The Normative Justification Of Health Law And Policy, D. Robert Macdougall

Publications and Research

In Righting Health Policy, D. Robert MacDougall argues that bioethics needs but does not have adequate tools for justifying law and policy. Bioethics’ tools are mostly theories about what we owe each other. But justifying laws and policies requires more; at a minimum, it requires tools for explaining the legitimacy of actions intended to control or influence others. It consequently requires political, rather than moral, philosophy. After showing how bioethicists have consistently failed to use tools suitable for achieving their political aims, MacDougall develops an interpretation of Kant’s political philosophy. On this account the legitimacy of health laws does …

Must Consent Be Informed? Patient Rights, State Authority, And The Moral Basis Of The Physician's Duties Of Disclosure, D. Robert Macdougall

Publications and Research

Legal standards of disclosure in a variety of jurisdictions require physicians to inform patients about the likely consequences of treatment, as a condition for obtaining the patient’s consent. Such a duty to inform is special insofar as extensive disclosure of risks and potential benefits is not usually a condition for obtaining consent in non-medical transactions.

What could morally justify the physician’s special legal duty to inform? I argue that existing justifications have tried but failed to ground such special duties directly in basic and general rights, such as autonomy rights. As an alternative to such direct justifications, I develop an …

Informed Consent: Foundations And Applications, Joanna Smolenski

Dissertations, Theses, and Capstone Projects

Since its advent in the 20th century, informed consent has become a cornerstone of ethical healthcare, and obtaining it a core obligation in medical contexts. In my dissertation, I aim to examine the theoretical underpinnings of informed consent and identify what values it is taken to protect. I will suggest that the fundamental motivation behind informed consent rests in something I’ll call bodily self-sovereignty, which I argue involves a coupling of two groups of values: autonomy and non-domination on the one hand, and self-ownership and personal integrity on the other. I will then go on to consider two 'case …

A Literary Analysis Of The Origin Of Human Embryonic Stem Cells, Its Advancements, Philosophical, Ethical, Sociocultural, And Political Aspects; An Investigation Of The Underlying Attributes That Affect One’S Views On Hesc Research To Resolve Turkey And Brazil’S Hesc Policy, Religious, And Cultural Conflicts, Haleema Shamsuddin

Honors Scholars Collaborative Projects

Human embryonic stem cells (hESCs) are cells derived from 5-day human embryos and are self-renewing cell lines that change into any type of cell in the body, a trait called pluripotency. hESCs have almost unlimited clinical and medical research potential. Despite the great therapeutic promise of hESC research, it comes with a controversial ethical debate due to its involvement with the destruction of the human embryo. The central argument revolves around the question of whether or not these human embryos should be ascribed equal moral status to fully developed humans. This thesis aims to analyze the origin and advancements of …

Automating Autism: Disability, Discourse, And Artificial Intelligence, Os Keyes

The Journal of Sociotechnical Critique

As Artificial Intelligence (AI) systems shift to interact with new domains and populations, so does AI ethics: a relatively nascent subdiscipline that frequently concerns itself with questions of “fairness” and “accountability.” This fairness-centred approach has been criticized for (amongst other things) lacking the ability to address discursive, rather than distributional, injustices. In this paper I simultaneously validate these concerns, and work to correct the relative silence of both conventional and critical AI ethicists around disability, by exploring the narratives deployed by AI researchers in discussing and designing systems around autism. Demonstrating that these narratives frequently perpetuate a dangerously dehumanizing model …

“How Could You Even Ask That?”: Moral Considerability, Uncertainty And Vulnerability In Social Robotics, Alexis Elder

The Journal of Sociotechnical Critique

When it comes to social robotics (robots that engage human social responses via “eyes” and other facial features, voice-based natural-language interactions, and even evocative movements), ethicists, particularly in European and North American traditions, are divided over whether and why they might be morally considerable. Some argue that moral considerability is based on internal psychological states like consciousness and sentience, and debate about thresholds of such features sufficient for ethical consideration, a move sometimes criticized for being overly dualistic in its framing of mind versus body. Others, meanwhile, focus on the effects of these robots on human beings, arguing that psychological …

Brain Complexity, Sentience And Welfare, Donald M. Broom

Animal Sentience

Neither sentience nor moral standing is confined to animals with large or human-like brains. Invertebrates deserve moral consideration. Definition of terms clarifies the relationship between sentience and welfare. All animals have welfare but humans give more protection to sentient animals. Humans should be less human-centred.

Ethical Considerations Regarding Paternalism In Medicine, Lola Holcomb

Richard T. Schellhase Essay Prize in Ethics

Paternalism and autonomy are typically conceptualized as opposing theoretical frameworks. With respect to medical ethics, autonomy is practiced by the patient when he/she has liberty and control over his/her own medical matters, and his/her opinions supersede those of the physician. Paternalism is practiced by the physician when he/she restricts the patient’s autonomy (sometimes against the patient’s will) to promote health and well-being while discouraging undesirable behaviors. This paper details and analyzes a number of cases of medical paternalism in practice, both from the past and in the present day, with the purpose of examining associated ethical considerations. Attention is given …

Disease Mongering: How Sickness Sells, Vanessa C. Iroegbulem

Augustana Center for the Study of Ethics Essay Contest

“Disease mongering” is the practice of widening diagnostic boundaries of an illness and promoting their public awareness to expand the markets for treatment and to increase profits. This tactic typically used by pharmaceutical companies, medical equipment manufacturers, insurance companies, and even some doctors and patient groups, has become a great concern. Disease mongering has since increased in parallel with “medicalization,” which attempts to label normal human conditions as medical problems, thus becoming the subject of medical study, diagnosis, prevention, or treatment. This paper first seeks to examine how an increasing amount of life’s natural conditions and ailments are being seen …

Plant-Based Diets And Covid-19: Those Who Harvest Crops Are At High Risk, Jarret S. Lovell

Animal Sentience

This commentary extends Wiebers & Feigin’s (2020) plea to adopt diets that are less dependent on animals by calling on experts and activists to work for change with regard to farm worker labor conditions. Already doing among the most dangerous jobs, farmworkers are at increased risk of COVID-19. As we increasingly transition to plant-based diets, we must all ensure that farmworkers have safe and just working conditions to meet the demands of our changing diets.

Rethinking Global Governance To Address Zoonotic Disease Risks: Connecting The Dots, Kelley Lee

Animal Sentience

Large-scale changes in human behaviour are urgently needed to prevent future pandemics involving zoonotic diseases such as COVID-19. However, this will not happen to the required degree, and with sufficient speed, without a major shift in how humanity collectively governs itself. Alongside a shift in focus from individual behaviours to the structural conditions underpinning the world economy that shape human behaviours, effective global governance presses us to connect more dots than ever before. The One Health approach is an important starting point but we need to go much further.

Autonomy, Suffering, And The Practice Of Medicine: A Relational Approach, Michael A. Stanfield

USF Tampa Graduate Theses and Dissertations

In this project, I argue that the conventional view of personal autonomy that is operational in contemporary American culture, bioethics and medical practice places undue emphasis on individualism and a limited range of personal qualities and attributes (such as self-sufficiency). Instead, I argue in favor of a relational approach to autonomy which recognizes that each person that exists has certain minimal connections or relations to others, and these connections/relations are identity-forming. Unfortunately, current medical practices have tended to overemphasize individuality and choice (consistent with the conventional view) while minimizing or excluding these relational aspects. As a result, informed consent and …

Introduction To Biomedical Ethics, Katherine Mendis

Open Educational Resources

This course introduces students to issues in the field of biomedical ethics, the theoretical tools bioethicists use to analyze them, and methodology for resolving clinical ethical dilemmas.

Protecting Patients Who Lack A Voice, Rainer Spiegel

Animal Sentience

Neither human young today nor future human generations nor non-human species have a voice in protecting the biosphere. Treves et al. propose courts and trustees for defending their interests. I describe an analogy with attempts to represent the interests of children and comatose patients in medicine.

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …