Bioethics and Medical Ethics Commons^™

Oregon's Death With Dignity Act: Socially Constructing A Good Death, Erin E. Mauck

Electronic Theses and Dissertations

As aid-in-dying legislation expands across the United States, this study examines the dynamics influencing participation in Oregon’s Death with Dignity Act. In addition to data from secondary sources, this thesis analyzes field research data collected in Oregon, including 14 in-depth interviews with volunteers and employees of two advocacy organizations at the center of legalized physician-assisted death. Themes emerged including the conditions that motivate participation, the importance of both personal and professional autonomy, the significance of a good death, and the growth of open dialogues about end of life choices. This thesis concludes with a discussion of the impact Death with …

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

Physician Assisted Dying: A Turning Point?, Lawrence O. Gostin, Anna E. Roberts

Georgetown Law Faculty Publications and Other Works

Physician Assisted Dying (PAD) has been lawful in some countries since the 1940s and in the United States since 1997. There is a body of social and scientific research that has focused on whether the practice has been misused and whether gaps exist in legislative safeguards. There are multiple concerns with physicians assisting patients to die: incompatibility with the physician’s role as a healer, devaluation of human life, coercion of vulnerable individuals (e.g., the poor and disabled), and the risk that PAD will be used beyond a narrow group of terminally ill individuals. Statutes in the United States have been …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Law, Ethics, And Public Health In The Vaccination Debates: Politics Of The Measles Outbreak, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The measles outbreak of early 2015 is symptomatic of a larger societal problem–the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” …

Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri

DNP Projects

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.

Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …

Legal And Ethical Responsibilities Following Brain Death: The Mcmath And Muñoz Cases, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

What are the legal and ethical implications of continuing to treat a brain dead patient? And may a hospital refuse to provide such treatment? These ethical and legal problems are raised in two recent cases. In the first Marlise Muñoz, a pregnant woman declared brain dead, was kept on life support against her family’s wishes due to the treating hospital’s interpretation of a Texas fetal protection law. In the other a hospital refused to treat Jahi McMath, a brain dead girl, despite her family's entreaties. The cases, at first, appear similar because in each case the hospital was refusing to …

Future Oversight Of Recombinant Dna Research: Recommendations Of An Institute Of Medicine Committee, Lawrence O. Gostin, Bruce M. Altevogt, Andrew M. Pope

Georgetown Law Faculty Publications and Other Works

The National Institutes of Health (NIH) established the Recombinant DNA Advisory Committee (RAC) in 1974 in response to public concerns about the safety of manipulating genetic material through recombinant DNA. The accumulation of 40 years of experience with gene transfer research has led to a better understanding of the risks. Yet, as gene transfer research has matured, the complexity of the overall regulatory environment has remained. Gene transfer research continues to be subjected to multiple layers of review: the Food and Drug Administration (FDA), institutional review boards, institutional biosafety committees, and the RAC. It is within the context of overlapping …

Public Health Emergencies: What Counts?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccines and drugs to prevent and treat Ebola Virus Disease that have never been tested in humans, and in scarce supply raise profound ethical challenges. What if good evidence emerged demonstrating safety and efficacy of drugs? What would be an ethical method of allocating scarce beneficial resources? The apparent preference given to foreign aid workers over West Africans provoked a firestorm. In addition to discussing the ethical allocation of scarce drugs, this article also asks a more fundamental question: Why did it take nearly 40 years after the first Ebola outbreak in 1976 to launch clinical trials?

Enhancing Communication Between Scientists, Government Officials, And The Lay Public: Advancing Science And Protecting The Public's Welfare Through Better Multi-Stakeholder Interfacing, Clark J. Lee, Patrick P. Rose, Earl Stoddard Iii

Homeland Security Publications

No abstract provided.

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

Sacrée Et Inviolable: The Hiv+ Mother In Ivoirian Health Policy, Amber Alaniz

Annual Undergraduate Conference on Health and Society

« La personne humaine est sacrée (2)… Le domicile est inviolable. Les atteintes ou restrictions ne peuvent y être apportées que par la loi. (4) La famille constitue la cellule de base de la société. L'État assure sa protection. (5)» Constitution of La Côte d’Ivoire, Articles 2,4,5[1]

The Ivoirian national constitution, authored and enacted in July of 2000, while expressing a devotion to democratic thought (Preamble) and to the sovereignty of the individual (Article 2), also acknowledges the primacy of the Ivoirian family and collective identity as the basis of society and advances a moral duty on the part …

Aids/Hiv Denialism: Patients’ Privacy Rights, Fadia Abdullah, Guadalupe Medrano

Festival of Communities: UG Symposium (Posters)

HIV is a sexually transmitted disease that develops into AIDS. There is no cure for it, only treatment. In this poster, we look at the pros and cons of disclosing this type of information. People who decide to disclose their HIV status may have various reasons for doing so, but most do it for emotional support and for prevention of spreading the disease. Those who decide to keep it private primarily do it to not face rejection, discrimination, degradation, and loss of respect. (Petronio Page 72) The problem with creating a public database is that many organizations are against the …

Placebos: Ethical Research Or Unethical Deceit, Tawnya Schirmeister, Sabrina Crilley

Festival of Communities: UG Symposium (Posters)

There is an ongoing debate between whether or not it is ethical for researchers to use placebos while studying terminal illnesses. Within this debate there are two parties, the party that believes that it is ethical and the party that believes that it is not. Both parties have many valid points and have very detailed arguments against one another. When determining whether or not the use of placebos is ethical or not, you must first understand what a placebo is, and what the different types are. This paper goes over what a placebo is, what the different types are, and …

Using Placebos In Research Involving Terminal Illnesses, Mark Day, Ryan Hicks

Festival of Communities: UG Symposium (Posters)

Placebos are medical interventions that falsely lead patients to believe that they are receiving treatment and that their condition is being changed, when truly no specific treatment is being administered. Using placebos in research involving terminal illnesses has become debatable. While a placebo could potentially give way to new treatments, through testing alongside a specific drug in a clinical trial, the placebo itself may fail and the patient is not cured leading to possible fatality. It has been found that using placebos in research, like performing surgeries, can aid in medical or clinical research and could help our society financially …

Aids Denialism, Erika Jenel Delos Santos, Roy Llana, Jocelyn Tan

Festival of Communities: UG Symposium (Posters)

AIDS denialism is a growing issue in many parts the world. Through scholarly journal articles, book resources and other research tactics, further understanding how HIV/AIDS denialism is unethical can be distinguished. Discovering that AIDS is most prominent in South Africa explains why denialism is as critical as it is. However, the unethical aspect of AIDS denialism is in effect particularly amongst families. When a South African inhabitant realizes they have AIDS, they feel outcasted by their families due to shame. They fear as though they will be disowned because they have flaws that are unacceptable. These family values are significant …

Vaccines Controversy, Jackelin Ruiz, Keith Wellman

Festival of Communities: UG Symposium (Posters)

Our research was conducted on a Vaccine controversy which raised the question on ethics, morality, safety and effectiveness of vaccination on children. The case study we focused on was about a study done by Dr. Andrew Wakefield and twelve other Colleagues, which was published in a well know journal The Lancet. The study has recently been retracted because an investigation found that he failed to mention that his research of the MMR vaccine was funded through solicitors seeking evidence to use against vaccine manufactures (Deer, Brian). To conclude our research we compared the current vaccination rates with the rates …

Embryonic Stem Cell Research, Michael Phan, Jeniene Hassan

Festival of Communities: UG Symposium (Posters)

Embryonic stem cell research has the potential to regenerate malfunctioning tissues and replace harmful cancer cells. Although it holds the potential to alleviate malicious disabilities and diseases, it raises ethical concerns due to the destruction of a fertilized human embryo. In certain religions (Catholics and Christians), embryonic stem cell research is detested due to the destruction of a human at its early stages of life (embryo). On the other hand, scientists believe that embryonic stem cells can “someday…used to treat human diseases.” (Hansen 879) This analysis on embryonic stem cell research will consider both the supporting and opposing side of …

Variables In Health Care Policy Making: Resolving A Quandary, George P. Smith Ii

Scholarly Articles

Contemporary debate in health care resource management is tied to a central moral issue: how to achieve the optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failure to tackle and resolve this issue in a confident and forthright manner ensures that the present approach to health care decision-making will continue in a state of indecisiveness if not, indeed, lethargy. Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Crafting a just solution to an equitable distribution of finite health care resources is, indeed, …

Book Review: Social Justice: The Moral Foundations Of Public Health And Health Policy, Robin West

Georgetown Law Faculty Publications and Other Works

This essay is a review of Social Justice: The Moral Foundations of Public Health and Health Policy by Madison Powers & Ruth Faden (2006).

In this pathbreaking book, senior bioethicists Powers and Faden confront foundational issues about health and justice. How much inequality in health can a just society tolerate? In a world filled with inequalities in health and well-being, which inequalities matter most and are the most morally urgent to address? In order to answer these questions, Powers and Faden develop a unique theory of social justice that, while developed for the specific contexts of public health and health …

Update - September 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Just Care: Rationing in a Public Health Crisis
-- Editorial
-- Graduate profiles
-- Jack W. Provonsha Lecture Series: Physician-Assisted Suicide: A Religious Perspective

Update - June 2005, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Universal Access to Health Care and Religious Basis of Human Rights

Update - June 2004, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Examining the Ethics of Praying With Patients
-- Editorial
-- Agape and the Deeply Forgetful
-- Congratulations to this year's clinical ethics graduates

Update - November 2003, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Editorial
-- Hindu Perspectives on Genetic Enhancements in Humans
-- HIPAA: Privacy and Public Good
-- 2003 Graduates

Environmental Public Health Awaits Rediscovery, Anthony Robbins, Phyllis Freeman

New England Journal of Public Policy

Preventing environmental exposures that threaten human health remains among the best but least attended to opportunities to improve everyone’s health. For more than a decade, medical care concerns, exacerbated by voracious competition among medical empires and the implacably growing number of uninsured, have often been misconstrued as constituting a complete agenda for health system reform. The authors explain the predicament from an historical perspective — how defining events moved U.S. health policy away from protecting the public against dangerous exposures toward unrealistic expectations that doctors will fix whatever goes wrong, at least for individuals with ample medical insurance. They explain …

Ethnic Minorities And Mental Health: Ethical Concerns In Counseling Immigrants And Culturally-Diverse Groups, Gemima M. Remy

Trotter Review

Between 1980 and 1990 nearly 9 million foreign-born individuals migrated to the United States. In 1993, the Immigration and Naturalization Service recorded the entry of over 900,000 immigrants and refugees. This figure is believed to be higher given the estimated 1.5 to 2.5 million people who enter this country illegally each year. Currently, ethnic minority groups make up one-fourth of the United States population. It is estimated that by the year 2000, one-third of the U.S. population will be comprised of ethnic minorities. As the population of the United States becomes increasingly diverse, considerable attention is being directed to a …

Update - May 1991, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Strategies for Moral Decision-Making: Confessions of a Moral Underling

[ The HIV Status of Health Professionals: Do Patients Have a Right to Know? ]
-- Risk Transmission of HIV form Infected Clinician to Susceptible Patients
-- Does the Patient Have a Right to Know the HIV Status of the Health-Care Worker?
-- Health-Care Professionals With Aids: A Patient's Right to Know?

Genetic Discrimination: The Use Of Genetically Based Diagnostic And Prognostic Tests By Employers And Insurers, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This paper analyzes the law, ethics and public policy concerning "genetic discrimination," defined as the denial of rights, privileges or opportunities on the basis of information obtained from genetically based diagnostic and prognostic tests. The Human Genome Initiative will enhance the ability to gather and organize information that may predict a person's future potential and disabilities. Enormous human benefits may ensue from understanding the etiology and pathophysiology of genetic disorders, including disease prevention through genetic counseling, and treatment of the disorders through genetic manipulation. This information will help clinicians understand and eventually treat many of the more than 4,000 diseases …

Ethical Principles For The Conduct Of Human Subject Research: Population-Based Research And Ethics, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

This paper provides a halting first step in organizing a set of ethical guidelines for the conduct of population-based research, surveillance and practice. These principles are not distinct from, but an expansion of, traditional ethics. Research ethics, which matured significantly from the Nuremberg Code through to the Helsinki IV and the Council for International Organizations of Medical Sciences (CIOMS) guidelines, nourished the individual human spirit. Ethical principles should have a similarly profound impact in the development of science and the protection of human populations in the 1990s and beyond.

The Aids Epidemic: A Prism Distorting Social And Legal Principles, Alec Gray

New England Journal of Public Policy

The AIDS epidemic is affecting American society in far-reaching and unexpected ways. It touches our institutions, our value systems, and our private lives. Social issues seem to change and become distorted by the epidemic 's prismlike effect. This article examines some of the major public health issues raised by the epidemic, ranging from testing to contact tracing and quarantine. It argues that while the civil rights of individuals may have to be sacrificed to stem the spread of the disease, those rights should not be abandoned unless a clear benefit to the public health would result.

Issues of discrimination in …