Bioethics and Medical Ethics Commons^™

Patient-Practitioner Relationship In The Post-Dobbs American Landscape, Lynette B. Martins, Scott J. Schweikart

Pace Law Review

The patient-practitioner relationship is among the most sacred and fundamental in health care, particularly in the realm of reproductive care. Laws regulating what practitioners can and cannot discuss in the exam room with patients have made a resurgence in the post-Dobbs era. In the reproductive care context, these restrictive laws impact patients’ access to critical medical services but also the fundamental underpinnings of the patient-practitioner relationship. In a post-Dobbs era, laws restricting abortion are increasingly dangerous to the health of those seeking these services. With no federal protection for access to abortion services and abortion services hinging on …

Dobbs And Sterilization Decision-Making: Understanding The Coercive Spillover Effects In Reproductive Choice, Thomas Wilson Williams

Pace Law Review

The Supreme Court majority in Dobbs v. Jackson Women’s Health Organization argued their decision would have limited impact beyond abortion rights. This Article examines how Dobbs and subsequent state abortion restrictions are likely to increase women’s reliance on permanent sterilization procedures, particularly among already marginalized populations. Drawing on emerging data and historical context, I argue that some post-Dobbs sterilizations should be understood as effectively coerced by state policies, implicating reproductive justice concerns and potentially undermining fundamental rights established in Skinner v. Oklahoma. Then, I demonstrate how interdisciplinary bioethics frameworks and methodologies can help courts better understand the full …

Something Is Rotten In The State Of Healthcare: Accountability, Affordability, And The Court Of Public Opinion, Isabelle Breier

Duke Law & Technology Review

Many countries worldwide recognize a right to health and provide legal recourse for securing that right. By contrast, for many Americans, there is no legal right or remedy that enables them to access healthcare if they cannot afford it. While there are some statutes and measures in place, such as the Emergency Medical Treatment and Active Labor Act (EMTALA) and Medicaid, coverage remains piecemeal and access to healthcare is not guaranteed. Conditioning people’s access to healthcare upon their ability to pay violates the foundational bioethical principle of justice. In the United States, individuals and advocates use social media to fill …

Two Lives, Shruti Trehan Mbbs

Journal of Wellness

A busy oncologist makes a decision to leave her busy, thriving, community practice in the Mid-West and moves to a Veterans Affairs hospital in South Florida in the quest for a better work-life balance.

The New Professional: Tips For Dealing With Unpleasant Patients, Amrita Patel Dds

The Journal of the Michigan Dental Association

This article emphasizes the importance of managing unpleasant patients in dentistry through empathy, effective communication, and tailored care. Dentists should understand that patient anxiety often stems from fear or past trauma. Building trust through clear explanations, personalized comfort measures, and pain management is crucial. Techniques like guided imagery and gradual exposure can help reduce anxiety. Consistency in care and follow-up support strengthens patient relationships, making even the most challenging patients more comfortable and cooperative.

This Is A Call To Action For All Primary Care Providers: Do Better For Your Transgender Patients, Kate Castor

Theses and Graduate Projects

Background: Patients of all ages benefit from primary care. However, not everyone has equal access to primary care. Transgender patients often face a multitude of barriers to receiving basic healthcare.

Purpose: Improve health outcomes for transgender patients, enlighten providers on significant disparities, and offer solutions to these disparities faced by transgender community in the healthcare setting and when receiving cancer screening.

Methods: Literature review comprising results from Augsburg University Lindell Library databases, American Journal of Medicine, and Google Scholar.

Conclusions: Everyone can do better for their transgender patients, but primary care providers should take extra care cultivating relationships with these …

Medical-Legal Partnerships Reinvigorate Systems Lawyering Using An Upstream Approach, Kate L. Mitchell, Debra Chopp

Articles

The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and health inequities. This article explores upstreaming and its use by MLPs in reframing legal practice.

The New Professional: Navigating The Journey: Finding Your Practice Philosophy As A New Dentist, Amrita Patel Dds

The Journal of the Michigan Dental Association

Dr. Amrita Patel highlights the importance of defining a practice philosophy as a new dentist. Self-reflection, mentorship, patient-centered care, continuous learning, and adaptability are crucial elements in this journey. Embracing personal values and ethics ensures authenticity and guides decision-making. The evolving nature of this philosophy underscores the need for flexibility and openness to change. Dentists can shape their professional identity and approach to patient care through introspection and experiential learning.

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

Nonfinancial Conflict Of Interest In Medical Research: Is Regulation The Right Answer, Nehad Mikhael

Journal of Law and Health

Medical research plays a vital role in advancing human knowledge, developing new therapies and procedures, and reducing human suffering. Following the atrocities committed in the name of medical research by German physicians during the Nazi era, the Nuremberg trials were held, and an ethical code was created to establish the limits within which medical research can operate. Consequently, legal regimes built upon this ethical foundation to develop laws that ensure the integrity of medical research and the safety of human subjects. These laws sought to protect human subjects by minimizing conflicts of interest that may arise during the process. Furthermore, …

Establishing Consent: The Role Of Women Representatives In Passing Informed Consent Laws, Sophia Stockham

Department of Political Science: Dissertations, Theses, and Student Research

What predicts the adoption of informed consent laws for pelvic exams within the United States? As of January 2023, 22 states have adopted informed consent laws for pelvic examinations on women, with eleven being under Democratic control, six being Republican control, and five with divided control between the legislature and gubernatorial level at the time of adoption. Little attention, however, has been given to women’s health mandates outside the issue of abortion and to variation among state partisan adoption regarding informed consent for pelvic exams. This paper examines the impact of partisanship, the percentage of women in the legislature, and …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

Conducting Research With Highly Portable Mri In Community Settings: A Practical Guide To Navigating Ethical Issues And Elsi Checklist, Francis X. Shen, Susan Wolf, Frances Lawrenz, Donnella S. Comeau, Barbara J. Evans, Damien Fair, Martha J. Farah, Michael Garwood, S. Duke Han, July Illes, Jonathan D. Jackson, Eran Klein, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan

Articles

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

Expert Stakeholder Perspectives On Emerging Technology For Neuroimaging Research With Highly Portable Mri: The Need For Guidance On Ethical, Legal, And Societal Issues, Molly K. Madzelan, Frances Lawrenz, Susan Wolf, Francis X. Shen

Articles

Portable MRI (pMRI) technology, which promises to transform brain imaging research by facilitating scanning in new geographic areas and the participation of new, diverse populations, raises many ethical, legal, and societal issues (ELSI). To understand this emerging pMRI ELSI landscape, we surveyed expert stakeholder views on ELSI challenges and solutions associated with pMRI research.

Introduction: Revolutionizing Neuroimaging Research With Highly Portable Mri: Confronting Ethical And Legal Challenges, Francis X. Shen, Frances Lawrenz, Susan M. Wolf

Articles

No abstract provided.

Scientists' Perspectives On Ethical Issues In Research With Emerging Portable Neuroimaging Technology: The Need For Guidance On Ethical, Legal, And Societal Implications (Elsi), Frances Daniels, Efrain Torres, Frances Lawrenz, Susan M. Wolf, Francis X. Shen

Articles

Deployment of new, more portable, and less costly neuroimaging technologies such as portable magnetoencephalography, electroencephalography, positron emission tomography, functional near-infrared spectroscopy, high-density diffuse optical tomography, and magnetic resonance imaging is advancing rapidly. Given this trajectory toward increasing use of neuroimaging outside the hospital, we sought to identify ethical, legal, and societal implications (ELSI) of these new technologies by understanding the perspectives of those scientists and engineers developing and implementing portable neuroimaging technologies in the United States, Europe, and Asia. Based on a literature review, we identified and contacted 19 potential interviewees and then conducted 11 semi-structured interviews in English by …

Ethical, Legal, And Policy Challenges In Field-Based Neuroimaging Research Using Emerging Portable Mri Technologies: Guidance For Investigators And For Oversight, Francis X. Shen, Susan M. Wolf, Francez Lawrenz, Donnella S. Comeau, Kafui Dzirasa, Barbara J. Evans, Damien Fair, Martha J. Farah, S. Duke Han, Judy Illes, Jonathan D. Jackson, Eran Klein, Karen S. Rommelfanger, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan, Michael Garwood

Articles

Researchers are rapidly developing and deploying highly portable MRI technology to conduct field-based research. The new technology will widen access to include new investigators in remote and unconventional settings and will facilitate greater inclusion of rural, economically disadvantaged, and historically underrepresented populations. To address the ethical, legal, and societal issues raised by highly accessible and portable MRI, an interdisciplinary Working Group (WG) engaged in a multi-year structured process of analysis and consensus building, informed by empirical research on the perspectives of experts and the general public. This article presents the WG’s consensus recommendations. These recommendations address technology quality control, design …

Returning Individual Research Results From Digital Phenotyping In Psychiatry, Francis X. Shen, Matthew L. Baum, Nicole Martinez-Martin, Adam S. Miner, Melissa Abraham, Catherine A. Brownstein, Nathan Cortez, Barbara J. Evans, Laura T. Germine, David C. Grady, Ingrid A. Holm, Elisa A. Hurley, Sara Kimble, Gabriel Lazaro-Munoz, Kimberlyn Leary, Mason Marks, Patrick J. Monette, Jukka-Pekka Onnela, P. Pearl O'Rourke, Scott L. Rauch, Carmel Shachar, Srijan Sen, Ipsit Vahia, Jason L. Vassy, Justin T. Baker, Barbara E. Bierer, Benjamin C. Silverman

Articles

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frame-works for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in …

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura D. Hermer

Faculty Scholarship

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

Fda Regulation Of Physicians' Professional Speech, Barbara J. Evans

UF Law Faculty Publications

The First Amendment to the U.S. Constitution constrains FDA’s power to impose content-based restrictions on physicians’ professional speech – that is, on the expert medical advice licensed physicians render to patients during clinical treatment encounters. In 2022, the U.S. Food and Drug Administration (FDA) clarified its plans to regulate clinical decision support (CDS) software by publishing a final guidance document. CDS tools process patient-specific health information along with various other sources of medical knowledge – such as clinical practice guidelines, drug labeling information, insights from published medical literature, or fresh insights gleaned by an artificial intelligence/machine learning (AI/ML) algorithm imbedded …

Conducting Research With Highly Portable Mri In Community Settings: A Practical Guide To Navigating Ethical Issues And Elsi Checklist, Francis X. Shen, Susan M. Wolf, Frances P. Lawrenz, Donnella S. Comeau, Barbara J. Evans, Damien A. Fair, Martha J. Farah, Michael Garwood, Duke Han, Judy Illes, Jonathan D. Jackson, Eran Klein, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan

UF Law Faculty Publications

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

Ethical Oversight And Social Licensing Of Portable Mri Research, Barbara J. Evans

UF Law Faculty Publications

This article explores two questions: (1) whether portable MRI research might escape regulatory oversight altogether under existing U.S. privacy and research ethical frameworks, leaving research participants without adequate protections, and (2) whether existing regulatory frameworks, when they do apply, can guard society’s broader interest in ensuring that portable MRI research pursues socially beneficial, ethically sound aims that minimize the potential for externalities affecting nonparticipating individuals and groups, who might be stigmatized or otherwise harmed even if they decline participation in the research.

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura Hermer

University of Michigan Journal of Law Reform

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

Reproductive Rights And Medico-Legal Education Post-Dobbs: A Fireside Chat, Michael S. Sinha, Anna Krotinger, Maya A. Phan, Louise P. King

All Faculty Scholarship

The Supreme Court’s 2022 decision in Dobbs v. Jackson Women’s Health Organization was a pivotal moment that reshaped the landscape of abortion policy and delivery of abortion care in the United States. To create a space for critical reflection on the implications of Dobbs for the teaching and learning of abortion care in both medical and legal education, the authors engage in a dialogue highlighting the varied perspectives of professionals and professionals-in-training in both the medical and legal professions. As new attacks on reproductive autonomy continue at both state and federal levels, we foreshadow a tumultuous landscape for abortion policy …

Synthetic Health Data: Real Ethical Promise And Peril, W. Nicholson Price Ii, Daniel Susser

Other Publications

Modern health research and development faces a dilemma. On the one hand, there is more data than ever — in electronic health records, in lab research, in public datasets, and on the internet — from which to extract potentially transformative scientific insights and to use as the basis for developing breakthrough health care technologies. On the other hand, using this data entails various risks: threats to patient privacy, skewed samples and approaches to analysis that can perpetuate demographic and other biases, and uneven access to data about rare conditions and small patient subgroups. Generating synthetic data has emerged as one …

Locating Liability For Medical Ai, W. Nicholson Price Ii, I. Glenn Cohen

Articles

When medical AI systems fail, who should be responsible, and how? We argue that various features of medical AI complicate the application of existing tort doctrines and render them ineffective at creating incentives for the safe and effective use of medical AI. In addition to complexity and opacity, the problem of contextual bias, where medical AI systems vary substantially in performance from place to place, hampers traditional doctrines. We suggest instead the application of enterprise liability to hospitals—making them broadly liable for negligent injuries occurring within the hospital system—with an important caveat: hospitals must have access to the information needed …

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Mid-Atlantic Ethics Committee Newsletter, Fall 2023

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The Abortion Rights Of Teens In The Post-Dobbs Era, J. Shoshanna Ehrlich

Cardozo Journal of Equal Rights & Social Justice

The article examines the erosion of minors' abortion rights following the Supreme Court's Dobbs v. Jackson Women's Health decision, which overturned Roe v. Wade and Planned Parenthood v. Casey. It argues that the post-Dobbs legal landscape disproportionately harms vulnerable populations, particularly teens, by undermining judicial bypass options and intensifying restrictions on abortion access. The analysis critiques the inconsistent application of legal frameworks, such as the "mature minor" rule and emancipation doctrines, which fail to protect teens' autonomy. The article advocates for recognizing minors as constitutional persons with medical self-consent rights to counter these restrictions.

State Oversight Of Polypharmacy And Psychotropic Medication Use Among Individuals With Intellectual And Developmental Disabilities: A Three State Case Study, James Houseworth, Kami L. Gallus, Tiffany Greene, Steven R. Erickson, Jennifer Lynn Jones, Laura Vegas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) are prescribed more medications than the general population, placing them at significantly higher risk for issues due to taking multiple medications (polypharmacy). There are currently no clear national standards for the administration of medications given this risk. The following policy analysis explores state policies related to prescription medication oversight. This analysis pays particular attention to the use of medications that alter one’s mental state (psychotropics) among people with IDD who receive home and community-based services (HCBS) in the United States. The article outlines current efforts implemented to reduce medication-related risks for people with …