Bioethics and Medical Ethics Commons^™

Why American Parents Circumcise Their Sons: An Integrative Review Of Literature, Lacy Lauber

Grace Peterson Nursing Research Colloquium

Background: Since medical evidence supports both pros and cons of routine neonatal male circumcision, expectant and new parents are left to make the decision to circumcise their sons on their own. There is limited research as to why American parents choose to circumcise their newborn sons.

Objectives: The purpose of this integrative literature review is to identify the reasons behind parental decision making in neonatal male circumcision in the United States. Understanding motivating factors in parental decision-making can highlight areas of prenatal education for expectant parents.

Method: An integrative literature review was conducted utilizing these online databases: PubMed, The Cumulative …

Every Word, Every Gesture, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Two nonverbal patients teach a novice clinician the power and often hidden impact of the physician-patient relationship.

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

Ethical Concerns When Minors Act As Standardized Patients., Erwin Jiayuan Khoo, Robert Schremmer, Douglas S. Diekema, John Lantos

Manuscripts, Articles, Book Chapters and Other Papers

When minors are asked to assist medical educators by acting as standardized patients (SPs), there is a potential for the minors to be exploited. Minors deserve protection from exploitation. Such protection has been written into regulations governing medical research and into child labor laws. But there are no similar guidelines for minors' work in medical education. This article addresses the question of whether there should be rules. Should minors be required to give their informed consent or assent? Are there certain practices that could cause harm for the children who become SPs? We present a controversial case and ask a …

The 1939 Dickinson-Belskie Birth Series Sculptures: The Rise Of Modern Visions Of Pregnancy, The Roots Of Modern Pro-Life Imagery, And Dr. Dickinson’S Religious Case For Abortion, Rose Holz

Women's and Gender Studies Program: Faculty Publications

This multidisciplinary essay examines the hugely influential—yet surprisingly overlooked—Birth Series sculptures. Created in 1939 by Dr. Robert L. Dickinson (obstetrician-gynecologist and leader of the Planned Parenthood Federation of America) and sculptor Abram Belskie, they illustrate the process of human development from fertilization through delivery. First displayed at the 1939–1940 World’s Fair in New York City, they were reproduced in a variety of forms and sent out across the United States and overseas. Hardly a brief fad, their popularity persisted into the 1980s. This essay has four purposes. First, it tells the stories of Dickinson and Belskie to appreciate their contributions …

Improving Healthcare Provider Knowledge In Acute And Primary Transgender Health Needs: The Implementation Of A Clinical Education Program With Urgent Care And Emergency Room Staff And Providers, Tonia Lower

Doctor of Nursing Practice Scholarly Projects

The purpose of this project was to improve knowledge and identify personal bias and beliefs in the acute and primary healthcare needs of transgender persons, through the implementation of a clinical education program with healthcare providers and staff working within the urgent care and emergency department settings. The need for such a program exists due to the lack of suitable and accessible healthcare that may lead to misdiagnosis, delay of treatment and poor health outcomes. Including clinical education in the acute and primary healthcare needs of transgender persons that can be integrated into healthcare organizations may aid in the improvement …

Medicine Outside The Clinic: The Growing Need For Physicians In Sexual Education Policy, Zachary Sanford

Marshall Journal of Medicine

Sex and sexuality are both topics of immense social and personal importance, owing their openness or constraint in large part to the society in which they are discussed. In homogenous groups it may be possible to reach firm consensus on what is, or is not, appropriate to consider a sexual norm and use an overarching set of religious or spiritual morals to reaffirm this decision. However, in western society and specifically in the United States, a theme of integration and amalgamation of wildly different cultures has presented an interesting case study in searching for common ground on basic social issues. …

Carotid Ultrasound Is Not Helpful In Simple Syncope, Nicholus Yee M.D., Shilin Patel M.D., Raymond Gong

Clinical Research in Practice: The Journal of Team Hippocrates

A critical appraisal and clinical application of Scott JW, Schwartz AL, Gates JD, Gerhard-Herman M, Havens JM. Choosing wisely for syncope: low-value carotid ultrasound use. J Am Heart Assoc. 2014 Aug 13;3(4). pii: e001063. doi: 10.1161/JAHA.114.001063

Advocating For Our Patients Using Clinical Research, Brandon Baker

Clinical Research in Practice: The Journal of Team Hippocrates

This reflection is about experiences trying to relate medical research evidence to actual patient care. This piece talks about shared decision-making about screening mammography.

Defining Quality In Medical Practice, Nicholas E. Boggs

Clinical Research in Practice: The Journal of Team Hippocrates

We need physicians who are willing to participate in creating the standard of care, and to hold insurance companies accountable for real evidence-based quality markers. Only then will patients receive adequate care and we as educators in medicine be able to adequately teach the next generation of physicians.

Animal Mourning: Précis Of How Animals Grieve (King 2013), Barbara J. King

Animal Sentience

Abstract: When an animal dies, that individual’s mate, relatives, or friends may express grief. Changes in the survivor’s patterns of social behavior, eating, sleeping, and/or of expression of affect are the key criteria for defining grief. Based on this understanding of grief, it is not only big-brained mammals like elephants, apes, and cetaceans who can be said to mourn, but also a wide variety of other animals, including domestic companions like cats, dogs, and rabbits; horses and farm animals; and some birds. With keen attention placed on seeking where grief is found to occur and where it is absent …

A Simulation To Improve The Clinical Nursing Instructor’S Teaching Of Ethics To Students In The Clinical Setting, Cynthia S. Randall Dnp

All Student Scholarship

Ethical knowledge and skill is crucial to the discipline of nursing and is considered foundational knowledge for nursing practice (American Nurses Association [ANA], 2008). Nurses who assume roles in clinical teaching may be clinically competent but may have limited nursing education experience or knowledge in clinical instruction. The purpose of this project was to improve the educational experience of clinical instructors in the teaching of ethics to students in the clinical setting. This DNP capstone was a quality improvement project with a mixed method design using simulation as a teaching strategy. Eight clinical instructors from a university based baccalaureate nursing …

Magic Bullet, Karen Haydock

The Transdisciplinary STEAM+ Journal

Two of the most powerful types of corporations in the world today are those that produce pharmaceuticals and weapons. While the corporations are concerned with increasing their profits, we wonder if their products have any magical powers.

[India ink on rag paper]

This poster explores the military-industrial complex. The weapons industry profits through imperialism. The pharmaceutical industry profits through by taking advantage of people’s illnesses.

The poster has multiple interpretations, hopefully encouraging the viewer to participate by asking relevant questions, such as:

“What is that person drinking?”

”Are they pills or bombs?”

“Medicines cure us - how can a pill …

Promoting Completion Of Advance Directives In A Hispanic Religious Congregation: An Evidence-Based Practice Project, Luis Daniel San Miguel, Mary Jo Clark

Doctor of Nursing Practice Final Manuscripts

Background: Hispanics utilize more aggressive medical treatment at the end of life and are less likely to receive end-of-life care consistent with their wishes than nonHispanic Whites. Hispanics are less likely than nonHispanic Whites to have an advance directive (AD). Increasing AD completion among Hispanics can promote end-of-life care consistent with their wishes, diminish healthcare disparities, and eliminate unnecessary healthcare spending. Objectives: To promote completion of advance directives by increasing knowledge, positive attitudes, and comfort with advance care planning (ACP) among Hispanics through culturally sensitive interventions. Intervention: The project was conducted in Spanish and implemented among a …

Are You Demonstrating The Value Of Caring?, Beth B. Boyd

Nursing Faculty Publications

Are you making a difference? Christian values and caring are at the heart of nursing practice. However, it seems there is little talk about caring values with nursing students, even though nurse educators can share these important messages with their students. Demonstrating compassion and caring in an environment of mutual respect can truly make a difference to future nurses.

Integrating Social Justice For Health Professional Education: Self-Reflection, Advocacy, And Collaborative Learning, Lena Hatchett, Nanette Elster, Katherine Wasson, Lisa Anderson, Kayhan Parsi

Journal of Health Ethics

Justice as fair and equal treatment for all is one of the core visions for health professional education to reduce racial and economic health disparities in bioethics, nursing and medicine. However, the current reality of deeply entrenched structural inequities across race, class, gender, and social privilege make it a challenge for students to become aware of practical health equity solutions. This paper illustrates how faculty and students can build their understanding of health equity solutions in health professional education through self-reflection, self-direction, advocacy, and collaborative learning opportunities. We provide lessons learned and teaching resources from nursing, medicine, and law.

Generational Conflicts Among Vietnamese Americans In The Health Care Decision Making Process, Georgie D. Nguyen

Journal of Health Ethics

In the U.S. there are approximately 1.3 million Vietnamese Americans. This group faced multiple problems after their immigration to the U.S. after the Fall of Saigon. While some easily acculturated within this group, others such as the older generation suffered difficulty doing so. The purpose of this article is to address concerns regarding the health care decision making process among the Vietnamese community and its importance to helping health care providers understand why there is a high mortality rate within this group.

Maximizing Doctor-Patient Communication Of A Positive Hiv/Aids Test Result: A Best Practices Approach, Vikki Yashandra Spann

Dissertations

The purpose of this study was to examine healthcare practitioner (HCP) communication of a positive human immodeficiency syndrome/acquired immunodeficiency syndrome (HIV/AIDS) test result in an effort to find best practices. The population of this study included healthcare practitioners who had to disclose a positive HIV/AIDS status to a patient. Data from specific accounts recalled by the healthcare practitioners were analyzed using grounded theory approach. The first research question was concerned with the strategies used by healthcare practitioners. The results indicated that there are two primary strategies used in HIV/AIDS disclosure: strategic interactive facilitation and strategic interactive force. The second and …

Is The Current State Of Medical Ethics Education Having An Impact On Medical Students?, Lauren Saltzburg

Journal of Health Ethics

Medical education prepares medical students as they transition from the classroom to clinical setting in caring for patients through education in the sciences, pharmacology, and medicine basics—but does it leave room for the courses that lack scientific basis, such as medical ethics? Current research has shown that medical students do not place much emphasis on medical ethics. This leads to skepticism and wariness for medical students to speak up about their concerns if faced with an ethical situation. The “hidden curriculum” that is seen in many medical schools has a large impact on medical students’ impressions of how to deal …

Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

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, …

Manipulating Fate: Medical Innovations, Ethical Implications, Theatrical Illuminations, Karen H. Rothenberg, Lynn W. Bush

Faculty Scholarship

Transformative innovations in medicine and their ethical complexities create frequent confusion and misinterpretation that color the imagination. Placed in historical context, theatre provides a framework to reflect upon how the ethical, legal, and social implications of emerging technologies evolve over time and how attempts to control fate through medical science have shaped -- and been shaped by -- personal and professional relationships. The drama of these human interactions is powerful and has the potential to generate fear, create hope, transform identity, and inspire empathy -- a vivid source to observe the complex implications of translating research into clinical practice through …

Ethics And The 'Seasons Of My Life' As A Dental Educator, David A. Nash

Oral Health Science Faculty Publications

Perhaps the first comprehensive ethics program in American dental schools was created in 1990 at the University of Kentucky by then dean David Nash. Nash recounts the emergence of his personal and professional interest in ethics using the structure of Daniel Levinson's book The Seasons of a Man's Life. Each season brings tasks of evolving and deepening ethical engagement. Being ethical is important; helping others to be so is special. Nash still teaches the course.

Bioethics And Biosecurity Education In China: Rise Of A Scientific Superpower., Barr S. Michael, Joy Yueyue Zhang

Book Chapters

This chapter explores ethics, education and the life sciences in China. It is based on work conducted by the authors in two separate but complimentary projects. Barr’s observations derive from interviews and discussions in Beijing, Shanghai and Guangzhou with life scientists and policymakers in infectious-disease hospitals, university-research labs, the Chinese Academy of Sciences, and the Ministry of Health. Zhang’s study focused on China’s governance of stem-cell research and involved interviews with scientists, ethicists and policymakers at more than 25 sites across China. Below, we set the context by describing the role of science in China’s quest to become a leading …

Three Ways Of Looking At A Health Law And Literature Class, Jennifer Bard, Thomas Mayo, Stacey A. Tovino

Faculty Articles

The authors of this Article participated in a panel at the American Society of Law, Ethics & Medicine Conference in 2008 that examined the use of literary materials in law school to teach medical ethics (and related matters) in a law school setting. This Article and the panel on which it was based reflect views on how literature can play a valuable role in helping law students and medical students understand important legal and ethical issues and concepts in health law and bioethics. In Part I, Stacey Tovino introduces the parallel fields of “literature and medicine” and “law and literature” …

Allies Not Adversaries: Teaching Collaboration To The Next Generation Of Doctors And Lawyers To Address Social Inequality, Elizabeth Tobin Tyler

Pro Bono Collaborative Staff Publications

Recent reports from the Carnegie Foundation for the Advancement of Teaching, as well as from other medical and legal educators, stress that professional training of doctors and lawyers focuses too narrowly on knowledge-based learning, and not enough on context-based problem solving, professionalism, and ethics. Tracing recent calls from both legal and medical educators to increase the teaching of ethics, social responsibility, the lawyer-client and doctor-patient relationship, and holistic problem-solving, this article offers a model of interdisciplinary medical-legal education focused on developing practitioners sensitive to the needs of diverse and disenfranchised clients and patients. It highlights a burgeoning medical-legal partnership model, …

Dedicatory Essay: Honoring Ian Mccoll Kennedy, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Ian Kennedy is perhaps the best known and most important figure in health law and ethics in the United Kingdom, and probably one of the most significant in Europe and North America. How did his life and career evolve to the point where he would wield such influence? This essay examines the leadership, erudition, and passion Ian Kennedy has brought to the field of health law and ethics. It is perhaps not an overstatement to suggest that Professor Kennedy virtually invented the field in the United Kingdom. He did so through his scholarship, public advocacy, and influence in shaping institutions, …

"The Profession Of Dentistry:" The University Of Kentucky's Curriculum In Professional Ethics, David A. Nash

Oral Health Science Faculty Publications

Among the most important learning that occurs in our nation's colleges of dentistry is learning to be a professional. While knowledge, perceptual-motor skills, and problem-solving abilities are basic to becoming a dentist, helping aspiring colleagues to apply their newly developing skills with integrity must be a fundamental concern. Increasingly, we are realizing that the quality of health care depends as significantly on the character of the health professional as it does on the individual's knowledge and skills. Concern for character, virtue, and integrity is the domain of ethics. This paper advances a justification for including a curriculum in professional ethics …