Bioethics and Medical Ethics Commons^™

The Fiduciary Argument Against Conscientious Refusal In Healthcare, Michael Robinson

Philosophy Faculty Articles and Research

The question of when, if ever, healthcare professionals with conscientious objections should be accommodated by permitting them to refuse to provide medical interventions to which they morally object is a heated issue that has received significant attention in the medical ethics literature. While many professional medical associations have long held that such objections may be accommodated in a broad range of cases, a vocal and growing minority has been fervently arguing that the medical profession should cease accommodating conscientious objections and should rarely, if ever, permit clinicians to refrain from providing medical care merely because it conflicts with their conscience. …

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 …

"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 …

A Treatise On Tool Development: The Arthroscope’S Cultural, Technological, And Metascientific Translation, Montgomery F. Waterer

Honors Theses

The arthroscope was a revolutionary development in the fields of medicine, engineering, and ethics. There are many valuable lessons to be learned from the story of its development and translation that are relevant to the future of medicine and society. Beginning with a brief description of the tool’s design, this paper will examine a period within the history of the arthroscope. This window contains multiple innovators and ends with the life and work of Dr. Robert Jackson. In examining the relevant historical facts of its development, this paper will then briefly address the importance of sports medicine in the development …

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 …

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, …

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 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 …

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 …

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 …

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 …

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 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 …

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 …