Bioethics and Medical Ethics Commons^™

Sexual Minority Rights Are Not Just For The West: Health And Safety Considerations In Africa, Robert Scott Stewart Ph.D., Dionne Van Reenen Ph.D., Richard Watuwa Ph.D.

Journal of Health Ethics

In a recent article, C.O. Akpan argues that it is “unnatural for a man to sleep with a man as with a woman, and the idea of marriage in this sense is an abomination” (“The morality of same-sex marriage: How not to globalize a cultural anomie,” Online Journal of Health Ethics, 13(1), 2017, p. 9). Arguments in favor of same sex marriage, he claims, are “driven and motivated by the human right fad” (p. 9) that is inappropriate for African countries.

We argue that the specific arguments Akpan employs against the morality of homosexuality and same-sex marriage are flawed. Our …

Is There A Doctor In The House? Medical Ethics And The Doctoral Honorific, Kenneth R. Pike, M. Scott Moore

Journal of Health Ethics

The proliferation of professional doctorates has reinvigorated debate over the use of the doctoral honorific. Doctorate holders are often addressed as “doctor” in academic contexts, but idiomatic American English associates “doctor” with physicians—licensed clinicians with doctoral degrees in medicine. The possibility of patient confusion has historically justified proscription of the doctoral honorific by others, including nurses, but recently such proscriptions have been withdrawn. An examination of history, language, and ethical reasoning leads us to conclude that, in the context of patient interaction, clinicians should eschew the doctoral honorific entirely. We think it appropriate for professionals to rely on training-pathway titles …

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 …

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 …

Demographics, Activities, And Environmental Factors Impact Burnout In A National Survey Of Emergency Medicine Residents, Nicole Battaglioli, Tim P. Moran, Simiao Li-Sauerwine

Journal of Wellness

Introduction: Burnout in emergency medicine and in residency training has been well-described. The impact of demographic, individual, and programmatic factors on burnout have not previously been determined in a national survey of emergency medicine residents. This study aimed to identify personal and environmental factors impacting resident burnout in a national sample of emergency medicine residents.

Methods: A prospective Emergency Medicine Resident Wellness Survey was administered in 2017. We surveyed respondents on demographic, personal, and environmental factors; each respondent also completed the Maslach Burnout Inventory - Human Services Survey. Linear regressions were used to identify variables associated with the Maslach Burnout …

Dying Well In Nursing Homes During Covid-19 And Beyond: The Need For A Relational And Familial Ethic, Jennifer Parks, Maria Howard

Philosophy: Faculty Publications and Other Works

This paper applies a relational and familial ethic to address concerns relating to nursing home deaths and advance care planning during Covid-19 and beyond. The deaths of our elderly in nursing homes during this pandemic have been made more complicated by the restriction of visitors even at the end of life, a time when families would normally be present. While we must be vigilant about preventing unnecessary deaths caused by coronavirus outbreaks in nursing homes, some deaths of our elders are inevitable. Thus, it is essential that advanced care planning occurs in a way that upholds the familial and relational …

Covid-19 And Challenges To The Traditional Understanding Of Individual Medical Autonomy, Callon A. Green

Honors Theses

Throughout history, vaccines have provided the human population with the ability to combat dangerous illnesses and avoid preventable suffering. Despite the benefits vaccines provide to the public health of the United States, anti-vaccination sentiment and resistance to vaccine uptake are still prevalent in the modern day. As the COVID-19 pandemic has developed into a major public health crisis that can be controlled through vaccination, the issues underlying vaccine resistance are becoming more critical to return to normal life. Using COVID-19 as a case study, it is evident that the individual choice to deny vaccination can have consequences on the health …

Phil 201: Bioethics, Cuny School Of Professional Studies

Open Educational Resources

An exploration of complex contemporary ethical problems from healthcare, the environment, and bioethics. Issues include problems of drugs and addiction, stigma toward people with disabilities, terminal illness and chronic health needs, resource allocation in times of disaster, infectious diseases, gene editing, and humans’ relationship with their environment. Classical and contemporary ethical theories, moral theories, and the fundamentals of scientific integrity will be applied to make principled, defensible, moral judgments.

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 …

Catholic Terminal Sedation-A New Framework For Providing Terminal Palliative Sedation As A Requirement In Catholic Healthcare Organizations, Noah Dimas

Graduate Student Research Symposium

The present attitudes surrounding death and dying in the United States have been trending toward the acceptance of so-called “Assisted Death” interventions at the end-of-life (EoL), specifically Physician-Assisted Suicide. The acceptance of these interventions is rooted in the notion of autonomy within the American culture of medicine that generally states a patient is allowed to request whatever medical interventions they wish. As such, legislative bodies around the United States have begun to legalize Assisted Death in response to the regularly cited desire to die peacefully and without pain from an expected terminal illness. However, for Catholic healthcare organizations, there is …

Three Roles Of Narratives In The Treatment Of Chronic Pain, Nina Atanasova

Philosophy and Religious Studies Department Faculty Publications

In this paper, I discuss the roles narratives play in the diagnostics, treatment, and recovery of chronic pain patients. I show that the successes of this narrative approach to the treatment of chronic pain support the biopsychosocial model of disease. The central example of narrative interventions discussed in the paper is pain neuroscience education. This is an intervention which aims at helping chronic pain patients reconceptualize their pain experiences so as to align them with neuroscientific knowledge of pain. Multiple clinical trials have established the success of these interventions in pain reduction. This shows that neuroscience pain education is in …

Dentistry And The Principle Of Justice: How Ethics Informs Oral Health Policy, Michael G. Maihofer Dds

Journal of the American College of Dentists

The article defines the dental professional’s ethical principle of Justice and discusses the obligations that come with adherence to this principle with an emphasis on that portion of the ADA Code’s definition which states “that the dental profession should actively seek allies throughout society on specific activities that will help improve access to care for all.

It examines this principle to better understand its relevance and importance to both clinical practice, dental education and emerging oral health policy. Also discussed is how dentistry’s ethical code intersects the realm of social justice making a persuasive argument for adopting strong policies on …

Ethical Price For Essential Pharmaceuticals?, Sang T. Truong

Student Research

Azidothymidine or AZT is an antiretroviral medication used to prevent and treat HIV/AIDS. Nowadays, AZT remains to be the primary active drug that can elongate the life of infected patients. Without treatment, patients can live for 5 to 10 years after infected. With the treatment, their life expectancy approaches the norm.

However, it is important to note that AZT is a life-saver for HIV patients only if they can afford it. An HIV patient needs to spend about $17,000 for AZT every year until the end of his life. Therefore, the estimated lifetime cost of HIV will be $600,000. This …

An Ethical Market For Kidney?, Sang T. Truong

Student Research

The kidney performs several vital functions that maintain our general health condition, including filtering waste chemicals out of our blood. Kidney failure is a condition where patients’ kidneys lose their ability to filter the waste from their blood, leading to accumulating toxin in their body. Without any medical care, a patient with kidney failure has a couple days to a couple of weeks to live. One way to elongate the life of the kidney-failure patient is through kidney transplant, where another kidney is implanted into the patient’s body.

In the U.S, it is illegal to trade a kidney for money. …

Heeding The Call Of Covid-19, David Wiebers, Valery Feigin

Animal Sentience

We are grateful to all of our commentators. They have provided a wide range of valuable perspectives and insights from many fields, revealing a broad interest in the subject matter. Nearly all the commentaries have helped to affirm, refine, expand, amplify, deepen, interpret, elaborate, or apply the messages in the target article. Some have offered critiques and suggestions that help us address certain issues in greater detail, including several points concerning industrialized farming and the wildlife trade. Overall, there is great awareness and strong consensus among commentators that any solution for preventing future pandemics and other related health crises must …

The Crossroads Of Wellness And Second Victim Syndrome: Identifying Factors That Alter The Pathway Of Caregiver Recovery Following An Unanticipated Adverse Patient Outcome, Kimia Zarabian, A. Katharine Hindle, Ivy Benjenk, Anita Vincent, Jamil M. Kazma, Benjamin Shambon, Raymond Pla, Eric Heinz

Journal of Wellness

Introduction: Second Victim Syndrome (SVS) describes the phenomenon in which a caregiver experiences a traumatic psychological and emotional response to an adverse patient event or medical error. Using quantitative survey analysis, we aim to better understand the personal factors that affect SVS development and recovery.

Methods: Caregivers at a small urban academic medical center who had experienced an adverse patient event in the past six months were invited to take part in this institution-wide, voluntary, quantitative, cross-sectional study. Three surveys were administered; the Holmes-Rahe Life Stress Inventory (HRLSI) was used as a surrogate to measure stressful life events. The …

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.

Proceeding Without Consent: The Ethics Of Disregarding Patient Preference For Paternalistic Reasons, Nicholas Munsey

Undergraduate Theses and Capstone Projects

Within the last few decades, modern medical regulations have brought the practicing medical community to an unprecedented level of accountability. Laws and regulations governing the practice of medicine were once, at best, loosely enforced guidelines; practices such as experimental surgeries, dangerous health testing, end of life care, and treatment of mental illness were left comparatively unregulated. The introduction of patient rights and new standards for practicing have left the medical community with a novel dilemma: how might one approach a patient who, according to medical advice, is in need of treatment if that patient is unable to express preference or …

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 …

The Ends Of Medicine And The Experience Of Patients, D. Robert Macdougall

Publications and Research

The ends of medicine are sometimes construed simply as promotion of health, treatment and prevention of disease, and alleviation of pain. Practitioners might agree that this simple formulation captures much of what medical practice is about. But while the ends of medicine may seem simple or even obvious, the essays in this issue demonstrate the wide variety of philosophical questions and issues associated with the ends of medicine. They raise questions about how to characterize terms like “health” and “disease”; whether medicine’s goals should be extended to include enhancement beyond normal human function; and whether the ends of medicine are …

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 …

Immunotherapy: Therapy Vs. Enhancement, Mariah Daly

Honors Program Theses

The battle against cancer is a long-standing struggle that has resulted in new information and the development of novel medical technologies. Current research aims to figure out a way to reprogram cells and bodily mechanisms to eliminate those cells that are cancerous without destroying healthy cells in the process. Methods which use the body’s own mechanisms, such as immunotherapy, have shown and continue to show potential for specifically targeting cancer cells. Adoptive T cell therapy is one form of immunotherapy that has gained significant attention and focus in the field. Therapies improve conditions up to the normal state of being, …

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.

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.

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.

Intervention Principles In Pediatric Health Care: The Difference Between Physicians And The State., D. Robert Macdougall

Publications and Research

According to various accounts, intervention in pediatric decisions is justified either by the best interests standard or by the harm principle. While these principles have various nuances that distinguish them from each other, they are similar in the sense that both focus primarily on the features of parental decisions that justify intervention, rather than on the competency or authority of the parties that intervene. Accounts of these principles effectively suggest that intervention in pediatric decision making is warranted for both physicians and the state under precisely the same circumstances. This essay argues that there are substantial differences in the competencies …

Exploring Parental Wishes And Personhood In The Grey Zones Of Neonatal Resuscitation, Alison Lindsay

Honors Projects

The intense societal debate churning around the moral status of fetuses includes topics such as qualifications for personhood, the role of the autonomous decisions of a fetus’ mother, and the obligations of society to protect fetuses. This paper analyzes extending this discussion to newborns in five sections. The first section presents a literature review of responses to a philosophical paper about the respective interests of parents and fetuses and newborns, elaborating on aspects of personhood and parental decision-making. The second section presents a literature review of medical and nursing discussion around resuscitation for extremely premature newborns, focusing on similar evaluations …