Bioethics and Medical Ethics Commons^™

Investigation Of Urinary Metabolomics In A Phase I Hookworm Vaccine Trial In Gabon, Madeleine Eunice Betouke Ongwe, Yoanne D Mouwenda, Koen A Stam, Peter G Kremsner, Bertrand Lell, David Diemert, Jeff Bethony, Maria E Bottazzi, Peter J Hotez, Remko V Leeuwen, Martin P Grobusch, Ayola A Adegnika, Oleg A Mayboroda, Maria Yazdanbakhsh

Center for Medical Ethics and Health Policy Staff Publications

Metabolomics provides a powerful tool to study physiological changes in response to various perturbations such as vaccination. We explored whether metabolomic changes could be seen after vaccination in a phase I trial where Gabonese adults living either in rural or semi-urban areas received the subunit hookworm vaccine candidates (Na-GST-1 and Na-APR-1 (M74) adjuvanted with Alhydrogel plus GLA-AF (n = 24) or the hepatitis B vaccine (n = 8) as control. Urine samples were collected and assayed using targeted 1H NMR spectroscopy. At baseline, a set of metabolites significantly distinguished rural from semi-urban individuals. The pre- and post-vaccination comparisons indicated significant …

Fast Cbt For Pediatric Ocd: A Multiple-Baseline Controlled Pilot Trial Of Parent Training In Exposure And Response Prevention Delivered, Lara J Farrell, Natalja A Nabinger De Diaz, Sharna Mathieu, Matthew L Mckenzie, Taka Miyamoto, Caroline L Donovan, Allison M Waters, Sonja March, Nicole Bothma, Rianca Kroon, Gabrielle Simcock, Robert S Ware, Robert R Selles, Eric A Storch, Thomas Ollendick

Center for Medical Ethics and Health Policy Staff Publications

Objective: The current study utilized a single case series, non-concurrent multiple baseline design to examine the efficacy of training parents via telehealth videoconferencing in exposure and response prevention (ERP) for home delivery of the treatment for their children and adolescents with obsessive compulsive disorder (OCD).

Method: There were nine participants aged 8 to 14 years who had received a primary diagnosis of OCD. The design involved a series of AB replications, whereby following pre-treatment assessments participants were randomly assigned to either a 2-week (n = 4) or 3-week (n = 5) baseline condition with weekly monitoring of their …

Creation Of A Global Vaccine Risk Index, Tasmiah Nuzhath, Peter J Hotez, Ashish Damania, P Shuling Liu, Brian Colwell

Center for Medical Ethics and Health Policy Staff Publications

The World Health Organization has identified vaccine hesitancy as one of its top ten global health threats for 2019. Efforts are underway to define the factors responsible for reductions in vaccine confidence. However, as global measles cases accelerated beginning in 2018, it became evident that additional factors were promoting measles re-emergence, including war, political and socio-economic collapse, shifting poverty, and vulnerability to weather events and climate change. Accordingly, we propose a Global Vaccine Risk Index (VRI) to consider these variables as a more comprehensive means to identify vulnerable nations where we might expect measles and other vaccine-preventable diseases to emerge …

A Mixed-Methods Protocol To Develop And Validate A Stewardship Maturity Matrix For Human Genomic Data In The Cloud, Vasiliki Rahimzadeh, Ge Peng, Mildred Cho

Center for Medical Ethics and Health Policy Staff Publications

This article describes a mixed-methods protocol to develop and test the implementation of a stewardship maturity matrix (SMM) for repositories which govern access to human genomic data in the cloud. It is anticipated that the cloud will host most human genomic and related health datasets generated as part of publicly funded research in the coming years. However, repository managers lack practical tools for identifying what stewardship outcomes matter most to key stakeholders as well as how to track progress on their stewardship goals over time. In this article we describe a protocol that combines Delphi survey methods with SMM modeling …

China’S Strategies For Governance Of Biotechnological Changes And New Ethical Challenges, Yaojin Peng, Zhou Qi

Bulletin of Chinese Academy of Sciences (Chinese Version)

Biotechnology is changing greatly over recent years, providing huge benefits to human society. However, the ethics, safety, and negative externalities of biotechnology have become increasingly prominent. Currently, biotechnology is still in the early stage of development, and full of high uncertainty. Technological changes in this field have the characteristics of stronger subversiveness, complexity, and social relevance. The world is facing a process of great development of biotechnology, new outbreaks of ethical challenges, and ethical governance reforms. China should take this opportunity to promote the high-quality development of biotechnology on the one hand, and on the other hand, adopt a multi-pronged …

Advance Care Planning Within Individualized Care Plans: A Component Of Emergency Preparedness, Heather L. Church, Christina Marsack-Topolewski, Jacqueline M. Mcginley, Victoria Knoke

Developmental Disabilities Network Journal

Federally-legislated Medicaid requirements for recipients with intellectual and/or developmental disabilities (IDD) to have a person-centered plan (PCP) do not specifically require that advanced care plans (ACP) be a component of the plan. However, coronavirus disease 2019 (COVID-19) has provided a salient reminder of the importance of incorporating ACP within the PCP for people who have IDD. As demonstrated by situations arising from COVID-19, emergencies and crises can dramatically alter access to care for people with IDD. This paper synthesizes results from an environmental scan related to ACP for adults with IDD. Findings suggest that the use of ACP, particularly when …

Fall 2021

Insights

True to Our Foundational Mission; Lourdes Torres Receives Prestigious Award; Fernando De Maio Joins Health Equity Initiative; LAS Professors Named to Faculty Fellow Program; Wilson-Garling Collection Classes and Exhibit; Welcoming the Stranger: The DePaul Migration Collaborative strives to build a better future for immigrants, refugees and asylum-seekers; An Alderpersonal Touch: Maria Hadden is putting her degree in international public service to work in Chicago’s 49th Ward; All In, Chicago: Collaboration powers the work of the Center for Community Health Equity

Lessons Learned From The Hiv/Aids Pandemic And Access To Medicines For Covid-19 Treatment, Thalia Le

Independent Study Project (ISP) Collection

There is an imminent need to address the healthcare disparities in accessing all COVID-19 medicinal products in developing countries. While logistical issues like inadequate production facilities such as the lack of vaccines administration capacity, storage issues, gap between supply and demand as well as vaccine hesitancy can certainly play a part in impeding COVID19 medicines distribution, patent monopolies and intellectual property protection laws further exacerbated the problem, especially when vaccines were at its early stages of authorization. Historical and contemporary case studies of efforts to challenge patents on HIV AVRs treatment provide a useful lens through which we may glean …

Corruption In Capsules: How It Is Legal For Companies To Put Harmful Ingredients In Vitamins And Dietary Supplements, Emily Leggiero

English Department: Research for Change - Wicked Problems in Our World

The vitamin and supplement industry has increased exponentially in profits as well as potential products on the market since the turn of the century. However, these products are not regulated, nor do they undergo any premarket clinical research or testing. Public health is compromised by vitamins and supplements that are available for American consumption that is disproportionately unregulated to their chemically similar counterparts. This wicked problem is facilitated through the combination of historical legislative definitions that has since been distorted for corrupt administrative gain through the allotment of corporate expenditures. Company disbursements are made to the same policymakers that create …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Racism In Healthcare, Elizabeth Dwyer

Black History at UNM

Living with the daily experience of racism can have direct, adverse effects on the health and wellbeing of Black, Indigenous, and People of Color (BIPOC) communities. Dr. Tracie Collins, former Dean, UNM College of Population Health, and current Secretary of Health of New Mexico, and Dr. Felisha Rohan-Minjares, Professor, UNM’s Department of Family and Community Medicine, explain how bias and racism impact health, treatment, and outcomes.

Mindfulness And The Need To Minimize The Risk Of Harm: A Proposal To Implement And Enforce Standards For Secular Mindfulness Practice, Michael Falick

Mindfulness Studies Theses

While Western mindfulness practice is indeed beneficial for many participants, the research now clearly demonstrates that for some meditators, there are attendant potential risks. These potential risks to practitioners require a level of care from those individuals (and corporations) that disseminate mindfulness practice. Historically, in traditional Buddhist practice, mindfulness was but one of the eight factors on the Noble Eightfold Path. An important component of traditional practice strongly relies on ethics in the delivery of the practice. A formalized standard of care for modern, secular mindfulness practices, and a method to implement and enforce that standard, will greatly enhance safety …

Prenatal Care For Undocumented Immigrants: Implications For Policy, Practice, And Ethics, Rachel Fabi

Population Health Research Brief Series

Nearly 250,000 babies are born each year to undocumented immigrant parents in the U.S. These babies are U.S. citizens, but undocumented immigrants are ineligible for most public insurance, making it difficult for them to access prenatal care. This research brief describes restrictive policies related to prenatal care for undocumented immigrants and discusses how these policies affect health care providers and the care they are able to offer pregnant immigrant women.

The Ethical Justification Of Increasing Awareness Of Preventive Medicine Among Healthcare Professionals, Patients And The General Public In The United States, Karishma Ether Moazzam

Electronic Theses and Dissertations

While practiced for centuries, preventive medicine has received increased attention during the recent times. Preventive medicine has a distinct mission to protect, promote, and maintain health as well as to prevent diseases, disabilities, and premature deaths. It aims to fulfill its mission through the combined form of clinical intervention and health promotion. In the recent years, preventive medicine has begun to lean more towards the clinical interventions, taking away from the health promotion. This imbalance has caused preventive medicine to lose its effectiveness in fulfilling its mission. One of the leading causes for such imbalance is the lack of proper …

Combatting The Opioid Epidemic In Texas By Holding Big Pharma Manufacturers Liable, Katherine Spiser

St. Mary's Law Journal

Abstract forthcoming

Precision Medicine And It's Ethical And Social Implications: Public Health And Gobal Persepctives, Evangel Sarwar

Electronic Theses and Dissertations

Ever since President Obama's launch of the Precision Medicine Initiative (PMI) in 2015, precision medicine (PM) has been anticipated as the new paradigm for healthcare with the capacity to “empower patients, researchers, and providers to work together toward the development of individualized care,” through research, technologies, and policies (President Obama, 2015). Precision Medicine (PM), in the form of genomics, offers unprecedented promise of providing new tools for improving health and reducing the burden of diseases, not just for the U.S. - but also globally. According to World Health Organization, genomics research and precision medicine will play a major part in …

Confidential Care For Adolescents In The U.S. Health Care System, Priya R. Pathak, Adriana Chou

Journal of Patient-Centered Research and Reviews

In providing care for adolescents, maintaining confidentiality should be considered a human right and an evidence-based component of quality care. Unfortunately, complexities in the U.S. legal and health care systems have created a setting in which confidential care is inaccessible to many adolescent patients. Federal laws provide a minimum standard for confidentiality protections, but variations in state legislation relating to minor consent, special health care services, and confidentiality exemptions create large variability in adolescent confidentiality rights across the country. In certain contexts, such as consensual sexual activity, legal provisions may not align with professional ethical standards in adolescent care. In …

Florida Adult Trauma Scorecard Methodology And Scene Transportation Choice, Patricia Maher

Walden Dissertations and Doctoral Studies

Prehospital management of patients who are traumatically injured within the state of Florida starts with the use of the Florida Adult Trauma Scorecard Methodology. The scorecard methodology may indicate that a patient is a Trauma Alert based on applied physiological and other judgment criteria. However, patients may be transported via Helicopter Emergency Medical Services (HEMS) without justified physiological needs. Rawls’ theory of justice posits that a fair and equal distribution of social resources is essential to public wellbeing. To evaluate this premise regarding prehospital trauma transports, archival 2015 data from the Florida Department of Health Trauma Registry was obtained. Using …

The Core Relation Between Hospitality (Philoxenia), Dignity And Vulnerability In Orthodox Christian Bioethics: A Contribution To Global Bioethics, Rabee Toumi

Electronic Theses and Dissertations

In a pluralistic world, reaching consensus in matters of bioethics has proved to be difficult, especially with the political polarization that nurtures inimical differences. This dissertation argues that a middle ground can be identified between the plurality of value systems in contemporary bioethics based on an anthropological approach. This middle ground that reflects commonalities of the human condition can be explored in relation to the foundational principles of Orthodox Christian anthropology. To identify this middle ground the analysis discusses the core relation between hospitality, dignity, and vulnerability as a contribution to global bioethics.

In general, based on Orthodox Christian theology …

“When One Shingle Sends Up Smoke”: The Summit Beacon Advises Akron About The Epidemic Cholera, 1849, Elizabeth Hall

Nineteenth-Century Ohio Literature

Elizabeth Hall explains the American cholera epidemic of 1849, with special attention to how cholera afflicted Akron, a booming canal town in Northeast Ohio. The article presents the full text of 1849 Akron newspaper articles on cholera and explains how their mix of good and bad information was published right before scientific breakthroughs in cholera research.

An Ethical Evaluation Of The Modern Pharmaceutical Industry, Kaitlyn Drennan

Dialogue & Nexus

Lack of transparency, wrongdoings, and unlawful promotion characterize the healthcare industry; these are especially prevalent within the pharmaceutical industry. Consequently, an investigation into the evidence of the corruption and the ethical infringement is needed. In this paper, I will evaluate the pharmaceutical industry’s adherence to the three major branches of ethics. The ever-increasing prices of pharmaceutical products, especially medications used for the combating of anaphylaxis and cancer, coupled with the compensatory-based medication promotion and research points to a major crisis in the realm of social justice. These examples, among many other current issues, lead to difficulties in individuals receiving the …

End Of Life Care For The Incarcerated, Codie Robinson

Dialogue & Nexus

As the prison population ages, a new need has come to light – caring for those who are in the final stage of life. This paper will examine the current end of life services provided to those in prison throughout the United States. After a general awareness of the system is presented, a more complete discussion of end of life care for prisoners will be considered, in light of ethics, social justice, and the Christian perspective. The two care options presented, hospice care and compassionate release, are observed through these lenses. In order to make a decision on how to …

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 …

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 …

Breaking The Silence: The Veterinarian’S Duty To Report, Martine Lachance

Animal Sentience

Animals, like children and disabled elders, are not only the subjects of abuse, but they are unable to report and protect themselves from it. Veterinarians, like human physicians, are often the ones to become aware of the abuse and the only ones in a position to report it when their human clients are unwilling to do so. This creates a conflict between professional confidentiality to the client and the duty to protect the victim and facilitate prosecution when the law has been broken. I accordingly recommend that veterinarian associations make reporting of abuse mandatory.

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 …