Bioethics and Medical Ethics Commons^™

Winners And Losers In The American Political Debates Of The Nation’S Health: An Ethical And Moral Dilemma, Dr. Sheila P. Davis

Journal of Health Ethics

The third and final issue of the Online Journal of Health Ethics for 2020 presents two poignant articles that are rankled with current health ethics and moral issues as the world races to a resolve for the COVID pandemic. There appears to be no easy, quick-fix solutions to the pandemic that has claimed over 1.11 million lives worldwide in this first wave. The Gellert article addresses his view of the U.S. government’s political response and the Gunn article presents an ethical perspective of the emerging promised vaccine to halt the virus.

An Epidemiological View Of The 2020 U.S. Presidential Election: Covid-19 And The Ethics Of Science Denial, George A. Gellert Md, Mph, Mpa

Journal of Health Ethics

COVID-19 is exploiting U.S. political and cultural polarization in the first presidential election to be driven by epidemiology and public health. Medical science is on the ballot as Americans’ views on economic re-opening fracture according to party affiliation. The difference between pro aggressive versus incremental re-opening, mask wearing and social distancing is rooted in respect for, or denial of, the science of epidemiological pandemic disease control. Political leaders at multiple levels, and in particular the president, have politicized the wearing of face masks and so intentionally obscured and misinformed the public regarding the objectively and scientifically proven value of these …

Ethical Aspects Of Covid-19 Antibody Testing, Stephen S. Hanson, Demetra Antimisiaris

The University of Louisville Journal of Respiratory Infections

One common COVID-19 test is the test for one or more of the antibodies that the body creates when it encounters the SARS-CoV-2 virus. Because these tests are often point-of-care, rapid tests that require only a blood sample, they may appear to patients to be an easily accessible and useful tool to guide their actions in the pandemic. However, serologic antibody tests should not be offered to patients in normal practice under nearly any circumstances. They are useful in narrow diagnostic settings in later stage infections, and they serve an important public health function, but they are not of benefit …

Intensive Animal Farming Conditions Are A Major Threat To Global Health, Cynthia Schuck-Paim

Animal Sentience

Wiebers & Feigin accurately propose that reducing the risks posed by infectious disease outbreaks and other global health challenges will depend critically on transitioning away from intensive animal farming practices. Creating the right incentive structure for this transition to happen is one of the great challenges in the years to come, but a much-needed step to ensure the health and well-being of current and future generations.

Situations Éthiques Vécues Par Des Infirmières En Lien Avec La Santé Et La Sécurité Au Travail, Chantal Caux, France Dupuis, Kathleen Lechasseur, Laurence Fortin-Pellerin, Jocelin Lecomte

Rapports de recherche scientifique

L’éthique de la santé fait partie intégrante de la pratique infirmière. L’éthique définit des principes, tels la bienfaisance ou le respect de l’autonomie, qui viennent baliser cette pratique. Ainsi, l’éthique est imbriquée dans toutes les interventions des infirmières et infirmiers (ci-après les infirmières). Il n’est pas rare toutefois que les infirmières vivent des expériences qui sont problématiques d’un point de vue éthique. On parlera souvent dans la littérature de dilemmes éthiques. Ces dilemmes peuvent avoir un impact négatif sur la santé de ces dernières. En effet, en raison de la détresse générée par ces dilemmes, les infirmières peuvent ressentir des …

Vaccines In Current Culture: The Hpv Vaccine Controversy, Alyssa Johnston

Senior Honors Theses

The use of vaccinations has drastically decreased mortality and morbidity rates related to infectious disease and has become an intrinsic part of modern health care. However, the fear of risks related to vaccines has been partially responsible for the decisions of many parents to delay or avoid vaccinating their children. The human papilloma virus (HPV) vaccine specifically is one of the most controversial vaccines in current culture due to reports of new onset or exacerbation of autoimmune diseases, infertility, and even death following its administration. This review synthesizes information regarding the relevance and safety of the HPV vaccine, as well …

Surgeons’ Views On Shared Decision-Making, Suraj Kannan, Jayhyun Seo, Kevin R. Riggs, Gail Geller, Emily F. Boss, Zackary D. Berger

Journal of Patient-Centered Research and Reviews

Purpose: Shared decision-making (SDM) has a significant role in surgical encounters, where decisions are influenced by both clinician and patient preferences. Herein, we sought to explore surgeons’ practices and beliefs about SDM.

Methods: We performed a qualitative study consisting of semi-structured individual interviews with 18 surgeons from private practice and academic surgery practices in Baltimore, Maryland. We purposively sampled participants to maximize diversity of practice type (academic vs private), surgical specialty, gender, and experience level. Interview topics included benefits and challenges to patient involvement in decision-making, communicating uncertainty to patients, and use of decision aids. Interviews were audio-recorded and transcribed. …

The George Floyd Of Healthcare, Sheila P. Davis, Phd, Fnp-C, Faan, Lsm-Bc, Gary Davis, Md

Journal of Health Ethics

Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.

Allocation Of Resources And Health Professionals’ Burden During The Covid-19 Pandemic: Reflections On Advanced Directives, Informed Consent And Social Perception In Mexico, Karen Herrera-Ferrá, Leonardo Souza-García, Antonio Muñoz-Torres

Journal of Health Ethics

One of the main problems in the COVID-19 pandemic is the insufficient availability of resources. This deficiency has resulted in emotional and moral burdens of health professionals. Decisions are having to be made as to who will live and who will die. Moreover, given the global impact of this pandemic, negative impacts are heightened in low and middle-income countries such as Mexico.

Authors focus on two issues related to, but not exclusive, to the Mexican healthcare system in an attempt to partially address scarce resources and health professionals’ burden. First, is the empowerment of patients’ autonomy through the incorporation of …

What The Covid-19 Crisis Is Telling Humanity, David Wiebers, Valery Feigin

Animal Sentience

The planet is in a global health emergency exacting enormous medical and economic tolls. It is imperative for us as a society and species to focus and reflect deeply upon what this and other related human health crises are telling us about our role in these increasingly frequent events and about what we can do to prevent them in the future.

Cause: It is human behavior that is responsible for the vast majority of zoonotic diseases that jump the species barrier from animals to humans: (1) hunting, capture, and sale of wild animals for human consumption, particularly in live-animal markets; …

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.

Strategies For Controlling Violence Against Healthcare Workers: Application Of Fuzzy Analytical Hierarchy Process And Fuzzy Additive Ratio Assessment, Fazel Rajabi, Mehdi Jahangiri, Farnaz Bagherifard, Sean Banaee, Payam Fahadi

Community & Environmental Health Faculty Publications

Objective: The present study aimed to identify and prioritize control measures of violence against Healthcare Workers (HWs) using the Fuzzy Analytical Hierarchy Process (FAHP) and Fuzzy Additive Ratio Assessment (F-ARAS).

Background: Occupational violence is a pervasive problem in healthcare centers. Reducing violence against staff is one of the challenges for healthcare managers.

Method: At the first stage, the most common criteria and control options for violence against HWs were identified and extracted using a review of previous studies. At the next stage, criteria for selection of control measures were prioritized using the FAHP. Finally, control measures of workplace violence were …

Contaminants Of Emerging Concern: Reconsidering Our Paradigm Of Water Pollution, Jonathan Gunasti

Pomona Senior Theses

In this senior thesis, I explore contaminants of emerging concern (CECs) and endocrine disrupting compounds (EDCs) and discuss the ways in which these novel contaminants defy traditional notions of pollution. I discuss the history and “emergence” of CECs and EDCs in scientific and public spheres and outline ongoing challenges to recognizing, prioritizing, and understanding the action of these contaminants. I position EDCs within the framework of environmental injustice and health disparities and suggest that these compounds could reinforce multigenerational health inequities. Finally, I perform a pilot analysis of the EDC bisphenol A (BPA) in Mt. Baldy Creek, the Los Angeles …

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.

One Welfare, The Role Of Health Professionals, And Climate Change, Anne Fawcett

Animal Sentience

Wiebers & Feigin argue that the COVID-19 crisis is a call for humanity to rethink our relationships with animals and the environment. This One Welfare approach has implications for the role of health care professionals and demands that we address climate change.

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

St. Mary's Law Journal

Abstract forthcoming

Quality Of Life Of Road Traffic Injury Survivors Aged 15-44 Years Suffered From Moderate And Severe Head Injuries In Karachi, Pakistan, S A. Abbasi, Tazeen Saeed Ali, Shafquat Rozi, Uzma Rahim Khan, Rashid Jooma

Community Health Sciences

Background: Most of Road traffic injuries are predicted to be the third leading contributor to the global burden of disease by 2020 and patients end up into head injuries which leave devastating impacts on individual and society. Quality of Life After Brain Injury (QOLIBRI) is a specific tool that measures quality of life in head injury patients.
Methods: This was a cross sectional study among 300 patients aged 15-45 years, attended emergency department of the Aga khan University Hospital. Structured questionnaire included demography, injury details, QOLIBRI, GOSE and WHO Disability Assessment Scale (WHODAS 12 items). Severity of injury was determined …

Public Health Policy: An Ethical Analysis Of Quarantine, Dina Alqahtani

Electronic Theses and Dissertations

As a public health measure quarantine has both historical and contemporary significance both in the United States and abroad. On the surface it represents a low-cost, low-tech way in which the spread of disease can be mitigated as its core requirement is that those who may have been exposed to an infectious agent are kept away from those who have not been exposed to that agent for enough time to determine whether or not infection has been spread. This has been utilized for centuries with both limited questions and scattered, inconsistent, or impossible to achieve oversight and goals. In understanding …

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 …

Addressing Lapses In Medical Education In Relation To Lgbtqia+ Healthcare Disparities, Daniel Pinto, Aubrey Olson

Rowan-Virtua Research Day

As the LGBT community gains more visibility and acceptance, the individuals identifying as LGBTQIA+ have been increasing. Unfortunately for this community, healthcare disparities for LGBT individuals continue. In fact in a national online survey done with LGBTQIA+ physicians, 65% had heard discriminatory comments made towards LGBTQIA+ patients, and 34% witnessed discriminatory care given to LGBTQIA+ patients. (Bonvinci) Rose Chapman, a senior lecturer at Curtin University Nursing School, contributed this discomfort that medical professionals seem to have with LGBTQIA+ families with socioeconomic background such as religious beliefs or familiarity with the topic. (Chapman) Nevertheless, another study published by the Medical Journal …

Female Genital Mutilation In The United States: Estimating The Number Of Girls At Risk, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

Female genital mutilation (FGM) destroys the capacity of women to experience sexual pleasure. It causes serious medical complications such as bleeding, painful urination, cysts, dangerous and recurrent bladder and urinary tract infections, the growth of scar tissue that make marital intercourse a nightmare and that turns childbirth into an experience of danger and torture. Due to immigration, FGM now poses a potential health crisis in the West, both in Europe and in the United States. To estimate how many girls who live in the West are at risk, one can measure the prevalence of FGM in the non-Western countries where …

Developing Technologically Advanced Research In Low- And Middle-Income Countries, Isa Abdulkadir, Tina Slusher, Fidelia Bode-Thomas, Sean Riordan, Jean-Baptiste Lepichon, Laila Hassan, Shehu Abdullahi, Akinyemi Ofakunrin, Stephen Oguche, Steven Shapiro, William Ogala

Posters

This poster presents a collaboration between a group of scientists in Nigeria and the USA in developing a genomic research project and the solutions adopted in tackling the ethical implications and partnership equity and ownership of such a project.

Law & Health Care Newsletter, Spring 2019

Law & Health Care Newsletter

No abstract provided.

Betrayed Partners And Men With Poisoned Souls: Interview With A Former Sex Buyer In Germany, Ingeborg Kraus

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Who Speaks For Me?: Addressing Variability In Informed Consent Practices For Minimal Risk Research Involving Foster Youth, Mary V. Greiner, Sarah J. Beal, Antonio Allen, Vikash Patel, Jareen Meinzen-Derr, Armand Antommaria

Journal of Health Disparities Research and Practice

Background: Youth in protective custody (i.e., foster care) are at higher risk for poorer physical and mental health outcomes compared with those who are not. These differences may be due in part to the lack of research on the population to create evidence-based recommendations for health care delivery. A potential contributor to this lack of research is difficulties in obtaining informed consent for empirical studies in this population. The objective of this study was to describe the approaches to obtaining informed consent in minimal risk studies of foster youth and provide recommendations for future requirements.

Methods: We conducted a …

Hippocratic Values In An Era Of Nuclear Asymmetry: Should U.S. Public Health Prepare For Nuclear War With North Korea?, George A. Gellert

Journal of Health Ethics

Objectives: Advancements in North Korean nuclear weapons have heightened tensions and increased risk for nuclear war. U.S. public health agencies are investing resources in nuclear attack preparation. Analyses assess the impact and value of existing protective public health strategies for limited nuclear exchange.

Methods: Projections of fatality/injury from a North Korean nuclear strike within North Asia and explosive impact mapping are used to assess the potential impact of an attack on major U.S. urban centers.

Results: A nuclear strike on the 20 largest U.S. urban centers would place 38.1% of Americans at risk. With 1-3 missiles of 250 kiloton yield …

Globalization Of Clinical Research And Assessment Of Global Access To Treatments Approved Between 2006-2015, Rafael Duncan Escandon

Walden Dissertations and Doctoral Studies

Globalization in clinical research and development has increased since the 1990s. Products approved in the United States (U.S.) and European Union (EU) include increasing numbers of research participants from low- and middle-income countries. The purposes of this quantitative correlational study were to investigate the lag time, or drug lag, between U.S. approval and the approval of selected drugs in all countries that hosted their pivotal clinical trials. The study population was limited to products approved first in the U.S. between 2006 and 2015. The health capability model and research for health justice framework were the theoretical frameworks for the study. …

Health For All: Using Utilitarianism To Require Childhood Vaccinations, Hannah Vercellotti

Augustana Center for the Study of Ethics Essay Contest

In the last few decades, many parents have chosen not to vaccinate their children against serious infectious diseases. In seeking exemptions, they often cite conflicting religious beliefs and fear of risks. Using the principle of utilitarianism, this paper argues that despite parents' cited religious beliefs and concerns about risks, state laws should require all children to get vaccinated unless doing so would cause direct harm to the child’s health. Adopting this mandate would ensure that the maximum number of people would benefit from immunity to serious and deadly diseases.

Servant Leadership Characteristics And Empathic Care: Developing A Culture Of Empathy In The Healthcare Setting, Mark Anthony Martin

Antioch University Dissertations & Theses

The purpose of this study was to assess the degree to which servant leadership characteristics are exhibited in medical group practices, and the degree to which servant leadership characteristics correlated with measures of empathic care. This study featured an explanatory mixed methods research design embedded in appreciative inquiry. A total of 189 mid-level practitioners consisting of nurse practitioners, physician assistants, and practice mangers responded to a 32-item scale survey that featured a six-point Likert scale to measure servant leadership items and a 10-point continuous scale to assess measures of empathic care. The servant leadership items were based on the seven …

Practice-Based Research Networks Ceding To A Single Institutional Review Board, Jeanette M. Daly, Tabria Weiner Harrod, Kate Judge, Leann C. Michaels, Barcey T. Levy, David L. Hahn, Lyle J. Fagnan, Donald E. Nease Jr.

Journal of Patient-Centered Research and Reviews

Historically, a single research project involving numerous practice-based research networks (PBRNs) required multiple institutional review boards (IRBs) to be involved in approval of the project. However, to avoid redundancies, federal IRB regulations now allow cooperative research projects that involve more than one institution to use reasonable methods of cooperative IRB review and to cede authority for review and oversight of the project to a single lead IRB. Through ceding, a lead IRB has the authority for review and oversight of the project delegated by all participating sites’ IRBs and becomes the IRB of record for the ceded sites. In the …