Bioethics and Medical Ethics Commons^™

Multiracial Patient Experiences With Racial Microaggressions In Health Care Settings, Cyndy R. Snyder, Prince Z. Wang, Anjali R. Truitt

Journal of Patient-Centered Research and Reviews

Purpose: Illuminating patients’ experiences of microaggressions in health care settings can help practitioners develop care that is more culturally responsive. While much of the literature on health care disparities focuses on minority groups generally, we sought to identify and to describe the ways in which racial microaggressions manifest for multiracial individuals and families specifically.

Methods: Using a combination of interviews and focus groups, we conducted 15 interviews and 3 focus groups. Eligible participants self-identified as more than one race and/or they self-identified as part of an interracial family, and they and/or someone they considered to be part of their family …

Variations In Institutional Review Board Processes And Consent Requirements For Trauma Research: An East Multicenter Survey, Jeffry Nahmias, Areg Grigorian, Scott Brakenridge, Randeep S. Jawa, Daniel N. Holena, John Varujan Agapian, Brandon Bruns, Paul J. Chestovich, Bruce Chung, Jonathan Nguyen, Carl I. Schulman, Kristan Staudenmayer, Rachel Dixon, Jason W. Smith, Andrew C. Bernard, Jose L. Pascual

School of Medicine Faculty Research

Oversight of human subject research has evolved considerably since its inception. However, previous studies identified a lack of consistency of institutional review board (IRB) determination for the type of review required and whether informed consent is necessary, especially for prospective observational studies, which pose minimal risk of harm. We hypothesized that there is significant inter-institution variation in IRB requirements for the type of review and necessity of informed consent, especially for prospective observational trials without blood/tissue utilization. We also sought to describe investigators’ and IRB members’ attitudes toward the type of review and need for consent. Eastern Association for the …

Radical Social Ecology As Deep Pragmatism: A Call To The Abolition Of Systemic Dissonance And The Minimization Of Entropic Chaos, Arielle Brender

Student Theses 2015-Present

This paper aims to shed light on the dissonance caused by the superimposition of Dominant Human Systems on Natural Systems. I highlight the synthetic nature of Dominant Human Systems as egoic and linguistic phenomenon manufactured by a mere portion of the human population, which renders them inherently oppressive unto peoples and landscapes whose wisdom were barred from the design process. In pursuing a radical pragmatic approach to mending the simultaneous oppression and destruction of the human being and the earth, I highlight the necessity of minimizing entropic chaos caused by excess energy expenditure, an essential feature of systems that aim …

Pornography As A Public Health Issue: Promoting Violence And Exploitation Of Children, Youth, And Adults, Elisabeth Taylor

Dignity: A Journal of Analysis of Exploitation and Violence

The pornography industry is expanding exponentially as a result of ongoing technological advances. The ability to stream videos over the internet and the ubiquity of the smart phone have meant that pornography producers are able to use algorithms to target potential consumers, to cultivate new sexual tastes and to deliver content to a more diverse audience over mobile devices. The advent of virtual reality pornography with interactive sex toys and sex robots imbued with artificial intelligence promises to unleash a further step-change in the extent to which pornography influences ‘real-world’ sexual culture. The critical analysis of pornography undertaken over decades …

Patients Are Our Teachers, Robert E. Becker, Mary V. Seeman

Journal of Patient-Centered Research and Reviews

In the patient-physician encounter, physicians hone their skills while alleviating the patient’s suffering. Both benefit. Leaning on the work of Hippocrates, Darwin, and William Osler, the authors sketch out the case for honoring patients as indispensable teachers of the art and science of medicine. They argue that this tradition of Hippocratic medicine both anticipates modern precision medicine and reawakens a focus on public health medicine, each a benefit to the patients and communities served by physicians. A community that compromises the learning relationship of physician to patient and population undermines quality of care.

Where Trying To Conceive Becomes A Community Effort: A Digital Ethnography Of Online Infertility Forums, Megan Burns

Sociology Honors Papers

Online forums for women using in vitro fertilization (IVF), or similar assisted reproductive technologies (ARTs), provide a useful setting to further evaluate and understand women’s expectations of motherhood, the relationship infertile women have with physicians and biomedicine, and their interactions on the forums. Some critics of ARTs consider them a tool of oppression in a pronatalist state. The pressure and desire to become a biological mother leads the women with access to these technologies to use them regardless. Through digital ethnographic research on four online ART forums, this research examines the intersection of altruism and self-interest in the ways forum-users …

Use Of Placebo In Supplementation Studies-Vitamin D Research Illustrates An Ethical Quandary., Leigh A. Frame, Jonathan P. Fischer, Gail Geller, Lawrence J Cheskin

Clinical Research and Leadership Faculty Publications

History has shown that without explicit and enforced guidelines, even well-intentioned researchers can fail to adequately examine the ethical pros and cons of study design choices. One area in which consensus does not yet exist is the use of placebo groups in vitamin supplementation studies. As a prime example, we focus on vitamin D research. We aim to provide an overview of the ethical issues in placebo-controlled studies and guide future discussion about the ethical use of placebo groups. Research in the field of vitamin D shows variation in how placebo groups are used. We outline four types of control …

Factors Associated With End-Of-Life Planning In Huntington Disease., Nancy R Downing, Siera Goodnight, Sena Chae, Joel S Perlmutter, Michael Mccormack, Elizabeth Hahn, Stacey K Barton, Noelle Carlozzi

Rowan-Virtua School of Osteopathic Medicine Departmental Research

OBJECTIVE: Knowledge of one's gene status for adult onset conditions provides opportunity to make advance end-of-life (EOL) plans. The purposes of these analyses were to (1) determine the prevalence of EOL plans, including advance directives (ADs) among persons across 3 stages of Huntington disease (HD) and (2) examine factors associated with having ADs in this sample.

METHODS: Data are from 503 participants in the HD Quality of Life study. Participants completed an online health-related quality-of-life survey that included questions regarding EOL planning and self-reported HD symptoms. Frequencies were calculated for EOL planning by the HD stage. Bivariate analysis and logistic …

A New Measure For End Of Life Planning, Preparation, And Preferences In Huntington Disease: Hdqlife End Of Life Planning, Noelle E Carlozzi, E A Hahn, S A Frank, J S Perlmutter, N D Downing, M K Mccormack, S Barton, M A Nance, S G Schilling, Hdqlife Site Investigators And Coordinators

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Huntington disease is a fatal inherited neurodegenerative disease. Because the end result of Huntington disease is death due to Huntington disease-related causes, there is a need for better understanding and caring for individuals at their end of life.

AIM: The purpose of this study was to develop a new measure to evaluate end of life planning.

DESIGN: We conducted qualitative focus groups, solicited expert input, and completed a literature review to develop a 16-item measure to evaluate important aspects of end of life planning for Huntington disease. Item response theory and differential item functioning analyses were utilized to examine …

Ethics And Cost-Effectiveness Of Naloxone, Allison Groch

Augustana Center for the Study of Ethics Essay Contest

This essay discusses the ethical components involved with using, distributing, and making naloxone readily available for reversing opioid overdoses. The cost-effectiveness of naloxone is also discussed as a reason why naloxone should be widely used in order to help fight the opioid epidemic.

“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.

Predictors Of Medical Students’ Attitudes Towards Abortion And Their Changes Overtime, Rebecca Elizabeth Morales

Sociology & Criminal Justice Theses & Dissertations

As new legislation is regularly being introduced to minimize Roe v. Wade’s protection of women’s right to choose in a medical setting, it is imperative to study what predictors may have an impact on abortion attitudes within the demographic of medical students, as well as how these predictors impact one’s willingness to provide the service in the future. The current study then, uses data collected in 2000 and 2015 from a medical school located in Virginia, and in collaboration with a research university in the state to examine what factors are associated with a willingness to provide an abortion, as …

The Italian Agreement Between The Government And The Regional Authorities: National Guidelines For Aai And Institutional Context, Martina Simonato, Marta De Santis, Laura Contalbrigo, Daniele Benedetti, Elisabetta Finocchi Mahne, Vincenzo Ugo Santucci, Silvio Borrello, Luca Farina

People and Animals: The International Journal of Research and Practice

Animal-assisted interventions (AAI) have developed considerably in the last half century, prompting various private and public realities dealing with AAI worldwide to work on and establish standards and best practice. However, AAI are still far from being regulated harmoniously. In this context, Italy offers a unique example at world level: here the spread of AAI has set in motion an ethical and legal reflection that led to the creation of the Italian National Reference Centre for AAI (NRC AAI) by ministerial decree in 2009 and the approval of National Guidelines for AAI in 2015. The Italian legislation on AAI is …

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

Grace Peterson Nursing Research Colloquium

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

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

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

The Problem Of Suffering: Universal Health Coverage As A Partial Solution, Christen Scaggs

Dialogue & Nexus

Universal Health Coverage is evaluated from a Christian Biblical perspective and found that it meets an appropriate standard of service to the poor. Christians should consider its benefits and drawbacks compared to doing nothing. The issue of diminished access to healthcare, burdensome medical costs, reduced coverage, and discrimination against impoverished individuals with specific regards to healthcare are all conquerable challenges.

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

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

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

Making Sex Work For The State : The Policing Of Sex Work In The United States., Madeline A Clabough

College of Arts & Sciences Senior Theses

This thesis analyzes the ways that sex work is regulated within the United States, and analyze the ways that regulation is shaped by contemporary feminist discourse. To do so, it analyzes the ways in which sex workers have been and pathologized since the 19th century, and address the ways that these conceptualizations have been incorporated into the legal regulation of sex workers. Finally, this thesis will look to contemporary practices in the state regulation of sex workers, and argue that the relationship between neoliberalism, the carceral state, and what has come to be termed “carceral feminism” operate in conjunction to …

Illegitimate Bodies In Legitimate Times: Life, Liberty And The Pursuit Of Movement, Brian Culp

Faculty Articles

Drawing on Michel Foucault’s concepts of state racism and biopower, the author of the 26th Delphine Hanna Lecture presents several claims: (a) that the idea of the illegitimate outsider in Western world governments like the United States has largely been influenced by ancient Greek ideals, (b) that a host of policies and intentional actions by power brokers create derision and hierarchies between “old” and “new” immigrant groups, and (c) neoliberal ideology couched in actions that aim “to protect the state” is nothing more than a recoding of traditional racist rhetoric that expands systemic racism. The author identifies the capabilities approach, …

Children’S Exposure To Environmental Toxins: Socioeconomic Factors And Subsequent Effects On Mental Health And Function, Dorothy L. Mcleod

Center for the Human Rights of Children

The physical environment in which children live, including the air they breathe and the water they drink, has a profound influence on their development. While children need many chemicals and nutrients to physically grow and develop normally, others, such as those deemed environmental toxins (e.g. pesticides, lead, mercury, and illicit substances) act instead as a threat to healthy development. These chemicals may have highly toxic effects, and while they are a threat to all individuals, they affect infants and children most severely. In order to provide an introduction to the issue of toxin exposure and mental health outcomes, to highlight …

Assisted Suicide, Valerie Ontiveros

Nebraska College Preparatory Academy: Senior Capstone Projects

Assisted suicide is when a physician helps a terminally ill patient die without pain. As of right now, it is illegal in most states. Organizations about this issue were organized in the late 1930's (Humphry). According to Pro-Con. Org, 79% of patients requested assisted suicide even before they came terminally ill –if it got to that point.

Many states have different laws on assisted suicide. In no doubt, these patients go through a tremendous amount of pain and no one but themselves should decide when enough is enough. Technological advances have allowed this generation to help aid a person when …

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

Women's and Gender Studies Program: Faculty Publications

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

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

Doctor of Nursing Practice Scholarly Projects

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

Calcium Phosphate As A Key Material For Socially Responsible Tissue Engineering, Vuk Uskoković, Victoria M. Wu

Pharmacy Faculty Articles and Research

Socially responsible technologies are designed while taking into consideration the socioeconomic, geopolitical and environmental limitations of regions in which they will be implemented. In the medical context, this involves making therapeutic platforms more accessible and affordable to patients in poor regions of the world wherein a given disease is endemic. This often necessitates going against the reigning trend of making therapeutic nanoparticles ever more structurally complex and expensive. However, studies aimed at simplifying materials and formulations while maintaining the functionality and therapeutic response of their more complex counterparts seldom provoke a significant interest in the scientific community. In this review …

Law & Healthcare Newsletter, Vol. 23, No. 2, Spring 2016

Law & Health Care Newsletter

No abstract provided.

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, …

Defining Quality In Medical Practice, Nicholas E. Boggs

Clinical Research in Practice: The Journal of Team Hippocrates

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

Privatization Of Biomedical Research: A Short Term Answer With Long Term Consequences, Frederick Azalekor

Nebraska College Preparatory Academy: Senior Capstone Projects

Biomedical research owned by the government is now available to be owned by private institutions. This results in stagnant innovations because researchers have trouble with all the restrictions that are placed by private institutions. Privatization of biomedical research has short term positive effects but its negative effects are overarching and disastrous. One way to combat this, is for licenses to be deployed slowly with future consequences in mind.

• Privatization has short term benefits but long term disadvantages are disastrous. • To reduce damaging effect, privatization must be deployed slowly and carefully. • Patents or proprietary ownership must be given …

The Experiment Must Continue: Medical Research And Ethics In East Africa, 1940–2014, Melissa Graboyes

Ohio University Press Open Access Books

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries.

Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans …

Family Planning And Population Control In Developing Countries: Ethical And Sociocultural Dilemmas., Edward A. Komu M.D, Salome N. N. Ethelberg

Journal of Health Ethics

Do governments have the right to restrict individual freedom and right to have fewer or more children? Is it justifiable to control population in order to benefit society as a whole? Most of family planning and population control policies and programs in developing countries face resistant from the same people it aims to help. This can be mainly due to some ethical, socio-cultural beliefs, and moral values held by individuals and society as a whole. The challenges call for a need of family planning and population control programs to invest in examining ethical and socio-cultural dilemmas pertaining to these programs …

Factors Associated With Belief In Conspiracies About Hiv/Aids Among Hiv-Positive African-American Patients, Andrew A. Zekeri, Youssouf Diabate

Professional Agricultural Workers Journal

Abstract

The purpose of this study is to examine factors associated with belief in conspiracies about HIV/AIDS among HIV-Positive African American patients. Survey data were collected from 256 African American patients living with HIV/AIDS attending two HIV clinics in Montgomery and Dothan, Alabama. The study used multiple regression analysis to examine how sociodemographic factors contribute to belief in conspiracies about HIV/AIDS. Education and age were significantly related to belief in conspiracies about HIV/AIDS among men and women. Beliefs in conspiracies about HIV/AIDS may be a barrier to HIV prevention among African Americans. Public health officials should work toward obtaining the …