Bioethics and Medical Ethics Commons^™

Moral Drifting And Covid-19 Precautions: The Impact On Team Stress Levels In Primary Care, Brittany N. Houston, Stacy Ogbeide

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic has given more focus on the concept of moral drifting. Moral or ethical drift is characterized as an insidious movement away from ethical behavior. Not only is this phenomenon present with routine tasks such as going to the grocery store, but it is influential and present in a setting being impacted by COVID-19: primary care. Integrated Primary Care and team-based care are incredibly valuable when caring for complex populations but also vital in mitigating the impacts of stress that moral drifting can cause on individual and team functioning.

A Feminist Challenge To Transgenderism. A Review Of Doublethink: A Feminist Challenge To Transgenderism By Janice G. Raymond, Esohe Aghatise

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Trans Doublethink And Newspeak. A Review Of Doublethink: A Feminist Challenge To Transgenderism By Janice Raymond, Heather Brunskell-Evans

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Maternal Wellness: Self, Matrescence, Obstetric Violence, And Self-Care, Vanessa V. Vales-Lewis

Dissertations, Theses, and Capstone Projects

In this dissertation, I engage in a self-study through an examination of my experience of matrescence (i.e., the transition to motherhood). I discuss my praxis in the development of a self-study on maternal wellness as it applies to my well-being as both a researcher and the researched. In Chapter 1, I preface this study by highlighting critical scholars and the bricoleurs who have been foundational in my undertaking of this work on a narrative study on maternal wellness. Using bricolage as part of a research methodological framework that involved key scholarly methodologies of authentic inquiry, emergence and contingence, and narratology, …

Emotional Component Of Pain Perception In The Medicinal Leech?, Brian D. Burrell

Animal Sentience

Crump et al. have provided a series of criteria to assess animal sentience that is focused on the perception of pain, which is known to have both sensory and emotional components. They also provide a qualitative scoring system to assess data that address the eight criteria and apply this paradigm to decapod crustaceans. The criteria laid out have the potential to be applied to other invertebrates typically thought to have sensory response to tissue damage, but no emotional component to pain perception.

Understanding The Role Of Race In American Medicine, Fariel C. A. Lamountain

Honors Theses

Long running inequity in health care and outcomes in the United States stem from failure to acknowledge the underlying role of the Transatlantic slave trade as it manifests in all facets of American society and commerce. This paper focuses specifically on the American medical system and its foundations to understand the precursors to generational trends in lack of access to healthcare and poor health for Black communities. This paper uses a three-pronged approach to understand the racist cycle of inequity, highlighting the history and origins of racism in American medicine, personal accounts and statistical evidence of inequity, and community and …

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 …

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 …

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 …

Post-Trial Access In Implanted Neural Device Research: Device Maintenance, Abandonment, And Cost, Gabriel Lázaro-Muñoz, Michelle T Pham, Katrina A Muñoz, Kristin Kostick-Quenet, Clarissa E Sanchez, Laura Torgerson, Jill Robinson, Stacey Pereira, Simon Outram, Barbara A Koenig, Philip A Starr, Aysegul Gunduz, Kelly D Foote, Michael S Okun, Wayne Goodman, Amy L Mcguire, Peter Zuk

Center for Medical Ethics and Health Policy Staff Publications

Background: Clinical trial participants who benefit from experimental neural devices for the treatment of debilitating and otherwise treatment-resistant conditions are generally not ensured continued access to effective therapy or maintenance of devices at the conclusion of trials.

Objective/hypothesis: Post-trial obligations have been extensively examined in the context of drug trials, but there has been little empirical examination of stakeholder perspectives regarding these obligations in the rapidly growing field of neural device research.

Methods: This study examined the perspectives of 44 stakeholders (i.e., 23 researchers and 21 patient-participants) involved in implantable neural device trials.

Results: Researchers were concerned about current post-trial …

Creating A Collaborative Trauma-Informed Interdisciplinary Citywide Victim Services Model Focused On Health Care For Survivors Of Human Trafficking, Juhi Jain, Mackenzie Bennett, Mark D Bailey, Daniel Liaou, Sheri-Ann O Kaltiso, Jordan Greenbaum, Kimberly Williams, Mollie R Gordon, Melissa I M Torres, Phuong T Nguyen, John H Coverdale, Victor Williams, Cayla Hari, Samantha Rodriguez, Temilola Salami, Jonell E Potter

Center for Medical Ethics and Health Policy Staff Publications

Although human trafficking is recognized as a public health issue, research on the health effects of human trafficking and best intervention practices is limited. We describe 2 citywide collaborative victim services models, the THRIVE (Trafficking, Healthcare, Resources, and Interdisciplinary Victim Services and Education) Clinic at the University of Miami and Jackson Health System in Miami, Florida, and the Greater Houston Area Pathways for Advocacy-based, Trauma-Informed Healthcare (PATH) Collaborative at Baylor College of Medicine, CommonSpirit Health, and San Jose Clinic in Houston, Texas, funded in part by the Office for Victims of Crime, which focus on trauma-informed health care delivery for …

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 …

Including A Chaplain And Culturally Sensitive Notary In End-Of-Life And Earlier Difficult Healthcare Issues, John Stonestreet

Journal of Health Ethics

Would patients and families benefit from a Doctor Body Cam? Linked from www.DoctorBodyCam.com, this article explores innovations providing accountability for ethical communication surrounding major healthcare decisions. One of the greatest challenges physicians face is living up to their own ideals, let alone others’ expectations, for high-stakes doctor-patient/family communication, especially at the end of life. From emotional strains to time limitations, a multiplicity of factors obfuscates the pursuit of excellence in this vital endeavor. Evidence suggests that, like nearly every other sector of healthcare and society, African American patients and families are most likely to get the short end of the …

A Call For Liberty And Justice For All: Unraveling The Complexities In 2021, Dr. Sheila P. Davis

Journal of Health Ethics

This Preface summarizes the articles in this issue. Seven articles are presented with center on liberty and justice for all populations discussed.

"I Felt What Was Happening In Our Country [Usa] With Race Was So Much Scarier Than The [Covid-19] Virus.” Black Lives Matter Protesters’ Beliefs And Practices During The Covid-19 Pandemic, Evelyn Arana-Chicas, Brooke D. Jones, Francisco Cartujano-Barrera, Ana Paula Cupertino

Journal of Health Ethics

This study describes the COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the U.S. Participants completed a survey on following COVID-19 guidelines and answered interview questions. Twenty participants were enrolled. Mean age was 29 and most were female (80%) and black (75%). Participants almost always wore their masks (75%) and washed their hands (85%) while protesting. Most reported rarely social distancing (55%) and not being concerned about COVID-19 (55%). Themes included: 1) Fighting for social justice, 2) Protesting is more important than COVID-19, 3) Unable to social distance, 4) Masks mostly worn, 5) Protests sparked global movement, …

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 …

Going Beyond The Data: Using Testimonies To Humanize Pedagogy On Black Health, Keisha S Ray

Faculty and Staff Publications

When health professions learners' primary pedagogical experience of Black people and how they become patients is through statistics, it becomes very easy for learners to think of Black people as data points rather than as individuals whose health is often at the mercy of racist institutions. When the human dimension of Black people's health is ignored, specifically the ways that poor health affects individual wellbeing, one of the barriers to proper health for Black patients is how to be seen and considered as a part of a larger problem of systemic racism and institutional injustices as well as individuals whose …

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 …

Culturally Sensitive Care For Hispanic Americans, Christopher Dodson, Courtney Hall

Scholars Week

The number of individuals that speak another language that is not English as their primary language is at an all time high in the United States, and this can make healthcare harder to access for this portion of the population. This research examines what barriers are present for those who do not speak English as their primary language, such as miscommunications, reduced trust in their provider related to being unable to speak directly with them, parts of their cultural practices and alternative medicines being ignored or misunderstood by healthcare providers, and not feeling secure enough to reveal sensitive information to …

Intersectionality, Relational Positionality, And The Lived Experiences Of Inequality: Contextualizing Intergenerational Opioid Use And The Constrained Choices Of Indigenous, Latina, And White Women Caregivers In Rural New Mexico, Carmela M. Roybal

Sociology ETDs

Opioid addiction is a serious and persistent global health issue. The federal Centers for Disease Control and Prevention (CDC) reported that between 1999 and 2016, more than 630,000 people in the United States died of an overdose of a prescription opioid or illicit drug (CDC 2018). Extant research has suggested that for nearly a century, New Mexico has experienced some of the highest rates of prescription and illicit opioid death in the nation (Goldstein and Herrera, 1995; Landon, 2003; Shah et al., 2008). I examined intergenerational opioid dependence through the lived experience of women caregivers of opioid-addicted family members. Data …

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 …

Of Blood Transfusions And Feeding Tubes: Anorexia-Nervosa And Consent, Samuel Director

Jepson School of Leadership Studies articles, book chapters and other publications

Individuals suffering from anorexia nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. This paper explores the following question: If an anorexic, A, wants to refuse food when the food would either be lifesaving or prevent serious bodily harm, can A's refusal be valid? It is shown that there is compelling reason to think that anorexics can validly refuse food, even in these extreme circumstances.

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 …

Make Your Wishes Known: Understanding The Challenges And Barriers For Providing Effective Ethics Consults To Low-Income African American Men, Ruth Nwefo

Symposium of Student Scholars

The distrust of the U.S. health care system is prevalent, especially within the African American (AA) community. This distrust is largely based on infamous cases such as the Tuskegee Syphilis Experiment and experiments conducted by James Marion Sims on slave women without anesthesia. While these experiments along with many others further advanced medicine, they severed trust between health care institutions and the African American community, bringing upon repercussions still felt today. Although many steps have been taken to rebuild trust in the health care system by establishing effective ethical guidelines, more needs to be done in terms of rebuilding the …

Black And White Health Disparities: Racial Bias In American Healthcare, Yasmeen Almomani

Bridges: An Undergraduate Journal of Contemporary Connections

This paper explores the historical implications of race in American society that have led to implicit racism in the healthcare system. Racial bias in healthcare against Black people is a factor in the health disparities between Black and white people in America, such as the gap in life expectancy, infant death, and maternal mortality. Black people are more likely to report racial discrimination from healthcare providers, which is a reason for the decreased quality of care received. The past justifications of slavery, the Tuskegee syphilis study, and the medical experimentations on Black women are horrifying but were considered acceptable in …

Information Needs Of Traditional Medicine Practitioners (Tmps) In Nigeria With A Particular Reference To Alimosho Local Government Of Lagos State, Adeniran Pauline Oghenekaro Mrs.

Library Philosophy and Practice (e-journal)

Information plays a crucial role in modern society. It helps people to develop their knowledge of the world. This knowledge guides them against mistakes leading to effectiveness and efficiency in all aspects of life. This survey aimed to determine the Information needs and sources of Information of Traditional Medicine Practitioners (TMPs) in Nigeria with reference to Alimosho Local Government Area of Lagos State. The study population comprised forty (40) registered traditional medicine practitioners in Alimosho Local Government Area of Lagos State. The questionnaire instrument was used for data collection in which forty (40) copies were administered to the traditional medicine …

Black Lips Don't Turn Blue: A Womanist Critique Of Discriminatory Language In Medical Education, Alison Lawrence

Womanist Ethics

This paper examines race and gender inequities in healthcare as it pertains to the unequal presentation of descriptors of illness in medical textbooks. The author adopts a womanist perspective to criticize the use of the white male body as the standard for all patients, which causes signs and symptoms in women and people of color to be dismissed as less important. Following an analysis of normalizing language in current medical texts as well as its consequences for patients, the author calls for a system-wide shift to more inclusive, intersectional medical education that not only acknowledges differences among patient groups, but …