Bioethics and Medical Ethics Commons^™

The Violence Of Postmodern “Gender Identity” Medicine, Heather Brunskell-Evans

Dignity: A Journal of Analysis of Exploitation and Violence

The medical “transition” of children with “gender dysphoria” is increasingly normalized in North America, Western Europe, Australia, New Zealand, and the United Kingdom. Although each country has specific national gender identity development services, the rationale for prescribing hormone treatment is broadly similar. A minority rights paradigm underpinned by postmodern theory has gained traction in the past 10 years and has been successful in influencing public policy, the education of pediatricians, endocrinologists, and mental health professionals. In this view, any response other than an affirmation of the child’s claim to be the opposite sex or “born in the wrong body” is …

Exploring Social Determinants Of Covid-19 Related Sickness And Suffering In The Bronx, Hamida Chumpa

Student Theses and Dissertations

Through a positivistic and phenomenological approach, the study examines social determinants of COVID-19 related sickness and suffering in the Bronx, New York City, New York, ZIP codes 10462, 10472, 10467, 10458, 10474, and 10464. I utilize a violence paradigm (structural and everyday violence) to describe the social determinants of risk and sickness-related suffering and deploy an assemblage framework to shed light on how these determinants create negative synergies that undermine wellbeing and render certain communities vulnerable to extreme suffering. The mixed methods include 64 surveys and eight interviews. Analysis methods include a descriptive analysis of survey results and a thematic …

Biomedical Ethics In The Medical School Curriculum: Lessons Learned From The Holocaust, Emma Flanagan

College Honors Program

The Holocaust, the murder of 6 million Jews, is the only medically-santioned genocide. This thesis explores the roles of Nazi doctors in the planning, organizing, and implementation of the organized mass murder of European Jewry. Given the German medical community’s complicity, it is imperative that physicians today are well informed about their profession’s history of involvement in the Holocaust. In addition, and by way of contrast, a study of the moral challenges faced by doctors imprisoned in concentration camps or in the ghettos of Nazi-occupied Europe might serve to better prepare physicians for future ethical dilemmas. In a survey of …

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience: Master of Public Health

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a guardian …

Genetic Testing In Pregnancies With Ultrasound Anomalies: Exploration Of Factors That Influence Uptake, Lukas D. Kruidenier

Dissertations and Theses (Open Access)

Prenatal genetic diagnostic and screening tests have been rapidly evolving over the past decade with the introduction and expansion of cell free DNA screening (cfDNA) and the use of chromosomal microarray (CMA) as a first-line test for evaluation of fetal anomalies. Understanding patient motivations for or against expanded genetic testing options is paramount, therefore this study aimed to ascertain the patient perspective. Ninety-nine patients with an ultrasound anomaly participated in an anonymous, cross-sectional, research survey assessing coping strategies, factors influencing the genetic testing decision, and demographic variables. After multivariable analysis, the desire for directive counseling regarding testing was correlated with …

Disparities In Access To Assisted Reproductive Technology Among Hispanic Women In The United States, Madison Gallagher

Honors Thesis

Infertility is a health problem that affects approximately 7 million women in the United States (Ethics Committee of the American Society for Reproductive Medicine, 2015). Due to the high costs of reproductive medicine and infertility treatment, these services tend to be expensive and have limited accessibility without full insurance coverage. Emerging literature outlines the disparities in access to proper treatment for reproductive complications. These existing studies highlight that many minority populations in the United States experience increased challenges regarding access to reproductive medicine and infertility treatment. Among these minority groups are Hispanic women, who are more likely to require reproductive …

Quarantine Ethics: From Past To Covid-19, Chrystal Barnes

OHSU-PSU School of Public Health Annual Conference

Quarantines have been a preventative measure for reducing communicable disease spread for centuries. The method of implementation can vary widely and to some extent requires some level of judgement from enforcing powers, often state police power. As such, historically, some quarantines have been unfairly enforced based on discriminatory practices. COVID-19 has brought about the most widespread and extended quarantine in U.S. history, which makes evaluating the ethics all the more critical. In addition, it is well established that COVID-19 impacts have disproportionately caused harm to populations, such as those who are of a low socioeconomic status and people of color. …

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 …

Assisted Reproductive Technologies And Health-Related Issues Among Women And Children: A Research Review, Laura Maria Corradi

Dignity: A Journal of Analysis of Exploitation and Violence

From their first use in the late 1970s until the mid-1990s, Assisted Reproductive Technologies (ART) gave rise to serious concerns by feminists internationally. Their questions ranged from asking about health risks to ethical and political problems inherent in these technologies. However, over the last 25 years, interest in women’s health which used to be central to feminist theory and politics, progressively decreased and with it concerns about ART. Today, while the medical literature about health risks in ART is increasing, the topic of women’s health in relation to reproductive technologies remains marginal in feminist discourse, social sciences, and the mainstream …

Suspicion Encoded: Women Of Color And Biometric Technology In The United States, Lilith A. Saylor

sprinkle: an undergraduate journal of feminist and queer studies

This paper explores the commodification of privacy through biometric technology in the United States. It examines the impact of this technology on poor women of color (WOC), arguing that poor WOC face intersectional discrimination based on the convergence of sex, race, and class in their identities. I highlight the unique and powerful intrusion of biometric technology into the lives of poor WOC, and argue that the connection between data and the physical body created through biometric data has formed an environment in which the state wields unrestricted control in all spheres over the privacy of poor WOC.

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …

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 …

Consensus Statement On Ethical & Safety Practices For Conducting Digital Monitoring Studies With People At Risk Of Suicide And Related Behaviors, Matthew K. Nock, Evan M. Kleiman, Melissa Abraham, Kate H. Bentley, David A. Brent, Ralph J. Buonopane, Franckie Castro-Ramirez, Christine B. Cha, Walter Dempsey, John Draper, Catherine R. Glenn, Jill Harkavy-Friedman, Michael R. Hollander, Jeffrey C. Huffman, Hye In S. Lee, Alexander J. Millner, David Mou, Jukka-Pekka Onnela, Rosalind W. Picard, Heather M. Quay, Osiris Rankin, Shannon Sewards, John Torous, Joan Wheelis, Ursula Whiteside, Galia Siegel, Anna E. Ordóñez, Jane L. Pearson

Psychology Faculty Publications

OBJECTIVE: Digital monitoring technologies (e.g., smart-phones and wearable devices) provide unprecedented opportunities to study potentially harmful behaviors such as suicide, violence, and alcohol/substance use in real-time. The use of these new technologies has the potential to significantly advance the understanding, prediction, and prevention of these behaviors. However, such technologies also introduce myriad ethical and safety concerns, such as deciding when and how to intervene if a participant's responses indicate elevated risk during the study?

METHODS: We used a modified Delphi process to develop a consensus among a diverse panel of experts on the ethical and safety practices for conducting digital …

Self-Concept, Healthcare, And Leadership: Understanding The Lived Experiences Of Physician Leaders In Urban Community Healthcare Centers, Eric James Charlton

Antioch University Dissertations & Theses

Reducing disparities in health services delivery and outcomes is a continued challenge. The consistence of healthcare disparities, despite advances in medical technology and increased awareness of the problem, poses an ongoing test to the nation. There is a growing body of work that demonstrates providing access to good primary care may be the most effective intervention at hand. For over 40 years, community health centers have been providing quality, comprehensive primary care focusing on reducing health outcome disparities. Increased awareness is now emphasizing primary care elimination of health disparities within disadvantaged, underserved populations. A major failing of the system that …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Animal Sentience: History, Science, And Politics, Andrew N. Rowan, Joyce M. D'Silva, Ian J.H. Duncan, Nicholas Palmer

Animal Sentience

This target article has three parts. The first briefly reviews the thinking about nonhuman animals’ sentience in the Western canon: what we might know about their capacity for feeling, leading up to Bentham’s famous question “can they suffer?” The second part sketches the modern development of animal welfare science and the role that animal-sentience considerations have played therein. The third part describes the launching, by Compassion in World Farming, of efforts to incorporate animal sentience language into public policy and regulations concerning human treatment of animals.

Assessing And Improving Knowledge Of Medical Decision-Making Capacity, Samantha J. Zohr

Master's Theses and Doctoral Dissertations

Clinical judgments of capacity have implications for the rights of the individual being assessed. While supported decision-making is recommended, it is not clear whether laypeople have sufficient knowledge to advocate for maximizing the autonomy of the person they assist. This study developed and evaluated a brief, computer-based intervention to increase knowledge about decision-making capacity, using a Solomon four-group design. A convenience sample of 160 participants completed the study via an online survey platform. Knowledge was assessed with a test designed for this study. A 2 x 2 factorial ANOVA found no pre-test sensitization, F(1, 156) = 0.09, p = .77, …

Automating Autism: Disability, Discourse, And Artificial Intelligence, Os Keyes

The Journal of Sociotechnical Critique

As Artificial Intelligence (AI) systems shift to interact with new domains and populations, so does AI ethics: a relatively nascent subdiscipline that frequently concerns itself with questions of “fairness” and “accountability.” This fairness-centred approach has been criticized for (amongst other things) lacking the ability to address discursive, rather than distributional, injustices. In this paper I simultaneously validate these concerns, and work to correct the relative silence of both conventional and critical AI ethicists around disability, by exploring the narratives deployed by AI researchers in discussing and designing systems around autism. Demonstrating that these narratives frequently perpetuate a dangerously dehumanizing model …

“How Could You Even Ask That?”: Moral Considerability, Uncertainty And Vulnerability In Social Robotics, Alexis Elder

The Journal of Sociotechnical Critique

When it comes to social robotics (robots that engage human social responses via “eyes” and other facial features, voice-based natural-language interactions, and even evocative movements), ethicists, particularly in European and North American traditions, are divided over whether and why they might be morally considerable. Some argue that moral considerability is based on internal psychological states like consciousness and sentience, and debate about thresholds of such features sufficient for ethical consideration, a move sometimes criticized for being overly dualistic in its framing of mind versus body. Others, meanwhile, focus on the effects of these robots on human beings, arguing that psychological …

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.

Brain Complexity, Sentience And Welfare, Donald M. Broom

Animal Sentience

Neither sentience nor moral standing is confined to animals with large or human-like brains. Invertebrates deserve moral consideration. Definition of terms clarifies the relationship between sentience and welfare. All animals have welfare but humans give more protection to sentient animals. Humans should be less human-centred.

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 …

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 …

Depaul Bioethicists And Their Roles In The Fight Against Covid-19, University Marketing And Communications, Craig Klugman, Valerie Koch

DePaul Download

At the heart of the COVID-19 pandemic are bioethicists, experts who help health professionals and elected officials navigate tough decisions. While the toughest choice for most of us was just staying home, bioethicists, such as DePaul’s Craig Klugman and Valerie Koch, helped answer tough questions to prepare communities for COVID-19. They both served on statewide planning efforts to prepare for a pandemic, and on this episode of DePaul Download, they discuss the response to COVID-19 and what may come next.

Spiritual And Religious Interventions For Medically High-Risk Adults: A Systematic Review, Nathanael J. Strissel

Senior Honors Theses

This systematic review is an update and expansion to the population and methods of a previous systematic review concerning spiritual and religious interventions for the well-being of terminally ill adults. After expanding the criteria to incorporate a more diverse population and including non-randomized experimental studies that contained relatively few concerns of bias, the results of the review are inconclusive due to insufficient data. The lack of usable data in the field highlights the ethical and theoretical issues with the use of experimental trials in analyzing the efficacy of spiritual and religious interventions. The development of spirituality in healthcare will remain …

The Impact Of Human Papillomavirus Educational Intervention Study On The Knowledge, Health Beliefs, Health Behaviors And Increasing The Use Of Gardasil In Women Of Color, Charlotte Hurst, Michael Hagensee, Syed Adeel Ahmed, Geornique M. Hayes

The Journal of the Research Association of Minority Professors

Lack of human papillomavirus (HPV) knowledge and cervical cancer awareness are factors contributing to a disproportion in African American (AA) women with cervical cancer. The purpose of this intervention study was to use gender specific and culturally appropriate HPV educational materials to increase HPV knowledge and cervical cancer awareness, to increase health beliefs, and the intent for AA women to use the HPV vaccine. Convenience sampling was used to describe a sample of 98 AA women recruited from an Ambulatory Women’s health clinic between 2015 and 2017. HPV educational videos and pamphlets materials were used to collect baseline and post …

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.

Patient Advocacy: A Tool For Resolving Ethical Issues For Patients That Use The Emergency Department For Chronic Care Management, Lawanda Baskin

Journal of Health Ethics

The current state of scientific knowledge on using the emergency department (ED) for chronic care management indicates that using the ED for chronic care management creates health disparities and burdens healthcare systems. Ethical concerns also arise because patients use the ED for chronic care management. This article discusses health literacy, self-care behaviors, and social support and the presence of patient suffering, nonmaleficence, and beneficence in patients who seek care for chronic care management in the ED. Patient advocacy as a tool to lessen these ethical issues is further discussed. Eighty-six participants were used in a cross-sectional correlational predictive study. Findings …

Influences On Ethical Decision-Making By Nurses Employed In Federal Health Care Facilities, Cecil Dean Blount

Walden Dissertations and Doctoral Studies

Healthcare professionals are tasked with making key decisions involving new and controversial approaches such as organ transplantation and life-prolonging technologies and treatments that raise various ethical issues. Suboptimal ethical choices by nurses can lead to negative patient outcomes and lower the quality of life in federal healthcare facilities. The purpose of this nonexperimental quantitative correlational study was to identify the factors that influence nurses’ ethical decision-making processes in U.S. federal healthcare facilities. The theoretical framework was based on Beauchamp and Childress’ ethical system of principlism. Three research questions addressed the nature and extent of the relationship between nurses’ Ethical Behavior …

On The Proposed Legalization Of Commercial Surrogacy: I Thought We Had Abolished The Sale Of Human Beings, Phyllis Chesler

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.