Bioethics and Medical Ethics Commons^™

Advances In Neuroscience Imply That Harmful Experiments In Dogs Are Unethical, Jarrod Bailey, Shiranee Pereira

Professional Science Research Ethics Collection

Functional MRI (fMRI) of fully awake and unrestrained dog 'volunteers' has been proven an effective tool to understand the neural circuitry and functioning of the canine brain. Although every dog owner would vouch that dogs are perceptive, cognitive, intuitive and capable of positive emotions/empathy, as indeed substantiated by ethological studies for some time, neurological investigations now corroborate this. These studies show that there exists a striking similarity between dogs and humans in the functioning of the caudate nucleus (associated with pleasure and emotion), and dogs experience positive emotions, empathic-like responses and demonstrate human bonding which, some scientists claim, may be …

Ethical Theories And Perspectives On End-Of-Life Decisions, Lauren Skelton

Dialogue & Nexus

This paper approaches several different ethical theories to see how they interact with the issue of withdrawing and withholding life-sustaining care. After the theories of Utilitarianism, Kantian and Prima Facie Deontology, Virtue Ethics, and Evolutionary Ethics are explored at length, Deontological theories are proven to be the best decision-making guide from the perspective of both patients and those in policy-making positions. When used together, Kantian and Prima Facie Deontology offer the overall best combination of ethical instruction and personal freedom.

The Ethical Considerations Of Physician-Assisted Suicide, Madeline Jordan

Dialogue & Nexus

With respect to physician-assisted suicide, several approaches to adjudicate an ethical position can be processed from the theories of utilitarianism, Kantian deontology, and virtue ethics. This paper will explore these three positions with respect to physician-assisted suicide and the pros and cons of each. In conclusion, based on my research and Christian beliefs, I will define why I reside with virtue ethics and why it leads me to a position that is against physician-assisted suicide at this particular point in my life.

Christian And Islamic Perspectives On The Ethical Dilemma Of In Vitro Fertilization (Ivf), Stephanie Sariles

Dialogue & Nexus

After defining IVF procedures and the associated biomedical ethics with each, I will compare and contrast Christian and Islamic perspectives on IVF. Christianity in general does not accept IVF, because it is an unnatural method of reproduction that can affect Christian traditions such as parenthood and marriage. Despite this view, Protestants, in particular, have opened up to IVF as a method for treating infertility. Islam fully accepts IVF provided the married couple follows Islamic law. Sunni Muslims do not accept gamete donation, but Shi’ite Muslims are more flexible with gamete donation and surrogacy.

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

An Ethical Evaluation Of The Modern Pharmaceutical Industry, Kaitlyn Drennan

Dialogue & Nexus

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

Incentives And Ethics In The Economics Of Body Parts, Nicola Lacetera

Osgoode Hall Law Journal

Research shows that properly devised economic incentives increase the supply of blood without hampering its safety; similar effects may be expected also for other body parts such as bone marrow and organs. These positive effects alone, however, do not necessarily justify the introduction of payments for supplying body parts, because these activities concern contested commodities or repugnant transactions. Societies may want to prevent these transactions even if they increase supply, because of ethical concerns. When transactions involve contested commodities, therefore, there often is tension between the efficiency-enhancing effects of trades mediated by a monetary price and the moral opposition to …

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.

End Of Life Care For The Incarcerated, Codie Robinson

Dialogue & Nexus

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

Volume 3 Editorial, Daniel Brannan

Dialogue & Nexus

No abstract provided.

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 …

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, …

A Survey Of Ethics Training In Undergraduate Psychology Programs At Jesuit Universities, Thomas G. Plante, Selena Pistoresi

Psychology

Training in ethics is fundamental in higher education among both faith-based and secular colleges and universities, regardless of one’s academic major or field of study. Catholic colleges and universities have included moral philosophy, theology, and applied ethics in their undergraduate curricula for generations. The purpose of this investigation was to determine what, if anything, Jesuit college psychology departments are doing to educate psychology majors regarding ethical issues. A survey method was used to assess the psychology departments of all 28 Jesuits colleges and universities in the United States. A total of 21 of the 28 schools responded and completed the …

Developing Morally Sensitive Policy In The Nicu: Donation After Circulatory Determination Of Death, Michael Van Manen, Nicole Kain

The Qualitative Report

Policy development is an important activity for the practice of healthcare. Policies, after all, may cultivate common practices and ensure that best available evidence is employed in clinical decision making. Qualitative research and individuals with expertise in qualitative research methods have much to offer policy makers. We were confronted with the situation of developing policy for donation after circulatory death (DCD) for our newborn intensive care program. Due the moral-ethical complexities surrounding DCD, and the limited experience with DCD in this context, we approached policy development from an iterative design perspective employing qualitative methods. We describe our experience in employing …

Whose Preferences Matter? A Patient-Centered Approach For Eliciting Treatment Goals, Nananda F. Col, Andrew J. Solomon, Vicky Springman, Calvin P. Garbin, Carolina Ionete, Lori Pbert, Enrique Alvarez, Brenda Tierman, Ashli Hopson, Christen Kutz, Idanis Berrios Morales, Carolyn Griffin, Glenn Phillips, Long H. Ngo

Department of Psychology: Faculty Publications

Background. Patients facing a high-stakes clinical decision are often confronted with an overwhelming array of options. High-quality decisions about treatment should reflect patients’ preferences as well as their clinical characteristics. Preference-assessment instruments typically focus on pre-selected clinical outcomes and attributes chosen by the investigator. Objective. We sought to develop a patient-centered approach to elicit and compare the treatment goals of patients with multiple sclerosis (MS) and healthcare providers (HCPs). Methods. We conducted five nominal group technique (NGT) meetings to elicit and prioritize treatment goals from patients and HCPs. Five to nine participants in each group responded silently to one question …

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 …

Emotions, Intuitions And Risk Perception In Critical Care, Oleksandr Dubov

Electronic Theses and Dissertations

The theory of decision-making as it applies to bioethics and healthcare assumes a rational decision maker: someone who knows all his alternatives, has clear preferences, can rank and weigh risks and benefits of an intervention, and always acts in his own best interests. However, the growing body of research from the field of decision science shows that, in reality, such a purely rational decision maker does not exist. Instead, patients are rational within personal or environmental constraints such as uncertainty or ambiguity in which non-rational approaches such as emotion and intuition are instrumental. This issue is particularly important in critical …

Fuzzy Logic In Health Care Settings: Moral Math For Value-Laden Choices, Sarah Voss

Journal of Humanistic Mathematics

This essay is intended as an example of “moral math”, i.e., ideas culled from mathematics which can positively impact social behavior. Specifically, it combines fuzzy logic with the ethical decisions which hospital staff and others are sometimes forced to make about health care (e.g., euthanasia issues following Hurricane Katrina). The assumption is that such decisions involve value-laden choices which lend themselves to “fuzzy” or “smart” protocols. The article discusses the history of fuzzy logic – what it is, how it is used, and how it might be even better-used as a support basis for making difficult choices …

Pain And Laboratory Animals: Publication Practices For Better Data Reproducibility And Better Animal Welfare, Larry Carbone, Jamie Austin

Laboratory Research and Animal Welfare Collection

Scientists who perform major survival surgery on laboratory animals face a dual welfare and methodological challenge: how to choose surgical anesthetics and post-operative analgesics that will best control animal suffering, knowing that both pain and the drugs that manage pain can all affect research outcomes. Scientists who publish full descriptions of animal procedures allow critical and systematic reviews of data, demonstrate their adherence to animal welfare norms, and guide other scientists on how to conduct their own studies in the field. We investigated what information on animal pain management a reasonably diligent scientist might find in planning for a successful …

Oregon's Death With Dignity Act: Socially Constructing A Good Death, Erin E. Mauck

Electronic Theses and Dissertations

As aid-in-dying legislation expands across the United States, this study examines the dynamics influencing participation in Oregon’s Death with Dignity Act. In addition to data from secondary sources, this thesis analyzes field research data collected in Oregon, including 14 in-depth interviews with volunteers and employees of two advocacy organizations at the center of legalized physician-assisted death. Themes emerged including the conditions that motivate participation, the importance of both personal and professional autonomy, the significance of a good death, and the growth of open dialogues about end of life choices. This thesis concludes with a discussion of the impact Death with …

An Analysis Of Women’S Access To Acute Opioid Detoxification Services In Maine: Identifying The Barriers To Treatment, Karen E. Conley

Muskie School Capstones and Dissertations

The lack of treatment facilities and services for opioid use disorder in Maine, combined with an increased prevalence of addiction, creates a potential for health inequity between men and women that may be intensified by barriers in access to care. This capstone study utilized detoxification screening inquiry forms and data obtained from the Milestone Foundation’s acute opioid detoxification program to assess and categorize barriers to access by gender. A barriers model was developed based on existing literature and was to identify potential associations among and between the known barriers to accessing treatment. Barriers were described as internally or externally based, …

The Ethics Of Animal Research: A Survey Of The Public And Scientists In North America, Ari R. Joffe, Meredith Bara, Natalie Anton, Nathan Nobis

Morality and Ethics of Animal Experimentation Collection

Background: To determine whether the public and scientists consider common arguments (and counterarguments) in support (or not) of animal research (AR) convincing.

Methods: After validation, the survey was sent to samples of public (Sampling Survey International (SSI; Canadian), Amazon Mechanical Turk (AMT; US), a Canadian city festival and children’s hospital), medical students (two second-year classes), and scientists (corresponding authors, and academic pediatricians). We presented questions about common arguments (with their counterarguments) to justify the moral permissibility (or not) of AR. Responses were compared using Chi-square with Bonferonni correction.

Results: There were 1220 public [SSI, n = 586; AMT, n = …

Does Environmental Enrichment Promote Recovery From Stress In Rainbow Trout?, Kieran C. Pounder, Jennifer L. Mitchell, Jack S. Thomson, Tom G. Pottinger, Jonathan Buckley, Lynne U. Sneddon

Experimental Research and Animal Welfare Collection

The EU Directive on animal experimentation suggests that all protected animals should have enrichment to improve welfare yet relatively little research has been conducted on the impact of enrichment in fish. Studies employing enrichment in zebrafish have been contradictory and all fish species should be provided with species-specific enrichments relevant to their ecology. Salmonids are important experimental models in studies within aquaculture, toxicology and natural ecosystems. This study therefore sought to establish whether an enriched environment in an experimental aquarium may promote improved welfare in rainbow trout (Oncorhynchus mykiss) by enhancing their recovery from invasive procedures. Trout were …

Physician Assisted Dying: A Turning Point?, Lawrence O. Gostin, Anna E. Roberts

Georgetown Law Faculty Publications and Other Works

Physician Assisted Dying (PAD) has been lawful in some countries since the 1940s and in the United States since 1997. There is a body of social and scientific research that has focused on whether the practice has been misused and whether gaps exist in legislative safeguards. There are multiple concerns with physicians assisting patients to die: incompatibility with the physician’s role as a healer, devaluation of human life, coercion of vulnerable individuals (e.g., the poor and disabled), and the risk that PAD will be used beyond a narrow group of terminally ill individuals. Statutes in the United States have been …

Age Differences In Cancer Treatment Decision Making And Social Support, Jessica Krok, Angela L. Palmer-Wackerly, Phokeng M. Dailey, Julianne C. Wojno, Janice L. Krieger

Department of Communication Studies: Faculty Publications

Objective: The aim of this study was to examine the decision-making (DM) styles of younger (18-39 years), middle-aged (40-59 years), and older (≥60 years) cancer survivors, the type and role of social support, and patient satisfaction with cancer treatment DM.

Method: Adult cancer survivors (N = 604) were surveyed using Qualtrics online software.

Results: Older adults reported significantly lower influence of support on DM than younger adults. The most common DM style for the age groups was collaborative DM with their doctors. Younger age was a significant predictor of independent (p < .05), collaborative with family (p < .001), delegated to doctor (p < .01), delegated to family (p < .001), and demanding (p < .001) DM styles.

Discussion: Despite having lower received social support in cancer …

Exploring Attitudes Toward Euthanasia Among Shelter Workers And Volunteers In Japan And The U.S., Maho Cavalier

HSU STUDENT THESES AND CAPSTONE PROJECTS

Conflicts between foreign and Japanese volunteers concerning decisions to euthanize animals that are in terminal condition were noted during anecdotal observation by this author at a Japanese animal rescue shelter. Thus, this research was undertaken to explore attitudes of shelter staff in Japan. As a point of comparison, U. S. shelter workers were also interviewed. Twenty current or former shelter workers (16 participants from Japan and 4 participants from the U.S.), ranging in age from 20 to 65, were interviewed. Face-to-face interviews were conducted with the Japanese participants; e-mail and/or Skype were used to conduct the interviews with the participants …

Opportunities And Challenges In The Use Of Personal Health Data For Health Research, Matthew J. Bietz, Cinnamon S. Bloss, Scout Calvert, Job G. Godino, Judith Gregory, Michael P. Claffey, Jerry Sheehan, Kevin Patrick

University of Nebraska-Lincoln Libraries: Faculty Publications

Objective: Understand barriers to the use of personal health data (PHD) in research from the perspective of three stakeholder groups: early adopter individuals who track data about their health, researchers who may use PHD as part of their research, and companies that market self-tracking devices, apps or services, and aggregate and manage the data that are generated.

Materials and Methods: A targeted convenience sample of 465 individuals and 134 researchers completed an extensive online survey. Thirty-five hourlong semi-structured qualitative interviews were conducted with a subset of 11 individuals and 9 researchers, as well as 15 company/key informants.

Results: Challenges to …

Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje

Antioch University Dissertations & Theses

Moral distress in nursing has been studied across many care contexts, yet there is a paucity of research on the experience among health care leaders.The purpose of this study was to understand the experiences and perceptions of moral distress in nurse leaders.This study used an interpretive description approach interviewing 32 Canadian nurse leaders about their experiences and perceptions of moral distress within their role as a leader and nurse.A constant comparative and thematic analysis process revealed three thematic patterns:(a) leaders suffer moral distress in similar and different ways from their employees; (b) relationships matter in the midst of coping and …

Decline In Ethical Concerns About Reproductive Technologies Among A Representative Sample Of Us Women, Arthur L. Greil, Kathleen S. Slauson-Blevins, Karina M. Shreffler, Katherine M. Johnson, Michele Lowry, Andrea R. Burch, Julia Mcquillan

Department of Sociology: Faculty Publications

Public awareness and utilization of assisted reproductive technology has been increasing, but little is known about changes in ethical concerns over time. The National Survey of Fertility Barriers, a national, probability-based sample of US women, asked 2031 women the same set of questions about ethical concerns regarding six reproductive technologies on two separate occasions approximately 3 years apart. At Wave 1 (2004–2007), women had more concerns about treatments entailing the involvement of a third party than about treatments that did not. Ethical concerns declined between Wave 1 and Wave 2, but they declined faster for treatments entailing the involvement of …