Bioethics and Medical Ethics Commons^™

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 …

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.

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 …

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 …

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, …

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 …

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

Review Of Edison Bicudo, Pharmaceutical Research, Democracy And Conspiracy: International Clinical Trials In Local Medical Institutions, Roberto Abadie

Department of Sociology: Faculty Publications

The pharmaceutical industry is—along with the financial and weapons industries—one of the most globalized and profitable business domains. But they wouldn’t make any profits if they weren’t able to recruit research subjects to test an increasing number of drugs. This global trial economy creates its own assemblages of clinical trials, often run by hired contract research organizations (CROs), who fight among each other in a rat-race competition, promising quick and effective trials; at the same time, enterprising countries, hospitals, and doctors jump on the drug trial economy bandwagon by promising quick, endless access to a large pool of research subjects, …

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 …

Law, Ethics, And Public Health In The Vaccination Debates: Politics Of The Measles Outbreak, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

The measles outbreak of early 2015 is symptomatic of a larger societal problem–the growing number of parents who decide against vaccinating their children. This failure is causing the resurgence of childhood diseases once eliminated from the United States.

This article explores the legal and ethical landscape of vaccine exemptions. While all states require childhood vaccinations, they differ significantly in the types of religious and/or philosophical exemptions permitted, the rigor of the application process, and available review mechanisms. States with relaxed exemption policies disproportionately experience more outbreaks of vaccine-preventable disease.

Vaccine exemptions are an illustration of the “tragedy of the commons,” …

Barriers To Health Care Among Laotian Americans In Middle Tennessee, Xaiyavong Saenphansiri

DNP Projects

Background. Laotian Americans have unique heath beliefs and practices. The cultural differences between Laotian American patients and American health care providers can create challenges in achieving not only evidence-based, but also culturally sensitive care. Although the current literature addresses barriers to health care for Asian Americans, there are few studies related to the Laotian-American minority.

Aim. Describing the particular barriers to preventive and curative care in the Laotian-American population in Middle Tennessee would inform strategies for successful prevention and early treatment programs for this population. The purpose of the study is to describe the health beliefs and barriers to …

‘‘We Can Wipe An Entire Culture’’: Fears And Promises Of Dna Biobanking Among Native Americans, Roberto Abadie, Kathleen Heaney

Department of Sociology: Faculty Publications

This paper explores Native American perceptions on DNA biobanking. A qualitative study was conducted among self-declared Native Americans living off reservation in two Midwest cities. Findings demonstrate a paradox: Informants maintain strong hopes for the transformative power of gene-based research while voicing very particular social anxieties. Emerging genomic technologies elicit concerns over the potential for genetic stigmatization or discrimination based on race, preventing access to health insurance or employment. Frequently, social anxieties adopt the narrative form of conspiracy theories which portray powerful agents exploiting or abusing a disenfranchised population. We argue that while Native Americans do not have a monopoly …

Documenting Mass Rape: Medical Evidence Collection Techniques As Humanitarian Technology, Jaimie Morse

Genocide Studies and Prevention: An International Journal

Aim: Emerging global networks of human rights activists, doctors, and nurses have advocated for increased collection of medical evidence in conflict-affected countries to corroborate allegations of sexual violence and facilitate prosecution in international and domestic courts. Such initiatives are part of broader shifts in human rights advocacy to document human rights violations using rigorous, standardized methodologies. In this paper, I consider three principal forms of medical evidence to document sexual violence and their use in these settings: the patient medical record, the medical certificate, and the sexual assault medical forensic exam (commonly known as the “rape kit”).

Methods: Combining archival …

Consent For Nondiagnostic Research Biopsies: A Pilot Study Of Participant Recall And Therapeutic Orientation, Roberto Abadie, Jonathan Kimmelman, Josiane Lafleur, Trudo Lemmens,

Department of Sociology: Faculty Publications

A growing number of clinical trials incorporate invasive procedures like nondiagnostic tumor biopsies for biomarker or pharmacodynamic analysis.1 Such invasive research procedures are ethically contentious. Tumor biopsies involve pain and complication risk,2 and at least one procedure-related death has been reported.3 However, nondiagnostic tumor biopsies obtained in the research context generally have no value for managing the participant’s medical condition. Some commentators therefore argue that research biopsies “take” from participants without “giving in return.”4 Because such procedures are conducted contrary to research participants’ medical interests, an ethical framework for enrolling patients in studies that include a research biopsy rides heavily …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

Enhancing Communication Between Scientists, Government Officials, And The Lay Public: Advancing Science And Protecting The Public's Welfare Through Better Multi-Stakeholder Interfacing, Clark J. Lee, Patrick P. Rose, Earl Stoddard Iii

Homeland Security Publications

No abstract provided.

Humane Society International’S Global Campaign To End Animal Testing, Troy Seidle

Experimentation Collection

The Research & Toxicology Department of Humane Society International (HSI) operates a multifaceted and science-driven global programme aimed at ending the use of animals in toxicity testing and research. The key strategic objectives include: a) ending cosmetics animal testing worldwide, via the multinational Be Cruelty-Free campaign; b) achieving near-term reductions in animal testing requirements through revision of product sector regulations; and c) advancing humane science by exposing failing animal models of human disease and shifting science funding toward human biology-based research and testing tools fit for the 21st century. HSI was instrumental in ensuring the implementation of the March 2013 …

A Vision Becoming Reality, Gill Langley

Laboratory Experiments Collection

Non-animal science in toxicology and health research has been progressing for decades, but only now is it being seen widely as advanced science. The emergence of novel human biology-based tools and models, combined with legislative and regulatory change, a 21st century concept for toxicology, continuing failures in the drug pipeline, and systematic critiques of animal models, have created a pivotal moment of change. The leading edge is starting to become the norm. Humans and other animals are likely to benefit as a result.

History Of The 3rs In Toxicity Testing: From Russell And Burch To 21st Century Toxicology, Martin L. Stephens, Nina S. Mak

Humane Science Movement Collection

Toxicity testing is a key part of the process of assessing the hazards, safety, or risk that chemicals and other substances pose to humans, animals, or the environment. Standardized methods for such testing, typically involving animals, began to emerge during the first half of the 20th century. In 1959, British scientists William Russell and Rex Burch proposed a framework for reducing, refining, or replacing animal use in toxicology and other forms of biomedical experimentation. This “3Rs” or “alternatives” approach emerged at a time of growing sensitivity to the use of animals in experimentation, and progress in its implementation has been …

The Closure Of New Orleans' Charity Hospital After Hurricane Katrina: A Case Of Disaster Capitalism, Kenneth Brad Ott

LSU New Orleans Theses and Dissertations

Abstract

Amidst the worst disaster to impact a major U.S. city in one hundred years, New Orleans’ main trauma and safety net medical center, the Reverend Avery C. Alexander Charity Hospital, was permanently closed. Charity’s administrative operator, Louisiana State University (LSU), ordered an end to its attempted reopening by its workers and U.S. military personnel in the weeks following the August 29, 2005 storm. Drawing upon rigorous review of literature and an exhaustive analysis of primary and secondary data, this case study found that Charity Hospital was closed as a result of disaster capitalism. LSU, backed by Louisiana state officials, …

Update - February 2012, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Cancer Stories: An Argument for Narrative Ethics
-- Dual-Degree Masters of Arts in Bioethics
-- From the Director
-- Finding a Voice for Seventh-day Adventist Ethics in the Radical Reformation?

Clinical Decisions, Margaret Fish

VA Engage Journal

From the very beginning of my experience in the dental hygiene program, patient care has been the central focus. Not just in administrating dental hygiene services, but in their safety. Every patient presenting to the clinic for treatment has their blood pressure measured. I would like to compare two very similar incidents with two different responses by the clinic staff I have experienced while on external rotation.

Guinea Pigging In Philadelphia, Roberto Abadie

Department of Sociology: Faculty Publications

On June 16, 2001, the national press first reported the death of Ellen Roche, a healthy 24-year-old who volunteered for an asthma study at Johns Hopkins University. The story revealed that a few days into the trial she felt very sick, was discharged, and sent home. Within some hours she checked into the emergency room at a local hospital and fell into a coma. Ellen remained in this state until her death a month later. She had received $375 for participating in seven to nine sessions as an outpatient in the clinical drug study that resulted in her death.

This …

Aids Denialism, Erika Jenel Delos Santos, Roy Llana, Jocelyn Tan

Festival of Communities: UG Symposium (Posters)

AIDS denialism is a growing issue in many parts the world. Through scholarly journal articles, book resources and other research tactics, further understanding how HIV/AIDS denialism is unethical can be distinguished. Discovering that AIDS is most prominent in South Africa explains why denialism is as critical as it is. However, the unethical aspect of AIDS denialism is in effect particularly amongst families. When a South African inhabitant realizes they have AIDS, they feel outcasted by their families due to shame. They fear as though they will be disowned because they have flaws that are unacceptable. These family values are significant …

Organs Watch: Possibilities And Perils For Public Anthropology, Roberto Abadie

Department of Sociology: Faculty Publications

Recent technological advances in biomedicine have introduced new therapeutic possibilities but have also contributed to the emergence of a global market for human bodies and body parts. For example, artificial modes of human reproduction created a market for eggs, semen, and surrogate wombs. In addition, organ transfer generated a demand for kidneys and half livers. The whole body has become a valuable commodity as professional research subjects venture into the economy of Phase I Clinical Trials, testing drug safety for pharmaceutical companies. In the process, the trade has become a deeply unequal one in which poor, vulnerable, and easily exploited …