Bioethics and Medical Ethics Commons^™

The Next Drug Epidemic Is Legal: The Nation's Kratom Problem Is More Complicated—And More Harmful—Than It Seems, Elizabeth Walsh

Capstones

This two-part health and science investigative piece reports how kratom and its offshoots have quietly fueled a lucrative and legal addiction epidemic for the last decade. While kratom’s derivative alkaloid 7-hyrdoxymitragynine made headlines this year and as the DEA is poised to ban the strong derivative, “natural” kratom and other kratom-derived products will remain. This piece tracks the history of the 'gas‑station opioid' crisis in the U.S. over ten years: what was thought to be an innocuous southeast Asian supplement has become multi-billion dollar industry built on gray‑area laws, marketed falsehoods, and regulatory loophooles.

Part 1: The ‘Gas Station Opioid’ …

Two Major Ontario Hospital Labs Bought Research Dogs From U.S. Breeder With Troubled Pastdogs Bred For Scientific And Medical Testing Suffer Abuse As The Scientific Industry Increasingly Turns To Alternatives For Research., Allison Hunter, Mary Beech, Sami Marshak, Kate Morano

Capstones

The purpose-bred dog breeding industry for research is little known. Each year, thousands of dogs are bred for scientific and medical testing, supplied to research facilities by a handful of major commercial breeders. But gaps in enforcement and regulation have allowed abuses to persist, even as the industry increasingly turns to alternatives to animal testing. Animal rights advocates have been decrying the treatment of these dogs. A federal Inspector General report found lax oversight of the industry, raising further concerns about how dogs are treated. This story was reported in collaboration with the Investigative Journalism Bureau, based in Toronto, and …

Essential Caretaking For Artists With Disabilities: Exploring The Overlooked Histories Of Hazel Knapp And Grandma Moses, Bryan P. Martin

Dissertations and Theses

This thesis explores the intersection of disability studies and art history, addressing the underrepresentation of disability in scholarship, especially concerning medical sociology and caretaking. Focusing on two early-twentieth-century self-taught American artists, Hazel Knapp (1908–95), who fell into obscurity, and Anna Mary Robertson Moses (1860–1961), best known as Grandma Moses, this is a comparative analysis of how disability influenced their artistic practices and shaped their divergent career outcomes. Knapp was born with Charcot-Marie-Tooth disease, a neurodegenerative disorder, and fell into obscurity due to a lack of support for her condition, but experienced a promising start to her career that included patronage …

Demarcating Psychopathologies: Nosology, Validity, And The Taxonomic Problem In Psychiatric Medicine, Julia Zentz Kolak

Dissertations, Theses, and Capstone Projects

In this dissertation, I argue that the discussion surrounding the role of values in the conceptualization of mental disorders is reproduced in critical debates surrounding the issue of reliability and validity in a psychiatric nosology. In so doing, I oppose the conventional separation of the demarcation problem and the crisis of validity in psychiatric classification, arguing instead that they are inextricably linked. After drawing out the intersection between these literatures in the conceptual history of the DSM and its much-maligned transition to an etiologically neutral taxonomy of mental disorders, I consider Carl Hempel’s proposed conciliation between descriptive and theoretical systematization …

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, …

Righting Health Policy: Bioethics, Political Philosophy, And The Normative Justification Of Health Law And Policy, D. Robert Macdougall

Publications and Research

In Righting Health Policy, D. Robert MacDougall argues that bioethics needs but does not have adequate tools for justifying law and policy. Bioethics’ tools are mostly theories about what we owe each other. But justifying laws and policies requires more; at a minimum, it requires tools for explaining the legitimacy of actions intended to control or influence others. It consequently requires political, rather than moral, philosophy. After showing how bioethicists have consistently failed to use tools suitable for achieving their political aims, MacDougall develops an interpretation of Kant’s political philosophy. On this account the legitimacy of health laws does …

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 …

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 …

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 …

Phil 201: Bioethics, Cuny School Of Professional Studies

Open Educational Resources

An exploration of complex contemporary ethical problems from healthcare, the environment, and bioethics. Issues include problems of drugs and addiction, stigma toward people with disabilities, terminal illness and chronic health needs, resource allocation in times of disaster, infectious diseases, gene editing, and humans’ relationship with their environment. Classical and contemporary ethical theories, moral theories, and the fundamentals of scientific integrity will be applied to make principled, defensible, moral judgments.

The Ends Of Medicine And The Experience Of Patients, D. Robert Macdougall

Publications and Research

The ends of medicine are sometimes construed simply as promotion of health, treatment and prevention of disease, and alleviation of pain. Practitioners might agree that this simple formulation captures much of what medical practice is about. But while the ends of medicine may seem simple or even obvious, the essays in this issue demonstrate the wide variety of philosophical questions and issues associated with the ends of medicine. They raise questions about how to characterize terms like “health” and “disease”; whether medicine’s goals should be extended to include enhancement beyond normal human function; and whether the ends of medicine are …

Eugenics In The 21st Century, Jessica Linn Chin

Dissertations, Theses, and Capstone Projects

Eugenics is the science of enhancing the human population through the management of breeding and hereditary traits. This thesis explores the history of eugenics and shows how eugenic practices continue in the 21^st century with advancements in technology and positive eugenic goals that can result in adverse effects on the human body and society. When Sir Francis Galton coined the term eugenics in 1883, he intended to improve British society with the use of positive eugenics. Galton used positive eugenics to encourage people with good mental and physical qualities to produce more children. He avoided negative eugenics, which involved …

Biomedical Ethics And Responsible Conduct Of Research, Katherine Mendis

Open Educational Resources

This course is an introduction to the moral challenges that arise in the design and execution of biomedical research and the development of medical interventions. A historical review segues into detailed examination of key ethical concepts and principles, as well as topics of particular concern. At the culmination of the semester, students apply their knowledge of research ethics to an ethical analysis of their MTM BioDesign projects.

Introduction To Biomedical Ethics, Katherine Mendis

Open Educational Resources

This course introduces students to issues in the field of biomedical ethics, the theoretical tools bioethicists use to analyze them, and methodology for resolving clinical ethical dilemmas.

Intervention Principles In Pediatric Health Care: The Difference Between Physicians And The State., D. Robert Macdougall

Publications and Research

According to various accounts, intervention in pediatric decisions is justified either by the best interests standard or by the harm principle. While these principles have various nuances that distinguish them from each other, they are similar in the sense that both focus primarily on the features of parental decisions that justify intervention, rather than on the competency or authority of the parties that intervene. Accounts of these principles effectively suggest that intervention in pediatric decision making is warranted for both physicians and the state under precisely the same circumstances. This essay argues that there are substantial differences in the competencies …

Preparing Physicians To Contend With The Problem Of Dual Loyalty, Holly G. Atkinson

Publications and Research

Dual loyalty is defined as, particularly as it pertains to the field of medicine, a conflict or potential conflict between a healthcare professional’s simul- taneous obligations–expressed or implied–to a patient and to a third party. Dual loyalty situations often compromise physicians’ ethical behavior, lead- ing them to participate, either knowingly or unknowingly, in human rights violations perpetrated by a third party, often the state. Classic dual loyalty situations include the participation of physicians in state-sanctioned torture or the death penalty. However, there are a number of other dual loyalty scenarios that arise routinely in clinical practice in both closed institutions …

My Preferred Pronoun Is She: Understanding Transgender Identity And Oral Health Care Needs, Diana V. Macri, Kate Wolfe

Publications and Research

This literature review summarizes current research and evidence regarding transgender persons and oral health. Methods: A search of the literature was conducted in the following databases: PubMed, Google Scholar, EBSCO Host, Science Direct, and Wiley Online Library using the keywords "transgender identity, gender non-conforming, discrimination, transition, binary systems, transgender oral cavity, transgender, transgender oral health, transgender dental health." Articles published from 2000 to 2017 in both peer-reviewed and non-peer reviewed journals, which reported information regarding the oral health status of transgender populations, were selected for review. Results: The search revealed 18 articles, only 7 of which pertained to the oral …

Sometimes Merely As A Means: Why Kantian Philosophy Requires The Legalization Of Kidney Sales, D. Robert Macdougall

Publications and Research

Several commentators have tried to ground legal prohibitions of kidney sales in some form of Kant’s moral arguments against such sales. This paper reconsiders this approach to justifying laws and policies in light of Kant’s approach to law in his political philosophy. The author argues that Kant’s political philosophy requires that kidney sales be legally permitted, although contracts for such sales must remain unenforceable. The author further argues that Kant’s approach to laws, such as those governing kidney distribution, was formed in part by considering and rejecting an assumption frequently employed in the bioethics literature, namely, that legal duties can …

Just Culture: It's More Than Policy, Linda Ann Paradiso, Nancy Sweeney

Publications and Research

Any healthcare organization’s top priority is effective and safe care. Despite this, medical error is the third-leading cause of death in the US. Hospitals are imperfect systems where nurses have competing demands and are forced to improvise and develop workarounds. Errors rarely occur in a vacuum, rather they’re a sequence of events with multiple opportunities for correction. Clinical nurses can have a significant impact on reducing errors due to their proximity to patients. When errors are identified, the events and impact on safe care need to be shared. Just culture is a safe haven that supports reporting. In a just …

Cultural Competence Amongst Undergraduate Healthcare Students (Spring 2019), Mary Lee, Tiffany Yip, Teresa Lok, Zoya Vinokur

Publications and Research

As students in the healthcare field, we want to be able to provide care that best serves the needs of a culturally diverse patient body. This study aims to look at whether healthcare students at City Tech are able to clearly define and understand the concepts of cultural competence and implicit bias in their healthcare encounters. Our research expands upon existing data from the previous

year. We opened the scope of the project to include students in non-healthcare majors to understand how the general student population perceives their healthcare encounters. While focusing on improving our data analysis, we distributed two …

Demystifying The Placebo Effect, Phoebe Friesen

Dissertations, Theses, and Capstone Projects

This dissertation offers a philosophical analysis of the placebo effect. After offering an overview of recent evidence concerning the phenomenon, I consider several prominent accounts of the placebo effect that have been put forward and argue that none of them are able to adequately account for the diverse instantiations of the phenomenon. I then offer a novel account, which suggests that we ought to think of the placebo effect as encompassing three distinct responses: conditioned placebo responses, cognitive placebo responses, and network placebo responses. Next, I consider implications of the placebo effect’s role in complementary and alternative medicine for discussions …

Quality Of Death People With Terminal Illnesses Are Turning To An Age-Old Method To End It All: Self-Starvation, Kazi E. Awal, Alyssa Pagano

Capstones

Voluntarily stopping eating and drinking (VSED) is getting more attention in the medical community. Though physician assisted dying legislation passed in two more states in 2016--there are now 7 states where it is legal--the practice, where doctors prescribe a lethal dose of sedatives so that terminally ill patients can end their own lives, is inaccessible to many. But fasting to death is a way for patients suffering from terminal illnesses or other debilitating diseases to end their lives on their own terms that is legal everywhere. As extreme as it sounds, research shows the process can be made comfortable with …

Ethics Pertaining To The Legalities Of Male Routine Infant Circumcision And Surrogate Consent To Non-Therapeutic Surgery, Jason A. Domashevskiy, Artem V. Domashevskiy

Publications and Research

Circumcision is the most contentious surgery performed in the world today. Approximately 38% of the world male population has been circumcised, mostly during the neonatal and prepubescent periods. Circumcision in regularly practiced ubiquitously throughout the Islamic countries, Israel, and the United States; the US is only country who regularly circumcises its boys for a non-religious reason. No world health body advocates circumcision prior to adulthood. Routine Infant Circumcision (RIC) violates the United Nations Policy on Genital Integrity, the Hippocratic Oath taken by doctors, and the rules for surrogate consent to surgery. Studies have shown no benefits to circumcision during the …

Under The Gun: Ongoing Assaults On Bahrain’S Health System, Richard Sollom, Holly G. Atkinson

Publications and Research

In February 2011, the Government of Bahrain began targeting health professionals who treated protesters. In April 2012, PHR's Richard Sollom, Deputy Director, and Holly Atkinson, MD, FACP, past President of PHR's Board and volunteer expert, authored a report showing the devastation on Bahrain's health system that have resulted from the Government of Bahrain’s continued assault on doctors, patients, and the healthcare system.

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …

Nazi Doctors, Psychology, And Evil, University Faculty Senate

CUNY UFS Publications

University Faculty Senate, Annual Dinner Meeting, Dec. 16, 1986

V. .Dessert/Guest Lecturer: Distinguished Professor Robert J. Lifton -"Nazi Doctors, Psychology, and Evil." Professor Lifton was appointed to John Jay College, the Graduate School and University Center, and the CUNY Mt. Sinai School of Medicine.

This talk was produced and distributed after the meeting Minutes.

An Alternative Policy For Obtaining Cadaver Organs For Transplantation, James L. Muyskens

Publications and Research

Two moral principles have been basic to the legal decisions concerning the rights and duties toward the newly dead. They are the duty to give decent burial and the denial to anyone of a right to ownership of the dead body for commercial profit. The next-of-kin-rather than the church or the state­ have come to bear the primary responsibility for providing decent burial.

The familial duty to give decent burial has come to be understood as a legal right to determine what is to be done to the body in the interval between death and burial.

Armed with this right, …