Bioethics and Medical Ethics Commons^™

Values-Based Clinical Ethics: A New Model Of Health And Ethics Consultation For Patients Suffering In Extremis, Adam Trainer

Electronic Theses and Dissertations

This dissertation argues that contemporary clinical ethics is inadequately equipped to support patients suffering in extremis because it relies on an insufficiently discriminating account of health and a constrained model of moral reasoning. Drawing on Bernard Lonergan, it reconceives health as an emergent, multi-layered, heuristic notion shaped by biological, psychological, social, and existential goods. On that basis, it critiques principlism’s global applicability thesis and the undergirding claim that its principles form part of the common morality, arguing that this justificatory structure is philosophically insufficient and practically limited for clinical ethics in cases marked by profound suffering, moral plurality, and normative …

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …

(Un)Intended Consequences Of Race In Medicine: The Ethics Of Race-Based Medical Practice And The Perpetuation Of Structural Racism, Allegra Merriweather

Electronic Theses and Dissertations

This dissertation proposes that race-based medicine acts as a form of structural racism that is ethically indefensible. While it may be claimed to be a neutral diagnostic tool, the medical use of race as a biological proxy only further enforces the very hierarchies it purports to remediate, reinscribing inequity from conception to death. Building off Jacques Ellul’s work on Technique, we interpret race-based medicine as a self-perpetuating system that values procedural expediency over moral accountability. In nine chapters, the analysis follows the ways this technique is manifested in genetics and assisted reproduction, where commodified racial selection preserves social hierarchies; in …

The Contribution Of Catholic Compromise Principles In Global Health, Scott N. Helstad

Electronic Theses and Dissertations

The Roman Catholic tradition has developed comprehensive ethical principles to address complex practical scenarios that encounter foundational value compromises. These are referred to as compromise principles and they have both a narrow and a broad focus. Narrowly, these compromise principles are critical for Catholic healthcare organizations in the United States with regard to the guidelines of the US Bishops in their Ethical and Religious Directives for Catholic Health Care Services. More broadly, these compromise principles are relevant in the secular realm regarding global health. This dissertation examines these varying perspectives, hence its title, “The Contribution of Catholic Compromise Principles …

Hospital Organizations’ Obligation To Promote Spiritual Well-Being Among Nurses: Development Of A Normative Ethical Argument, Michael Jordan

Electronic Theses and Dissertations

This dissertation presents an innovative strategy to promote the support of nurses' spirituality within hospital organizations. By focusing on the spiritual well-being of nurses by hospital organizations, with a natural extension into nursing schools, the approach aims to enhance nurse’s ability to protect their own spirituality, provide comprehensive spiritual care to patients, and increase nurse moral resilience. By investing in nurses' spirituality and spiritual growth, hospitals can potentially increase job satisfaction among nursing staff, improve patient care outcomes, and create a more holistic healing environment for both nurses and patients. As the nursing shortage continues and the number of nurses …

The Ethical Imperative Of The Renewal Of Virtue Within The Moral Community Of Catholic Healthcare, Amanda Altobell

Electronic Theses and Dissertations

Catholic healthcare is one of the largest nonprofit organizations and providers in the United States, offering medical care to many diverse communities. The fundamental mission of Catholic healthcare is to bring about Christ’s healing ministry and live out the fundamental principle of caring for the vulnerable in pursuit of the common good. However, there have been many missteps, not only due to a more polarized and secular community but also to scandals and conflict due to previous hierarchical and rules-based anthropology that often misses the person's lived experience. Therefore, this dissertation will argue that for Catholic healthcare to survive the …

Challenges To Reproductive Justice: An Ethical Analysis Of Reproductive Technologies And Disparities, Courtney Brenner

Electronic Theses and Dissertations

This dissertation analyzes the Reproductive Justice Framework to describe possible solutions to the ethical challenges related to reproductive healthcare disparities. Various frameworks to support reproductive equity fail to address the challenges marginalized individuals face in accessing reproductive health services. The four ethical principles of autonomy, beneficence, nonmaleficence, and justice serve as foundational tools to support reducing these disparities. This dissertation uses the Reproductive Justice Framework to analyze the unequal distribution of harms among marginalized women. It highlights how access to care, such as Assisted Reproductive Technologies (ART), is disproportionately inaccessible to marginalized women. Then, it discusses the relationship between marginalized …

Ethical Considerations In The Diagnosis And Treatment Of Autism Spectrum Disorder, Ferdinand Okafor

Electronic Theses and Dissertations

This dissertation is an ethical response to the ethical issues in the assessment, diagnosis, and treatment of autism. The problems that underlie the discussion are misconception about autism and Autistics. The misconception about autism and Autistics lead to misinterpretation of the neurological functioning, cognition, and the behaviors of Autistics. Consequently, it influences the approach and model of care in the assessment, diagnosis, and treatment of autism. Currently, the analytic approach and biomedical model of disease are applied in the assessment, diagnosis, and treatment of autism. The motive of the analytic approach and biomedical care is to cure autism. The consequence …

Muslim Spirituality As A Foundation In Bioethics For Patient Encounters In Health Care, Sara Rahman

Electronic Theses and Dissertations

Spirituality plays a major role in decision making for individuals with faith-based values. There is often hesitation to discuss the role of faith in healthcare as a core value and coping mechanism. The growing cultural diversity amongst patients and physicians has increased the need to understand eastern religious principles and incorporate them into bioethical guidance. Even as the 2nd largest religion in the world, Islam has not been sufficiently integrated into religious bioethics in western medicine. Muslim populations of patients and physicians are growing, increasing the need for better understanding of how Islamic principles impact healthcare delivery. Although Islamic law …

The Ethical Contributions Of Nudges To Healthcare, Ian Doherty

Electronic Theses and Dissertations

“The Ethical Contributions of Nudges to Healthcare” examines the ethical use, implications, and rationale for using nudges in healthcare. The use of nudges in healthcare are being empirically examined. This leaves much to be examined from the ethical perspective. To examine the ethical perspective, the dissertation lays out how nudges interact with and enhance the biomedical principles of autonomy and beneficence. The dissertation then turns to clinical ethics. Nudges, more specifically the framing effect, are paired with trust in the patient-physician relationship to discern how best to aid a patient in his or her medical decision-making. The dissertation then investigates …

The Ethics Of Involuntary Psychiatric Hospitalization: A Comprehensive Analysis Of Policies, Practice, And Ethical Oversight, Mariah Chobany

Electronic Theses and Dissertations

As a specialized field of medicine, psychiatry presents unique ethical challenges and dilemmas distinct from other medical disciplines. A particularly complex aspect of psychiatric care involves the involuntary treatment of patients who may be unable to make informed decisions about their care or participation in research due to the debilitating effects of their psychiatric condition. This presents a significant challenge for providers and researchers, particularly concerning capacity issues and the informed consent process. Despite the intricacies and complexities of ethical dilemmas in psychiatric treatment and research, there is a notable lack of comprehensive guidance in policies and practices on addressing …

From Policymaking To Legislation, The Need For A Secular Turn In Bioethics Discourse To Uphold, As A Function Of The Greater Good, Policy For Legislation Of Medically Aided Dying In The United States Of America, Scott Dyer

Electronic Theses and Dissertations

A person’s right to self-determination is a central aspect of living in a democratic nation. Similarly, decisions regarding medical care are generally left up to the patient to determine what treatment is or is not appropriate. The same should apply to end-of-life care as well, especially when a patient desires to hasten his or her death via medically aided dying. However, due to the illegality of medically assisted dying in most of the United States, the right to a self-determined death is not possible for the majority of American citizens. One of the main reasons for this is due to …

The Ethics Of Vulnerability In Health Care, Hannah Dieterle

Electronic Theses and Dissertations

This dissertation seeks to address vulnerability within clinical healthcare settings. Currently, clinical vulnerability is underrecognized and insufficiently researched which leads to the perpetuation of negative health outcomes for vulnerable populations. Specifically, there is a lack of a consistent and universal definition of vulnerability which has built a shaky foundation on which to discuss vulnerability. This dissertation begins to address these issues and increase awareness on clinical vulnerability due to some populations experiencing the devastating effects of vulnerability at a higher and disproportionate rate when compared to other populations. There is a clear need for increased attention from ethicists and medical …

The Ethical Duty Of Care For Suicide Ideation, Tah Ngijoi Yogo

Electronic Theses and Dissertations

With suicide being a leading global cause of death, there is a need to explore the ethical complexities surrounding suicide and preventive measures. This dissertation questions the morality of suicide by examining the historical and philosophical dimensions across cultures and religions. The text argues for an approach that acknowledges rational suicide while developing the ethics of paternalistic measures for suicide prevention of vulnerable populations.

Considering the ethics of autonomy, the dissertation discusses the practice of nudging in healthcare to highlight the role of paternalism in supporting informed consent. The text proposes an enhanced autonomy model that balances trust, influence, and …

The Ethical Justification Of Medical Interventions Across The Spectrum Of Healthcare For Patients Preceding The Age Of Consent: The Tension Between Surrogate Consent And Minor Assent, Erin Scroggins

Electronic Theses and Dissertations

This dissertation, The Ethical Justification of Medical Interventions Across the Spectrum of Healthcare for Patients Preceding the Age of Consent: the Tension Between Surrogate Consent and Minor Assent, will aim to provide ethical justification for medical intervention for patients preceding the age of consent. To begin, decision-making for medical intervention in all forms will be examined. Followed by, beginning of life interventions into complex and controversial situations for medical intervention which then leads into end-of-life considerations for patients preceding the age of consent. These chapters will pose various ethical considerations for some more contentious dilemmas. It has been pondered …

The Contributions Of Philosophical Anthropology To Healthcare Ethics, Bura Koroba

Electronic Theses and Dissertations

The first principles of bioethics, autonomy, beneficence, nonmaleficence, and justice have contributed immensely to healthcare ethics. The procedural approach streamlines the decision-making process, protects vulnerable subjects, and fosters stability and trust in the patient-caregiver relationship. Yet, the principles are demonstrably insufficient, riddled with limitations and loopholes that could stand in the way of care.[i] Several recommendations have been proffered to remedy the deficiencies. Value ethics, for instance, has been touted as a proficient addendum to the foundations established by the principles. Still, these have not sufficiently addressed all arising issues in bioethics. Besides the challenges encountered in decision-making, opposing …

The Contribution Of Pope Francis’ Integral Ecology To Global Ethics, Salvatore Enzo Del Brocco

Electronic Theses and Dissertations

The defense of the dignity and inviolability of human life has always gained prominence in the doctrine of the Catholic Church. With Pope Francis' concept of integral ecology, Catholic bioethics is expanded to a broader understanding. His vision of integral ecology, global bioethics, and solidarity emphasizes the interconnectedness of all things and the importance of caring for one another and the planet. It calls us to recognize our common humanity and to work together for the common good by facing the numerous emerging problems of our times, which threaten the dignity of human life and the future life of the …

Perinatal Ethics: The Role Of Ethics Consultation Around Parental Dilemmas Before And After Birth, Giulia Adele Dinicola

Electronic Theses and Dissertations

This dissertation, “Perinatal Ethics: the Role of Ethics Consultation around Parental Dilemmas Before and After Birth,” aims to examine the nuances of clinical ethics consultations in the field of perinatal ethics. Perinatal ethics entails ethical quandaries that emerge during a life-changing shift in prospective parents’ lives: pregnancy, childbirth, and the first days to months of their child’s life. Although pregnancy and childbirth often come with happy and joyful memories; this is not always the case. When fetal anomalies are diagnosed either with prenatal screening tests, or when maternal health complications develop during pregnancy, or when delivery-related emergencies occur during childbirth, …

Transforming Chaplain Ethics: The Clinical Ethics Of Spiritual Care In A Pluralistic Healthcare Environment In The United States, Robert Alan Price

Electronic Theses and Dissertations

This dissertation, “Transforming Chaplain Ethics: The Clinical Ethics of Spiritual Care in a Pluralistic Healthcare Environment in the United States,” aims to examine the clinical ethics of religious and spiritual care provided by clinical chaplains for patients and families receiving treatment in a pluralistic healthcare context in the United States.

Clinical chaplains are more than clergypersons and they are more than clinicians; they are a highly specialized marriage of both worlds. There is a fundamental asymmetry between functioning as a leader in a local religious community or faith tradition and providing clinical spiritual care in a pluralistic healthcare environment. This …

Healthcare For Undocumented People In America, Richard Pazer

Graduate Student Research Symposium

Millions of undocumented people live in America and roughly a million have entered every year since 2021. This is a hot-button issue in mainstream politics for a variety of reasons. However, there is an issue that tends to get overlooked which is their health care. In most states, undocumented people do not qualify for healthcare coverage of any kind. This leaves them reliant on EMTALA and emergency departments (ED). Through an examination of the various state and federal policies that pertain to undocumented people’s healthcare coverage, we can see that these people are in desperate need of assistance. It becomes …

The Contribution Of Principlism To Foster Ethical And Clinical Reciprocity In Resolving Healthcare Dilemmas, Dominic Glorioso

Electronic Theses and Dissertations

Principlism is an ethical method that uses an analytical framework based on a set of principles that can function as guidelines for healthcare professionals. The term was made

famous by the work of two bioethicists, Tom L. Beauchamp and James F. Childress. Their book, Principles of Biomedical Ethics and its multiple editions described a set of norms that are basic

for biomedical ethics. The first edition of their book was published in 1979, and the ninth edition in 2019. Its persistence and durability speak for themselves. In addition, their writings made

famous the four bioethical principles of respect for Autonomy, …

The Integration Of Catholic Mission And Ethics In Contributing To A Good Death, Noah Dimas

Electronic Theses and Dissertations

Catholic healthcare ethics exists within a morality that is under regular heavy scrutiny. This is furthered by the healthcare space itself becoming more secular as the greater society itself moves beyond the religious origins of healthcare. However, this does not have to be relegated to a negative. Rather, this can become a strong call to action for Catholic healthcare to rally together and advocate for itself in the wider healthcare space. This is especially true as these challenges to the Catholic moral-ethical framework begin to question the presence of both Catholic and religious healthcare as whole. These challenges, if left …

The Ethics Of Governance Of Data Analytics In Healthcare, Andrew Harrington

Electronic Theses and Dissertations

Recent literature and studies on data governance usually focus on data ethics and governance from a specific country or industry, which has been mostly business, without considering the larger global impact that is affected. Data is a worldwide asset; thus, its implications and considerations should be viewed as such. Hence, this dissertation attempts to incorporate this view by weaving together topics in healthcare, such as the blending of finance and delivery, data governance at the micro and macro levels, data analytics in healthcare, ethics of AI and information management, and technology’s impact on end-of-life practices. Through highlighting these areas of …

The Ethical Contribution Of Cultural Diversity As A Social Determinant Of Health, Pooja Patel

Electronic Theses and Dissertations

The dissertation examines how cultural diversity as a social determinant of health, aligned with human life, human dignity, human rights, and human equity provides an ethical contribution. My explanation of the ethical contribution of cultural diversity as a SDOH refers to a quadrant of topics that expands the approach of the UNESCO Declaration of Bioethics and Human Rights. The UNESCO approach addresses cultural diversity in relation to human dignity and human rights. I adopt a quadrant of topics that aligns human dignity with human life and human rights with equity. Aligning these topics in the quadrant (dignity/life and rights/equity) explains …

Do Adolescent Patients Have A Right To Be Informed About Fertility Preservation Options By Virtue Of The Conventions On The Rights Of The Child?, Giulia Adele Dinicola

Graduate Student Research Symposium

The 1989 United Nations Convention on the Rights of the Child not only states that children should be heard in matters of their concern according to their age and maturity, but also that children should have a right to have access to information. However, when it comes to medical indications, a consensus has not been reached on whether parents should disclose healthcare complications to their adolescent child. Adolescent disclosure becomes even more controversial when related to non-lifesaving procedures. In the United States, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the …

The Hermeneutics Of Nudging: The Reciprocity Between Transhumanism And Nudging, Ian Doherty

Graduate Student Research Symposium

This paper investigates and evaluates the implications of nudging someone toward transhumanism. Transhumanism offers a path to alleviate suffering and transcend our physical and mental limitations. Transhumanist technologies consist of alterations like genetic modification, neural implants, and molecular nanotechnology. These technologies are meant to give people full morphological freedom over their bodies. Although transhumanism remains a largely unknown movement, this is where nudge theory can help raise its prominence. Nudge theory aims to help people make better choices, and aid them in making better decisions related to their health and lifestyle. If paired correctly, transhumanism seems to be a perfect …

The Ethical Imperative Of Inclusion In Healthcare Innovation: Scaling And Sustaining Digital Health Equity, Lukas E. Chandler

Electronic Theses and Dissertations

The COVID-19 pandemic revealed the harm of digital health exclusion. Excluded groups could not benefit from virtual care due to device access gaps, broadband connectivity, and digital and language literacy levels. A lack of engagement with historically excluded populations in digital health innovation is an ethical harm and a maleficent form of social exclusion. Digital tools in healthcare delivery represent more than just a strategy for promoting health equity; they signify an opportunity to address health inequities in the health technology design process.

The historical focus of healthcare ethics on bedside decision-making issues largely explains why the field lacks concerted …

Ethical Oversight Of Roles & Relationships In Treatment & Research In Advanced Disease States, Alexa Vercelli

Electronic Theses and Dissertations

There is often ethical analysis focusing solely on the care of the patient by the physician or on the protection of the research participant by the clinical investigator, but those two are often overlapping. By paralleling the analysis of treatment and research, it emphasizes the specific ethical approaches necessary for individuals facing advanced diseases states in the separate roles of being a patient or participant. It also gives guidance to the complexity of the ethics surrounding medical professionals who float between the roles of treating physicians and clinical investigators. As individuals with advanced disease states are considered a vulnerable population …

Respecting The Ethical Tension Between Surveillance And Privacy In Promoting Public Health And Disease Management, Kamal Althobaiti

Electronic Theses and Dissertations

The recognition of the need to undertake surveillance and to protect privacy is well established. However, the continually changing circumstances and fast-paced development of healthcare today requires a continuing need to respect this ethical tension between surveillance and privacy. Hence, this dissertation is to respect the ethical tension between surveillance and privacy in promoting public health and disease management. This dissertation investigates the ethics of conducting public health surveillance, including the challenges associated with obtaining consent and protecting data from unauthorized access. The dissertation will focus on the ethical consequences of big data, including issues associated with obtaining informed consent, …

Exploring Moral Permissibility Of Nurse Participation In Limited Resuscitation, Felicia Stokes

Electronic Theses and Dissertations

This dissertation offers a novel approach to support nurses when they face conflict between clinicians and families or alternate decision-makers over potentially inappropriate end-of-life goals of care. This dissertation will provide a normative analysis of the moral permissibility of limited resuscitation, with arguments supported by analyses of families’ and nurses’ perspectives and actions in the EoL decision-making process. Limited resuscitation is a cardiopulmonary resuscitation effort where full pharmacologic and mechanical intervention is not used, or the length of the resuscitative effort is shortened. It is typically associated with deception because it is performed without the knowledge of patients and families. …