Bioethics and Medical Ethics Commons^™

Establishing Consent: The Role Of Women Representatives In Passing Informed Consent Laws, Sophia Stockham

Department of Political Science: Dissertations, Theses, and Student Research

What predicts the adoption of informed consent laws for pelvic exams within the United States? As of January 2023, 22 states have adopted informed consent laws for pelvic examinations on women, with eleven being under Democratic control, six being Republican control, and five with divided control between the legislature and gubernatorial level at the time of adoption. Little attention, however, has been given to women’s health mandates outside the issue of abortion and to variation among state partisan adoption regarding informed consent for pelvic exams. This paper examines the impact of partisanship, the percentage of women in the legislature, and …

Escaping Death: Naloxone's Chemical Nature And Potential To Combat The Opioid Epidemic, Abigale Miller

Honors Program: Senior Projects (Public)

Naloxone is a life-saving drug with the ability to reverse an opioid overdose. As the opioid epidemic’s death toll rises, we can turn to Naloxone as a tool to combat the crisis. The epidemic, born of corruption, has a wide reach among the people of the United States, with especially firm grasps on middle-aged people, sufferers of chronic pain, white Americans and those living in the eastern portion of the country. Naloxone’s elegant design saves lives by effectively competing for a position on an opioid biding receptor in the brain to almost instantly end an overdose and restore normal breathing. …

Establishing Trust In Hiv/Hcv Research Among People Who Inject Drugs (Pwid): Insights From Empirical Research, Roberto Abadie, Shira Goldenberg, Melissa Welch-Lazoritz, Celia B. Fisher

Department of Sociology: Faculty Publications

Background — The establishment of trust between researchers and participants is critical to advance HIV and HCV prevention particularly among people who inject drugs (PWID) and other marginalized populations, yet empirical research on how to establish and maintain trust in the course of community health research is lacking. This paper documents ideas about trust between research participants and researchers amongst a sub-sample of PWID who were enrolled in a large, multi-year community health study of social networks and HIV/HCV risk that was recently conducted in rural Puerto Rico.

Methods — Qualitative research was nested within a multi-year Social Network and …

Repealing The Aca Without A Replacement — The Risks To American Health Care, Barack Obama

United States Public Health Resources

Health care policy often shifts when the country’s leadership changes. That was true when I took office, and it will likely be true with President-elect Donald Trump. I am proud that my administration’s work, through the Affordable Care Act (ACA) and other policies, helped millions more Americans know the security of health care in a system that is more effective and efficient. At the same time, there is more work to do to ensure that all Americans have access to high-quality, affordable health care. What the past 8 years have taught us is that health care reform requires an evidence-based, …

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 …

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 …

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 …

Privatization Of Biomedical Research: A Short Term Answer With Long Term Consequences, Frederick Azalekor

Nebraska College Preparatory Academy: Senior Capstone Projects

Biomedical research owned by the government is now available to be owned by private institutions. This results in stagnant innovations because researchers have trouble with all the restrictions that are placed by private institutions. Privatization of biomedical research has short term positive effects but its negative effects are overarching and disastrous. One way to combat this, is for licenses to be deployed slowly with future consequences in mind.

• Privatization has short term benefits but long term disadvantages are disastrous. • To reduce damaging effect, privatization must be deployed slowly and carefully. • Patents or proprietary ownership must be given …

Distributed Cognition In Cancer Treatment Decision Making: An Application Of The Decide Decision-Making Styles Typology, Janice L. Krieger, Jessica L. Krok-Schoen, Phokeng M. Dailey, Angela L. Palmer-Wackerly, Nancy Schoenberg, Electra D. Paskett, Mark Dignan

Department of Communication Studies: Faculty Publications

Distributed cognition occurs when cognitive and affective schemas are shared between two or more people during interpersonal discussion. Although extant research focuses on distributed cognition in decision making between health care providers and patients, studies show that caregivers are also highly influential in the treatment decisions of patients. However, there are little empirical data describing how and when families exert influence. The current article addresses this gap by examining decisional support in the context of cancer randomized clinical trial (RCT) decision making. Data are drawn from in-depth interviews with rural, Appalachian cancer patients (N = 46). Analysis of transcript …

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 …

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, …

‘‘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 …

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 …

Review Of Manon Parry, Broadcasting Birth Control: Mass Media And Family Planning, Rose Holz

Women's and Gender Studies Program: Faculty Publications

As Manon Parry explains in her interesting new book, ‘Many of the women who wrote [to the Birth Control Review] noted that they had read about [Margaret] Sanger’s work in the press, confirming the important role of the mass media in publicizing and building support for the movement’ (p. 13). Therein lies the crux of Parry’s project: the use of publicity was central to the family planning movement and a sustained analysis of its use over time is long overdue. To that end, she challenges several long-standing historiographic assumptions and unearths more than a few fascinating stories. For example, …

Confidentiality And Mental Health/Chaplaincy Collaboration, Denise Bulling, Mark Dekraai, Tarik Abdel-Monem, Jason A. Nieuwsma, William C. Cantrell, Keith Ethridge, Keith Meador

University of Nebraska Public Policy Center: Publications

Confidentiality can both facilitate and inhibit working relationships of chaplains and mental health professionals addressing the needs of service members and veterans in the United States. Researchers conducted this study to examine opportunities for improving integration of care within the Department of Defense (DoD) and Department of Veterans Affairs (VA). Interviews were conducted with 198 chaplains and 201 mental health professionals in 33 DoD and VA facilities. Using a blended qualitative research approach, researchers identified several themes from the interviews, including recognition that integration can improve services; chaplaincy confidentiality can facilitate help seeking behavior; and mental health and chaplain confidentiality …

Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

Book Review: Dream Of Ding Village By Yan Lianke, Mike Frick

China Beat Blog: Archive 2008-2012

Unsurprisingly, the Chinese government levied a “three nos” ban—no sales, no distribution, and no promotion—against Dream of Ding Village after its publication in 2005. Though the storytelling relies heavily on dream sequences, Yan takes little poetic license when exposing the depth of the state’s culpability in spreading HIV among poor, medically-naïve farmers. He is just as uncompromising when detailing how officials denied responsibility for the ensuing AIDS epidemic, even as they profited from its human tragedy. No one in Ding Village receives medical care, mental health counseling, food assistance, or a chance to hold the blood heads legally accountable. Cast …

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 …

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 …

Exploiting A Research Underclass In Phase 1 Clinical Trials, Carl Elliott, Roberto Abadie

Department of Sociology: Faculty Publications

In November 1996, the Wall Street Journal reported that Eli Lilly was paying homeless alcoholics from a local shelter to participate in safety testing of new drugs at its trial site in Indianapolis.1 “These individuals want to help society,” asserted Lilly’s director of clinical pharmacology. The subjects, however, said they took part for easy money and free room and board. Although Lilly reportedly offered the lowest per diem in the business, it managed to attract poor subjects from all over the country.1 The medical director of the local Homeless Initiative Program said Lilly had created a “shadow economy” of paid …