Bioethics and Medical Ethics Commons^™

"First, Do No Harm": Ethical Failures And Preventive Solutions In The United States Pharmaceutical System - A Narrative Review, Rebekah R. Bailey

Honors Theses

The United States pharmaceutical system is highly advanced but faces growing ethical concerns related to drug development and marketing, overprescription, and high drug costs. This thesis examines how pharmaceutical marketing, regulatory practices, and prescribing behaviors may conflict with the ethical principle of “first, do no harm.”

Using a narrative review of interdisciplinary literature in public health, medical ethics, and applied ethics, this thesis analyzes patterns in drug development, marketing strategies, and regulatory oversight. The findings suggest that ethical issues are systemic, driven by commercial incentives, inconsistent regulatory standards, and an increasing reliance on pharmaceutical solutions. These factors contribute to overmedicalization, …

Expanding Expanded Access: A Case Of Onc201 And The Ethical Limitations Of Compassionate Use, Ava C. Hutchings

Honors Theses

This study examines the ethical and structural limitations of the Expanded Access program in the United States, with particular focus on its application to terminal pediatric illness. Although the program is intended to provide patients with life-threatening conditions access to investigational therapies outside of clinical trials, its effectiveness in serving critically ill children remains uncertain. This program is analyzed through careful consideration of regulatory review and ethical theory. Key policies governing Expanded Access are examined alongside scholarly discussions of pediatric autonomy and parental authority.

A case study of ONC201, a now-approved investigational drug, is used to illustrate how Expanded Access …

A Treatise On Tool Development: The Arthroscope’S Cultural, Technological, And Metascientific Translation, Montgomery F. Waterer

Honors Theses

The arthroscope was a revolutionary development in the fields of medicine, engineering, and ethics. There are many valuable lessons to be learned from the story of its development and translation that are relevant to the future of medicine and society. Beginning with a brief description of the tool’s design, this paper will examine a period within the history of the arthroscope. This window contains multiple innovators and ends with the life and work of Dr. Robert Jackson. In examining the relevant historical facts of its development, this paper will then briefly address the importance of sports medicine in the development …

The Ethical Limits Of Physician Autonomy In Reproductive Medicine, Isabel Martens

Honors Theses

In vitro fertilization is a relatively new medical practice that helps people who face infertility be able to reproduce. Reproductive medicine providers face ethical dilemmas often in their field, only some of which have standards of care. There are questions in the medical landscape pertaining to physician autonomy versus patient autonomy, which heavily apply to reproductive medicine providers. Patient autonomy is highly valued in medical ethics; however, physician autonomy should also be considered. When a physician decides who can and cannot reproduce, ethical considerations must be followed to maintain the practice of reproductive autonomy. Limited policies exist that manage reproductive …

The Conservative Approach To Informed Consent: The Evidentiary Model And An Antidote To The Problem Of Framing Effects In Medical Decision-Making, James D. Polk

Honors Theses

Since the latter part of the 20th century, there has been a gradual but significant shift of the doctor-patient relation from paternalism to a more patient-centric approach. As such, informed consent – the legal and moral requirement that a physician fully disclose relevant details to their patient and gain their consent – is a central doctrine to patient-centric care. Gone are the days of the doctor governing the patient: the patient is now considered a valuable and important decision-maker. Achieving informed consent is the foundation of patient centric medicine. Therefore, it is of the utmost importance that philosophical consideration be …

Lack Of Patient-Centered Care Relative To Evidence-Based Practice In Clinical Diagnosis And Treatment Of Endometriosis In The U.S.: A Review, Piper E. Scoskie

Honors Theses

This scoping review examines the impact of combining Patient-Centered Care (PCC) and Evidence-Based Care (EBC) on clinical outcomes and patient satisfaction in the diagnosis and treatment of endometriosis in the United States. In particular, the review aims to (1) examine the body of research from the United States to learn more about the connection between PCC and EBC and their collective impact on patient satisfaction and clinical outcomes in the treatment of endometriosis; (2) identify the gaps in existing research and practice, specifically regarding PCC procedures, varying patient populations, and longitudinal investigations; and (3) provide recommendation for future research and …

Reproductive Justice In Mississippi: A Call For Reform And Acknowledgement, Andie Udziela

Honors Theses

In this thesis, I apply the values of the Reproductive Justice Movement to reproductive healthcare resources in Mississippi to advocate for reproductive policy reform. I begin by navigating the historic racial discrimination in gynecology and how it manifested in Mississippi. Dr Sim’s abusive experimentation on Anarcha, Betsy, and Lucy depict how Anti-Black racism took root in gynecology and obstetrics and was later expanded on by the eugenic goals of white supremacy and the feminist movement through Margaret Sanger and the Mississippi Appendectomy. Then I discuss the current availability of reproductive care in Mississippi to low-income individuals to emphasize socioeconomic and …

At The End Of Life: Conceptualizing Human Dignity And Assisted Suicide Debates In Contemporary Germany, Edith-Marie Green

Honors Theses

As medicine improves and breakthroughs on cures for illnesses formerly thought deadly continue to develop, the global population continues to age. This has introduced new concerns about aging and end-of-life health care. One proposed end-of-life healthcare solution is assisted suicide, although the practice is not without its controversies. The case of assisted suicide in Germany is of particular interest for a variety of reasons, and the practice has not had an easy path there. A series of debates in 2015 led to the practice being banned, but that ban was overturned in 2020 by Germany’s Constitutional Court. While assisted suicide …

Redlining And Opioid Overdose Outcomes: Do Historical Housing Policies Still Impact Health Today?, Sahana Paravantavida

Honors Theses

This study examines the relationship between historical housing policies and current health outcomes, specifically the impact of redlining on opioid overdose rates. Using data collected from the state of New Jersey, neighborhoods with a history of redlining have higher rates of opioid overdose deaths. My findings suggest that historical housing policies, which systematically excluded certain populations from accessing affordable housing and resources, continue to impact health outcomes today.

Providing Culturally Competent Eldercare For Asian Americans, Britney Ngo

Honors Theses

As the Asian American elderly population continues to grow, it is important to acknowledge cultural factors that may impact their behavior, attitudes, preferences, and decisions in the context of eldercare. Cultural competency acknowledges and considers these factors while providing care that includes biophysical factors of healthcare as well as non-medical dimensions of care such as language and culture.

This thesis seeks to address the applications of providing culturally competent eldercare to Asian Americans and offer future recommendations to care settings that have limited resources by utilizing a multidisciplinary review of literature accompanied by interviews with representatives from On Lok, a …

Understanding The Role Of Race In American Medicine, Fariel C. A. Lamountain

Honors Theses

Long running inequity in health care and outcomes in the United States stem from failure to acknowledge the underlying role of the Transatlantic slave trade as it manifests in all facets of American society and commerce. This paper focuses specifically on the American medical system and its foundations to understand the precursors to generational trends in lack of access to healthcare and poor health for Black communities. This paper uses a three-pronged approach to understand the racist cycle of inequity, highlighting the history and origins of racism in American medicine, personal accounts and statistical evidence of inequity, and community and …

Covid-19 And Challenges To The Traditional Understanding Of Individual Medical Autonomy, Callon A. Green

Honors Theses

Throughout history, vaccines have provided the human population with the ability to combat dangerous illnesses and avoid preventable suffering. Despite the benefits vaccines provide to the public health of the United States, anti-vaccination sentiment and resistance to vaccine uptake are still prevalent in the modern day. As the COVID-19 pandemic has developed into a major public health crisis that can be controlled through vaccination, the issues underlying vaccine resistance are becoming more critical to return to normal life. Using COVID-19 as a case study, it is evident that the individual choice to deny vaccination can have consequences on the health …

From Forced To Voluntary Participation: The History Of Biomedical Human Experimentation In The United States After The Second World War, Haley L. Andonian

Honors Theses

For as long as medicine and medical practices have been around, so has the need for testing treatments in or procedures on the human body. Over the course of history, however, the nature, structure, and prominence of human biomedical experimentation has changed drastically both on an international and national level. My thesis focuses on revealing the driving forces behind these changes in administrative, legal and social factors related to human experimentation in an effort to connect the dots from the manipulative, forceful and unethical experimentation of early medical practitioners to the safe, voluntary and highly regulated experimentation characteristic of clinical …

Don't Know, Do Not Resuscitate: A Principle For The Creation Of The Kingdom Of Ends In The Icu, Griffen Isaac Allen

Honors Theses

In the United States today 20% of all Americans die in Intensive Care Units, or ICUs. These were developed in the 50s, 60s, and 70s to centralize medical resources to help treat critically ill patients with new technologies like ventilators, dialysis, and other tools that are now commonplace. This occurred simultaneously with the emergence of individualistic autonomy, understood as the patient's right to dictate their treatment, as the dominant force in medical ethics. Ostensibly both of these developments would seem beneficial for patients. However, the ultimate result is overly aggressive care that strips patients of their dignity and ensures that …

When Evil Met Science: Nazi Medicine And Eugenics, Ashley Corey

Honors Theses

During World War II, millions of innocent people were murdered in Nazi Germany. For Hitler and his followers, having a pure race meant having a strong, unified country, and Germany took this idea to extreme and disturbing lengths. Corruption filled the government at all levels. As physicians were the only people authorized to run the gas chambers, traditional healers became death symbols. The Nazis and their physicians used their power to manipulate and murder for the collective goals of the country, as well as the personal gains that came with the high-end job titles. As I reveal the history and …