Bioethics and Medical Ethics Commons^™

Beyond The Binary: Strengthening Nursing Students’ Proficiency Of Equitable Health Promotion, Martha K. Findley

Theses

Background: Sexual and gender diverse (SGD) populations continue to experience significant health inequities, yet prelicensure nursing curricula often lack structured, evidence‑based training to prepare students for equitable care.

Purpose: This study evaluated whether a targeted, transgender‑focused simulation could improve nursing students’ clinical knowledge and preparedness for providing equitable health promotion to SGD populations.

Methods: A pre‑/post‑intervention design was used with senior‑level nursing students who completed a transgender patient simulation emphasizing communication, assessment, and equitable health promotion. Students completed a validated survey measuring knowledge and preparedness in caring for SGD patients.

Results: Significant improvements across most survey items demonstrated that the …

Explaining Variation In Medical Aid In Dying Policy Across U.S. States, Abigail Hopper

Undergraduate Theses, Capstones, and Recitals

This paper asks why Medical Aid in Dying (MAiD) policy in the United States does not follow a simple partisan pattern between states. Existing scholarship on morality policy emphasizes ideological conflict and partisan alignment, but this framework cannot fully explain why states with similar political compositions have adopted different MAiD policy outcomes, indicating that some key mechanisms shaping the variation have been overlooked. To address this, this paper combines a national dataset of MAiD policies across all fifty states with a comparative case study of Montana, Colorado, and West Virginia, focusing on differences in institutional venues, framing strategies, and coalition …

Moving Beyond Traditional Cost Containment For Glp-1 Coverage Within Oregon's Proposed Universal Health Plan, Manoj Rajesh

University Honors Theses

In 2022, Oregon voters passed Measure 111, constitutionally mandating access to affordable health care. As the Universal Health Plan Governance Board (UHPGB) designs the state's proposed single-payer system, it faces an unprecedented financial vulnerability: the clinical demand for GLP-1 receptor agonists. These high-cost, indefinite-use medications for obesity and metabolic syndrome threaten to overwhelm fixed public budgets. Historically, both the Oregon Health Plan's Medicaid framework and commercial private insurers have relied on static cost-containment models—categorical exclusions, step therapy, and aggressive utilization management—that achieve short-term fiscal solvency at the expense of comprehensive preventative care. This thesis argues that to fulfill the mandate …

"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 …

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 …

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 …

Navigating The Ethical Landscape Of Ai Created Responsibility Gaps In Healthcare, Kelsey Dwyer '26

Honor Scholar Theses

This work is a philosophical analysis of the ethical dilemma of AI-created responsibility gaps, or the idea that it is challenging to find someone to hold responsible for outcomes produced by an autonomous system. In particular, my focus is specifically on addressing responsibility gaps created by AI used in healthcare. This complex issue of responsibility gaps becomes more intense in the setting of critical areas of life like healthcare, where moral responsibility is a foundational component of upholding medical ethics. My paper will take a deep dive into exploring the intricacies of this complex problem by applying a pre-existing conceptual …

Knowledgable Births: Advancing Informed Consent In Maternal Healthcare, Ella A. Forrester

Senior Theses

Background:

Informed consent is both a legal requirement and an ethical cornerstone of healthcare, ensuring that patients understand and voluntarily agree to medical treatments. However, evidence suggests that the informed consent process is often inadequately implemented in maternal healthcare settings, particularly during childbirth. While giving birth, women retain full decision-making capacity but are not consistently provided with sufficient information or support to exercise this right. Contributing factors include ineffective patient–provider communication, limited health literacy, and insufficient access to culturally responsive educational resources.

Methods:

This study aimed to address gaps in accessible prenatal education by developing an online resource platform, Know …

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 …

Not Biological, But Built: Structural And Metabolic Pathways Driving Black Maternal Health Disparities In The United States, Alexandra I. Umegboh

CMC Senior Theses

Black infants in the United States are more than twice as likely to die before their first birthday than white infants, a disparity often attributed to genetics, behavior, or individual health choices. However, this idea is challenged by a key contradiction: African immigrant women consistently experience better birth outcomes than U.S.-born Black women despite being similarly racialized. This thesis investigates the origins of this reproductive advantage and the factors contributing to its decline over time. By drawing on epidemiological data, metabolic health research, and literature on African diasporic healing traditions, it argues that the “healthy immigrant effect” is not biological, …

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 …

(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 …

Representation Of Diseases And Health Care In Selected African Gyno-Texts, Rachael K. Aderoju

Electronic Theses and Dissertations

This study explores the interdisciplinary field of literature and medicine through a feminist psychoanalytic lens, focusing on how Nigerian female writers represent illness, healthcare, and medical ethics in post-independence gyno-texts. Traditionally, scholarship in this field has centered on andro-texts (literary works authored by men), leaving a critical gap in the exploration of women’s perspectives. This research addresses that gap by analyzing nine prose works authored by Nigerian women, including texts by Chimamanda Ngozi Adichie, Ayobami Adebayo, Lola Shoneyin, and Samira Haruna Sanusi. These texts are examined for their portrayal of diseases such as infertility, cancer, bipolar disorder, and renal failure, …

The Global Clinical Trials Ecosystem: A Critical Evaluation And Future Outlook, Sydney-Ariel D. Muneses

Undergraduate Honors Theses

As global clinical trials expand, inconsistencies in regulatory and ethical frameworks are increasingly evident, raising concerns about economic sustainability and participant protections. Existing research attributes this surge to pharmaceutical companies seeking cost efficiencies in emerging markets but acknowledges the challenges posed by fragmented oversight across international jurisdictions. To examine these limitations, a modified Delphi approach was used to gather expert insights from key stakeholders in global clinical trials. Findings highlighted systemic inefficiencies and ethical gaps, emphasizing the need for regulatory harmonization to balance scientific rigor, economic feasibility, and equitable participant treatment. By identifying critical shortcomings and proposing strategies to align …

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 …

I Am (Me)Dicine: An Analysis On The Influence Of Humanities Courses Within The Construction Of Internal And External Identities Within Pre-Med Students At Uno, Alix Barnes

Theses/Capstones/Creative Projects

The purpose of this project is to investigate how arts and humanities coursework may enhance the development of internal and external identities for premedical students beyond their traditional scientific coursework. A literature review shows positive findings on identity development and the influence of arts and humanities coursework on medical education. This investigation will take place through a mixed-method survey distributed to UNO premedical students and will explore themes of self-reflection, personal and professional growth, and understanding of external perspectives. An optional question prompts respondents to reflect further on their work within arts and humanities courses and their impact on these …

On Death And Disease: How Physicians’ Perspectives Compare Across Specialties Through Written Work, Stephanie Anne C. Alkonga

Honors Capstones

Narrative medicine is a tool that the medical field is increasingly utilizing to cultivate patient-centered and culturally competent doctors and to reflect on lived experiences through texts that focus on psychosocial best practices. This study aims to examine the language used in physician-written works that address how physicians in different medical specialties treat the aging and the terminally ill, and how they view the deceased. Qualitative data guided by thematic questions will primarily be used in the analysis and comparison of these texts’ tone, rhetoric, diction, and similar literary devices to uncover if certain patterns arise across such specialties. Findings …

Heterotopias Of Confinement: Zoo Architecture And The Loss Of Elephant Agency, Clayton Gill Beasley

Electronic Theses and Dissertations

Zoos functions as a site where human-animal relationships are structured through built environments that mediate control and representation. This study examines zoos as heterotopias—spaces where power and surveillance are negotiated between human observers and captive nonhuman animals. While zoos are often framed as spaces of conservation and education, their architectural design reinforces hierarchies of observation and confinement, shaping both human perceptions of nature and the lived experiences of nonhuman animals. This research focuses on Asian elephants as a critical species within this framework, exploring how their captivity illuminates tensions between human-imposed structures and nonhuman autonomy. Drawing from theories of heterotopia, …

Am I Woke Enough To Serve In Healthcare: A Secondary Analysis Of Pre-Health Students’ Personal And Professional Growth By Engaging In Cultural Competency Assessments, Harolynn Williams

All Dissertations

Healthcare providers must be equipped to serve an increasingly diverse population, yet cultural competence remains underemphasized in undergraduate pre-health education. This study explored how embedded cultural competency training influences undergraduate pre-health students’ perceptions of personal and professional growth. Using a qualitative descriptive design, the research incorporated intercultural assessments, the Intercultural Development Inventory (IDI), and the Global Competence Certificate (GCC), along with qualitative reflections from students enrolled in three versions of a cultural competence course: a year-long course, a semester-long course, and a short-term study abroad immersion six-week course. Findings revealed that students demonstrated measurable growth in cultural awareness, knowledge, communication, …

The State Of Abortion Training In Medical School And Family Medicine Residency Curricula: A Scoping Literature Review, Eric James Reece

Capstone Experience: Master of Public Health

This project aims to assess how abortion education has been integrated into medical training over the past decade, with a particular focus on understanding its current state in medical schools and family medicine residencies, including those offering specialized programs affiliated with RHEDI (Reproductive Health Education in Family Medicine) and TEACH (Training in Early Abortion for Comprehensive Healthcare). Given the ever-evolving legal landscape following the June 4^th, 2022 Supreme Court case of Dobbs v. Jackson Women’s Health Organization, this review explores how both federal- and state-level legal restrictions impact access to abortion training and attempts to identify gaps …

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 …

Inside The Mad Mind: Medical Ethics In 19th Century Fiction, Danielle Dentremont

College Honors Program

The professionalization of medicine in mid-to-late 19th century America and Britain corresponded with heightened critical scrutiny of the ethics of doctor-patient relationships in contemporary fiction. With ethics frameworks of the century focused primarily on good fellowship between practitioners, it was difficult to charge practitioners with bad ethics. Yet, the broader debates of vivisection and women’s rights brought to light power imbalances between men and women that novelists began to suggest were present in medicine as well. Wilkie Collins’ Heart and Science weighs in on the danger of the doctor-scientist encroaching on women’s rights with the suggestion that women will 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 …

Implementation Of Robotics And Artificial Intelligence To Oncological Surgery, Ian Ngo

Nursing | Senior Theses

Background/ significance: Introduced in the late 20th century, robotic systems have enhanced surgeons’ capabilities by providing accurate and precise control of instruments. These systems helped minimize invasiveness in surgical procedures, providing greater precision, and gave flexibility to difficult-to-access areas of the body. Tools powered by AI help surgeons accurately identify and remove cancerous tissues, which can lead to better surgical outcomes and fewer complications. Purpose: The purpose of this study is to focus on evaluating how Robotic-Assisted Systems (RAS) and Artificial Intelligence (AI) impact surgical precision, patient recovery, and to address economic efficiencies. associated with integrating said systems into the …

Exploring Lgbtq+ Competency In Healthcare, Jordan Whiteman

Honors College Theses

Marginalized groups such as the LGBTQ+ community are known to face healthcare disparities that negatively affect their process of navigating healthcare systems. This project explores the perceived lack of representation and understanding of the LGBTQ+ community within healthcare settings, exposing the deficits in knowledge for unique challenges and inequalities these patients may face. By viewing the literature, a myriad of complications faced by LGBTQ+ people in clinical settings can be identified. They possess a generalized feeling of mistrust towards the healthcare system. Healthcare staff overall describe low confidence with caring for this demographic. Heteronormativity’s presence in the field of healthcare …