Bioethics and Medical Ethics Commons^™

Reviewing Existing Knowledge Prior To Conducting Animal Studies, Andrew Knight

Experimentation Collection

Highly polarised viewpoints about animal experimentation have often prevented agreement. However, important common ground between advocates and opponents was demonstrated within a discussion forum hosted at www.research-methodology.org.uk in July–August 2008, by the independent charity, SABRE Research UK. Agreement existed that many animal studies have methodological flaws — such as inappropriate sample sizes, lack of randomised treatments, and unblinded outcome assessments — that may introduce bias and limit statistical validity. There was also agreement that systematic reviews of the human utility of animal models yield the highest quality of evidence, as their reliance on methodical and impartial methods to select significant …

Faecal-Centric Approaches To Wildlife Ecology And Conservation; Methods, Data And Ethics, C. T. Darimont, T. E. Reimchen, H. M. Bryan, P. C. Paquet

Ethics and Conservation Biology Collection

Abundant and commonly encountered in the field, wildlife faeces have long attracted scientists. Recent advances in molecular techniques, however, especially when coupled with creative study designs, can now yield a great variety of high quality data. Herein, we review the opportunities and challenges of faecal-centric approaches to address ecological and conservation questions using wolves of coastal British Columbia, Canada, as a case system. We begin by discussing methodological considerations, which should have broad applicability to any wildlife study system. We then summarize the extensive and unique variety of data that has emerged from our ‘facts from faeces’ approach with wolves, …

The Moral Justification For Journalism, Sandra L. Borden

Center for the Study of Ethics in Society Papers

Papers presented for the Center for the Study of Ethics in Society Western Michigan University

Ethical Decision-Making Regarding Multiple Relationships Between Therapist And Client, Diana Jochai

Loma Linda University Electronic Theses, Dissertations & Projects

The current study examined a new conceptual model of factors critical to a therapist’s decision-making process when faced with the potential of a nonsexual multiple relationship with a client. This new model was founded on the conceptual framework proposed by Street, Douglas, Geiger, & Martinko (2001) and integrated the components of the decision-making process and the individual and situational factors influencing those components identified in existing general conceptual models and specific behavioral guidelines. For the ethical decision-making process to begin, a practitioner must be able to recognize the presenting problem as an ethical dilemma (Brazerman, 1986; Jones, 1991; Street et …

Referral In The Wake Of Conscientious Objection To Abortion, Carolyn Mcleod

Philosophy Publications

Currently, the preferred accommodation for conscientious objection to abortion in medicine is to allow the objector to refuse to accede to the patient's request so long as the objector refers the patient to a physician who performs abortions. The referral part of this arrangement is controversial, however. Pro-life advocates claim that referrals make objectors complicit in the performance of acts that they, the objectors, find morally offensive. McLeod argues that the referral requirement is justifiable, although not in the way that people usually assume.

Mid-Atlantic Ethics Committee Newsletter, Fall 2008

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Heme Induces Endothelial Tissue Factor Expression: Potential Role In Hemostatic Activation In Patients With Hemolytic Anemia, Yamaja Setty, Suhita G. Betal, Jie Zhang, Marie J. Stuart

Department of Pediatrics Faculty Papers

Objectives: We explored the possibility that heme, an inflammatory mediator and a product of intravascular hemolysis in patients with hemolytic anemia including sickle cell disease, could modulate hemostasis by an effect on endothelial tissue factor (TF) expression.

Methods: Levels of TF mRNA, protein and procoagulant activity were measured in heme-treated endothelial cells. Results: Heme induces TF expression on the surface of both macrovascular and microvascular endothelial cells in a concentration-dependent manner, with 12-fold to 50-fold induction being noted (enzyme-linked immunosorbent assay) between 1 and 100 μm heme (P < 0.05). Complementary flow cytometry studies showed that the heme-mediated endothelial TF expression was quantitatively similar to that of tumor necrosis factor-alpha (TNF-α). Heme also upregulated the expression of TF mRNA (8-fold to 26-fold), protein (20-fold to 39-fold) and procoagulant activity (5-fold to 13-fold) in endothelial cells in a time-dependent manner. The time-course of heme-mediated TF antigen expression paralleled the induction of procoagulant activity, with antibody blocking studies demonstrating specificity for TF protein. Interleukin (IL)-1α, and TNF-α are not involved in mediating the heme effect, as antibodies against these cytokines and IL-1-receptor antagonist failed to block heme-induced TF expression. Inhibition of heme-induced TF mRNA expression by sulfasalazine and curcumin suggested that the transcription factor nuclear factor kappaB is involved in mediating heme-induced TF expression in endothelial cells.

Conclusions: Our results demonstrate that heme induces TF expression by directly activating …

Phosphatidylserine-Positive Erythrocytes Bind To Immobilized And Soluble Thrombospondin-1 Via Its Heparin-Binding Domain, Suhita G. Betal, Yamaja Setty

Department of Pediatrics Faculty Papers

Phosphatidylserine (PS)-dependent erythrocyte adhesion to endothelium and sub-endothelial matrix components is mediated in part via thrombospondin (TSP). While TSP exhibits multiple cell-binding domains, the PS-binding site on TSP is unknown. Since a cell-binding domain for anionic heparin is located at the amino-terminus, we hypothesized that PS-positive red cells (PS+ve-RBCs) bind to this domain. We demonstrate that both heparin and its low-molecular-weight derivative enoxaparin (0.5-50u/ml) inhibited PS+ve-RBC adhesion to immobilized TSP in a concentration-dependent manner (21-77% inhibition, P<0.05). Pre-incubation of immobilized TSP with an antibody against the heparin-binding domain blocked PS+ve-RBC adhesion to TSP. Antibodies that recognize the collagen- and the carboxy-terminal CD47-binding domain on TSP had no effect on this process. While pre-incubation of PS+ve-RBCs with TSP-peptides from the heparin-binding domain containing the specific heparin-binding motif KKTRG inhibited PS+ve-erythrocyte adhesion to matrix TSP (P<0.001), these peptides in the immobilized form supported PS-mediated erythrocyte adhesion. A TSP-peptide lacking the binding-motif neither inhibited nor supported PS+ve-RBC adhesion. Additional experiments show that soluble-TSP also interacted with PS+ve-RBCs via its heparin-binding domain. Our results demonstrate that PS-positive erythrocytes bind to both immobilized and soluble TSP via its heparin-binding domain and that both heparin and enoxaparin, at clinically relevant concentrations, block this interaction. Other studies have shown that heparin inhibited P-selectin- and soluble-TSP-mediated sickle erythrocyte adhesion to endothelial cells. Our results taken together with the previously documented findings provide a rational basis for clinical use of heparin or its low-molecular-weight derivatives as therapeutic agents in treating vaso-occlusive pain in patients with sickle cell disease.

Human Embryonic Stem Cell Research, Justice, And The Problem Of Unequal Biological Access, Mark Moller

Faculty Publications

No abstract provided.

Atypical Onset As Predictor Of Poor Outcome In Pediatric Systemic Lupus Erythematosus (Psle), A Taddio, E Rossetto, L Lepore, A C. Brescia, C Bracaglia, S Caminiti, E Cortis, D Rigante, A Stabile, M Montico, L Ronfani, C D. Rosé

Department of Pediatrics Faculty Papers

Poster Presentation.

Healing The Effects Of Medical Errors: A Vision Of Justice As Wholeness, Christiane Catharine Schubert

Loma Linda University Electronic Theses, Dissertations & Projects

Medical errors cannot be avoided completely even when employing the greatest care and applying the most sophisticated medical technologies. They occur when organizational, human, technical, or environmental factors lead to unintentional failures which result in recognizable physical, mental, spiritual, or social harm to patients. Until recently, the medical profession has responded with silence while patients remained uncompensated or resorted to the legal system. Professional distancing undermines transparency and patient safety while medical malpractice litigation ruptures the fragile relationships between patients and healthcare providers in whom patients trust. Philosophically, these responses draw on the framework of deontological liberalism, promoting notions of …

Reply To Joseph Ellin's Of All Professions, Prostitution Is The Oldest (Except Possibly For Teaching), Michael Davis

Center for the Study of Ethics in Society Papers

No abstract provided.

Volunteer Studies In Pain Research — Opportunities And Challenges To Replace Animal Experiments: The Report And Recommendations Of A Focus On Alternatives Workshop, C. K. Langley, Q. Aziz, C. Bountra, N. Gordon, P. Hawkins, A. Jones, G. Langley, T. Nurmikko, I. Tracey

Experimentation Collection

Despite considerable research, effective and safe treatments for human pain disorders remain elusive. Understanding the biology of different human pain conditions and researching effective treatments continue to be dominated by animal models, some of which are of limited value. British and European legislation demands that non-animal approaches should be considered before embarking on research using experimental animals. Recent scientific and technical developments, particularly in human neuroimaging, offer the potential to replace some animal procedures in the study of human pain. A group of pain research experts from academia and industry met with the aim of exploring creatively the tools, strategies …

Professions "Of All Professions, Begging Is The Best" A Paper By Michael Davis. Response By Joseph Ellin. Professor Davis' Reply, Center For The Study Of Ethics In Society

Center for the Study of Ethics in Society Papers

Michael Davis' original paper was presented to the Center of the Study of Ethics in Society Western Michigan University on October 4, 2007.

"Of All Professions Begging Is The Best" - Some Problems In The Study Of Professions, Michael Davis

Center for the Study of Ethics in Society Papers

Michael Davis' original paper was presented to the Center of the Study of Ethics in Society Western Michigan University on October 4, 2007.

Of All Professions, Prostitution Is The Oldest (Except Possibly For Teaching), Joseph Ellin

Center for the Study of Ethics in Society Papers

Response by Joseph Ellin to a paper by Michael Davis Professions "Of All Professions, Begging is the Best"

Infant Mortality In Delaware: The Need To Improve Maternal Health And Reduce Premature Births., David A. Paul. Md

Department of Pediatrics Faculty Papers

Delaware's high infant mortality rate continues to be driven by an increasing number of premature births. Premature birth is a complex problem with both social and medical roots. Based on the CDC road map, programs aimed at improving preconception health of women of childbearing age are blossoming in Delaware. In addition, Delaware's infant mortality rate can only be reduced if we are able to diminish disparities in health care delivery, and improve the social factors influencing infant mortality. These factors include diminishing family support, low high school graduation rate, poor housing, and a lack of health insurance.

Mid-Atlantic Ethics Committee Newsletter, Summer 2008

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Enhancing Autonomy In Paid Surrogacy, Jennifer Damelio '06, Kelly Sorensen

Philosophy and Religious Studies Faculty Publications

The gestational surrogate – and her economic and educational vulnerability in particular – is the focus of many of the most persistent worries about paid surrogacy. Those who employ her, and those who broker and organize her services, usually have an advantage over her in resources and information. That asymmetry exposes her to the possibility of exploitation and abuse. Accordingly, some argue for banning paid surrogacy. Others defend legal permission on grounds of surrogate autonomy, but often retain concerns about the surrogate. In response to the dilemma of a ban versus bald permission, we propose a ‘soft law’ approach: states …

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 …

Mid-Atlantic Ethics Committee Newsletter, Spring 2008

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Infertility And Moral Luck: The Politics Of Women Blaming Themselves For Infertility, Carolyn Mcleod, Julie Ponesse

Philosophy Publications

Infertility can be an agonizing experience, especially for women. And, much of the agony has to do with luck: with how unlucky one is in being infertile, and in how much luck is involved in determining whether one can weather the storm of infertility and perhaps have a child in the end. We argue that bad luck associated with being infertile is often bad moral luck for women. The infertile woman often blames herself or is blamed by others for what is happening to her, even when she cannot control or prevent what is happening to her. She has simply …

Update - March 2008, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Editorial: Sectarian Self Engaging the Other
-- The Necessity of Interfaith Dialogue
-- A Comparative Approach to Islam and Democracy
-- Fethullah Gülen and the 'People of the Book': A Voice from Turkey for Interfaith Dialogue (Reprint)
-- News from the Center

The Role And Legal Status Of Health Care Ethics Committees In The United States, Diane E. Hoffmann, Anita J. Tarzian

Faculty Scholarship

Over a quarter of a century has passed since health care ethics committees (HCECs) in the United States received legal recognition as alternatives to the courts in resolving conflicts related to patient end-of-life care. By the mid to late 1980s HCECs had been established in over half of U.S. hospitals and had received a certain legitimacy in the health care system. Given their age and growth one could characterize them developmentally as emerging from adolescence and establishing themselves in young adult-hood. As a result, we might expect that they would have resolved the identify crisis characterizing the adolescent years. Yet, …

Book Review: "Human Dignity And Bioethics: Essays Commissioned By The President's Council On Bioethics, Leslie Meltzer Henry

Faculty Scholarship

The President’s Council on Bioethics frequently invokes -- but never defines -- the notion of human dignity in its reports on caregiving, stem-cell research, cloning, assisted reproduction, and biomedical enhancement. This article argues that the Council employs the language of dignity so loosely in its policy recommendations that the word is often nothing more than a rhetorical trump card to reject policies at odds with the Bush administration’s perspective. This article examines how the Council uses the word dignity; explores competing philosophical, theological, and political understandings of the word; and suggests ways in which a more productive dialogue about dignity's …

Ada Constitution & Bylaws (2008), American Dental Association

Constitution & Bylaws

The ADA Commons Constitution & Bylaws archival collection comprises printed issues of the American Dental Association's Constitution and Bylaws. The collection also includes the ADA Charter and the ADA Code of Ethics issued 1924-1946.

Non-Animal Methodologies Within Biomedical Research And Toxicity Testing, Andrew Knight

Experimentation Collection

Laboratory animal models are limited by scientific constraints on human applicability, and increasing regulatory restrictions, driven by social concerns. Reliance on laboratory animals also incurs marked – and in some cases, prohibitive – logistical challenges, within high-throughput chemical testing programmes, such as those currently underway within Europe and the US. However, a range of non-animal methodologies is available within biomedical research and toxicity testing. These include: mechanisms to enhance the sharing and assessment of existing data prior to conducting further studies, and physicochemical evaluation and computerised modelling, including the use of structure-activity relationships and expert systems. Minimally-sentient animals from lower …

To The Bitter End: Disparities In End-Of-Life Care, Alberto Coustasse, Theresa Quiroz, Sue G. Lurie

Management Faculty Research

Although technological advancements have provided the means to sustain life and provide care regardless of whether the treatment is appropriate and compassionate given the condition of the patient, bioethical, legal, and moral concerns related to disparities in care still arise in the United States. These concerns call into question the necessity to continue life-sustaining or palliative care treatments when patients and/or families are faced with end-of-life decisions. This study will focus on various historical, clinical cultural, and ethical issues that have placed this dilemma into a controversial public spectrum, by using case studies retrieved from referenced literature, which illustrate disparities …

Social Justice And Health Care Management: An Elusive Quest?, George P. Smith Ii

Scholarly Articles

Contemporary debate on health care resource management is tied to a central moral issue: namely, how to achieve an optimum level of reasonable or appropriate treatment based on the medical condition of each patient. Failing to tackle and resolve this issue in a confident and forthright manner assures the present approach to health care decision making to continue in a state of indecisiveness if, indeed, not lethargy.

Undergirding this moral issue is the foundational economic dilemma of controlling costs while limiting access to health care resources. Finding a just solution to an equitable distribution of finite health care resources is …

Of Panjandrums, Pooh Bahs, Parvenus, And Prophets: Law, Religion, And Medical Science, George P. Smith Ii

Scholarly Articles

This Monograph derives from a Lecture, under the same title, given in Sydney, Australia, honoring Michael D. Kirby, AC, CMG, Justice of The High Court of Australia. The first part of the Monograph analyses the significant contributions that Justice Kirby has made as a compassionate champion of human rights and acknowledges what is styled as the Kirby Ethic which, in turn, is seen as the foundation for the body of work of the Justice as well as the moving force in his private life as well. Building upon a theory of transcendent idealism which interprets God's purpose as safeguarding the …