Bioethics and Medical Ethics Commons^™

Stress Of Conscience: Concept Clarification, Muder Alkrisat, Manal Alatrash

Journal of Health Ethics

Workers in healthcare systems are predisposed to work-related stress based on moral factors. Stress results when nurses are exposed to ambiguous moral situations, or when they are prevented by hospitals or their employees from doing what they ought to do. Such experiences have been described as stress of conscience because they give rise to a troubled conscience. Empirical studies indicate that health care employees, including nurses, sometimes refer to stress of conscience when faced with ethically difficult situations related to patient care.

Public Health Promotion In Bangladesh Through The Community Health Clinics: A Foucauldian Analysis, Biplab Kumar Halder

Journal of Health Ethics

The system of community health clinics in Bangladesh is contributing largely to improving the public health status of rural communities in Bangladesh. The significant success of this health promotion program leads medicine to its summit of power to influence the prevalent power structure in rural Bangladesh. A critical analysis of this paradigm shift is demanded in the context of public health. A Foucauldian analysis of the public health scenario of Bangladesh is most relevant in this context. In the paper, I propose a critical analysis of the public health apparatus of Bangladesh as manifested in the community health clinics, from …

Exploring Attitudes Toward Euthanasia Among Shelter Workers And Volunteers In Japan And The U.S., Maho Cavalier

HSU STUDENT THESES AND CAPSTONE PROJECTS

Conflicts between foreign and Japanese volunteers concerning decisions to euthanize animals that are in terminal condition were noted during anecdotal observation by this author at a Japanese animal rescue shelter. Thus, this research was undertaken to explore attitudes of shelter staff in Japan. As a point of comparison, U. S. shelter workers were also interviewed. Twenty current or former shelter workers (16 participants from Japan and 4 participants from the U.S.), ranging in age from 20 to 65, were interviewed. Face-to-face interviews were conducted with the Japanese participants; e-mail and/or Skype were used to conduct the interviews with the participants …

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 …

Genetic Analysis And The Ethics Of Secondary Findings, Jacob Zieba 16

Honor Scholar Theses

No abstract provided.

Acceptance Of Uncertainty: Uncertainty As A Heuristic Tool Applied To The Issue Of Medical Errors, Angelika Potempa

Philosophy Faculty Publications

This is an exploration of uncertain certainties and certain uncertainties with reference to, mainly, systemic approaches to medical errors.

Stand By You: An Interprofessional Compassionate Service, Rose Allen, Renato Santos, Arlenna Williams, Sarita Khanal

All Publications

No abstract provided.

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 …

Choosing An Allograft Or Autograft In Orthopedic Surgeries For Athletes, Cassandra M. Izzo

Honors Theses and Capstones

Athletes and their doctors have the choice of using an allograft or autograft in reconstruction surgeries. The purpose of this study is to see if there is a difference in the healing mechanism and surgical outcome in using an allograft or autograft during orthopedic surgical procedures, as well as to analyze graft rejection and disease transmission through donor tissue.

Doctors and athletic trainers were interviewed in order to learn about the healing mechanisms and advantages and disadvantages of allografts and autografts in order to conclude if one was better than the other. College level athletes on different sports teams were …

Veterinarians Need Support To Break The Silence, Anne Fawcett

Animal Sentience

The question of whether reporting animal abuse should be mandatory for veterinarians is an important one. Veterinarians have dual obligations, both to their animal patients and to their human clients. Mandatory reporting can only be supported in a context in which veterinary professionals are (a) trained to recognise the signs of animal abuse; (b) trained to elicit a history sensitively from clients who may themselves be victims of abuse or supported in doing so; (c) supported by appropriate, responsive authorities; (d) reasonably protected from legal recriminations.

Autonomy And Distributive Justice At The End Of Life, Corinna Fukushima

Scripps Senior Theses

Discussions of autonomy at the end of life in health care contexts is no new phenomenon. However, what seems to have changed in issues of autonomy is cases where patients want to refuse a treatment to cases where patients are demanding more treatment when medical professionals may not agree or be able to provide them with the medical treatment. Some key competing interests impacting patient autonomy include beneficence-doing what is in the best interests of the health or well-being of the patient- and resource limitations. Here, I will explore distributive justice theories that impact the end of life and how …

Ethics Pertaining To The Legalities Of Male Routine Infant Circumcision And Surrogate Consent To Non-Therapeutic Surgery, Jason A. Domashevskiy, Artem V. Domashevskiy

Publications and Research

Circumcision is the most contentious surgery performed in the world today. Approximately 38% of the world male population has been circumcised, mostly during the neonatal and prepubescent periods. Circumcision in regularly practiced ubiquitously throughout the Islamic countries, Israel, and the United States; the US is only country who regularly circumcises its boys for a non-religious reason. No world health body advocates circumcision prior to adulthood. Routine Infant Circumcision (RIC) violates the United Nations Policy on Genital Integrity, the Hippocratic Oath taken by doctors, and the rules for surrogate consent to surgery. Studies have shown no benefits to circumcision during the …

Missing The 'Target': Preventing The Unjust Inclusion Of Vulnerable Children For Medical Research Studies, Ruqaiijah Yearby

All Faculty Scholarship

The central purpose of medical research on children is to generate new knowledge that can improve children’s health, subject to ethical standards that promote justice. Incorporated in U.S. law, international law, and European Union law, the Justice Principle prohibits targeting in medical research, which is the selection of research subjects because of their manipulability and compromised position, rather than for reasons directly related to the problem being studied. Unfortunately, medical research studies involving children have too often violated the Justice Principle, by targeting children in a compromised position due to their health status and vulnerable to manipulability because of their …

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 …

Whole-Genome Sequencing And Disability In The Nicu: Exploring Practical And Ethical Challenges., Michael J. Deem

Manuscripts, Articles, Book Chapters and Other Papers

Clinical whole-genome sequencing (WGS) promises to deliver faster diagnoses and lead to better management of care in the NICU. However,several disability rights advocates have expressed concern that clinical use of genetic technologies may reinforce and perpetuate stigmatization of and discrimination against disabled persons in medical and social contexts. There is growing need, then, for clinicians and bioethicists to consider how the clinical use of WGS in the newborn period might exacerbate such harms to persons with disabilities. This article explores ways to extend these concerns to clinical WGS in neonatal care. By considering these perspectives during the early phases of …

The Future Of Abortion Law In The United States, Gerard V. Bradley

Journal Articles

In 1971, Judith Jarvis Thomson published what was then and still often is regarded as a trailblazing philosophical defense of a woman’s right to have a lawful abortion. It is time to revisit Thomson’s paper. The aim here is not to engage Thomson’s pro-choice conclusions, which are indeed mistaken, but to show that her question—to what extent can abortion be morally justified, assuming that it is the deliberate killing of one person by his or her mother—is the question today in American law concerning abortion. Pro-life people and groups argue among themselves about the prudence of political efforts to roll …

The Need For Soft Skills In A Medical Assistant Program, Micheal L. Randolph

Walden Dissertations and Doctoral Studies

There is a perceived soft skills problem within the medical assistant program (MAP) at a 2-year technical college in the Midwestern United States. Soft skills refer to relational skills such as practicing self-management, communicating with various groups, adapting to change, negotiating, and resolving conflict. The purposes of this intrinsic case study were to (a) understand the perspectives of faculty, staff, and leadership regarding students' soft skills ability within the study MAP and (b) identify important soft skills needed in the workplace. An integrative conceptual framework that drew upon vocational and organizational theories was used as a theoretical framework for the …

Introduction To Bioethics Special Supplement V: Ethical Issues In Genomic Testing Of Children., John D. Lantos

Manuscripts, Articles, Book Chapters and Other Papers

Next-generation genome sequencing of children is one of the most promising and most challenging new technologies in pediatrics. On the one hand, it offers the hope that we will be able to diagnose rare conditions that were previously impossible to diagnose, which, in turn, might lead to new treatments. On the other hand, the technology for sequencing presents daunting problems of interpretation. It is problematic to conduct the research necessary to characterize the pathogenicity of those variants at the same time that we are using them to guide the clinical care of children who have complex medical problems. It is …

Please Do Whatever It Takes To End Our Daughter's Suffering!, Stéphan Clément De Cléty, Marie Friedel, A A Eduard Verhagen, John D. Lantos, Brian S. Carter

Manuscripts, Articles, Book Chapters and Other Papers

What is the best way to care for a child with severe neurologic impairment who seems to be dying and is in intractable pain? Can we give sedation as we remove life support? Is it ethically permissible to hasten death? In the United States, 5 states have legalized assisted suicide (although only for competent adults). In Belgium and the Netherlands, euthanasia is legal for children under some circumstances. We present a case in which parents and doctors face difficult decisions about palliative care. Experts from Belgium, the Netherlands, and the United States then discuss how they would respond to such …

Moral Distress And The Health Care Organization, Andy Kondrat

Dissertations

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress.

In …

Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje

Antioch University Dissertations & Theses

Moral distress in nursing has been studied across many care contexts, yet there is a paucity of research on the experience among health care leaders.The purpose of this study was to understand the experiences and perceptions of moral distress in nurse leaders.This study used an interpretive description approach interviewing 32 Canadian nurse leaders about their experiences and perceptions of moral distress within their role as a leader and nurse.A constant comparative and thematic analysis process revealed three thematic patterns:(a) leaders suffer moral distress in similar and different ways from their employees; (b) relationships matter in the midst of coping and …

Animal Mourning: Précis Of How Animals Grieve (King 2013), Barbara J. King

Animal Sentience

Abstract: When an animal dies, that individual’s mate, relatives, or friends may express grief. Changes in the survivor’s patterns of social behavior, eating, sleeping, and/or of expression of affect are the key criteria for defining grief. Based on this understanding of grief, it is not only big-brained mammals like elephants, apes, and cetaceans who can be said to mourn, but also a wide variety of other animals, including domestic companions like cats, dogs, and rabbits; horses and farm animals; and some birds. With keen attention placed on seeking where grief is found to occur and where it is absent …

Breaking The Silence: The Veterinarian’S Duty To Report, Martine Lachance

Animal Sentience

Animals, like children and disabled elders, are not only the subjects of abuse, but they are unable to report and protect themselves from it. Veterinarians, like human physicians, are often the ones to become aware of the abuse and the only ones in a position to report it when their human clients are unwilling to do so. This creates a conflict between professional confidentiality to the client and the duty to protect the victim and facilitate prosecution when the law has been broken. I accordingly recommend that veterinarian associations make reporting of abuse mandatory.