Bioethics and Medical Ethics Commons^™

How To Compromise On Saving The Most Lives: A Commentary On Hellman And Nicholson, “Rationing And Disability”, David Wasserman

Washington and Lee Law Review Online

Deborah Hellman and Kate Nicholson’s “Rationing Disability” is a skillfully integrated analysis of the legal and ethical challenges of avoiding disability discrimination in setting priorities for the allocation of scarce lifesaving resources. Their analysis goes beyond the important but narrow question of what it means to wrongfully discriminate against people with disabilities in this context to the broader question of how to find a principled compromise between the consequentialist goals of public health and the potentially conflicting public value of “equal concern and respect” for each person. I will focus on this broader issue.

I agree with much …

Connecting Human Dignity, Non-Violence, And Environment For Healthcare Ethics In Nigeria, John Mark Ogu

Electronic Theses and Dissertations

Abstract

Connecting Human Dignity, Non-violence, and Environment in Health Care for Nigeria

By

John Mark Chinaemerem Ogu

December 2021

Dissertation supervised by Peter Ikechukwu Osuji, Ph.D.

This dissertation presents a global public health ethical approach based on social justice that connects human dignity, non-violence, and the environment in Nigeria. Recently, different places globally are witnessing uprisings and violence; some of these are linked to environmental scarcity. These are threats to global health, peace, development, and security because violence of any type or form is a global public health and security menace and an affront to human dignity. Environmental scarcity, especially …

A Public Health Ethics Approach To Substance Use Disorder, Adele Flaherty

Electronic Theses and Dissertations

The goal of the dissertation is to undertake an analysis of substance use disorders that focuses on a public health ethics perspective. The ethical argument focuses upon justifying the use of harm reduction and is primarily concerned with the current opioid crisis. While substance abuse/misuse over the course of history has been identified as a public health concern, this dissertation presents substance use disorders over the course of the lifespan, examining various contexts in which it can affect daily living and health outcomes. It achieves this by analyzing substance use disorders through the lens of the socioecological model of public …

The Contribution Of Bioethics To Home Healthcare (Hhc) In Saudi Arabia, Saeed Alghamdi

Electronic Theses and Dissertations

This dissertation examines the contribution of bioethics to Home Healthcare (HHC) In Saudi Arabia (SA). Through exploring the critical bioethical issues that have influenced the implementation of home health care, the dissertation highlights the significance of incorporating bioethics in home health care. Organizational ethics has led to the regulation of healthcare professionals, patients, and the stakeholders within clinical care settings. Healthcare organizations and other stakeholders, such as global health bodies, should formulate laws and policies that promote bioethics in contemporary healthcare. The Kingdom of Saudi Arabia, through the Ministry of Health, should promote the adoption of home health care services …

Student Pharmacists’ Emotional Responses And Coping During The Covid-19 Pandemic, Hannah E. Johnson, Deaundre Bumpass, Aric Schadler, Jeffrey Cain

Journal of Wellness

Introduction: Health professions students, including student pharmacists, have been impacted by the coronavirus disease 19 (COVID-19 pandemic) as schools have transitioned to remote learning and cancelled milestone events. During times of crises, media consumption and hobby participation also impact well-being. The adverse emotional responses and coping strategies of student pharmacists amidst the COVID-19 pandemic have not been evaluated, nor have factors that may contribute to emotional responses. The purpose of this study is to determine Doctor of Pharmacy students’ emotional responses and coping precipitated by the COVID-19 pandemic, and the influence of media use, working status, and participation in hobbies. …

Agency And Health Policies, Rodrigo Lopez Barreda

Journal of Health Ethics

In the current medical ethics literature, the concept of agency is receiving growing attention. Nevertheless, many of those definitions are narrow in scope. This article intends to provide a deeper understanding of this concept, allowing for its use in clinical practice and public health policies. First, it revises the current concept of agency and some of its shortcomings. Then, the article presents two philosophical accounts of agency, identifying three relevant features, namely time-extended organised planfulness, endorsement of their own actions, and identification with the activity. Lastly, the article depicts how those features may help in the application of agency …

Including A Chaplain And Culturally Sensitive Notary In End-Of-Life And Earlier Difficult Healthcare Issues, John Stonestreet

Journal of Health Ethics

Would patients and families benefit from a Doctor Body Cam? Linked from www.DoctorBodyCam.com, this article explores innovations providing accountability for ethical communication surrounding major healthcare decisions. One of the greatest challenges physicians face is living up to their own ideals, let alone others’ expectations, for high-stakes doctor-patient/family communication, especially at the end of life. From emotional strains to time limitations, a multiplicity of factors obfuscates the pursuit of excellence in this vital endeavor. Evidence suggests that, like nearly every other sector of healthcare and society, African American patients and families are most likely to get the short end of the …

A Call For Liberty And Justice For All: Unraveling The Complexities In 2021, Dr. Sheila P. Davis

Journal of Health Ethics

This Preface summarizes the articles in this issue. Seven articles are presented with center on liberty and justice for all populations discussed.

"I Felt What Was Happening In Our Country [Usa] With Race Was So Much Scarier Than The [Covid-19] Virus.” Black Lives Matter Protesters’ Beliefs And Practices During The Covid-19 Pandemic, Evelyn Arana-Chicas, Brooke D. Jones, Francisco Cartujano-Barrera, Ana Paula Cupertino

Journal of Health Ethics

This study describes the COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the U.S. Participants completed a survey on following COVID-19 guidelines and answered interview questions. Twenty participants were enrolled. Mean age was 29 and most were female (80%) and black (75%). Participants almost always wore their masks (75%) and washed their hands (85%) while protesting. Most reported rarely social distancing (55%) and not being concerned about COVID-19 (55%). Themes included: 1) Fighting for social justice, 2) Protesting is more important than COVID-19, 3) Unable to social distance, 4) Masks mostly worn, 5) Protests sparked global movement, …

Health Inequality As A Socially Created Complex System, Michele Battle-Fisher

Journal of Health Ethics

Brought to light by COVID-19, and the Black Lives Matter and Twitter #BlackBioethics movements, bioethics as a discipline has not intentionally accounted for distributive justice in its scholarship. Modern society exhibits gross disparities that affect marginalized populations who suffer amid social, financial, physical and emotional stressors. While marginalized groups that are underserved are not monoliths, disparity persists in disadvantaged communities regardless of social and economic strata. Disparity is the epitome of injustice. The overemphasis on proximal determinants demonstrates ill placed overemphasis on personal culpability whilst ignoring systemic factors that result in structural injustice. The sciences of complexity and systems thinking …

An Ethical Comparison Of The Covid-19 National Disease Control Performance Of China, Canada And The U.S. In The First Year Of The Pandemic, George A. Gellert, Gabriel L. Gellert

Journal of Health Ethics

Objective: First year government pandemic control performance is compared in China, Canada and the USA to understand the ethical bases of different population outcomes achieved.

Methods: Comparative analysis of ethical underpinnings and implications of pandemic performance includes degree of authoritarian power deployed to mitigate disease spread; benefits of single payer health care; impact of socioeconomic, racial/ethnic and health care inequities; anti-government sentiment/distrust; national leadership engagement; and science denial.

Results: National COVID-19 response efforts vary according to the extent to which they leveraged autocratic tactics, from China whose highly autocratic first year pandemic performance was emulated, through liberal democracies like Canada …

Sexual Minority Rights Are Not Just For The West: Health And Safety Considerations In Africa, Robert Scott Stewart Ph.D., Dionne Van Reenen Ph.D., Richard Watuwa Ph.D.

Journal of Health Ethics

In a recent article, C.O. Akpan argues that it is “unnatural for a man to sleep with a man as with a woman, and the idea of marriage in this sense is an abomination” (“The morality of same-sex marriage: How not to globalize a cultural anomie,” Online Journal of Health Ethics, 13(1), 2017, p. 9). Arguments in favor of same sex marriage, he claims, are “driven and motivated by the human right fad” (p. 9) that is inappropriate for African countries.

We argue that the specific arguments Akpan employs against the morality of homosexuality and same-sex marriage are flawed. Our …

Is There A Doctor In The House? Medical Ethics And The Doctoral Honorific, Kenneth R. Pike, M. Scott Moore

Journal of Health Ethics

The proliferation of professional doctorates has reinvigorated debate over the use of the doctoral honorific. Doctorate holders are often addressed as “doctor” in academic contexts, but idiomatic American English associates “doctor” with physicians—licensed clinicians with doctoral degrees in medicine. The possibility of patient confusion has historically justified proscription of the doctoral honorific by others, including nurses, but recently such proscriptions have been withdrawn. An examination of history, language, and ethical reasoning leads us to conclude that, in the context of patient interaction, clinicians should eschew the doctoral honorific entirely. We think it appropriate for professionals to rely on training-pathway titles …

Going Beyond The Data: Using Testimonies To Humanize Pedagogy On Black Health, Keisha S Ray

Faculty and Staff Publications

When health professions learners' primary pedagogical experience of Black people and how they become patients is through statistics, it becomes very easy for learners to think of Black people as data points rather than as individuals whose health is often at the mercy of racist institutions. When the human dimension of Black people's health is ignored, specifically the ways that poor health affects individual wellbeing, one of the barriers to proper health for Black patients is how to be seen and considered as a part of a larger problem of systemic racism and institutional injustices as well as individuals whose …

China’S Strategies For Governance Of Biotechnological Changes And New Ethical Challenges, Yaojin Peng, Zhou Qi

Bulletin of Chinese Academy of Sciences (Chinese Version)

Biotechnology is changing greatly over recent years, providing huge benefits to human society. However, the ethics, safety, and negative externalities of biotechnology have become increasingly prominent. Currently, biotechnology is still in the early stage of development, and full of high uncertainty. Technological changes in this field have the characteristics of stronger subversiveness, complexity, and social relevance. The world is facing a process of great development of biotechnology, new outbreaks of ethical challenges, and ethical governance reforms. China should take this opportunity to promote the high-quality development of biotechnology on the one hand, and on the other hand, adopt a multi-pronged …

Intersectionality, Relational Positionality, And The Lived Experiences Of Inequality: Contextualizing Intergenerational Opioid Use And The Constrained Choices Of Indigenous, Latina, And White Women Caregivers In Rural New Mexico, Carmela M. Roybal

Sociology ETDs

Opioid addiction is a serious and persistent global health issue. The federal Centers for Disease Control and Prevention (CDC) reported that between 1999 and 2016, more than 630,000 people in the United States died of an overdose of a prescription opioid or illicit drug (CDC 2018). Extant research has suggested that for nearly a century, New Mexico has experienced some of the highest rates of prescription and illicit opioid death in the nation (Goldstein and Herrera, 1995; Landon, 2003; Shah et al., 2008). I examined intergenerational opioid dependence through the lived experience of women caregivers of opioid-addicted family members. Data …

Culturally Sensitive Care For Hispanic Americans, Christopher Dodson, Courtney Hall

Scholars Week

The number of individuals that speak another language that is not English as their primary language is at an all time high in the United States, and this can make healthcare harder to access for this portion of the population. This research examines what barriers are present for those who do not speak English as their primary language, such as miscommunications, reduced trust in their provider related to being unable to speak directly with them, parts of their cultural practices and alternative medicines being ignored or misunderstood by healthcare providers, and not feeling secure enough to reveal sensitive information to …

Strong Constraints From Cosine-100 On The Dama Dark Matter Results Using The Same Sodium Iodide Target, Govinda Adhikari, Estella B De Souza, Nelson Carlin, Jae Jin Choi, Seonho Choi, Mitra Djamal, Anthony C Ezeribe, Luis E França, Chang Hyon Ha, In Sik Hahn, Eunju Jeon, Jay Hyun Jo, Han Wool Joo, Woon Gu Kang, Matthew Kauer, Hyounggyu Kim, Hongjoo Kim, Kyungwon Kim, Sunghyun Kim, Sun Kee Kim, Won Kyung Kim, Yeongduk Kim, Yong-Hamb Kim, Young Ju Ko, Eun Kyung Lee, Hyunseok Lee, Hyun Su Lee, Hye Young Lee, In Soo Lee, Jaison Lee, Jooyoung Lee, Moo Hyun Lee, Seo Hyun Lee, Seung Mok Lee, Douglas Leonard, Bruno B Manzato, Reina H Maruyama, Robert J Neal, Stephen L Olsen, Byung Ju Park, Hyang Kyu Park, Hyeonseo Park, Kangsoon Park, Ricardo L C Pitta, Hafizh Prihtiadi, Sejin Ra, Carsten Rott, Keon Ah Shin, Andrew Scarff, Neil J C Spooner, William G Thompson, Liang Yang, Gyun Ho Yu

Faculty and Staff Publications

We present new constraints on dark matter interactions using 1.7 years of COSINE-100 data. The COSINE-100 experiment, consisting of 106 kg of tallium-doped sodium iodide [NaI(Tl)] target material, is aimed to test DAMA’s claim of dark matter observation using the same NaI(Tl) detectors. Improved event selection requirements, a more precise understanding of the detector background, and the use of a larger dataset considerably enhance the COSINE-100 sensitivity for dark matter detection. No signal consistent with the dark matter interaction is identified and rules out model-dependent dark matter interpretations of the DAMA signals in the specific context of standard halo model …

Should Employment Division V Smith Be Overturned?, Jake Greenblum, Ryan Hubbard

School of Medicine Publications

Health professionals seeking religious exemption from caring for some patients or providing some interventions receive robust legal protection. Similarly, religiously affiliated organizations have great latitude in deciding which services to offer. These protections could soon become stronger, as the US Supreme Court considers 2 cases that revisit constraints on exemption claims established in Employment Division, Department of Human Resources of Oregon v Smith (1990). This article contends that overturning this case’s precedent might result in clinicians claiming more religious exemptions, which, barring acts of US Congress, would erode the rule of law and increase risk of harm to patients.

The Ratio Method: Addressing Complex Tort Liability In The Fourth Industrial Revolution, Harrison C. Margolin, Grant H. Frazier

St. Mary's Law Journal

Emerging technologies of the Fourth Industrial Revolution show fundamental promise for improving productivity and quality of life, though their misuse may also cause significant social disruption. For example, while artificial intelligence will be used to accelerate society’s processes, it may also displace millions of workers and arm cybercriminals with increasingly powerful hacking capabilities. Similarly, human gene editing shows promise for curing numerous diseases, but also raises significant concerns about adverse health consequences related to the corruption of human and pathogenic genomes.

In most instances, only specialists understand the growing intricacies of these novel technologies. As the complexity and speed of …

Advance Care Planning Within Individualized Care Plans: A Component Of Emergency Preparedness, Heather L. Church, Christina Marsack-Topolewski, Jacqueline M. Mcginley, Victoria Knoke

Developmental Disabilities Network Journal

Federally-legislated Medicaid requirements for recipients with intellectual and/or developmental disabilities (IDD) to have a person-centered plan (PCP) do not specifically require that advanced care plans (ACP) be a component of the plan. However, coronavirus disease 2019 (COVID-19) has provided a salient reminder of the importance of incorporating ACP within the PCP for people who have IDD. As demonstrated by situations arising from COVID-19, emergencies and crises can dramatically alter access to care for people with IDD. This paper synthesizes results from an environmental scan related to ACP for adults with IDD. Findings suggest that the use of ACP, particularly when …

Fall 2021

Insights

True to Our Foundational Mission; Lourdes Torres Receives Prestigious Award; Fernando De Maio Joins Health Equity Initiative; LAS Professors Named to Faculty Fellow Program; Wilson-Garling Collection Classes and Exhibit; Welcoming the Stranger: The DePaul Migration Collaborative strives to build a better future for immigrants, refugees and asylum-seekers; An Alderpersonal Touch: Maria Hadden is putting her degree in international public service to work in Chicago’s 49th Ward; All In, Chicago: Collaboration powers the work of the Center for Community Health Equity

Remdesivir Has Questionable Efficacy In Patients With Severe Covid-19 Receiving High-Flow Oxygen, Gabriel Burdick

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report using:

Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 — Final Report. N Engl J Med. 2020;383:1813-1826. https://doi.org/10.1056/NEJMoa2007764

for a patient with severe COVID-19.

Mid-Atlantic Ethics Committee Newsletter, Fall 2021

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Lessons Learned From The Hiv/Aids Pandemic And Access To Medicines For Covid-19 Treatment, Thalia Le

Independent Study Project (ISP) Collection

There is an imminent need to address the healthcare disparities in accessing all COVID-19 medicinal products in developing countries. While logistical issues like inadequate production facilities such as the lack of vaccines administration capacity, storage issues, gap between supply and demand as well as vaccine hesitancy can certainly play a part in impeding COVID19 medicines distribution, patent monopolies and intellectual property protection laws further exacerbated the problem, especially when vaccines were at its early stages of authorization. Historical and contemporary case studies of efforts to challenge patents on HIV AVRs treatment provide a useful lens through which we may glean …

Reimagining Bioethics Curricula: Centering Antiracism, Diversity, Equity, And Inclusion, Shika Kalevor, Marie-Laura Allirajah, Isabella Hernandez, Phoebe Ozuah

Presentations

As bioethicists, we engage with social, political, and health care systems that all center on relationality. Part of our responsibility in occupying space within these systems is recognizing where bias, power, and privilege lie, and how our positionality can either contribute to or take away from progress toward a morally conscious society. Bioethicists have the opportunity to remediate preventable harms and address issues of equity, justice, diversity, and oppression. We can also address these issues as core to our growing knowledge base. From our own experiences as bioethics students from multidisciplinary backgrounds, we know that these topics are not sufficiently …

Of Blood Transfusions And Feeding Tubes: Anorexia-Nervosa And Consent, Samuel Director

Jepson School of Leadership Studies articles, book chapters and other publications

Individuals suffering from anorexia nervosa experience dysmorphic perceptions of their body and desire to act on these perceptions by refusing food. In some cases, anorexics want to refuse food to the point of death. This paper explores the following question: If an anorexic, A, wants to refuse food when the food would either be lifesaving or prevent serious bodily harm, can A's refusal be valid? It is shown that there is compelling reason to think that anorexics can validly refuse food, even in these extreme circumstances.

Decreasing Unintentional Pregnancies For Tennesseans, Paula M. Todd

Electronic Theses and Dissertations

In 2018, 49% of all pregnancies in the United States were unintended, with women with a lower- income status being five times more likely to experience an unplanned pregnancy. Tennessee has a high rate of unintended pregnancies, particularly among the uninsured, low-income, and rural teen populations; some 22% of these unintended pregnancies end in abortion. Oral or transdermal contraceptives that are affordable and accessible for women of childbearing age can reduce unintentional pregnancies. The addressed gap in clinical practice was that contraceptives are not currently available over the counter in Tennessee pharmacies without a prescription, which necessitates a costly medical …

How Analogizing Socio-Legal Responses To Organ Transplantation Can Further The Legalization Of Reproductive Genetic Innovation, Myrisha S. Lewis

Faculty Publications

The Nobel Foundation emphasized the significance of genetic innovation to society, science, and medicine by awarding the 2020 Nobel Prize in Chemistry to “the CRISPR/Cas9 genetic scissors.” This Article focuses on “reproductive genetic innovation,” a term that includes cytoplasmic transfer, mitochondrial transfer, and germline or heritable gene editing techniques that are all categorized as “experimental” in the United States. These techniques all use in vitro fertilization, a legal and widely available practice. Yet reproductive genetic innovation has resulted in controversy and numerous barriers including a recurring federal budget rider, threats of federal enforcement action, and the unavailability of federal funding. …

Emergency Medicine Shift Factors Causing The Most Stress Among Emergency Medicine Residents, Mohamad Moussa, Kristen Hayden, Chia-Hao Shih, Sadik Khuder, Zayd Safadi, Connor Parsell

Journal of Wellness

Introduction: Past studies demonstrate that stress and anxiety affect emergency medicine physicians, but the causal factors identified are usually from sources outside the work shift. We attempt to show the relationship between intrinsic factors of a work shift and anxiety perceived by residents, while also examining differing gender responses.

Methods: In 2018, a cross-sectional survey of emergency medicine residents in the United States was distributed anonymously through the Emergency Medicine Residents Association. The survey consisted of demographic questions, novel questions identifying intrinsic factors, and the Generalized Anxiety Disorder 7-item (GAD-7) scale. Spearman correlation, independent t-test, and multivariate analysis of variance …