Bioethics and Medical Ethics Commons^™

The Health Insurance Portability And Accountability Act And Its Impact On Privacy And Confidentiality In Healthcare, Allyssa Stadler

Senior Honors Theses

The world of healthcare and technology has continued to grow and expand into the future while HIPAA (the Health Insurance Portability and Accountability Act), the foundational patient privacy law in the United States of America, is attempting to keep up with this new world. This thesis reviews HIPAA and other health-related laws necessary to understanding patient privacy. It analyzes peer-reviewed studies on patient confidentiality and HIPAA to elicit the patient’s and provider’s opinion on HIPAA and patient confidentiality. Lastly, the current challenges of patient confidentiality and HIPAA are discussed, and potential solutions are suggested to improve these issues.

In With A Runny Nose, Out In A Body Bag: Why Is It So Difficult For Black Women To Leave The Hospital Alive?, Chelsea Carter

Liberal Arts Capstones

In the Black community, there is an unspoken understanding about going to the doctor with a runny nose, and leaving in a body bag. A recent article published by The Oprah Magazine demonstrates that racism is rampant in the United States healthcare system, and it is taking the lives of Black women at an alarmingly disproportionate rate (Stallings, 2018). When seeking medical treatment, many Black women are at the mercy of doctors who hold an implicit bias against Black women. Simply put, implicit bias describes when people behave and treat others based on negative preconceptions they have about other people, …

Comparison Of Mortality Data From Nebraska’S Rural & Metropolitan Health Districts, Claire Figi

Theses/Capstones/Creative Projects

As there has been minimal research done on the correlation between communities identified as rural or metropolitan and their mortality rates, this research aims to provide baseline evidence that mortality rates associated with non-infectious and infectious diseases are connected to an area’s rural or metropolitan classification. This study analyzed public data from the Nebraska Department of Health and Human Services and the Center for Disease Control to compare mortality rates related to the top two causes of death in both rural and metropolitan health districts of the state of Nebraska, United States. This data was then compared to mortality rates …

Rates Of Positive Suicide Screens Among The Emergency, Inpatient And Outpatient Clinics At A Tertiary Care Children’S Hospital, Fajar Raza, Hung-Wen Yeh, John Lantos, Mark Connelly, Shayla Sullivant

Posters

Background: Prior research has suggested that rates and acuity of suicidality are elevated among patients seen in EDs and in certain clinics. However, the occurrence and severity of suicide risk has been rarely studied in the pediatric clinic populations due in part to unsystematic screening. We examined suicidality across different pediatric clinical care settings based on data from our newly implemented hospital-wide suicide risk screening program.


Objective: To determine a) which patient populations presented with the highest rates of suicidality; and b) the percentage of patients who had current thoughts of suicide and were thus deemed “acute.”


Design/Methods: We conducted …

The Effect Of Covid-19 On The Detection And Prevalence Of Suicidality In Adolescents, John Lantos, Hung-Wen Yeh, Fajar Raza, Mark Connelly, Shayla Sullivant

Presentations

Background: The COVID-19 pandemic saw changes to the delivery of health services and concerns about psychological morbidity not directly related to COVID infection. We analyzed the effects of the pandemic on our hospital’s program to screen adolescents for suicidality.

Objective: To determine the effect of the COVID-19 pandemic on 1) a hospital-wide screening program for suicidality in teens; and 2) the prevalence of positive screens for suicidality.

Design/Methods: Our study population was all patients > 12yo seen as inpatients or in the ED or clinics at a children’s hospital in Apr-June in 2019 (T1) and 2020 (T2). Eligible pts were screened …

Genetic Testing In Pregnancies With Ultrasound Anomalies: Exploration Of Factors That Influence Uptake, Lukas D. Kruidenier

Dissertations and Theses (Open Access)

Prenatal genetic diagnostic and screening tests have been rapidly evolving over the past decade with the introduction and expansion of cell free DNA screening (cfDNA) and the use of chromosomal microarray (CMA) as a first-line test for evaluation of fetal anomalies. Understanding patient motivations for or against expanded genetic testing options is paramount, therefore this study aimed to ascertain the patient perspective. Ninety-nine patients with an ultrasound anomaly participated in an anonymous, cross-sectional, research survey assessing coping strategies, factors influencing the genetic testing decision, and demographic variables. After multivariable analysis, the desire for directive counseling regarding testing was correlated with …

Nebraska Public Guardianship Of Unbefriended Patients: A Preliminary Review Of Health Outcomes And Cost Savings, Emily N. Berzonsky

Capstone Experience: Master of Public Health

Unbefriended patients often experience an extended length of stay in the hospital while their medical providers await legal appointment of a public guardian to make their medical decisions. The medically unnecessary days the unbefriended patient spends in the hospital equates to high costs for the hospital, but more importantly, negative health outcomes for the patient. The purpose of this study is to provide literature and data to support recommendations for possible changes in Nebraska’s public guardianship appointment process. A literature review seeks to answer: (1) What is the median hospital length of stay for an unbefriended patient without a guardian …

Climate Change And Vaccines: Distrust Of Science In Politics And The Media, Natalie Montalbano

Senior Honors Projects

Distrust in science and the scientific process has increased significantly over the last fifty years, and this distrust is particularly apparent in the fields of climate change and vaccination. Climate change, a relatively new scientific issue, has become one of the hottest topics discussed in both U.S and world politics. The existence and real threat of anthropogenic global warming was publicly declared by National Geographic in 2004, but climate scientists had acknowledged that humans were causing the warming of our Earth as early as the 1980’s. Vaccines, despite being safe and effective in curbing the spread of infectious diseases, have …

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 …

Disparities In Access To Assisted Reproductive Technology Among Hispanic Women In The United States, Madison Gallagher

Honors Thesis

Infertility is a health problem that affects approximately 7 million women in the United States (Ethics Committee of the American Society for Reproductive Medicine, 2015). Due to the high costs of reproductive medicine and infertility treatment, these services tend to be expensive and have limited accessibility without full insurance coverage. Emerging literature outlines the disparities in access to proper treatment for reproductive complications. These existing studies highlight that many minority populations in the United States experience increased challenges regarding access to reproductive medicine and infertility treatment. Among these minority groups are Hispanic women, who are more likely to require reproductive …

In With A Runny Nose, Out In A Body Bag: Why Is It So Difficult For Black Women To Leave The Hospital Alive?, Chelsea Carter

Scholars Week

In the Black community, there is an unspoken understanding about Black people going to the doctor with a runny nose, and leaving in a body bag. A recent article published by The Oprah Magazine demonstrates that racism is rampant in the United States healthcare system, and it is taking the lives of Black women at an alarmingly disproportionate rate (Stallings, 2018). When seeking medical treatment, many Black women are at the mercy of doctors who possess an implicit bias against Black women. Simply put, implicit bias describes the phenomenon in which people behave and treat others based on negative preconceptions …

Quarantine Ethics: From Past To Covid-19, Chrystal Barnes

OHSU-PSU School of Public Health Annual Conference

Quarantines have been a preventative measure for reducing communicable disease spread for centuries. The method of implementation can vary widely and to some extent requires some level of judgement from enforcing powers, often state police power. As such, historically, some quarantines have been unfairly enforced based on discriminatory practices. COVID-19 has brought about the most widespread and extended quarantine in U.S. history, which makes evaluating the ethics all the more critical. In addition, it is well established that COVID-19 impacts have disproportionately caused harm to populations, such as those who are of a low socioeconomic status and people of color. …

Corruption In Capsules: How It Is Legal For Companies To Put Harmful Ingredients In Vitamins And Dietary Supplements, Emily Leggiero

English Department: Research for Change - Wicked Problems in Our World

The vitamin and supplement industry has increased exponentially in profits as well as potential products on the market since the turn of the century. However, these products are not regulated, nor do they undergo any premarket clinical research or testing. Public health is compromised by vitamins and supplements that are available for American consumption that is disproportionately unregulated to their chemically similar counterparts. This wicked problem is facilitated through the combination of historical legislative definitions that has since been distorted for corrupt administrative gain through the allotment of corporate expenditures. Company disbursements are made to the same policymakers that create …

Mid-Atlantic Ethics Committee Newsletter, Spring 2021

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Phil 201: Bioethics, Cuny School Of Professional Studies

Open Educational Resources

An exploration of complex contemporary ethical problems from healthcare, the environment, and bioethics. Issues include problems of drugs and addiction, stigma toward people with disabilities, terminal illness and chronic health needs, resource allocation in times of disaster, infectious diseases, gene editing, and humans’ relationship with their environment. Classical and contemporary ethical theories, moral theories, and the fundamentals of scientific integrity will be applied to make principled, defensible, moral judgments.

A Literary Analysis Of The Origin Of Human Embryonic Stem Cells, Its Advancements, Philosophical, Ethical, Sociocultural, And Political Aspects; An Investigation Of The Underlying Attributes That Affect One’S Views On Hesc Research To Resolve Turkey And Brazil’S Hesc Policy, Religious, And Cultural Conflicts, Haleema Shamsuddin

Honors Scholars Collaborative Projects

Human embryonic stem cells (hESCs) are cells derived from 5-day human embryos and are self-renewing cell lines that change into any type of cell in the body, a trait called pluripotency. hESCs have almost unlimited clinical and medical research potential. Despite the great therapeutic promise of hESC research, it comes with a controversial ethical debate due to its involvement with the destruction of the human embryo. The central argument revolves around the question of whether or not these human embryos should be ascribed equal moral status to fully developed humans. This thesis aims to analyze the origin and advancements of …

A Tour Of Gender Critical Literature: A Review Of Transgender Body Politics By Heather Brunskell-Evans, Az Hakeem

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Public Health And History: Vaccination Regulation In The Northeastern States, Kate Campbell

Student Research

In 1905 Henning Jacobson went before the United States Supreme Court in Jacobson v. Massachusetts and argued that his constitutional right to liberty was infringed upon when compulsory vaccination laws were introduced. When mandatory vaccination laws were introduced in Cambridge, Massachusetts there was another deadly smallpox epidemic racing through the northeastern states. Government officials believed that the best way to control the disease and ultimately stop the spread was through government intervention. The Supreme Court ultimately ruled that as a citizen of the United States it is often times necessary to give up some forms of liberty in order to …

Catholic Terminal Sedation-A New Framework For Providing Terminal Palliative Sedation As A Requirement In Catholic Healthcare Organizations, Noah Dimas

Graduate Student Research Symposium

The present attitudes surrounding death and dying in the United States have been trending toward the acceptance of so-called “Assisted Death” interventions at the end-of-life (EoL), specifically Physician-Assisted Suicide. The acceptance of these interventions is rooted in the notion of autonomy within the American culture of medicine that generally states a patient is allowed to request whatever medical interventions they wish. As such, legislative bodies around the United States have begun to legalize Assisted Death in response to the regularly cited desire to die peacefully and without pain from an expected terminal illness. However, for Catholic healthcare organizations, there is …

Pandemics: Expediting Medications Through The Trial Period For The Greater Good, Lauren Raike

Augustana Center for the Study of Ethics Essay Contest

This paper attempts to address the concern of rushing medications, specifically vaccines, to market during a global pandemic. The FDA has a very rigorous process that medications go through in order to be put on the market and while it is very effective in making medications safe, it takes a very long time to get that approval. During a widespread pandemic like COVID-19, access to a medication that would slow the spread of a virus would save countless lives and the economies of countries worldwide. This paper looks into the specific process the FDA uses to put medicine on the …

Assisted Reproductive Technologies And Health-Related Issues Among Women And Children: A Research Review, Laura Maria Corradi

Dignity: A Journal of Analysis of Exploitation and Violence

From their first use in the late 1970s until the mid-1990s, Assisted Reproductive Technologies (ART) gave rise to serious concerns by feminists internationally. Their questions ranged from asking about health risks to ethical and political problems inherent in these technologies. However, over the last 25 years, interest in women’s health which used to be central to feminist theory and politics, progressively decreased and with it concerns about ART. Today, while the medical literature about health risks in ART is increasing, the topic of women’s health in relation to reproductive technologies remains marginal in feminist discourse, social sciences, and the mainstream …

Hands, Marc Perlman

HCA Healthcare Journal of Medicine

“Hands” is inspired by my first encounter with a donor in the cadaver lab during my first year of medical school. This poem highlights the intimate relationship between the medical student and their “first patient” and captures the factors that helped me realize the grandeur of the dissecting experience. Through an awareness of the donor’s hands, I became viscerally aware that the cadaver is a real human being who donated their corporeality to help students learn. The bilateral vulnerability of this experience is a critical milestone in the development of health care providers. Given the recent transition from in-person to …

Physicians’ Emotional Intelligence: Improving Performance While Reducing Burnout, Miriam Zylgerblait Lisigurski, Umair Shaikh, Brian Toston

HCA Healthcare Journal of Medicine

Today’s physicians are being confronted with an increasing number of challenges and opportunities as our evolving healthcare system progresses into the future. The expectation is not only to provide the best clinical care, but also to satisfy metrics, fulfill budgets, achieve high patient satisfaction levels and accomplish institutional requirements in order to be considered good providers. All these additional demands seem to be affecting not only the clinical performance of physicians but also their wellness, increasing the risk of burnout, depression and suicide.

Cited At Nuremberg: The American Eugenics Movement, Its Influence Abroad, The Buck V. Bell Decision, And The Subsequent Bioethical Implications Of The Holocaust, Bessie Blackburn

Bound Away: The Liberty Journal of History

Eugenics was a bioethical movement that captivated many Americans at the turn of the nineteenth century and even into the Progressive era. No event in American history better encapsulates the American eugenics movement than the trial of Carrie Buck and her later forced sterilization. This trial is monumental not only to understanding American eugenic policy, but also international reactions and Nazi Germany’s chilling use of this pseudoscience in the Holocaust. In order to best understand the trial of Carrie Buck, one must look first look at the origins of eugenics, second, the context of the eugenics movement in America and …

Suspicion Encoded: Women Of Color And Biometric Technology In The United States, Lilith A. Saylor

sprinkle: an undergraduate journal of feminist and queer studies

This paper explores the commodification of privacy through biometric technology in the United States. It examines the impact of this technology on poor women of color (WOC), arguing that poor WOC face intersectional discrimination based on the convergence of sex, race, and class in their identities. I highlight the unique and powerful intrusion of biometric technology into the lives of poor WOC, and argue that the connection between data and the physical body created through biometric data has formed an environment in which the state wields unrestricted control in all spheres over the privacy of poor WOC.

Three Roles Of Narratives In The Treatment Of Chronic Pain, Nina Atanasova

Philosophy and Religious Studies Department Faculty Publications

In this paper, I discuss the roles narratives play in the diagnostics, treatment, and recovery of chronic pain patients. I show that the successes of this narrative approach to the treatment of chronic pain support the biopsychosocial model of disease. The central example of narrative interventions discussed in the paper is pain neuroscience education. This is an intervention which aims at helping chronic pain patients reconceptualize their pain experiences so as to align them with neuroscientific knowledge of pain. Multiple clinical trials have established the success of these interventions in pain reduction. This shows that neuroscience pain education is in …

Assessing And Improving Knowledge Of Medical Decision-Making Capacity, Samantha J. Zohr

Master's Theses and Doctoral Dissertations

Clinical judgments of capacity have implications for the rights of the individual being assessed. While supported decision-making is recommended, it is not clear whether laypeople have sufficient knowledge to advocate for maximizing the autonomy of the person they assist. This study developed and evaluated a brief, computer-based intervention to increase knowledge about decision-making capacity, using a Solomon four-group design. A convenience sample of 160 participants completed the study via an online survey platform. Knowledge was assessed with a test designed for this study. A 2 x 2 factorial ANOVA found no pre-test sensitization, F(1, 156) = 0.09, p = .77, …

"As Long As I'M Me": From Personhood To Personal Identity In Dementia And Decision-Making, James Toomey

Elisabeth Haub School of Law Faculty Publications

As people, especially older people, begin to develop dementia, we confront ethical questions about when and how to intervene in their increasingly compromised decision-making. The prevailing approach in philosophically-inclined bioethics to tackling this challenge has been to develop theories of “decision-making capacity” based on the same characteristics that entitle the decisions of moral persons to respect in general. This Article argues that this way of thinking about the problem has missed the point. Because the disposition of property is an identity-dependent right, what matters in dementia and decision-making is an individual’s personal identity with their prior self, not their moral …

Dentistry And The Principle Of Justice: How Ethics Informs Oral Health Policy, Michael G. Maihofer Dds

Journal of the American College of Dentists

The article defines the dental professional’s ethical principle of Justice and discusses the obligations that come with adherence to this principle with an emphasis on that portion of the ADA Code’s definition which states “that the dental profession should actively seek allies throughout society on specific activities that will help improve access to care for all.

It examines this principle to better understand its relevance and importance to both clinical practice, dental education and emerging oral health policy. Also discussed is how dentistry’s ethical code intersects the realm of social justice making a persuasive argument for adopting strong policies on …

Implementación De Políticas De Prevención Y Control De La Obesidad Infantil En Estados Unidos Y Latinoamérica: Lecciones Para La Investigación Y La Práctica Transfronterizas, Mireya Vilar-Compte, Rafael Perez-Escamilla, Elizabeth Rhodes, Olga L. Sarmiento, Camila Corvalan, Rachel Sturke, Susan Vorkoper

Department of Public Health Scholarship and Creative Works

Aunque se han hecho avances en el desarrollo y aplicación a gran escala de inter-venciones eficaces contra la obesidad infantil, los retos siguen siendo importantes. Nuestro objetivo era comprender las causas del éxito de Estados Unidos y los países latinoamericanos en la implementación de políticas y programas (PYP) contra la obe-sidad e identificar oportunidades de mejora aplicando los principios de la ciencia de la implementación. Seleccionamos tres estudios de comparación de casos: (1) el etique-tado frontal en los envases de alimentos (México y Chile), (2) los programas de calles abiertas y calles para el juego (Colombia y Estados Unidos) y …