Bioethics and Medical Ethics Commons^™

Ethical Price For Essential Pharmaceuticals?, Sang T. Truong

Student Research

Azidothymidine or AZT is an antiretroviral medication used to prevent and treat HIV/AIDS. Nowadays, AZT remains to be the primary active drug that can elongate the life of infected patients. Without treatment, patients can live for 5 to 10 years after infected. With the treatment, their life expectancy approaches the norm.

However, it is important to note that AZT is a life-saver for HIV patients only if they can afford it. An HIV patient needs to spend about $17,000 for AZT every year until the end of his life. Therefore, the estimated lifetime cost of HIV will be $600,000. This …

An Ethical Market For Kidney?, Sang T. Truong

Student Research

The kidney performs several vital functions that maintain our general health condition, including filtering waste chemicals out of our blood. Kidney failure is a condition where patients’ kidneys lose their ability to filter the waste from their blood, leading to accumulating toxin in their body. Without any medical care, a patient with kidney failure has a couple days to a couple of weeks to live. One way to elongate the life of the kidney-failure patient is through kidney transplant, where another kidney is implanted into the patient’s body.

In the U.S, it is illegal to trade a kidney for money. …

How To End Our Stories: A Study Of The Perspectives Of Seniors On Dementia And Decision-Making, James Toomey

Elisabeth Haub School of Law Faculty Publications

Because dementia can cause individuals to make decisions that they otherwise would not, the law needs a mechanism to determine which decisions are entitled to the respect of the legal system and which may be overridden by others. In the philosophical literature, three primary theories for how to make this determination have been offered. First, "Cognitivism" posits that whether a decision should be recognized is a function of the mechanical functioning of the individual's brain at the time the decision is made. Second, "Essentialism" holds that decisions should be recognized so long as they are consistent with the cluster of …

Ada Constitution & Bylaws (2021), 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.

Getting Real: The Maryland Healthcare Ethics Committee Network’S Covid‑19 Working Group Debriefs Lessons Learned, Norton Elson, Howard Gwon, Diane Hoffmann, Adam M. Kelmenson, Ahmed Khan, Joanne F. Kraus, Casmir C. Onyegwara, Gail Povar, Fatima Sheikh, Anita J. Tarzian

Faculty Scholarship

No abstract provided.

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Towards A Holistic Risk Model For Safeguarding The Pharmaceutical Supply Chain: Capturing The Human-Induced Risk To Drug Quality, Heather R. Campbell

Theses and Dissertations--Pharmacy

Counterfeit, adulterated, and misbranded medicines in the pharmaceutical supply chain (PSC) are a critical problem. Regulators charged with safeguarding the supply chain are facing shrinking resources for inspections while concurrently facing increasing demands posed by new drug products being manufactured at more sites in the US and abroad. To mitigate risk, the University of Kentucky (UK) Central Pharmacy Drug Quality Study (DQS) tests injectable drugs dispensed within the UK hospital. Using FT-NIR spectrometry coupled with machine learning techniques the team identifies and flags potentially contaminated drugs for further testing and possible removal from the pharmacy. Teams like the DQS are …

Hospital Nurses' Moral Distress And Coping During Covid-19: A Pilot Study, Abigail Latimer

Theses and Dissertations--Social Work

The COVID-19 pandemic caused a wave of critically ill patients, overwhelming hospitals, and creating unprecedented conditions for hospital employees, particularly bedside nurses. Concerns about the emotional and mental well-being of nurses have already been raised prior to the pandemic and depression, anxiety, and PTSD symptoms among nurses during the pandemic have been observed. Given the increased infection and safety risks, staffing shortages, inadequate personal protective equipment and resources, and hospital restrictions causing many nurses to be patients’ only support, there is also a growing concern about how these institutional and personal restrictions to providing best care and practicing ethically have …

Estimated Glomerular Filtration Rate And The Racial Multiplier: Clinical Implications And Current Attitudes, Brittney A. Spooner

Honors Theses and Capstones

Chronic kidney disease (CKD) is associated with high morbidity and mortality and has high and increasing incidence worldwide. CKD is characterized by a reduction in glomerular filtration rate (GFR), but as GFR is difficult to measure directly, estimated glomerular filtration rate (eGFR) equations have been created to measure serum creatinine levels as a function of GFR. Some eGFR equations contain a racial multiplier that increases the eGFR of black patients, causing a spurious increase in reported kidney function. This study included a literature search that collected information on the rationale behind the multipliers usage and a survey that gathered information …

Animal Sentience: History, Science, And Politics, Andrew N. Rowan, Joyce M. D'Silva, Ian J.H. Duncan, Nicholas Palmer

Animal Sentience

This target article has three parts. The first briefly reviews the thinking about nonhuman animals’ sentience in the Western canon: what we might know about their capacity for feeling, leading up to Bentham’s famous question “can they suffer?” The second part sketches the modern development of animal welfare science and the role that animal-sentience considerations have played therein. The third part describes the launching, by Compassion in World Farming, of efforts to incorporate animal sentience language into public policy and regulations concerning human treatment of animals.

Effectively Communicating Comprehensive Tumor Genomic Profiling Results: Mitigating Uncertainty For Advanced Cancer Patients, Nicci Bartley, Megan C. Best, Barbara B. Biesecker, Alana Fisher, David Goldstein, Bettina Meiser, David M. Thomas, Mandy L. Ballinger, Phyllis Butow

IES Papers and Journal Articles

Objective: To understand advanced cancer patients’ experience of uncertainty when receiving comprehensive tumor genomic profiling (CTGP) results, and their perceptions of how healthcare provider (HCP) communication impacts uncertainty.

Methods: Thirty-seven semi-structured interviews with advanced cancer patients were conducted within two weeks of patients receiving CTGP results. Transcripts were thematically analyzed, using an inductive approach.

Results: We identified three themes that illustrate patient experience of uncertainties when receiving CTGP results: 1. Type and degree of uncertainty fluctuates along with changing illness circumstances and the nature of the CTGP results; 2. HCPs’ co-ordination of care and communication shapes uncertainty, with immediate, clearer …

Heeding The Call Of Covid-19, David Wiebers, Valery Feigin

Animal Sentience

We are grateful to all of our commentators. They have provided a wide range of valuable perspectives and insights from many fields, revealing a broad interest in the subject matter. Nearly all the commentaries have helped to affirm, refine, expand, amplify, deepen, interpret, elaborate, or apply the messages in the target article. Some have offered critiques and suggestions that help us address certain issues in greater detail, including several points concerning industrialized farming and the wildlife trade. Overall, there is great awareness and strong consensus among commentators that any solution for preventing future pandemics and other related health crises must …

Consensus Statement On Ethical & Safety Practices For Conducting Digital Monitoring Studies With People At Risk Of Suicide And Related Behaviors, Matthew K. Nock, Evan M. Kleiman, Melissa Abraham, Kate H. Bentley, David A. Brent, Ralph J. Buonopane, Franckie Castro-Ramirez, Christine B. Cha, Walter Dempsey, John Draper, Catherine R. Glenn, Jill Harkavy-Friedman, Michael R. Hollander, Jeffrey C. Huffman, Hye In S. Lee, Alexander J. Millner, David Mou, Jukka-Pekka Onnela, Rosalind W. Picard, Heather M. Quay, Osiris Rankin, Shannon Sewards, John Torous, Joan Wheelis, Ursula Whiteside, Galia Siegel, Anna E. Ordóñez, Jane L. Pearson

Psychology Faculty Publications

OBJECTIVE: Digital monitoring technologies (e.g., smart-phones and wearable devices) provide unprecedented opportunities to study potentially harmful behaviors such as suicide, violence, and alcohol/substance use in real-time. The use of these new technologies has the potential to significantly advance the understanding, prediction, and prevention of these behaviors. However, such technologies also introduce myriad ethical and safety concerns, such as deciding when and how to intervene if a participant's responses indicate elevated risk during the study?

METHODS: We used a modified Delphi process to develop a consensus among a diverse panel of experts on the ethical and safety practices for conducting digital …

Ethical Health Care In An African Context: Linking Conventional Medicine And Traditional Healing Practices In Igboland, Nigeria., Michael Osondu Okoro

Dissertations

This dissertation argues that in Nigeria’s Igboland, a health care ethic reflective of the Roman Catholic Christian faith must build links between the rightful practices of both conventional Western medicine and traditional Igbo healers. It calls such a health care ethic an “integral health care ethic” in the Nigerian Igbo context.The inspiration for this dissertation comes from the growing respect given to indigenous people and their knowledge by the Roman Catholic Church since the Second Vatican Council and, more specifically, the attention Pope Francis has given to indigenous people in his writings and speeches. For example, in his remarks on …

Could "The Wonder Equation" Help Us To Be More Ethical? A Personal Reflection, Margaret Somerville

Medical Papers and Journal Articles

This is a personal reflection on what I have learnt as an academic, researching, teaching and participating in the public square in Bioethics for over four decades. I describe a helix metaphor for understanding the evolution of values and the current “culture wars” between “progressive” and “conservative” values adherents, the uncertainty people’s “mixed values packages” engender, and disagreement in prioritizing individual rights and the “common good”. I propose, as a way forward, that individual and collective experiences of “amazement, wonder and awe” have the power to enrich our lives, help us to find meaning and sometimes to bridge the secular/ …

Transhumanist Genetic Enhancement: Creation Of A 'New Man' Through Technological Innovation, George Mendz, Michael Cook

Medical Papers and Journal Articles

The transhumanist project of reshaping human beings by promoting their improvement through technological innovations has a broad agenda. This study focuses on the enhancement of the human organism through genetic modification techniques. Transhumanism values and a discussion of their philosophical background provide a framework to understand its ideals. Genetics and ethics are employed to assess the claims of the transhumanist program of human enhancement. A succinct description of central concepts in genetics and an explanation of current techniques to edit the human genome serve to assess the capabilities and limitations of editing techniques. Potential benefits and liabilities of human enhancement …

Posthumanism: Creation Of 'New Men' Through Technological Innovation, George L. Mendz, Michael Cook

Medical Papers and Journal Articles

he posthumanist project proposes directing the evolution of human beings by promoting their improvement through technological means to create a variety of entities that will have few or no common characteristics with current humans. Its agenda is extremely broad and this study mostly addresses enhancement of the human organism through genetic modification techniques. An overview of posthumanist values and a brief discussion of its philosophical background provide a framework to understand its ideals. Genetics and ethics are employed to assess some claims of the posthumanist program of creating evolved humans; in particular, the capabilities and limitations of techniques for somatic …

Another Step In Diagnostics Consultation Model© Actualization: Examining The Impact Of Consultation Workflow Processes On Providers' Clinical Decision Making, Elizabeth K. Leibach

Theses and Dissertations

Background
Communication errors in health services delivery significantly compromise quality in clinical decision making (CDM). Diagnostic information generated by clinical laboratories (CL) accounts for as much as 93% of objective data in the clinical record and therefore is foundational in CDM. This work describes the Diagnostics Consultation Model© (DCM©), a CL communications portal, which supports CDM within interprofessional teams, providers, and institutions. Specific aims were to develop and validate a workflow prediction index (the complexity index, CI) to assign resolution of consultation requests based on an algorithm comprised of characteristics available at the point of consultation initiation. The CI functions …

Is Germline Gene Editing Exceptional?, Myrisha S. Lewis

Faculty Publications

Advances in gene editing have recently received significant scientific and media attention. Gene editing, especially CRISPR-Cas9, has revived multiple longstanding ethical debates, including debates related to parental autonomy, health disparities, disability perspectives, and racial and economic inequalities. Germline, or heritable, gene editing generates several newer, neglected bioethical debates, including those about the shared human germline and whether there is a "line" that humans should not cross.

This Article addresses several interrelated ethical and legal questions related to germline gene editing. Those questions address why, if at all, germline gene editing needs to be regulated and, if germline gene editing needs …

Self-Concept, Healthcare, And Leadership: Understanding The Lived Experiences Of Physician Leaders In Urban Community Healthcare Centers, Eric James Charlton

Antioch University Dissertations & Theses

Reducing disparities in health services delivery and outcomes is a continued challenge. The consistence of healthcare disparities, despite advances in medical technology and increased awareness of the problem, poses an ongoing test to the nation. There is a growing body of work that demonstrates providing access to good primary care may be the most effective intervention at hand. For over 40 years, community health centers have been providing quality, comprehensive primary care focusing on reducing health outcome disparities. Increased awareness is now emphasizing primary care elimination of health disparities within disadvantaged, underserved populations. A major failing of the system that …

Adolescent Medical Decisionmaking Rights: Reconciling Medicine And Law, Doriane Lambelet Coleman, Philip M. Rosoff

Faculty Scholarship

Dennis Lindberg came into his aunt’s care when he was in the 4th grade because his parents struggled with drug addiction and could not provide for him. At thirteen, he was baptized in his aunt’s faith as a Jehovah’s Witness. Just days after he turned fourteen, on November 6, he was diagnosed with acute lymphoblastic leukemia.

The prognosis was that Dennis had a 75% chance of cure with standard oncology treatment. Consistent with the requirements of his new faith, however, Dennis told his doctors, “I do not want to be treated if the requirement is that I would have to …