Bioethics and Medical Ethics Commons^™

Moral Drifting And Covid-19 Precautions: The Impact On Team Stress Levels In Primary Care, Brittany N. Houston, Stacy Ogbeide

Advances in Clinical Medical Research and Healthcare Delivery

The COVID-19 pandemic has given more focus on the concept of moral drifting. Moral or ethical drift is characterized as an insidious movement away from ethical behavior. Not only is this phenomenon present with routine tasks such as going to the grocery store, but it is influential and present in a setting being impacted by COVID-19: primary care. Integrated Primary Care and team-based care are incredibly valuable when caring for complex populations but also vital in mitigating the impacts of stress that moral drifting can cause on individual and team functioning.

A Feminist Challenge To Transgenderism. A Review Of Doublethink: A Feminist Challenge To Transgenderism By Janice G. Raymond, Esohe Aghatise

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Maternal Wellness: Self, Matrescence, Obstetric Violence, And Self-Care, Vanessa V. Vales-Lewis

Dissertations, Theses, and Capstone Projects

In this dissertation, I engage in a self-study through an examination of my experience of matrescence (i.e., the transition to motherhood). I discuss my praxis in the development of a self-study on maternal wellness as it applies to my well-being as both a researcher and the researched. In Chapter 1, I preface this study by highlighting critical scholars and the bricoleurs who have been foundational in my undertaking of this work on a narrative study on maternal wellness. Using bricolage as part of a research methodological framework that involved key scholarly methodologies of authentic inquiry, emergence and contingence, and narratology, …

Trans Doublethink And Newspeak. A Review Of Doublethink: A Feminist Challenge To Transgenderism By Janice Raymond, Heather Brunskell-Evans

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Brief Of Amici Curiae Christian Medical & Dental Associations And Coptic Medical Association Of North America In Support Of Defendants' Motions To Dismiss, John A. Meiser, Francesca M. Genova, Christopher J. Schweickert

Court Briefs

No. 3:21-cv-06654-VC
Lonny Shavelson v. California Department of Health Care Services

From the Argument

Whether and to what extent doctors should be allowed to participate in intentionally ending the lives of their patients is one of the most important questions in public bioethics. The vast majority of states allow no physician participation at all. California is one of nine states that have passed laws allowing physicians to “assist” a patient’s suicide by making lethal drugs available. But each stops there. No state allows what the plaintiffs in this case now demand: that doctors be allowed to actively euthanize patients by …

Learning From South Korea’S Covid-19 Response: Why Centralizing The United States Public Health System Is Essential For Future Pandemic Responses, Meghan Ricci

Seattle Journal of Technology, Environmental, & Innovation Law

The COVID-19 pandemic revealed stark differences in governmental preparedness across the globe. The United States, once thought of as a global leader in public health, had the theoretical skill and efficiency to handle the pandemic but failed to utilize those skills and resources during an actual health crisis. In the spring of 2020, everyone watched the U.S.’s reaction to the unfolding of the COVID-19 pandemic due to its historic placeholder as a global leader and innovator. However, the performance of the U.S. in response to the global pandemic disappointed both global commentators and U.S. citizens. This paper will compare the …

Ethical, Legal, And Social Issues In The Earth Biogenome Project, Jacob S. Sherkow, Katharine B. Barker, Irus Braverman, Robert Cook-Deegan, Richard Durbin, Carla L. Easter, Melissa M. Goldstein, Maui Hudson, W. John Kress, Harris A. Lewin, Debra J. H. Mathews, Catherine Mccarthy, Ann M. Mccartney, Manuela Da Silva, Andrew W. Torrance, Henry T. Greely

Journal Articles

The Earth BioGenome Project (EBP) is an audacious endeavor to obtain whole-genome sequences of representatives from all eukaryotic species on Earth. In addition to the project’s technical and organizational challenges, it also faces complicated ethical, legal, and social issues. This paper, from members of the EBP’s Ethical, Legal, and Social Issues (ELSI) Committee, catalogs these ELSI concerns arising from EBP. These include legal issues, such as sample collection and permitting; the applicability of international treaties, such as the Convention on Biological Diversity and the Nagoya Protocol; intellectual property; sample accessioning; and biosecurity and ethical issues, such as sampling from the …

Hiv-1 Genetic Diversity A Challenge For Aids Vaccine Development: A Retrospective Bibliometric Analysis, Abdur Rashid, Kang Li, Yi Feng, Tauseef Ahmad, Yimam Getaneh, Yueyang Yu, Xiaoyan Hu, Syed Hani Abidi, Yiming Shao

Department of Biological & Biomedical Sciences

Background: Despite recent advances in human immunodeficiency virus-1 (HIV-1) prevention, a fast, safe, and effective vaccine will probably be necessary to end the HIV/AIDS pandemic. This study was conducted to evaluate global research trends and map the key bibliometric indices in HIV-1 genetic diversity from 1998 to 2021.
Methods: A comprehensive online search was conducted in the Web of Science Core Collection database to retrieve published literature on HIV-1 genetic diversity. Key bibliometric indicators were calculated and evaluated using HistCiteTM, Bibliometrix: An R-tool, and VOSviewer software for windows.
Results: A total of 2,060 documents written by 9,201 authors and published …

Creating A Pre-Illness Covid-19 Action Plan: A Web-Based Public Education Initiative, Brian S. Hustad

DNP Research Projects

Abstract

Background: The COVID-19 pandemic took the world by storm in the beginning stages of 2020. Public health agencies were overwhelmed, undermanned, and therefore slow to respond. Information began to flow at an unprecedented rate. Yet, very limited resources were put into place to present this information or to instruct the public on evidence-based prevention, treatment, or care at home during active infection.

Intervention: A project website was created and accessed through a QR code on the project flyer or by entering the URL into any browser. Participants were able to access three evidence- based video modules, which introduced the …

Ada Constitution & Bylaws (2022), 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.

Trust But Verify: Ethical Considerations Of Potential Misdiagnoses And Incorrect Patient Diagnoses, Eric Grisham

View All Washington/Montana GME

Presented at the 2022 Virtual Northwest Medical Research Symposium

2022: Global Ethical Think Tank, Sheila A. Davis Phd

Journal of Health Ethics

Editor's introduction to Volume 18, Number 1 of the Journal of Health Ethics.

Emotional Component Of Pain Perception In The Medicinal Leech?, Brian D. Burrell

Animal Sentience

Crump et al. have provided a series of criteria to assess animal sentience that is focused on the perception of pain, which is known to have both sensory and emotional components. They also provide a qualitative scoring system to assess data that address the eight criteria and apply this paradigm to decapod crustaceans. The criteria laid out have the potential to be applied to other invertebrates typically thought to have sensory response to tissue damage, but no emotional component to pain perception.

Fair Access To Scarce Medical Capacity For Non-Covid-19 Patients: A Role For Reserves, Govind C. Persad, Parag A. Pathak, Tayfun Sönmez, M. Utku Unver

Sturm College of Law: Faculty Scholarship

As hospitals in the US and elsewhere fill again with patients with covid-19, discussions about how to fairly allocate scarce medical resources have come to the fore once again. One frequently voiced concern is that non-covid-19 patients with urgent health needs are facing indefinitely postponed surgeries, long-distance hospital transfers, or even are unable to access medical treatment. In our view, a reserve or categorised priority system could help. It could be used to fairly distribute scarce medical capacity—such as staffing, physical space, and medical treatments—between covid-19 and non-covid-19 patients, just as it has been used or proposed to allocate covid-19 …

Errors In Converting Principles To Protocols: Where The Bioethics Of Us Covid‐19 Vaccine Allocation Went Wrong, William F. Parker, Govind C. Persad, Monica E. Peek

Sturm College of Law: Faculty Scholarship

For much of 2021, allocating the scarce supply of Covid-19 vaccines was the world's most pressing bioethical challenge, and similar challenges may recur for novel therapies and future vaccines. In the United States, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) identified three fundamental ethical principles to guide the process: maximize benefits, promote justice, and mitigate health inequities. We argue that critical components of the recommended protocol were internally inconsistent with these principles. Specifically, the ACIP violated its principles by recommending overly broad health care worker priority in phase 1a, using being at least seventy-five …

Nursing Education For Central Line-Associated Bloodstream Infections In Intensive Care Units, Carren Sandra Mullings

Walden Dissertations and Doctoral Studies

Central line associated blood stream infections (CLABSIs) are the most acquired hospital infection in the United States. CLABSI is caused by bacteria that enter the bloodstream through a central line. In the United States, CLABSI has a mortality rate of 18%, and every year 250,000 people are infected. Of these, 30,000 patients die due to CLABSI infections, hospital stays are prolonged, and hospital costs are increased. Patients in an intensive care unit (ICU) are more exposed to CLABSI because of procedures that break tissues and skin, such as the insertion of a central line. A gap in practice was identified …

Potential And Limitations Of Using Stem Cells To Cure Alzheimer’S Disease: A Literature Review Of Its Potential And Ethical Limitations In Translation To Human Trials, Eleni Zivla

OUR Journal: ODU Undergraduate Research Journal

Alzheimer's disease has become one of the most significant, life-limiting illnesses of our time as a result of the rapid increase in the average life expectancy. To successfully develop a cure for this yet incurable disease, one must understand the pathology of Alzheimer’s disease. As found in recent research studies, a brain that is diagnosed with Alzheimer's is characterized by the presence of extracellular amyloid plaques composed of the amyloid-beta (Aβ) peptide and intracellular neurofibrillary tangles composed of the microtubule-associated protein: tau. In this literature review, several stem cell therapies are being reviewed as a potential cure for Alzheimer’s disease …

Understanding The Role Of Race In American Medicine, Fariel C. A. Lamountain

Honors Theses

Long running inequity in health care and outcomes in the United States stem from failure to acknowledge the underlying role of the Transatlantic slave trade as it manifests in all facets of American society and commerce. This paper focuses specifically on the American medical system and its foundations to understand the precursors to generational trends in lack of access to healthcare and poor health for Black communities. This paper uses a three-pronged approach to understand the racist cycle of inequity, highlighting the history and origins of racism in American medicine, personal accounts and statistical evidence of inequity, and community and …

Man Vs Machine: How Will Artificial Intelligence And Machine Learning Systems Impact Cancer Diagnosis And The Patient-Physician Relationship?, Aditya Kotha, Faye Prichard

Undergraduate Research Posters

Oncologic diagnosticians are physicians who specialize in interpreting diagnostic exams to diagnose cancer in patients. Software companies have been developing artificial intelligence (AI) systems to interpret these exams to diagnose cancer. These AI systems may affect the traditional role of oncologic diagnosticians if they were to be implemented in the clinical setting. Therefore, I set out to answer my research question: How will AI and machine learning systems impact the roles of oncologic diagnosticians in diagnosing cancer and the patient-physician relationship? By analyzing surveys and studies, I examined the attitudes of oncologic diagnosticians versus cancer patients toward implementing AI systems …

Cpap Acceptance And Adherence In Osa Patients In Lower Northern Region Part Of Thailand, Mantana Prakassajjatham

Chulalongkorn Medical Journal

Background: Continuous positive airway pressure (CPAP) is the mainstay in obstructive sleep apnea (OSA) treatment. Good CPAP adherence reduces many risks of diseases and improves the overall quality of life.

Objective: The purpose of this study was to determine the acceptance and adherence to CPAP therapy among Thai patients with OSA who attend an otorhinolaryngology sleep clinic.

Methods: This retrospective study was conducted at the otorhinolaryngology sleep clinic, Naresuan University Hospital, Thailand between January 2015 and October 2021. The study enrolled all patients over 18 years old with OSA diagnosis. The patients were scheduled for follow-up appointments at least two …

Physician Assisted Dying (Pad): An Investigation Into The Mechanistic Action Of Opioid, Benzodiazepine, And Barbiturate Administration As An Alternative Measure To Forgoing Life Sustaining Treatment And Aggressive Palliation., Jordana Chanel Deighton

CMC Senior Theses

Whilst modern medicine has increased longevity, the rise in life expectancy has brought about new struggles, namely that of aging and age related disease. Thus, humanity has been presented with a new problem: at what point is death preferable to aggressive life-prolonging treatment in the face of inevitable death? And if so, what right do individuals have to control the circumstances of their death? In the West, traditionally, individuals who seek to end their own lives in the face of terminal illness opt for forgoing artificial hydration and nutrition. Driven by an increase in desire for autonomous dignified death, a …

Righting Health Policy: Bioethics, Political Philosophy, And The Normative Justification Of Health Law And Policy, D. Robert Macdougall

Publications and Research

In Righting Health Policy, D. Robert MacDougall argues that bioethics needs but does not have adequate tools for justifying law and policy. Bioethics’ tools are mostly theories about what we owe each other. But justifying laws and policies requires more; at a minimum, it requires tools for explaining the legitimacy of actions intended to control or influence others. It consequently requires political, rather than moral, philosophy. After showing how bioethicists have consistently failed to use tools suitable for achieving their political aims, MacDougall develops an interpretation of Kant’s political philosophy. On this account the legitimacy of health laws does …

Creating A Collaborative Trauma-Informed Interdisciplinary Citywide Victim Services Model Focused On Health Care For Survivors Of Human Trafficking, Juhi Jain, Mackenzie Bennett, Mark D Bailey, Daniel Liaou, Sheri-Ann O Kaltiso, Jordan Greenbaum, Kimberly Williams, Mollie R Gordon, Melissa I M Torres, Phuong T Nguyen, John H Coverdale, Victor Williams, Cayla Hari, Samantha Rodriguez, Temilola Salami, Jonell E Potter

Center for Medical Ethics and Health Policy Staff Publications

Although human trafficking is recognized as a public health issue, research on the health effects of human trafficking and best intervention practices is limited. We describe 2 citywide collaborative victim services models, the THRIVE (Trafficking, Healthcare, Resources, and Interdisciplinary Victim Services and Education) Clinic at the University of Miami and Jackson Health System in Miami, Florida, and the Greater Houston Area Pathways for Advocacy-based, Trauma-Informed Healthcare (PATH) Collaborative at Baylor College of Medicine, CommonSpirit Health, and San Jose Clinic in Houston, Texas, funded in part by the Office for Victims of Crime, which focus on trauma-informed health care delivery for …

A Mixed-Methods Protocol To Develop And Validate A Stewardship Maturity Matrix For Human Genomic Data In The Cloud, Vasiliki Rahimzadeh, Ge Peng, Mildred Cho

Center for Medical Ethics and Health Policy Staff Publications

This article describes a mixed-methods protocol to develop and test the implementation of a stewardship maturity matrix (SMM) for repositories which govern access to human genomic data in the cloud. It is anticipated that the cloud will host most human genomic and related health datasets generated as part of publicly funded research in the coming years. However, repository managers lack practical tools for identifying what stewardship outcomes matter most to key stakeholders as well as how to track progress on their stewardship goals over time. In this article we describe a protocol that combines Delphi survey methods with SMM modeling …

Investigation Of Urinary Metabolomics In A Phase I Hookworm Vaccine Trial In Gabon, Madeleine Eunice Betouke Ongwe, Yoanne D Mouwenda, Koen A Stam, Peter G Kremsner, Bertrand Lell, David Diemert, Jeff Bethony, Maria E Bottazzi, Peter J Hotez, Remko V Leeuwen, Martin P Grobusch, Ayola A Adegnika, Oleg A Mayboroda, Maria Yazdanbakhsh

Center for Medical Ethics and Health Policy Staff Publications

Metabolomics provides a powerful tool to study physiological changes in response to various perturbations such as vaccination. We explored whether metabolomic changes could be seen after vaccination in a phase I trial where Gabonese adults living either in rural or semi-urban areas received the subunit hookworm vaccine candidates (Na-GST-1 and Na-APR-1 (M74) adjuvanted with Alhydrogel plus GLA-AF (n = 24) or the hepatitis B vaccine (n = 8) as control. Urine samples were collected and assayed using targeted 1H NMR spectroscopy. At baseline, a set of metabolites significantly distinguished rural from semi-urban individuals. The pre- and post-vaccination comparisons indicated significant …

Fast Cbt For Pediatric Ocd: A Multiple-Baseline Controlled Pilot Trial Of Parent Training In Exposure And Response Prevention Delivered, Lara J Farrell, Natalja A Nabinger De Diaz, Sharna Mathieu, Matthew L Mckenzie, Taka Miyamoto, Caroline L Donovan, Allison M Waters, Sonja March, Nicole Bothma, Rianca Kroon, Gabrielle Simcock, Robert S Ware, Robert R Selles, Eric A Storch, Thomas Ollendick

Center for Medical Ethics and Health Policy Staff Publications

Objective: The current study utilized a single case series, non-concurrent multiple baseline design to examine the efficacy of training parents via telehealth videoconferencing in exposure and response prevention (ERP) for home delivery of the treatment for their children and adolescents with obsessive compulsive disorder (OCD).

Method: There were nine participants aged 8 to 14 years who had received a primary diagnosis of OCD. The design involved a series of AB replications, whereby following pre-treatment assessments participants were randomly assigned to either a 2-week (n = 4) or 3-week (n = 5) baseline condition with weekly monitoring of their …

Post-Trial Access In Implanted Neural Device Research: Device Maintenance, Abandonment, And Cost, Gabriel Lázaro-Muñoz, Michelle T Pham, Katrina A Muñoz, Kristin Kostick-Quenet, Clarissa E Sanchez, Laura Torgerson, Jill Robinson, Stacey Pereira, Simon Outram, Barbara A Koenig, Philip A Starr, Aysegul Gunduz, Kelly D Foote, Michael S Okun, Wayne Goodman, Amy L Mcguire, Peter Zuk

Center for Medical Ethics and Health Policy Staff Publications

Background: Clinical trial participants who benefit from experimental neural devices for the treatment of debilitating and otherwise treatment-resistant conditions are generally not ensured continued access to effective therapy or maintenance of devices at the conclusion of trials.

Objective/hypothesis: Post-trial obligations have been extensively examined in the context of drug trials, but there has been little empirical examination of stakeholder perspectives regarding these obligations in the rapidly growing field of neural device research.

Methods: This study examined the perspectives of 44 stakeholders (i.e., 23 researchers and 21 patient-participants) involved in implantable neural device trials.

Results: Researchers were concerned about current post-trial …

Features Of Burnout Amongst Pathologists: A Reassessment, Michael B Cohen, Marisa Saint Martin, David J Gross, Kristen Johnson, Stanley J Robboy, Thomas M Wheeler, Rebecca L Johnson, W Stephen Black-Schaffer

Faculty, Staff and Students Publications

There has been little rigorous assessment of burnout among pathologists and pathology trainees. Given this relative dearth of relevant literature on pathologist burnout, this report aims to raise awareness of the issue among those working in and around this specialty. Our results are based on a survey given in conjunction with the American Board of Pathology's (ABPath) biennial Continuing Certification (CC) reporting of activities required of diplomates to maintain certification. The survey was voluntary, open to all diplomates participating in CC, and conducted over two consecutive years (2019 and 2020), with alternate years comprising different sets of diplomates. The data …

Creation Of A Global Vaccine Risk Index, Tasmiah Nuzhath, Peter J Hotez, Ashish Damania, P Shuling Liu, Brian Colwell

Center for Medical Ethics and Health Policy Staff Publications

The World Health Organization has identified vaccine hesitancy as one of its top ten global health threats for 2019. Efforts are underway to define the factors responsible for reductions in vaccine confidence. However, as global measles cases accelerated beginning in 2018, it became evident that additional factors were promoting measles re-emergence, including war, political and socio-economic collapse, shifting poverty, and vulnerability to weather events and climate change. Accordingly, we propose a Global Vaccine Risk Index (VRI) to consider these variables as a more comprehensive means to identify vulnerable nations where we might expect measles and other vaccine-preventable diseases to emerge …