Bioethics and Medical Ethics Commons^™

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

The Million Veteran Program 1990-1991 Gulf War Era Survey: An Evaluation Of Veteran Response, Characteristics, And Representativeness Of The Gulf War Era Veteran Population, Kelly M Harrington, Rachel Quaden, Lea Steele, Drew A Helmer, Elizabeth R Hauser, Sarah T Ahmed, Mihaela Aslan, Krishnan Radhakrishnan, Jacqueline Honerlaw, Xuan-Mai T Nguyen, Sumitra Muralidhar, John Concato, Kelly Cho, J Michael Gaziano, Stacey B Whitbourne, On Behalf Of The Va Million Veteran Program

Center for Medical Ethics and Health Policy Staff Publications

To address gaps in understanding the pathophysiology of Gulf War Illness (GWI), the VA Million Veteran Program (MVP) developed and implemented a survey to MVP enrollees who served in the U.S. military during the 1990–1991 Persian Gulf War (GW). Eligible Veterans were invited via mail to complete a survey assessing health conditions as well as GW-specific deployment characteristics and exposures. We evaluated the representativeness of this GW-era cohort relative to the broader population by comparing demographic, military, and health characteristics between respondents and non-respondents, as well as with all GW-era Veterans who have used Veterans Health Administration (VHA) services and …

To Till And To Keep: Following The Ethical Imperative To Care For Creation Through Gender Exploration And Expression, Phoebe Carstens

Obsculta

In light of the recent USCCB document regarding 'the Moral Limits to Technological Manipulation of the Human Body,' this essay explores an alternative, transgender-affirming ethical framework drawn from Pope Francis's Laudato si’. Within this framework, gender-affirming care is presented as fulfilling the call to care for creation through exploration and cultivation of the self.

Bioethics And A Theology Of Vulnerability, Carrie Oneil-Smith

Obsculta

This essay looks at how a theology of vulnerability can contribute to ethical decision-making in an increasingly secular society. Relationality, power dynamics and scriptural justifications are considered, as well as early contributions made to this nascent field of Christian thought. This essay was written for a class on Health Care Ethics taught by Dr. Mary Ann Kish.

Late Have I Loved Thee: Reintroducing The Journal Of Health Ethics Twenty Years Later, Peter A. Depergola Ii

Journal of Health Ethics

The Editor-in-Chief provides an overview of Volume 20, Issue 1.

Examining The Ethics Behind Icu Admission During The Covid-19 Pandemic, Brian Eclarinal

Journal of Health Ethics

During the COVID-19 pandemic surge, the demand for ICU beds far exceeds its supply in the hospitals. The healthcare team had to confront themselves with an ethical dilemma of distributing the limited beds to patients who required ICU admission and therefore needed to prioritize. This paper examines various ethical theories and principles that were used during the pandemic in assigning patients to ICU beds and proposes an algorithm to aid in decision making for ICU bed assignment in order to achieve a fair allocation of this scarce resource.

Navigating Religious Attitudes Towards Assisted Reproductive Technology, Gretchen Ruschman

Gaines Fellow Senior Theses

As global infertility rates increase, the growing utilization of assisted reproductive technology (ART), specifically in vitro fertilization (IVF), has introduced a range of ethical concerns. Religious beliefs play a crucial role in shaping societal norms and guiding individual ethical deliberation, which is also true in navigating the ethical framework surrounding ART. Therefore, it is important to acknowledge the role of religion in shaping perspectives on ART and explore the role of religion in ethical decision-making on an individual and a community scale. This study explored different religious perspectives on ethical issues surrounding the current state and potential future advancements of …

A Closer Look At The Humanistic Aspects Of The Opioid Epidemic And Its Implications For Pharmaceutical Ethics And Law, Eriel Burns

Gaines Fellow Senior Theses

This paper elucidates the humanistic elements of this crisis, that is, the ethical challenges it poses and the role of culture in it. The opioid crisis disturbs several bioethics principles as indicated by the fact that it burgeoned out of the health care system as opposed to the illicit environments of the underground market. The book Dreamland by investigative journalist and storyteller, Sam Quinones encapsulates the complexity of the opioid epidemic through research and interviews with important figures related to the crisis such as physicians, people with opioid use disorder, and pharmaceutical sales representatives, among others. Quinones details that the …

Breathe, Renee J Flores

Faculty and Staff Publications

This is a personal essay about breasts. It focuses on my experiences as a young girl, moving through adolescence to a history of breast cancer in my family, including my mother's breast cancer diagnosis. As a physician, patient, and wife, I reflect on the choices that I have to make and what this means for my identity as a woman and mother.

A Mixed-Method Evaluation Of Implementation Determinants For Chaplain Intervention In A Hospital Setting, Jennifer S Mascaro, Marianne P Florian, Erin Brauer, Patricia K Palmer, Marcia J Ash, Maureen Shelton, Roman Palitsky, Deanna M Kaplan, Shaheen Rana, Cam Escoffery, Charles L Raison, George H Grant

Faculty and Staff Publications

Healthcare chaplains address broad social and emotional dimensions of care within a pluralistic religious landscape. Although the development and evaluation of chaplaincy interventions has advanced the field, little research has investigated factors influencing the implementation of new chaplain interventions. In this mixed-method study, we examined attitudes about evidence-based interventions held by chaplain residents (n = 39) at the outset of an ACPE-accredited residency program in the southeast United States. We also used semi-structured interviews (n = 9) to examine residents' attitudes, beliefs, and decision-making processes after they trained in the delivery of a novel manualized intervention, Compassion-Centered Spiritual Health (CCSH). …

Conducting Research With Highly Portable Mri In Community Settings: A Practical Guide To Navigating Ethical Issues And Elsi Checklist, Francis X. Shen, Susan Wolf, Frances Lawrenz, Donnella S. Comeau, Barbara J. Evans, Damien Fair, Martha J. Farah, Michael Garwood, S. Duke Han, July Illes, Jonathan D. Jackson, Eran Klein, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan

Articles

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

Expert Stakeholder Perspectives On Emerging Technology For Neuroimaging Research With Highly Portable Mri: The Need For Guidance On Ethical, Legal, And Societal Issues, Molly K. Madzelan, Frances Lawrenz, Susan Wolf, Francis X. Shen

Articles

Portable MRI (pMRI) technology, which promises to transform brain imaging research by facilitating scanning in new geographic areas and the participation of new, diverse populations, raises many ethical, legal, and societal issues (ELSI). To understand this emerging pMRI ELSI landscape, we surveyed expert stakeholder views on ELSI challenges and solutions associated with pMRI research.

Introduction: Revolutionizing Neuroimaging Research With Highly Portable Mri: Confronting Ethical And Legal Challenges, Francis X. Shen, Frances Lawrenz, Susan M. Wolf

Articles

No abstract provided.

Scientists' Perspectives On Ethical Issues In Research With Emerging Portable Neuroimaging Technology: The Need For Guidance On Ethical, Legal, And Societal Implications (Elsi), Frances Daniels, Efrain Torres, Frances Lawrenz, Susan M. Wolf, Francis X. Shen

Articles

Deployment of new, more portable, and less costly neuroimaging technologies such as portable magnetoencephalography, electroencephalography, positron emission tomography, functional near-infrared spectroscopy, high-density diffuse optical tomography, and magnetic resonance imaging is advancing rapidly. Given this trajectory toward increasing use of neuroimaging outside the hospital, we sought to identify ethical, legal, and societal implications (ELSI) of these new technologies by understanding the perspectives of those scientists and engineers developing and implementing portable neuroimaging technologies in the United States, Europe, and Asia. Based on a literature review, we identified and contacted 19 potential interviewees and then conducted 11 semi-structured interviews in English by …

Ethical, Legal, And Policy Challenges In Field-Based Neuroimaging Research Using Emerging Portable Mri Technologies: Guidance For Investigators And For Oversight, Francis X. Shen, Susan M. Wolf, Francez Lawrenz, Donnella S. Comeau, Kafui Dzirasa, Barbara J. Evans, Damien Fair, Martha J. Farah, S. Duke Han, Judy Illes, Jonathan D. Jackson, Eran Klein, Karen S. Rommelfanger, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan, Michael Garwood

Articles

Researchers are rapidly developing and deploying highly portable MRI technology to conduct field-based research. The new technology will widen access to include new investigators in remote and unconventional settings and will facilitate greater inclusion of rural, economically disadvantaged, and historically underrepresented populations. To address the ethical, legal, and societal issues raised by highly accessible and portable MRI, an interdisciplinary Working Group (WG) engaged in a multi-year structured process of analysis and consensus building, informed by empirical research on the perspectives of experts and the general public. This article presents the WG’s consensus recommendations. These recommendations address technology quality control, design …

Returning Individual Research Results From Digital Phenotyping In Psychiatry, Francis X. Shen, Matthew L. Baum, Nicole Martinez-Martin, Adam S. Miner, Melissa Abraham, Catherine A. Brownstein, Nathan Cortez, Barbara J. Evans, Laura T. Germine, David C. Grady, Ingrid A. Holm, Elisa A. Hurley, Sara Kimble, Gabriel Lazaro-Munoz, Kimberlyn Leary, Mason Marks, Patrick J. Monette, Jukka-Pekka Onnela, P. Pearl O'Rourke, Scott L. Rauch, Carmel Shachar, Srijan Sen, Ipsit Vahia, Jason L. Vassy, Justin T. Baker, Barbara E. Bierer, Benjamin C. Silverman

Articles

Psychiatry is rapidly adopting digital phenotyping and artificial intelligence/machine learning tools to study mental illness based on tracking participants’ locations, online activity, phone and text message usage, heart rate, sleep, physical activity, and more. Existing ethical frame-works for return of individual research results (IRRs) are inadequate to guide researchers for when, if, and how to return this unprecedented number of potentially sensitive results about each participant’s real-world behavior. To address this gap, we convened an interdisciplinary expert working group, supported by a National Institute of Mental Health grant. Building on established guidelines and the emerging norm of returning results in …

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura D. Hermer

Faculty Scholarship

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

Variability In Perceptions Of Complementary Health Approaches Among Graduate Student Trainees, Delaney C. Bilodeau

Theses and Dissertations

Complementary Health Approaches (CHAs) encompass a diverse range of practices which are often used both independently and alongside conventional medical treatments. Understanding how graduate students training in different fields perceive CHAs is important because these professional trainees will go on to occupy roles as healthcare practitioners, researchers, policy makers, and consumers. This study used sequential rank agreement methods (Ekstrøm, Gerds, & Jensen, 2019) to investigate variations in perceptions of CHAs in a sample of graduate students (N = 416) from 140 possible training programs. Ratings of CHA familiarity, perceptions of CHA legitimacy, and willingness to recommend CHAs were compared …

Fda Regulation Of Physicians' Professional Speech, Barbara J. Evans

UF Law Faculty Publications

The First Amendment to the U.S. Constitution constrains FDA’s power to impose content-based restrictions on physicians’ professional speech – that is, on the expert medical advice licensed physicians render to patients during clinical treatment encounters. In 2022, the U.S. Food and Drug Administration (FDA) clarified its plans to regulate clinical decision support (CDS) software by publishing a final guidance document. CDS tools process patient-specific health information along with various other sources of medical knowledge – such as clinical practice guidelines, drug labeling information, insights from published medical literature, or fresh insights gleaned by an artificial intelligence/machine learning (AI/ML) algorithm imbedded …

Conducting Research With Highly Portable Mri In Community Settings: A Practical Guide To Navigating Ethical Issues And Elsi Checklist, Francis X. Shen, Susan M. Wolf, Frances P. Lawrenz, Donnella S. Comeau, Barbara J. Evans, Damien A. Fair, Martha J. Farah, Michael Garwood, Duke Han, Judy Illes, Jonathan D. Jackson, Eran Klein, Matthew S. Rosen, Efraín Torres, Paul Tuite, J. Thomas Vaughan

UF Law Faculty Publications

Highly portable and accessible MRI technology will allow researchers to conduct field-based MRI research in community settings. Previous guidance for researchers working with fixed MRI does not address the novel ethical, legal, and societal issues (ELSI) of portable MRI (pMRI). Our interdisciplinary Working Group (WG) previously identified 15 core ELSI challenges associated with pMRI research and recommended solutions. In this article, we distill those detailed recommendations into a Portable MRI Research ELSI Checklist that offers practical operational guidance for researchers contemplating using this technology.

Ethical Oversight And Social Licensing Of Portable Mri Research, Barbara J. Evans

UF Law Faculty Publications

This article explores two questions: (1) whether portable MRI research might escape regulatory oversight altogether under existing U.S. privacy and research ethical frameworks, leaving research participants without adequate protections, and (2) whether existing regulatory frameworks, when they do apply, can guard society’s broader interest in ensuring that portable MRI research pursues socially beneficial, ethically sound aims that minimize the potential for externalities affecting nonparticipating individuals and groups, who might be stigmatized or otherwise harmed even if they decline participation in the research.

Ada Constitution & Bylaws (2024), 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.

Assessing Disparities In Culturally Competent Care In Ethnic Burn Patients, Min Kang

Nursing | Student Research Posters

One of the most debilitating injuries one can suffer is a burn. It is even worse when certain individuals can not access the high quality care such as immigrants. With immigration rates increasing over the last several decades, these populations often lack the proper medical care that they deserve. The overarching theme in this population is that they face challenges in attaining positive patient outcomes due to cultural differences.

• Lack of Culturally Competent Care in Burn Care
• Addressing Cultural Safety and Quality of Care in Burn Injury Management
• Analyzing Disparities in Access to Culturally Competent Burn care

Clinical Simulation Workshop For Healthcare Undergrads, Chloe Bennett, Erica Y. Hinojosa, Jennifer Roye, Steven Gellman

UTA Libraries Staff Publications - Archive

This is curriculum for a full 10-day clinical experience workshop designed for undergraduate healthcare students. It includes lesson plans and all accompanying digital materials.

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura Hermer

University of Michigan Journal of Law Reform

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

Early Onset Colorectal Cancer: Research, Trends & Challenges, Sarah E. Smith

Capstone Showcase

Early onset colorectal cancer (EOCRC) incidence and mortality are rising in a global trend, contrasting with improvements seen in late-onset colorectal cancer (LOCRC). EOCRC appears to differ in presentation, histology, and pathology from LOCRC painting concerns of a more aggressive tumor profile. With incidence steadily climbing, there is still lacking awareness and guidance on screening for EOCRC. This article aims to provide background on EOCRC including epidemiology, risk factors, and traits, as well as to explore methods for adjusting provider screening criteria to combat this concerning trend.

Preventive Genetic Screening: Genetics And Ethics, Elena Vinton

Scripps Senior Theses

For completion of my dual thesis at Scripps College in Biology and Bioethics, I analyzed the feasibility of preventive genetic screening both ethically and genetically. Because each discipline approaches academic inquiry differently, I decided to ask two sequential questions: (1) How are variants analyzed in preventive genetic screening? (Biology) (2) Do patients who undergo preventive genetic screening have the ‘right not to know’ their genetic status – including medically actionable genetic information? (Bioethics). I have separated my ethical and biological inquiries into two sections. The first section is an ethical inquiry into the justification of the ‘right not to know’ …

Animal Personality And Sentience As Distinct Concepts, Mark Briffa

Animal Sentience

Owens et al (2024) discuss how knowledge of both animal personality and sentience in target populations can be leveraged to enhance wildlife conservation programmes. In this commentary I expand on the distinction between these two concepts. Behavioural differences should be considered broadly across conservation programmes, not just those involving species deemed sentient.

The Ethics Of Brain-Machine Interfaces, Devon J. Lynn

Honors Undergraduate Theses

Brain Machine Interfaces (BMI) are a rapidly developing technology that raise unique ethical issues that demand review. They have demonstrated impressive restorative potential, particularly for individuals living with epilepsy, and those who are locked in. Although BMIs have the potential to provide significant benefit to millions of users, further advancement of the technology should proceed cautiously, according to the guidelines outlined in this paper. Failure to adhere to ethical guidelines could lead to severe privacy concerns, and would violate moral principles of beneficence, virtue ethics, care ethics, and utilitarianism. Despite the moral risks, BMIs hold promise for reshaping future healthcare …