Bioethics and Medical Ethics Commons^™

Systematic Review: Burnout In Health Care Professionals, Nicolas X. Tovar

The Journal of Purdue Undergraduate Research

No abstract provided.

The Next Drug Epidemic Is Legal: The Nation's Kratom Problem Is More Complicated—And More Harmful—Than It Seems, Elizabeth Walsh

Capstones

This two-part health and science investigative piece reports how kratom and its offshoots have quietly fueled a lucrative and legal addiction epidemic for the last decade. While kratom’s derivative alkaloid 7-hyrdoxymitragynine made headlines this year and as the DEA is poised to ban the strong derivative, “natural” kratom and other kratom-derived products will remain. This piece tracks the history of the 'gas‑station opioid' crisis in the U.S. over ten years: what was thought to be an innocuous southeast Asian supplement has become multi-billion dollar industry built on gray‑area laws, marketed falsehoods, and regulatory loophooles.

Part 1: The ‘Gas Station Opioid’ …

Two Major Ontario Hospital Labs Bought Research Dogs From U.S. Breeder With Troubled Pastdogs Bred For Scientific And Medical Testing Suffer Abuse As The Scientific Industry Increasingly Turns To Alternatives For Research., Allison Hunter, Mary Beech, Sami Marshak, Kate Morano

Capstones

The purpose-bred dog breeding industry for research is little known. Each year, thousands of dogs are bred for scientific and medical testing, supplied to research facilities by a handful of major commercial breeders. But gaps in enforcement and regulation have allowed abuses to persist, even as the industry increasingly turns to alternatives to animal testing. Animal rights advocates have been decrying the treatment of these dogs. A federal Inspector General report found lax oversight of the industry, raising further concerns about how dogs are treated. This story was reported in collaboration with the Investigative Journalism Bureau, based in Toronto, and …

(Un)Intended Consequences Of Race In Medicine: The Ethics Of Race-Based Medical Practice And The Perpetuation Of Structural Racism, Allegra Merriweather

Electronic Theses and Dissertations

This dissertation proposes that race-based medicine acts as a form of structural racism that is ethically indefensible. While it may be claimed to be a neutral diagnostic tool, the medical use of race as a biological proxy only further enforces the very hierarchies it purports to remediate, reinscribing inequity from conception to death. Building off Jacques Ellul’s work on Technique, we interpret race-based medicine as a self-perpetuating system that values procedural expediency over moral accountability. In nine chapters, the analysis follows the ways this technique is manifested in genetics and assisted reproduction, where commodified racial selection preserves social hierarchies; in …

Limits On Wimp Dark Matter With Nai(Tl) Crystals In Three Years Of Cosine-100 Data, G H Yu, N Carlin, J Y Cho, J J Choi, S Choi, A C Ezeribe, L E França, C Ha, I S Hahn, S J Hollick, E J Jeon, H W Joo, W G Kang, M Kauer, B H Kim, H J Kim, J Kim, K W Kim, S H Kim, S K Kim, W K Kim, Y D Kim, Y H Kim, Y J Ko, D H Lee, E K Lee, H Lee, H S Lee, H Y Lee, I S Lee, J Lee, J Y Lee, M H Lee, S H Lee, S M Lee, Y J Lee, D S Leonard, N T Luan, V H A Machado, B B Manzato, R H Maruyama, R J Neal, S L Olsen, B J Park, H K Park, H S Park, J C Park, K S Park, S D Park, R L C Pitta, H Prihtiadi, S J Ra, C Rott, K A Shin, D F F S Cavalcante, M K Son, N J C Spooner, L T Truc, L Yang, Cosine-100 Collaboration

Faculty and Staff Publications

We report limits on weakly interacting massive particle (WIMP) dark matter derived from three years of data collected by the COSINE-100 experiment with NaI(Tl) crystals, achieving an improved energy threshold of 0.7 keV. This lowered threshold enhances sensitivity in the sub-GeV mass range, extending the reach for direct detection of low-mass dark matter. Although no excess of WIMP-like events was observed, the increased sensitivity enabled a model-insensitive comparison between the expected WIMP signal rate-based on mass limits from our data-and DAMA's reported modulation amplitude. Our findings strongly disfavor the DAMA signal as originating from WIMP interactions, fully excluding DAMA/LIBRA 3σ …

A Narrative Review Of Dual Loyalty Conflicts In Custodial Settings And Implications For Community Practice, Michelle Suh, Marc David Robinson, Holland Kaplan

Center for Medical Ethics and Health Policy Staff Publications

Dual loyalty dilemmas are conflicts between health care professionals' obligations toward their patients and third-party interests. These conflicts are more common and starker in custodial settings, such as jails and prisons, military detention facilities, immigration detention centers, and involuntary psychiatric institutions. Despite encountering patients in custody, health care professionals (HCPs) in community settings have limited knowledge and training. In this narrative review, we examined dual loyalty conflicts faced by HCPs working in custodial settings and then applied the identified themes to community-based hospitals where HCPs care for patients in custody. We searched databases for original papers relating to patients in …

Survey Of U.S. Reproductive Medicine Clinicians’ Attitudes On Polygenic Embryo Screening, Rémy A Furrer, Dorit Barlevy, Aayushi Gandhi, Shai Carmi, Todd Lencz, Stacey Pereira, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Polygenic embryo screening (PES) is used to screen embryos for their genetic likelihood of developing complex conditions and traits. We surveyed 152 U.S. reproductive endocrinology and infertility specialists (REIs) on their views of PES. While most respondents (97%) were at least slightly familiar with PES, general approval of PES was low (12%), with the majority expressing disapproval (46%) or uncertainty (42%). A majority (58%) believed risks outweigh benefits, while only 16% felt benefits outweigh risks. Most clinicians (85-77%) were very or extremely concerned about low accuracy, confusion over results, false expectations, and eugenics. Nonetheless, when asked to vote on whether …

Aging And The Screen: Toxic Commodification Of The Female Body In The Substance (2024), Damlasu Uyug Sengun, Tuncer Mert Aydın, Zeynep Ozdamar Ertekin

Markets, Globalization & Development Review

Representations of the aging female body have increased in media, but their presence is still shaped by social norms and market-driven ideals. On the contrary, The Substance (2024), an absurd, postmodern body horror, provides us a provocative critique of contemporary society’s obsession with youth and beauty and the way our culture defines and commodifies aging, especially in relation to women’s bodies and identities. Our review of The Substance incorporates consumer culture theory with Julia Kristeva’s concept of the abject (1982), Laura Mulvey’s theory of the male gaze (1975), and Barbara Creed’s notion of the monstrous-feminine, (1993) to explore the toxic …

Is Ageism A Problem In Dentistry? It Would Appear That No One Or No Segment Of Society Is Immune From Acting Questionably—And, Possibly, Illegally—Toward Seniors., Stuart Segelnick Dds, Ms

The New York State Dental Journal

While attending local, stat and national dental meetings through the years, and even the most recent NYSDA House of Delegates meeting, I am repeatedly surprised to hear comments from senior society officers decrying the “old men in the room” and declaring they have had “enough of the old whitehaired men” dominating the higher echelons of our organization. The younger dentists listening nod their heads in approval. What these well-meaning, experienced dentists were trying to highlight was the need to have younger and more diverse dentists involved in organized dentistry.

A Historical Cohort Comparison After Inpatient Admission For Adolescents With Anorexia Nervosa: Feasibility Of Virtual Group Therapy, Elizabeth V Franklin, Margaret Mathias, Rachel Wolfe, Duc T Nguyen, Drusilla M Rosales, Sofia Pedroza, Albert C Hergenroeder, Constance M Wiemann

Center for Medical Ethics and Health Policy Staff Publications

Objective: Access to follow-up care after a medical admission for adolescents with anorexia nervosa (AN) is important; yet access can be delayed or unavailable. This study assessed the feasibility and acceptability of a supplemental virtual 8-week outpatient group therapy program following inpatient care. A secondary aim explored the outpatient program's impact on self-reported anxiety, disordered eating, and depression symptoms, and readmission rates.

Method: A retrospective chart review study compared 68 adolescents (aged 11-18) with AN enrolled in an 8-week group therapy program (Recovery and Prevention Program [RAPP]) to 64 adolescents who were not enrolled in RAPP (historical cohort). "RAPP completers" …

Capacity Over Cognition: A Case Of High-Risk Disease And Homelessness, Mikalah E. Maury, Avery M. Duncan, Rebecca A. Taylor, Mary Ann Beil, Maulikkumar A. Patel

HCA Healthcare Journal of Medicine

Background

Medical decision-making in indigent patients with baseline cognitive deficits and lack of supportive resources is a difficult problem that reveals many ethical issues. Performing high-level medical procedures (eg, invasive surgery, chemotherapy, radiation therapy) on these patients without supportive resources brings into question the efficacy and necessity of treatment if it places the patient at higher risk of additional complications and mortality.

Case Presentation

In this article, we present a case of a 62-year-old indigent man with a long history of encephalopathy secondary to alcohol abuse, presenting with an aggressive head and neck cancer impacting his quality of life.

Conclusion …

The History Of Nazi Neuroscience: Tracing Evidence Through Voids, Angela Gushue

Claremont-UC Undergraduate Research Conference on the European Union

During the Holocaust (1933-1945), voids were created by the destruction of ethics, morality, and human life. We can detect this absence because of material traces of the events. My paper applies the theory of relational ontology of absence to a collection of empty jars on display at the Josephinum, a medical history museum in Vienna. The jars once contained human remains of children murdered in the “euthanasia” program at Am Spiegelgrund, a psychiatric clinic in Vienna where 789 were killed during the Nazi era. These victims were not commemorated until the early 2000s, when the specimen jars were emptied and …

Ethical Care Is Excellent Care: Exploring How Dentists Can Approach Treating Visually Impaired Patients Through Different Ethical Frameworks, Elizabeth Gershater

Journal of the American College of Dentists

The Ozar-Hasegawa Annual Student Ethics Award recognizes an outstanding scholarly submission in dental ethics, published annually in the Journal of the American College of Dentists (JACD). This article highlights the winning work, selected for its significant contribution to advancing ethical reflection and professional responsibility in dentistry.

Upholding The Social Contract In A Profit-Driven System, Kamyar Sartipi

Journal of the American College of Dentists

The Ozar-Hasegawa Annual Student Ethics Award recognizes an outstanding scholarly submission in dental ethics, published annually in the Journal of the American College of Dentists (JACD). This article highlights the winning work, selected for its significant contribution to advancing ethical reflection and professional responsibility in dentistry.

Silent Signals: Human Trafficking And The Dental Professional’S Duty To Act, Pamela Zarkowski

Journal of the American College of Dentists

Human trafficking is a global public health and human rights crisis that includes forced labor and commercial sexual exploitation. Dental professionals are uniquely positioned to recognize signs of trafficking, as many victims encounter healthcare settings, including dental offices, during their exploitation. This article introduces the types and prevalence of trafficking, outlines legal and ethical responsibilities, and provides clinical red flags, case scenarios, and actionable strategies for screening and reporting. Myths that hinder detection are also addressed. By recognizing their ethical duty to protect vulnerable patients, dental professionals can become vital allies in the identification and support of trafficking survivors.

21st-Century Dental Public Health: Revisiting The Role Of Community Water Fluoridation, Larry Williams, Preetha Kanjirath

Journal of the American College of Dentists

Community water fluoridation (CWF) has been celebrated as a major public health achievement, significantly reducing dental caries and narrowing oral health disparities. While historically effective, today’s fluoride exposure landscape has shifted, with multiple sources contributing to cumulative intake. This article reviews the scientific foundation, mechanisms of action, public health benefits, and ethical considerations surrounding CWF, alongside real-world outcomes from policy reversals. It examines contemporary concerns, including potential neurodevelopmental risks and vulnerable populations, and calls for recalibrated policies that maintain caries prevention benefits while monitoring total fluoride exposure to ensure safety in modern contexts.

Digital Media, Truth Decay, And The Inversion Of Trust In Science, Nicholas Mosca

Journal of the American College of Dentists

Digital media enables the rapid dissemination of scientific oral health information from subject experts to the public. However, it also poses significant risks by facilitating the dissemination of misinformation and disinformation, thereby blurring the boundaries between truth and fallacy. This paper characterizes the decay of scientific truth in policymaking, characterized by increased public debate about scientific facts and a decline in confidence in science. It describes psychological mechanisms, such as confirmation bias and motivated reasoning, and social dynamics, including algorithm-driven content distribution and echo chambers, that accelerate the circulation of misleading science information. It suggests psychological interventions to counter misinformation, …

A Wake-Up Call, Michael G. Maihofer Dds

Journal of the American College of Dentists

The Editorial is a feature in each issue of the JACD. It includes commentary on issue content, relevant topics, or other items of interest to the fellowship.

Ethical Dilemmas Surrounding Community Water Fluoridation, Roopwant Kaur, Herminio Perez, Mark Moss

Journal of the American College of Dentists

Since the 1950s, community water fluoridation (CWF) has stood as a cornerstone of dental public health. However, a growing amount of public scrutiny necessitates reflection on the ethical basis for coming to a firm position on the topic. Aside from CWF, fluoride in the form of ingestible supplements has recently been identified as a concern by the US Food and Drug Administration. Indeed, it is challenging to wade through the facts, opinions, misinformation, and policy shifts. This article examines the ethical dilemmas that surround CWF through the lens of the American Dental Association (ADA) Principles of Ethics and Code of …

J Am Coll Dent 2025 92 1

Journal of the American College of Dentists

The Journal of the American College of Dentists (JACD) publishes scholarly articles, editorials, essays, and reflections addressing the ethical, professional, and social dimensions of dentistry. The Journal serves as a forum for advancing ethics, professionalism, leadership, and excellence within the dental community. By fostering dialogue across disciplines and perspectives, JACD provides readers with insights that encourage ethical, professional practice, lifelong learning, and service to the public, reinforcing dentistry’s commitment to advancing oral healthcare and the common good.

Consent For Organ Donation In India: Factors, Challenges, And Opportunities – A Review, Preetha Vijayalakshmi, Yashfeen M

Journal Of Indian Physician Associates

India’s organ donation rate remains under 1 per million population, markedly lower than the consent rates observed in Canada and Spain. This narrative review synthesizes evidence from Indian and global literature to explore systemic, sociocultural, and individual factors influencing consent for deceased organ donation in India. Systemic barriers include delayed referrals, inadequate hospital infrastructure, and a shortage of trained transplant coordinators. Sociocultural factors, such as family decision-making under the Transplantation of Human Organs Act (1994), religious misconceptions, and concerns about bodily integrity, significantly hinder consent. Individual factors, including low awareness and a knowledge–action gap despite altruistic intentions, impede progress. Comparative …

Pharmacist Quality Of Work-Life During Covid-19 Pandemic In Cagayan De Oro, Junnin Gay Labrigas Garay, Rugine Riel D. Barsobia, Zoe Kyra Evasco, Bonnie Louise Elorde

Pacific Journal of Health

During the COVID-19 pandemic, pharmacists have been one of the most accessible healthcare workers working in the frontline providing the medication and drug needs of patients. Their roles and responsibilities in work expanded and to some redefined as the pandemic hit. Adjustments in their work, and workplaces were also implemented in adherence to the pandemic situation. The quality of work life of frontline pharmacists were affected because of the changes brought by the pandemic. A descriptive qualitative study design was used to determine the pharmacist’s quality of work-life during the COVID-19 pandemic in Cagayan de Oro City. The place was …

The 10-Year Functional Outcome Of Ponseti Treatment Of Idiopathic And Arthrogrypotic Clubfeet With An Age-Matched Control, Chris Church, Nicole Wang, Stephanie Butler, Jose J Salazar-Torres, John Henley, Freeman Miller, Nancy Carlin, Maureen Donohoe, L Reid Nichols

Faculty and Staff Publications

Background: The Ponseti method is accepted as an effective primary conservative treatment for idiopathic clubfoot (IC) using serial casting, percutaneous Achilles tenotomy, and prolonged bracing. The outcomes of its use in treating rigid clubfoot in arthrogryposis are unclear. This study assesses the outcomes of the Ponseti method in children with IC and arthrogrypotic clubfoot at an average age of 10 years.

Methods: Outcomes of the Ponseti method were retrospectively studied in ambulatory children ages 8.0 to 12.9 years in the gait lab between 2004 and 2024. Children were excluded due to the presence of nonidiopathic or nonarthrogryposis-related clubfoot and history …

Accreditation Standards Must Protect Trainees: Creating Ethical Fellowship Programs, Anna D Goff, Ryan J Dougherty, Joelle Robertson-Preidler

Faculty and Staff Publications

No abstract provided.

Real-World Use Of Classic And Non-Classic Psychedelics In Hispanic/Latino Adults With Obsessive-Compulsive Disorder: International Findings From The Latino Study, David S Mathai, Jill O Robinson, Kevin Wagner, Logan Neitzke-Spruill, Dayan Berrones, Jacey L Anderberg, Renee M Frederick, Vanessa Zavala Cruz, Josselyn S Muñoz, Latin American Trans-Ancestry Initiative For Ocd Genomics, Brazilian Obsessive-Compulsive Spectrum Disorder Working Group;, Carolyn I Rodriguez, Lynnette A Averill, James J Crowley, Eric A Storch, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Objective: Despite growing research on the potential mental health benefits of psychedelics, there has been limited study of these drugs in populations with obsessive-compulsive disorder (OCD) and with Hispanic and Latin American (H/L) ancestry.

Methods: Demographic and clinical assessments were conducted as part of the Latin American Trans-ancestry Initiative for OCD genomics (LATINO) Study in H/L participants with OCD living throughout the Americas. Self-reported data on the prevalence of naturalistic psychedelic use and associated outcomes on OCD symptoms were collected in a subsample of 2,639 adults. Descriptive statistics and regression analyses were used to assess psychedelic use, predictors of use, …

Parental Expectations Of Pediatric Care For Children, Brenan T. Cash, Jacquelyn D. Wiersma-Mosley, Donia Timby, Laura Herold

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Access to childhood pediatrics is a major factor for a full and healthy childhood for all children from adolescence to adulthood. However, the physical health aspect has been the main focus of most primary care clinics, and there is little focus on mental health. Mental health issues, which involve anxiety, depression, and post-traumatic stress, are more prominent than they have ever been, as up to 30% of children have experienced mental health issues that involve post-traumatic stress disorder, especially during the pandemic years. This study employed a non-experimental, quantitative analysis utilizing online closed-ended survey questions. Caretakers were offered an anonymous, …

Combined Annual Modulation Dark Matter Search With Cosine-100 And Anais-112, N Carlin, J Y Cho, J J Choi, S Choi, A C Ezeribe, L E França, C Ha, I S Hahn, S J Hollick, S B Hong, E J Jeon, H W Joo, W G Kang, M Kauer, B H Kim, H J Kim, J Kim, K W Kim, S H Kim, S K Kim, W K Kim, Y D Kim, Y H Kim, Y J Ko, D H Lee, E K Lee, H Lee, H S Lee, H Y Lee, I S Lee, J Lee, J Y Lee, M H Lee, S H Lee, S M Lee, Y J Lee, D S Leonard, N T Luan, V H A Machado, B B Manzato, R H Maruyama, R J Neal, S L Olsen, H K Park, H S Park, J C Park, J S Park, K S Park, K Park, S D Park, R L C Pitta, H Prihtiadi, S J Ra, C Rott, K A Shin, D F F S Cavalcante, M K Son, N J C Spooner, L T Truc, L Yang, G H Yu, J Amaré, J Apilluelo, S Cebrián, D Cintas, I Coarasa, E García, M Martínez, Y Ortigoza, A Ortiz De Solórzano, T Pardo, J Puimedón, M L Sarsa, C Seoane

Faculty and Staff Publications

The annual modulation signal, claimed to be consistent with dark matter as observed by DAMA/LIBRA in a sodium-iodide based detector, has persisted for over two decades. COSINE-100 and ANAIS-112 were designed to test the claim directly using the same target material. COSINE-100, located at Yangyang Underground Laboratory in South Korea, and ANAIS-112, located at Canfranc Underground Laboratory in Spain, have been taking data since 2016 and 2017, respectively. Each experiment published its respective results independently. In this Letter, we present the results of an annual modulation search as a test of the signal observed by DAMA/LIBRA with the first three …

Ethical Issues Involved In Solid Organ Xenotransplantation., Daniel J Hurst, Chris Bobier, Luz A Padilla

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Xenotransplantation (specifically, genetically modified pig-to-human transplant of organs, tissues, or cells) clinical trials are set to begin in the United States after decades of pre-clinical studies and recent decedent and compassionate use investigations. This article provides a primer on the key ethical issues attendant with this emerging therapy. We explore four central areas of concern: (i) the use of animals to meet human transplant needs, as well as their welfare since they are housed in non-natural conditions, (ii) the risk of infectious disease transfer from the porcine graft to the human recipient, known as xenozoonosis, (iii) patient selection criteria for …

Dementia As A Critical Lens On The Role Of Narrative In Medical Training And Practice, Erin Gentry Lamb

Faculty Scholarship

Narrative holds an important place within medicine and medical education, but an uncritical use of narrative can have troubling consequences for the care of patients who have limited or no capacity for self-narration, such as those living with dementia. We argue that the guiding principles in the use of narrative within medicine and medical education must be inclusivity and opportunity. We illustrate how medical training can benefit from a more inclusive definition of narrative, and we present a selection of innovative approaches to narrative coming out of literary studies, narrative gerontology, and medical and health humanities that focus on metaphor, …

A Qualitative Exploration Of Child, Caregiver, And Clinician Perspectives On Mental Health In Children With Osteogenesis Imperfecta, Justin H Qian, Andrew D Wiese, Clarissa Gonzalez, Whitney S Shepherd, Hannah Cho, Gianna M Colombo, Julia M Morales, Selena Guo, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Kara Ayers, Members Of The Bbdc, Marie-Eve Robinson, Chaya N Murali, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Osteogenesis imperfecta (OI) is a heritable connective disorder with clinical manifestations including bone fragility and short stature. Previous research identified psychosocial themes related to mental health among children with OI and their caregivers, such as independence, social isolation, depression, and anxiety. Several studies have also examined clinicians of individuals with OI for their perspectives on mental health among their patients. However, no known studies have compared psychosocial themes among all three participant groups concurrently. This qualitative study examined mood and anxiety, along with risk and protective factors, from perspectives of youths, parents, and clinicians. Semi-structured interviews were conducted, which were …