Bioethics and Medical Ethics Commons^™

Rethinking Ethics For An Era Of Trusted Computational Tools, Kristin M Kostick-Quenet, Meghan Hurley, John Herrington, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Computer perception (CP) technologies are poised to deliver near real-time behavioral insights with high precision. As technical barriers recede, our field's ethical focus must shift from "Can we trust the data?" to "Should we use it here, and how?" We propose a contextual ethics framework that: (1) defines the appropriate scope of CP integration; (2) advocates codesigned roadmaps to manage expectations and epistemic conflict; (3) expands evaluation beyond performance metrics to humanistic outcomes; and (4) anticipates future high performance systems to safeguard dignity, empathy, and shared decision-making in clinical care.

Anticipating Animal Ethics Concerns In Islet Xenotransplantation, Sheetal Mohanty, Daniel J. Hurst, Amy Glasofer

Rowan-Virtua Research Day

Type 1 diabetes mellitus (T1D) necessitates life-sustaining insulin therapy or, in select cases, islet allotransplantation, which is limited by donor scarcity. Islet xenotransplantation (XTx; genetically modified pig-to-human transplant) is one potential alternative. Patient perceptions about islet XTx are largely unexplored. This study examined patient support for XTx when T1D patients learned that 25-50 pigs may be needed to treat one adult. Patient viewpoints toward islet XTx suggest animal ethics concerns may extend to the magnitude of animals required to treat a single patient. As clinical trials advance, addressing these values and risk tolerances is essential for developing informed consent frameworks …

Ce Spotlight:, David Foe

The Journal of the Michigan Dental Association

This source highlights on-demand continuing education courses provided by the MDA to help dental professionals meet state relicensure requirements. Featured topics include diagnosing trigeminal neuropathy, identifying human trafficking warning signs, ethics and dental jurisprudence, and 2026 updates for infection control. The courses are designed to be convenient and are counted toward specific Michigan Board of Dentistry requirements, such as pain management and delegation of duties.

The Vipeholm Experiments: A Case Study Of Unethical Dental Research, Lainie Ross Md, Phd

Journal of the American College of Dentists

Modern-day research ethics training often begins with a discussion of the medical research atrocities committed by Nazi health care professionals and the resulting 10-principle Nuremberg Code, which is often considered to be the beginning of modern-day medical research regulations. It is occasionally mentioned that Nazi dentists also conducted unethical research in the concentration camps, and a few were brought to trial. In this manuscript, I compare two studies (one medical and one dental) conducted after World War II that violated the Nuremberg Code.

I describe and compare the well-known Willowbrook Hepatitis studies conducted by infectious disease doctors on vulnerable institutionalized …

Artificial Intelligence In Medical Ethics Education: A Descriptive Study Of Eight Models In Multiple Choice Question Generation, John Obeid, Christopher Bobier, Alex Gillham, Adam Omelianchuk, Daniel Hurst

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Integrating artificial intelligence (AI) into medical education poses barriers and opportunities for medical educators. One of those opportunities is content creation for medical ethics assessment. Assessing the performance of AI in generating multiple choice questions (MCQs) in ethics that aligns with United States Medical Licensing Examination (USMLE) is important. The present study evaluates the performance of eight AI models-GPT-4 Turbo, GPT-3.5 Turbo 0125, o1 Mini, o1 Preview, GPT-4, Claude 3.5 Sonnet, Claude 3 Opus, and Gemini-in regard to the relevance, clarity, and accuracy of generated ethics-based MCQs.

Methods: Each of the eight models was tasked with generating two sets …

Designing Inclusive Newborn Sequencing Research: Insights From Parents In Underrepresented Communities, Maya C Del Rosario, Sheyenne A Walmsley, Barbara W Harrison, Crystal T Stephens, Bethany Zettler, Greysha Rivera-Cruz, Priyal Agrawal, Amy Brower, Stephanie Chigbu, Kurt D Christensen, Casie A Genetti, Richetta Givens, Nina B Gold, Inez V Reeves, Isabella Schichter, Habib Shariat, Sandra Simon, Hadley Stevens Smith, Melissa Uveges, Robert C Green, Ingrid A Holm, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Background: It is essential that studies of genomic sequencing (GS) in newborns and children include individuals from under-represented racial and ethnic groups (URG) to ensure future applications are equitably implemented. We conducted interviews with parents from URG to better understand their perspectives on GS research, develop strategies to reduce barriers to enrollment, and facilitate research participation.

Methods: Semi-structured interviews with 50 parents from URG.

Results: Nearly all parents said they would be interested in participating in an infant GS study. Parents were interested in participating in GS research for reasons including clinical utility, personal utility, and/or family health benefits. Deterrents …

Stakeholder Perspectives On Humanistic Implementation Of Computer Perception In Health Care: Qualitative Study, Kristin M Kostick-Quenet, Meghan E Hurley, Syed Ayaz, John D Herrington, Casey J Zampella, Julia Parish-Morris, Birkan Tunç, Gabriel Lázaro-Muñoz, Jennifer Blumenthal-Barby, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Background: Computer perception (CP) technologies-including digital phenotyping, affective computing, and related passive sensing approaches-offer unprecedented opportunities to personalize health care, especially mental health care, yet they also provoke concerns about privacy, bias, and the erosion of empathic, relationship-centered practice. At present, it remains elusive what stakeholders who design, deploy, and experience these tools in real-world settings perceive as the risks and benefits of CP technologies.

Objective: This study aims to explore key stakeholder perspectives on the potential benefits, risks, and concerns associated with integrating CP technologies into patient care. A better understanding of these concerns is crucial for responding to …

Is Being A Shareholder ‘In Name Only’ A Problem?, Daniel Schulte Jd

The Journal of the Michigan Dental Association

This column addresses the legal risks for Michigan dentists entering "shareholder in name only" agreements with non-dentist entities. Michigan law requires dental practices to be owned by licensed dentists to ensure professional control over public healthcare. Arrangements where management companies or manufacturers can reclaim stock for a nominal fee effectively strip the dentist of true ownership. This lack of control can lead to ethical conflicts, such as pressure to sell specific appliances regardless of professional judgment. Engaging in such schemes may endanger a dentist's license by thwarting state laws intended to protect clinical independence.

Dental Professionalism In A Changing World: Challenges & Opportunities, Robert P. Iovino, Dds, Ma Dds, Ma

Journal of the American College of Dentists

This manuscript examines the erosion of traditional dental professionalism amid rising educational costs, declining membership in professional associations, and the growing influence of corporate ownership and private equity in dentistry. Drawing perspectives from economics, sociology, philosophy, law, and ethics, it traces the historical development of professional licensure and its role in safeguarding clinical autonomy, ethical integrity, and public trust. The analysis highlights how deregulation and profit-driven practice models challenge the profession’s social contract. The manuscript argues that preserving strong civic institutions, restrictive licensure standards, and humanities-informed education is essential to sustaining dentistry as a learned profession rather than a commodified …

The Personal, Professional, And Practice: Integrating Health Humanities Into Dental Education, Margie Hodges Shaw Jd, Ma, Phd, Michael Yunker Dds, Nicholas Mercado Drph, Ms

Journal of the American College of Dentists

Dentistry’s evolution as a profession reflects both scientific progress and enduring tensions between commercial and service-oriented models of care. Despite long-standing commitments to ethical education, dental training continues to privilege technical mastery over professional identity formation, leaving some future practitioners underprepared for the ethical and relational complexities of clinical practice. This paper situates these challenges within the historical separation of dentistry and medicine and argues that integrating the health humanities into dental education can strengthen professional identity formation and clinical ethics competency. Using a case study, we demonstrate how biases, professional obligations, and patient trust intersect in practice. We introduce …

The Ethics Of Clinical Ethics, Matthew Shea

Center for Medical Ethics and Health Policy Staff Publications

The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional …

The Global Clinical Trials Ecosystem: A Critical Evaluation And Future Outlook, Sydney-Ariel D. Muneses

Undergraduate Honors Theses

As global clinical trials expand, inconsistencies in regulatory and ethical frameworks are increasingly evident, raising concerns about economic sustainability and participant protections. Existing research attributes this surge to pharmaceutical companies seeking cost efficiencies in emerging markets but acknowledges the challenges posed by fragmented oversight across international jurisdictions. To examine these limitations, a modified Delphi approach was used to gather expert insights from key stakeholders in global clinical trials. Findings highlighted systemic inefficiencies and ethical gaps, emphasizing the need for regulatory harmonization to balance scientific rigor, economic feasibility, and equitable participant treatment. By identifying critical shortcomings and proposing strategies to align …

A Survey Of Factors Affecting Students Ethical Attitude Toward Medical Disobedience, Quinn Simpson, Jason Adam Wasserman

Posters

• Government regulations, particularly post-Roe v. Wade, create ethical conflicts for physicians between patient care and legal constraints.¹
• Decisions influenced by external pressures can negatively affect patient health.¹

Characteristics, Policies, And Practices Of Clinical Ethics Fellowship Programs, Amanda Bachand, Ellen Fox, Jason Adam Wasserman

Posters

• While clinical ethics fellowship programs are now commonplace in U.S. hospitals, recent research has revealed significant problems including a shortage of personnel who are appropriately trained to perform ethics consultation, lack of access to high quality training for ethics consultants, and lack of funding for clinical ethics training.1

• Our goal was to accurately describe the characteristics, policies, and practices of existing clinical ethics fellowship programs in the U.S. and Canada as well as the opinions of clinical ethics fellowship program directors regarding program standards, accreditation, and funding through a robust questionnaire.

• This project focused specifically on the …

The Ethics Of Gene Editing Hereditary Deafness, Jasmine Borie

Richard T. Schellhase Essay Prize in Ethics

Gene editing has been a hot topic of interest in the field of science, and many gene editing solutions for heritable diseases are in the works. In most cases, gene editing is done with good intentions, but there are some instances where it would not be favorable for reasons that may not be inherently obvious to everyone. Several forms of deafness and hearing loss can be inherited, meaning that it can be passed down from parent to offspring. Curing hereditary deafness using gene editing may seem like a good idea, but it can lead to unintentional discrimination and further stigmatization …

Classic Philosophers On Modern Issues: The Ethics Of Germline Editing, Grace O. Decostanza

Richard T. Schellhase Essay Prize in Ethics

The prospect of using CRISPR-Cas-9 technology to edit human embryos in a process called germline editing has the potential to irreparably change the world as we know it. Many pose the question: if you could save your child from having a disease, would you? But I argue that is not the only—or even, real—question we should be asking. Instead, I ask you, should we be changing humanity as we know it in ways that elude even our foremost scientists? Should we decide what disabilities make people not worth being people? Should we introduce a technology knowing full well that it …

Ethical Considerations For Sharing Aggregate Results From Pragmatic Clinical Trials, Stephanie R Morain, Abigail Brickler, Joseph Ali, Patricia Pearl O'Rourke, Kayte Spector-Bagdady, Benjamin Wilfond, Vasiliki Rahimzadeh, Caleigh Propes, Kayla Mehl, David Wendler

Center for Medical Ethics and Health Policy Staff Publications

A growing literature has explored the ethical obligations and current practices related to sharing aggregate results with research participants. However, no prior work has examined these issues in the context of pragmatic clinical trials. Several characteristics of pragmatic clinical trials may complicate both the ethics and the logistics of sharing aggregate results. Among these characteristics include that pragmatic clinical trials may affect the rights, welfare, and interests of not only patient-subjects but also clinicians, meaning that results may be owed to a broader range of groups than typically considered in other research contexts. In addition, some pragmatic clinical trials are …

Moral Distress In Secondary School Athletic Trainers, Matthew J. Drescher, Matthew J. Rivera, Lindsey E. Eberman

Internet Journal of Allied Health Sciences and Practice

Moral distress is prevalent in healthcare and prolonged moral distress is directly linked to feelings of burnout and intent to leave the profession. Moral distress has been examined in other healthcare professions, including physician practice and nursing, but not in athletic training. Due to their likelihood to be isolated and have high patient loads, secondary school athletic trainers (SSATs) may experience moral distress. This study aimed to examine the experiences and perceptions of moral distress in SSATs. SSATs were recruited via email through the Athletic Training Locations and Services (ATLAS) database. A total of 603 SSATs completed the survey and …

A Caution Against Customized Ai In Healthcare, Kristin M Kostick-Quenet

Center for Medical Ethics and Health Policy Staff Publications

This article critiques the shift towards personalized AI in healthcare and other high-stakes domains, cautioning that without careful deliberation, customized AI systems can compromise the diversity and reach of human knowledge by restricting exposure to critical information that may conflict with users' preferences and biases. Customized AI should be applied with caution and intention where access to a wide and diverse range of perspectives is essential for impartial, informed decision making.

Confidentiality In Addiction Treatment: Navigating 42 Cfr Part 2 Within Human Services, Chaniece Winfield, Jessica Huffman

Counseling & Human Services Faculty Publications

Recent federal legislation, including the Mental Health Parity and Addiction Equity Act (MHPAE) and the Comprehensive Addiction and Recovery Act (CARA), has placed greater emphasis on quality integrated health care, with a focus on access, treatment options, and evidence-based practices. Changes to Federal 42 CFR privacy protections also impact individuals seeking substance use disorder treatment, either as a primary diagnosis or comorbidity. Human service professionals, as generalists in the behavioral health field, provide vital treatment, recovery, and prevention services for individuals with substance use and addictive disorders. This paper explores the implications of these legislative changes, particularly regarding privacy protections …

The Ethics Of Student Attrition In Healthcare Education Programs, Kent Haina Jr, Peter A. Depergola Ii

Journal of Health Ethics

Student attrition is a problem in healthcare education programs, but there is little in the literature regarding the organizational ethics of lowering it. Some argue that lowering attrition is unethical, because it would lower academic and professional standards, potentially impacting patient care. Others say students deserve to make decisions about when to leave a course of study. However, these arguments ignore inequities in attrition, as well as the conflicts of interest in, and moral obligations of colleges and universities. Lowering attrition rates in healthcare education programs is inherently ethical because it levels the playing field for underrepresented minorities that disproportionately …

Talking About Suffering In The Intensive Care Unit, Brent M Kious, Judith B Vick, Peter A Ubel, Olivia Sutton, Jennifer Blumenthal-Barby, Christopher E Cox, Deepshikha Ashana

Center for Medical Ethics and Health Policy Staff Publications

Background: Some have hypothesized that talk about suffering can be used by clinicians to motivate difficult decisions, especially to argue for reducing treatment at the end of life. We examined how talk about suffering is related to decision-making for critically ill patients, by evaluating transcripts of conversations between clinicians and patients' families.

Methods: We conducted a secondary qualitative content analysis of audio-recorded family meetings from a multicenter trial conducted in the adult intensive care units of five hospitals from 2012-2017 to look at how the term "suffering" and its variants were used. A coding guide was developed by consensus-oriented discussion …

Investigation Of The Relationship Between Nursing Students’ Ethical Sensitivities And Care Behaviors, Pınar Yel, Neriman Zengin, Aysenur Çetin Üçeriz

Makara Journal of Health Research

Background: Care encompassing ethical and legal aspects is essential for nursing and involves actions that aim to improve individual well-being. In this study, we assessed the relationship between nursing students’ ethical sensitivity and care behaviors.

Methods: This descriptive study included 191 students enrolled at a foundation university who consented to participate. Relevant data were gathered by using the Descriptive Information Form, Ethical Sensitivity Scale Adapted for Nursing Students, and Caring Behaviors Scale-24. Surveys were conducted face-to-face with the attending students and via Google Forms for the non-attending students.

Results: The mean total score of the ethical sensitivity …

Muslim Spirituality As A Foundation In Bioethics For Patient Encounters In Health Care, Sara Rahman

Electronic Theses and Dissertations

Spirituality plays a major role in decision making for individuals with faith-based values. There is often hesitation to discuss the role of faith in healthcare as a core value and coping mechanism. The growing cultural diversity amongst patients and physicians has increased the need to understand eastern religious principles and incorporate them into bioethical guidance. Even as the 2nd largest religion in the world, Islam has not been sufficiently integrated into religious bioethics in western medicine. Muslim populations of patients and physicians are growing, increasing the need for better understanding of how Islamic principles impact healthcare delivery. Although Islamic law …

The Ethics Of Involuntary Psychiatric Hospitalization: A Comprehensive Analysis Of Policies, Practice, And Ethical Oversight, Mariah Chobany

Electronic Theses and Dissertations

As a specialized field of medicine, psychiatry presents unique ethical challenges and dilemmas distinct from other medical disciplines. A particularly complex aspect of psychiatric care involves the involuntary treatment of patients who may be unable to make informed decisions about their care or participation in research due to the debilitating effects of their psychiatric condition. This presents a significant challenge for providers and researchers, particularly concerning capacity issues and the informed consent process. Despite the intricacies and complexities of ethical dilemmas in psychiatric treatment and research, there is a notable lack of comprehensive guidance in policies and practices on addressing …

From Policymaking To Legislation, The Need For A Secular Turn In Bioethics Discourse To Uphold, As A Function Of The Greater Good, Policy For Legislation Of Medically Aided Dying In The United States Of America, Scott Dyer

Electronic Theses and Dissertations

A person’s right to self-determination is a central aspect of living in a democratic nation. Similarly, decisions regarding medical care are generally left up to the patient to determine what treatment is or is not appropriate. The same should apply to end-of-life care as well, especially when a patient desires to hasten his or her death via medically aided dying. However, due to the illegality of medically assisted dying in most of the United States, the right to a self-determined death is not possible for the majority of American citizens. One of the main reasons for this is due to …

What Patients And Caregivers Want To Know When Consenting To The Use Of Digital Behavioral Markers, Anika Sonig, Christine Deeney, Meghan E Hurley, Eric A Storch, John Herrington, Gabriel Lázaro-Muñoz, Casey J Zampella, Birkan Tunc, Julia Parish-Morris, Jenny Blumenthal-Barby, Kristin Kostick-Quenet

Center for Medical Ethics and Health Policy Staff Publications

Artificial intelligence (AI)-based computational tools for deriving digital behavioral markers are increasingly able to automatically detect clinically relevant patterns in mood and behavior through algorithmic analysis of continuously and passively collected data. The integration of these technologies into clinical care is imminent, most notably in clinical psychology and psychiatry but also other disciplines (e.g., cardiology, neurology, neurosurgery, pain management). Meanwhile, ethical guidelines for implementation are lacking, as are insights into what patients and caregivers want and need to know about these technologies to ensure acceptability and informed consent. In this work, we present qualitative findings from interviews with 40 adolescent …

The Challenge Of Regulating Pharmaceutical Clinical Trials In The 21st Century With A Focus On Guatemala, Alejandro Cerón, Antonio Ricafort, Carter Saccocio, Maria Delmonte, Jordan Vasquez, Amarri Bishop, Julia Atwood, Addison Bucsko, Jordan Lewis, Alexandra Welch, Itzael Garcia, Ella Wald, Selena Johnson, Crystal Jin, Talya Riciputi, Lindsey Speer, Vanessa Udo-Obong, Soren Engberg, Tessa Lindstrom

Anthropology: Undergraduate Student Scholarship

This report was prepared by the students and instructor of the "Right to Health in Theory and Practice" class taught in the fall of 2024 at the University of Denver. The report was prepared for the Vice Ministry of Health Regulation, Surveillance and Control of the Ministry of Public Health and Social Assistance of Guatemala. The work used the following guiding question: What can a country like Guatemala do to regulate international pharmaceutical clinical trials in the context of research commercialization? In other words, the work was guided by three important elements. First, the regulatory aspect of clinical trials. Second, …

Citation Bias, Diversity, And Ethics, Keisha S Ray, Perry Zurn, Jordan D Dworkin, Dani S Bassett, David B Resnik

Faculty and Staff Publications

How often a researcher is cited usually plays a decisive role in that person's career advancement, because academic institutions often use citation metrics, either explicitly or implicitly, to estimate research impact and productivity. Research has shown, however, that citation patterns and practices are affected by various biases, including the prestige of the authors being cited and their gender, race, and nationality, whether self-attested or perceived. Some commentators have proposed that researchers can address biases related to social identity or position by including a Citation Diversity Statement in a manuscript submitted for publication. A Citation Diversity Statement is a paragraph placed …

The Ethics Of Vulnerability In Health Care, Hannah Dieterle

Electronic Theses and Dissertations

This dissertation seeks to address vulnerability within clinical healthcare settings. Currently, clinical vulnerability is underrecognized and insufficiently researched which leads to the perpetuation of negative health outcomes for vulnerable populations. Specifically, there is a lack of a consistent and universal definition of vulnerability which has built a shaky foundation on which to discuss vulnerability. This dissertation begins to address these issues and increase awareness on clinical vulnerability due to some populations experiencing the devastating effects of vulnerability at a higher and disproportionate rate when compared to other populations. There is a clear need for increased attention from ethicists and medical …