Bioethics and Medical Ethics Commons^™

Let She Who Has The Womb Speak: Regulating The Use Of Human Oocyte Cryopreservation To The Detriment Of Older Women, Browne C. Lewis

Law Faculty Articles and Essays

This article is divided into three parts. Part I examines the arguments in favor of banning human oocyte cryopreservation. Part II explores the reasons some opponents of human oocyte cryopreservation might give to support restrictions on the use of frozen oocytes. Part III analyzes the possible ethical and legal challenges that may arise in the event that the government seeks to ban the use of frozen oocytes or restrict the use of frozen oocytes based solely on the age of the potential mother.

Advanced Cancer Patient Preferences For Receiving Molecular Profiling Results, Megan Best, Phyllis Butow, Chris Jacobs, Ilona Juraskova, Jacqueline Savard, Bettina Meiser, David Goldstein, Mandy Ballinger, Nicci Bartley, Christine Napier, Grace Davies, David Thomas, Kathy Tucker, Timothy Schlub, Ainsley J. Newson

IES Papers and Journal Articles

Objective: This study aimed to discern preferences for receiving somatic molecular profiling (MP) results in cancer patients who have given consent to undergo testing.

Methods: We conducted a mixed‐methods study to explore patients’ views on which MP results they would like to receive and why. Advanced cancer patients (n=1299) completed questionnaires after giving consent to participate in a parent genomics study and undergoing MP. A subset of patients (n=20) participated in qualitative interviews.

Results: Almost all (96%) participants were interested in receiving results which would direct cancer treatment (i.e. were actionable). A smaller majority wanted to access results which were …

Presumed Consent And Priority Allocation Systems For Organ Donation Legislation In The United States: Making The Moral Case, Ann K. Shapiro, Peter A. Depergola Ii

Philosophy, Theology and Religious Studies Faculty Publications

In recent decades, developed nations, such as the United States, have seen the gap between the demand and the supply of transplantable organs widen, despite national campaigns intended to promote donor registration. This organ shortage crisis has deprived thousands of a basic quality of life and has caused a substantial increase in the cost of alternative medical care such as dialysis. In an attempt to address the shortage, some countries have instituted explicit “opt-out” and “priority allocation” policies that operate under the principle of presumed consent and offer higher priority on transplantation lists to registered donors. This paper seeks to …

Is “Vital Motion” A Halakhic Concept?, Ira Bedzow, Noam Stadlan, John Loike

Touro Law Review

No abstract provided.

Anthropogenic Suffering Of Farmed Animals: The Other Side Of Zoonoses, Jean-Jacques Kona-Boun

Animal Sentience

Wiebers & Feigin’s (W&F’s) target article warns of the zoonotic threat to human health from factory farming and urges phasing out meat production and consumption, for the benefit of both human and nonhuman animals. This commentary focuses on the physical and emotional suffering of farmed animals. This varies by species, production system and geographic location, but suffering is there throughout all stages of production — breeding, housing, transport, usage and slaughter. Ubiquitous monitoring of all facilities where farmed animals are kept, with surveillance cameras recording all phases of production would help reduce some forms of suffering. Other forms are caused …

What The Covid-19 Crisis Is Telling Humanity, David Wiebers, Valery Feigin

Animal Sentience

The planet is in a global health emergency exacting enormous medical and economic tolls. It is imperative for us as a society and species to focus and reflect deeply upon what this and other related human health crises are telling us about our role in these increasingly frequent events and about what we can do to prevent them in the future.

Cause: It is human behavior that is responsible for the vast majority of zoonotic diseases that jump the species barrier from animals to humans: (1) hunting, capture, and sale of wild animals for human consumption, particularly in live-animal markets; …

Rethinking Global Governance To Address Zoonotic Disease Risks: Connecting The Dots, Kelley Lee

Animal Sentience

Large-scale changes in human behaviour are urgently needed to prevent future pandemics involving zoonotic diseases such as COVID-19. However, this will not happen to the required degree, and with sufficient speed, without a major shift in how humanity collectively governs itself. Alongside a shift in focus from individual behaviours to the structural conditions underpinning the world economy that shape human behaviours, effective global governance presses us to connect more dots than ever before. The One Health approach is an important starting point but we need to go much further.

Strategies For Controlling Violence Against Healthcare Workers: Application Of Fuzzy Analytical Hierarchy Process And Fuzzy Additive Ratio Assessment, Fazel Rajabi, Mehdi Jahangiri, Farnaz Bagherifard, Sean Banaee, Payam Fahadi

Community & Environmental Health Faculty Publications

Objective: The present study aimed to identify and prioritize control measures of violence against Healthcare Workers (HWs) using the Fuzzy Analytical Hierarchy Process (FAHP) and Fuzzy Additive Ratio Assessment (F-ARAS).

Background: Occupational violence is a pervasive problem in healthcare centers. Reducing violence against staff is one of the challenges for healthcare managers.

Method: At the first stage, the most common criteria and control options for violence against HWs were identified and extracted using a review of previous studies. At the next stage, criteria for selection of control measures were prioritized using the FAHP. Finally, control measures of workplace violence were …

Contaminants Of Emerging Concern: Reconsidering Our Paradigm Of Water Pollution, Jonathan Gunasti

Pomona Senior Theses

In this senior thesis, I explore contaminants of emerging concern (CECs) and endocrine disrupting compounds (EDCs) and discuss the ways in which these novel contaminants defy traditional notions of pollution. I discuss the history and “emergence” of CECs and EDCs in scientific and public spheres and outline ongoing challenges to recognizing, prioritizing, and understanding the action of these contaminants. I position EDCs within the framework of environmental injustice and health disparities and suggest that these compounds could reinforce multigenerational health inequities. Finally, I perform a pilot analysis of the EDC bisphenol A (BPA) in Mt. Baldy Creek, the Los Angeles …

Plant-Based Diets And Covid-19: Those Who Harvest Crops Are At High Risk, Jarret S. Lovell

Animal Sentience

This commentary extends Wiebers & Feigin’s (2020) plea to adopt diets that are less dependent on animals by calling on experts and activists to work for change with regard to farm worker labor conditions. Already doing among the most dangerous jobs, farmworkers are at increased risk of COVID-19. As we increasingly transition to plant-based diets, we must all ensure that farmworkers have safe and just working conditions to meet the demands of our changing diets.

One Welfare, The Role Of Health Professionals, And Climate Change, Anne Fawcett

Animal Sentience

Wiebers & Feigin argue that the COVID-19 crisis is a call for humanity to rethink our relationships with animals and the environment. This One Welfare approach has implications for the role of health care professionals and demands that we address climate change.

Influences On Ethical Decision-Making By Nurses Employed In Federal Health Care Facilities, Cecil Dean Blount

Walden Dissertations and Doctoral Studies

Healthcare professionals are tasked with making key decisions involving new and controversial approaches such as organ transplantation and life-prolonging technologies and treatments that raise various ethical issues. Suboptimal ethical choices by nurses can lead to negative patient outcomes and lower the quality of life in federal healthcare facilities. The purpose of this nonexperimental quantitative correlational study was to identify the factors that influence nurses’ ethical decision-making processes in U.S. federal healthcare facilities. The theoretical framework was based on Beauchamp and Childress’ ethical system of principlism. Three research questions addressed the nature and extent of the relationship between nurses’ Ethical Behavior …

Case Analysis Of Acute Care Guidelines For The Prevention Of Pressure Ulcers, Carle Ray

Walden Dissertations and Doctoral Studies

Prevention of pressure ulcers (PUs) in acute care settings is an attempt to avoid adverse events (AE). Literature shows that wounds such as PUs are the most prevalent complication for spinal cord injury patients (SCI) including quadriplegic individuals (QI). SCI and QI bring important pressure ulcer (PU) prevention knowledge to the hospital which involves teamwork and participation by nurses, organizations, and patients. The purpose of this qualitative study was to examine the effectiveness of acute care guidelines for PUs by drawing insights from multiple sources including interviews with QI, healthcare clinicians, care providers, family members, and an online search of …

Comparing Moral Reasoning Across Graduate Occupational And Physical Therapy Students And Practitioners, Brenda S. Howard, Cheyenne Kern, Olivia Milliner, Lindsey Newhart, Sarah K. Burke

Journal of Occupational Therapy Education

Practicing clinicians must use moral reasoning to solve ethical problems and combat moral distress. Development of moral reasoning in occupational therapy (OT) and physical therapy (PT) students has been significantly under researched. The purpose of this study was to analyze the differences in moral reasoning between first year and second year OT and PT students and between students and OT and PT practitioners. Investigators utilized a cross-sectional study design with a convenience sample of University of Indianapolis OT and PT students and a combination of convenience and snowball sampling to recruit licensed OT and PT practitioners. One hundred and fifty-four …

Ambiguous Genitalia And Disorders Of Sexual Differentiation, Khawar T. Mehmood, Rebecca M. Rentea

Manuscripts, Articles, Book Chapters and Other Papers

The birth of an infant with ambiguous genitalia generates difficult multiple medical, surgical, ethical, psychosocial, and physical issues for patients and their parents. Phenotypic sex results from the differentiation of internal ducts and external genitalia under the influence of hormones and other additional factors. When discordance occurs among three process es (chromosomal, gonadal, phenotypic sex determination), a DSD is the result. Terminology such as hermaphrodite, pseudo-hermaphrodite, and intersex, are considered to be pejorative and dated. These terms have been replaced by the term disorders of sexual development (DSD) by the consensus statement on management of intersex disorders. Disorders of sexual …

Balancing Conscience: A Response To Fernandes & Ecret, Ian D. Wolfe, Maryam Guiahi

Manuscripts, Articles, Book Chapters and Other Papers

There are many lessons that bioethics can learn from the Holocaust. Forefront are the lessons from the Nuremberg trials and the formation of research ethics. An often-overlooked lesson is how the Nazi regime was able to construct a hierarchy in such a way that influenced people to act in horrendous ways. Fernandes & Ecret, writing in Conatus – Journal of Philosophy 4, no. 2 (2019), highlight the influence of hierarchy on the moral silence of nurses and physicians within the Nazi regime. While we greatly enjoyed the paper, and think it is an important contribution, we find several misrepresentations of …

Checklist-Ethical Analysis And Decision-Science, Melinda Wilding

Bioethics Program of Study

No abstract provided.

The Ethical Justification Of Increasing Awareness Of Preventive Medicine Among Healthcare Professionals, Patients And The General Public In The United States, Karishma Ether Moazzam

Electronic Theses and Dissertations

While practiced for centuries, preventive medicine has received increased attention during the recent times. Preventive medicine has a distinct mission to protect, promote, and maintain health as well as to prevent diseases, disabilities, and premature deaths. It aims to fulfill its mission through the combined form of clinical intervention and health promotion. In the recent years, preventive medicine has begun to lean more towards the clinical interventions, taking away from the health promotion. This imbalance has caused preventive medicine to lose its effectiveness in fulfilling its mission. One of the leading causes for such imbalance is the lack of proper …

Anticipation, Accompaniment, And A Good Death In Perinatal Care., Bryanna S. Moore, Brian S. Carter, Bryan Beaven, Katie House, Joel House

Manuscripts, Articles, Book Chapters and Other Papers

The ethics of perinatal care, and the experiences of families who receive such care, remains a nascent area of inquiry. It can be hard to see how existing "good death" constructs apply to the experiences of fetal patients and their families. In this paper, we explore two themes raised by a case at our fetal health center: anticipation and accompaniment. In this case, a mother presented to our fetal health center; her unborn son, our fetal patient, was diagnosed with life-threatening hypoplastic left heart syndrome and endocardial fibroelastosis. The parents were told that their son's life expectancy, upon birth, was …

Must A Physician Treat A Disruptive Or Abusive Patient Or Can The Doctor Fire That Person?, Samuel D. Hodge, Jr.

DePaul Journal of Health Care Law

No abstract provided.

Evaluating Controlled Substance Documentation In An Electronic Medical Record, Delora Brooks

Dissertations

The Centers for Disease Control and Prevention (CDC) directives issued in 2016 gave guidelines for safely prescribing opiates; however, primary source discussions about methods used for documenting opioid and controlled substance monitoring within an electronic medical record (EMR) are limited (Hussain, Nelson, Polston & Zheng, 2019). This leaves individual providers to determine the appropriate way to document. Inconsistent documentation may not protect providers or organizations from regulatory, civil or criminal liability. As stated by Raveesh, Nayak & Kumbar (2016), “The best way to handle medico-legal issues is by preventing them”. Even with the advent and widespread use of EMRs, documentation …

Combatting The Opioid Epidemic In Texas By Holding Big Pharma Manufacturers Liable, Katherine Spiser

St. Mary's Law Journal

Abstract forthcoming

"Farewell" To Prognosis In Shared Decision-Making, Robert F. Johnson

Peer Reviewed Articles

Whether because of a cultural pattern or personal preference, palliative care clinicians encounter persons approaching the end of life who wish to limit or forego prognostic information relating to their situation. This scenario has received attention in a recent motion picture as well as a newly available advance directive modification—the Prognosis Declaration form. The ordinary expectation for end-of-life shared decision-making with a capable person is clinician disclosure of the best effort at prognostic assessment. The optimal match between the expressed values, goals, and preferences of the person with available clinician expertise is hopefully achieved. For the clinician, a person’s choice …

Autonomy, Suffering, And The Practice Of Medicine: A Relational Approach, Michael A. Stanfield

USF Tampa Graduate Theses and Dissertations

In this project, I argue that the conventional view of personal autonomy that is operational in contemporary American culture, bioethics and medical practice places undue emphasis on individualism and a limited range of personal qualities and attributes (such as self-sufficiency). Instead, I argue in favor of a relational approach to autonomy which recognizes that each person that exists has certain minimal connections or relations to others, and these connections/relations are identity-forming. Unfortunately, current medical practices have tended to overemphasize individuality and choice (consistent with the conventional view) while minimizing or excluding these relational aspects. As a result, informed consent and …

Changing The Expectations: Disability In The 21st Century Hpr 226g, Joanna Burkhardt

Library Impact Statements

No abstract provided.

What Do Faculties Specializing In Brain And Neural Sciences Think About, And How Do They Approach, Brain-Friendly Teaching-Learning In Iran?, Sahar Ghanbari, Fariba Haghani, Malahat Akbarfahimi

Journal of Mind and Medical Sciences

Objective: to investigate the perspectives and experiences of the faculties specializing in brain and neural sciences regarding brain-friendly teaching-learning in Iran. Methods: 17 faculties from 5 universities were selected by purposive sampling (2018). In-depth semi-structured interviews with directed content analysis were used. Results: 31 sub-subcategories, 10 subcategories, and 4 categories were formed according to the “General teaching model”. “Mentorship” was a newly added category. Conclusions: A neuro-educational approach that consider the roles of the learner’s brain uniqueness, executive function facilitation, and the valence system are important to learning. Such learning can be facilitated through cognitive load considerations, repetition, deep questioning, …

Cultural Competency In Latinoamerican Countries: From A Hispanic Resident Perspective, Ivania T. Irby Md

Psychiatry

No abstract provided.

A Belmont Report For Animals?, Hope Ferdowsian, L. Syd M. Johnson, Jane Johnson, Andrew Fenton, Adam Shriver, John Gluck

Professional Science Research Ethics Collection

Human and animal research both operate within established standards. In the United States, criticism of the human research environment and recorded abuses of human research subjects served as the impetus for the establishment of the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, and the resulting Belmont Report. The Belmont Report established key ethical principles to which human research should adhere: respect for autonomy, obligations to beneficence and justice, and special protections for vulnerable individuals and populations. While current guidelines appropriately aim to protect the individual interests of human participants in research, no similar, comprehensive, …

Law & Health Care Newsletter, Fall 2019

Law & Health Care Newsletter

No abstract provided.

Child And Parent Perceptions Of Participating In Multimethod Research In The Acute Aftermath Of Pediatric Injury, Christine Kindler, Nancy Kassam-Adams, Tia Borger, Meghan L. Marsac

Pediatrics Faculty Publications

Background:

Despite growing evidence that participation in psychological trauma research is well tolerated by children and parents, ethics boards may voice concerns regarding research with families with recent acute trauma exposure. Factors impacting child and parent experiences of research participation are not well documented, particularly for methodologies including observational components.

Objectives:

This study describes child and parent perceptions of research participation involving an observational task following an acute traumatic event and explores potential relationships between research experience and selected demographic factors (race/ethnicity, sex, age, prior trauma exposure), and post-traumatic stress symptoms.

Methods:

As part of a larger study on the …