Bioethics and Medical Ethics Commons^™

Mid-Atlantic Ethics Committee Newsletter, Fall 2017

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The Importance Of Clinicians And Community Members Receiving Timely And Accurate Information About Waterborne Hazards, Steven S. Coughlin Phd, Osman Yousufzai

School of Medicine Faculty Research

It is important for clinicians and community members to receive up-to-date information about the microbiological and elemental composition of local water supplies. Clinicians play an important role in helping their patients to interpret water quality data and understand the potential impact of water quality on their health. Expanding the medical school curriculum to include environmental health, public health, and health disparities—including disparities related to environmental quality and waterborne hazards—is key to clinicians’ fulfilling this role.

Considering Aspects Of The 3rs Principles Within Experimental Animal Biology, Lynne U. Sneddon, Lewis G. Halsey, Nic R. Bury

Biomedical Research and Alternative Methods Collection

The 3Rs – Replacement, Reduction and Refinement – are embedded into the legislation and guidelines governing the ethics of animal use in experiments. Here, we consider the advantages of adopting key aspects of the 3Rs into experimental biology, represented mainly by the fields of animal behaviour, neurobiology, physiology, toxicology and biomechanics. Replacing protected animals with less sentient forms or species, cells, tissues or computer modelling approaches has been broadly successful. However, many studies investigate specific models that exhibit a particular adaptation, or a species that is a target for conservation, such that their replacement is inappropriate. Regardless of the species …

Clinicians’ Perspectives And Utilization Regarding Harm Reduction In Nursing Practice In Care Of Persons With Addiction: A Literature Review, Audrey Killarney

Grace Peterson Nursing Research Colloquium

Clinicians’ perspectives and utilization regarding harm reduction in nursing practice in care of persons with addiction: A literature review

Audrey Killarney, BS

Prof. Michelle Neuman, MSN, APN, RN

NSG 598: Graduate Research Synthesis

18 August 2017

Introduction

Background & Significance

Harm reduction is a concept best described as the recognition that individuals will engage in unhealthy behaviors, and the goal is to minimize the associated potential harm. (Stockwell, Reist, Macdonald, Benoit, & Jansson, 2010). Classically, it was used an alternative model of care for treating smokers and controlling the spread of HIV and hepatitis B (Henwood, Padgett, & Tiderington, 2014). …

Every Word, Every Gesture, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Two nonverbal patients teach a novice clinician the power and often hidden impact of the physician-patient relationship.

Why It’S Not Ok For Doctors To Participate In Executions, Robert F. Johnson

Peer Reviewed Articles

A plea for direct physician participation in executions was presented by Sandeep Jauhar in a New York Times Op-Ed (“Why It’s OK for Doctors to Participate in Executions”—April 21, 2017). Jauhar’s article is not a discussion of the ethics of capital punishment. He describes his own opposition “as a matter of principle, as a doctor.” However, since capital punishment is legal in 31 states, with required physician participation in several, he acquiesces to a utilitarian stance rather than the principled approach he acknowledges is expected of a physician in this circumstance.

Nietzsche’S Posthuman Imperative: On The Human, All Too Human Dream Of Transhumanism, Babette Babich

Articles and Chapters in Academic Book Collections

No abstract provided.

International Consensus Principles For Ethical Wildlife Control, Sara Dubois, Nicole Fenwick, Erin A. Ryan, Liv Baker, Sandra E. Baker, Ngaio J. Beausoleil, Scott Carter, Barbara Cartwright, Federico Costa, Chris Draper, John Griffin, Adam Grogan, Gregg Howald, Bidda Jones, Kate E. Littin, Amanda T. Lombard, David J. Mellor, Daniel Ramp, Catherine A. Schuppli, David Fraser

Ethics and Conservation Biology Collection

Human–wildlife conflicts are commonly addressed by excluding, relocating, or lethally controlling animals with the goal of preserving public health and safety, protecting property, or conserving other valued wildlife. However, declining wildlife populations, a lack of efficacy of control methods in achieving desired outcomes, and changes in how people value animals have triggered widespread acknowledgment of the need for ethical and evidence-based approaches to managing such conflicts. We explored international perspectives on and experiences with human–wildlife conflicts to develop principles for ethical wildlife control. A diverse panel of 20 experts convened at a 2-day workshop and developed the principles through a …

Advances In Neuroscience Imply That Harmful Experiments In Dogs Are Unethical, Jarrod Bailey, Shiranee Pereira

Professional Science Research Ethics Collection

Functional MRI (fMRI) of fully awake and unrestrained dog 'volunteers' has been proven an effective tool to understand the neural circuitry and functioning of the canine brain. Although every dog owner would vouch that dogs are perceptive, cognitive, intuitive and capable of positive emotions/empathy, as indeed substantiated by ethological studies for some time, neurological investigations now corroborate this. These studies show that there exists a striking similarity between dogs and humans in the functioning of the caudate nucleus (associated with pleasure and emotion), and dogs experience positive emotions, empathic-like responses and demonstrate human bonding which, some scientists claim, may be …

Mid-Atlantic Ethics Committee Newsletter, Summer 2017

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Comparison Of The Effects Of A Pharmaceutical Industry Decision Guide And Decision Aids On Patient Choice To Intensify Therapy In Rheumatoid Arthritis, Richard W, Martin, Ryan D. Enck, Donald J. Tellinghuisen, Aaron T. Eggebeen

University Faculty Publications and Creative Works

To compare the effects a pharmaceutical industry decision guide and International Patient Decision Aids Standard (IPDAS) compliant patient decision aids (PtDA) on patient medication beliefs and choice to intensify therapy. Methods. Rheumatoid arthritis (RA) patients, who had never taken etanercept (Enbrel), took part in a mail survey. They were presented with a hypothetical decision scenario where they were asked to consider adding etanercept to their current regimen. Each patient was randomized to review 1 of 3 forms of an etanercept-specific decision support: a long PtDA (LONG DA), a short PtDA (SHORT DA), or the manufacturer's Enbrel decision guide (Pharm Booklet). …

Germ-Line Gene Editing And Congressional Reaction In Context: Learning From Almost 50 Years Of Congressional Reactions To Biomedical Breakthroughs, Russell A. Spivak, J.D., I. Glenn Cohen, J.D., Eli Y. Adashi, M.D., M.S.

Journal of Law and Health

On December 18, 2015, President Obama signed into law a policy rider forestalling the therapeutic modification of the human germ line. The rider, motivated by the science’s potential unethical ends, is only the most recent instance in which the legislature cut short the ongoing national conversation on the acceptability of a developing science. This essay offers historical perspective on what bills were proposed and passed surrounding four other then-developing scientific breakthroughs—Recombinant DNA, in vitro fertilization, Cloning, Stem Cells—to better analyze how Congress is, and should, regulate this exciting and promising science.

The Social And Historical Subject In Sartre And Foucault And Its Implications For Healthcare Ethics, Kimberly Siobhan Engels

Dissertations (1934 -)

This dissertation explores Jean Paul Sartre’s and Michel Foucault’s view that subjectivity is socially and historically constituted. Additionally, it explores their corresponding ethical thought and how these viewpoints can be applied to ethical issues in the delivery of healthcare. Sartre and Foucault both hold the view that human beings as subjects are not just participants or spectators in social practices, rather, they become subjects with ontological possibilities through their interaction with these practices. In Chapter One, I trace Sartre’s views on subjectivity in his two major works Being and Nothingness and The Critique of Dialectical Reason, Volume 1, showing how …

Ethical Theories And Perspectives On End-Of-Life Decisions, Lauren Skelton

Dialogue & Nexus

This paper approaches several different ethical theories to see how they interact with the issue of withdrawing and withholding life-sustaining care. After the theories of Utilitarianism, Kantian and Prima Facie Deontology, Virtue Ethics, and Evolutionary Ethics are explored at length, Deontological theories are proven to be the best decision-making guide from the perspective of both patients and those in policy-making positions. When used together, Kantian and Prima Facie Deontology offer the overall best combination of ethical instruction and personal freedom.

The Ethical Considerations Of Physician-Assisted Suicide, Madeline Jordan

Dialogue & Nexus

With respect to physician-assisted suicide, several approaches to adjudicate an ethical position can be processed from the theories of utilitarianism, Kantian deontology, and virtue ethics. This paper will explore these three positions with respect to physician-assisted suicide and the pros and cons of each. In conclusion, based on my research and Christian beliefs, I will define why I reside with virtue ethics and why it leads me to a position that is against physician-assisted suicide at this particular point in my life.

Christian And Islamic Perspectives On The Ethical Dilemma Of In Vitro Fertilization (Ivf), Stephanie Sariles

Dialogue & Nexus

After defining IVF procedures and the associated biomedical ethics with each, I will compare and contrast Christian and Islamic perspectives on IVF. Christianity in general does not accept IVF, because it is an unnatural method of reproduction that can affect Christian traditions such as parenthood and marriage. Despite this view, Protestants, in particular, have opened up to IVF as a method for treating infertility. Islam fully accepts IVF provided the married couple follows Islamic law. Sunni Muslims do not accept gamete donation, but Shi’ite Muslims are more flexible with gamete donation and surrogacy.

Gadgets And Grieving: A Chronological Analysis On The Ways In Which Advancements In Medical Technologies Have Altered The Grieving Process, Grace Mcnair

Dialogue & Nexus

Since the 1940s, both end-of-life care and advancements in medical technologies have expanded exponentially. This article explores the advancements in medical technologies and how these have altered the way that Western society grieves death. With the capabilities to prolong life, the family, the patient, and the medical team, all grieve the end of life in different ways. This article provides a chronological analysis of palliative care, hospice care, and various medical advancements. These changes in medicine are then paralleled with alterations in the bereavement process. This article explores historical narratives of Western society’s transformation of grief through the lens of …

An Ethical Evaluation Of The Modern Pharmaceutical Industry, Kaitlyn Drennan

Dialogue & Nexus

Lack of transparency, wrongdoings, and unlawful promotion characterize the healthcare industry; these are especially prevalent within the pharmaceutical industry. Consequently, an investigation into the evidence of the corruption and the ethical infringement is needed. In this paper, I will evaluate the pharmaceutical industry’s adherence to the three major branches of ethics. The ever-increasing prices of pharmaceutical products, especially medications used for the combating of anaphylaxis and cancer, coupled with the compensatory-based medication promotion and research points to a major crisis in the realm of social justice. These examples, among many other current issues, lead to difficulties in individuals receiving the …

Incentives And Ethics In The Economics Of Body Parts, Nicola Lacetera

Osgoode Hall Law Journal

Research shows that properly devised economic incentives increase the supply of blood without hampering its safety; similar effects may be expected also for other body parts such as bone marrow and organs. These positive effects alone, however, do not necessarily justify the introduction of payments for supplying body parts, because these activities concern contested commodities or repugnant transactions. Societies may want to prevent these transactions even if they increase supply, because of ethical concerns. When transactions involve contested commodities, therefore, there often is tension between the efficiency-enhancing effects of trades mediated by a monetary price and the moral opposition to …

The Voluntary Practice Of Eugenics: Risk-Taking And Religiosity As Determinants Of Attitudes Toward Conceiving Children With Potential Genetic Disorders And Inheritable Diseases, Roy K. Chen, Allison R. Fleming, Lisa Kuhn, Amanda L. Foster

School of Rehabilitation Services & Counseling Faculty Publications

The purpose of this study was to examine attitudes toward the voluntary practice of eugenics among people with high-risk inheritable diseases and genetic disorders. Participants consisted of 426 students attending two large public universities in the south and southwestern regions of the United States. The study used the modified scale of attitudes toward mental retardation and eugenics, the risk-taking questionnaire, and the dimensions of religious ideology importance scale. A general linear model was tested to answer the research question. The results showed that the model was significant (p < 0.001; adjusted r2 of 0.078). Significant main effects were found in race [F (4,378) = 2.538, p = 0.04, η² = 0.026], risk avoidance [F (1,378) = 12.536, p < 0.001, η² = 0.032] and importance of religion [F (1,378) = 5.530, p = 0.019, η² = 0.014]. Cultural, ethnic, and religious variables influenced people’s views toward disability. One’s perception of both disability and its impact on quality of life will influence his or her feelings about eugenics and babies with congenital conditions.

Ethical Concerns For Assisted Reproductive Technologies, Olga Najera

Dialogue & Nexus

The development of assisted reproductive technologies has provided new options for infertile couples in their pursuit of parenthood. As a result of the successful implementation of in vitro fertilization (IVF), gestational surrogacy is now an alternative. Other technology, such as genetic enhancement, could potentially become available for human beings soon; however, numerous ethical concerns have been raised by the fact that it requires germline engineering. The concerns brought about by these new reproductive technologies will be addressed in light of the teachings of the Roman Catholic Church and of the following ethical theories: Kantian, evolutionary, utilitarian, and virtue ethics.

An Analysis Of Altruism, Sarah Siemens

Dialogue & Nexus

Scientists, freethinkers, and philosophers have attempted to find an explanation of the role of altruism in a natural world that is compatible to the dominantly accepted Darwinian principle of natural selection. Many postulates have been developed in an attempt to explain how self-sacrificial behaviors are cohesive within the “survival of the fittest” ideology. This has caused many scientists to broaden the definition of altruism to understand its components in the physical world. In order to understand how absolute altruism is solely found through God’s love, it is necessary to examine each subset of scientific altruism to reveal their differences. None …

The Problem Of Suffering: Universal Health Coverage As A Partial Solution, Christen Scaggs

Dialogue & Nexus

Universal Health Coverage is evaluated from a Christian Biblical perspective and found that it meets an appropriate standard of service to the poor. Christians should consider its benefits and drawbacks compared to doing nothing. The issue of diminished access to healthcare, burdensome medical costs, reduced coverage, and discrimination against impoverished individuals with specific regards to healthcare are all conquerable challenges.

End Of Life Care For The Incarcerated, Codie Robinson

Dialogue & Nexus

As the prison population ages, a new need has come to light – caring for those who are in the final stage of life. This paper will examine the current end of life services provided to those in prison throughout the United States. After a general awareness of the system is presented, a more complete discussion of end of life care for prisoners will be considered, in light of ethics, social justice, and the Christian perspective. The two care options presented, hospice care and compassionate release, are observed through these lenses. In order to make a decision on how to …

Volume 3 Editorial, Daniel Brannan

Dialogue & Nexus

No abstract provided.

Determining The Knowledge, Attitudes And Beliefs Of Healthcare Providers In Treating Non-Specific Acute And Chronic Back Pain, Stacey L. Kale

Doctor of Nursing Practice Scholarly Project

An Abstract of the Scholarly Project by

Stacey Kale

Managing back pain has become a public health and clinical challenge (Krein et al., 2016). Incidence of back pain related complaints requiring treatment in the US is estimated at 11.2% of the adult population (Dowell, Haegerich, & Chou, 2016). New research suggests that it is the most common pain problem (Pauline, 2016). It is the third most expensive health disorder and is exceeded only by cancer and heart disease. Many health care providers lack formal pain management education and training thus leaving them at risk for failing to properly manage patients …

Making Sex Work For The State : The Policing Of Sex Work In The United States., Madeline A Clabough

College of Arts & Sciences Senior Theses

This thesis analyzes the ways that sex work is regulated within the United States, and analyze the ways that regulation is shaped by contemporary feminist discourse. To do so, it analyzes the ways in which sex workers have been and pathologized since the 19th century, and address the ways that these conceptualizations have been incorporated into the legal regulation of sex workers. Finally, this thesis will look to contemporary practices in the state regulation of sex workers, and argue that the relationship between neoliberalism, the carceral state, and what has come to be termed “carceral feminism” operate in conjunction to …

Illegitimate Bodies In Legitimate Times: Life, Liberty And The Pursuit Of Movement, Brian Culp

Faculty Articles

Drawing on Michel Foucault’s concepts of state racism and biopower, the author of the 26th Delphine Hanna Lecture presents several claims: (a) that the idea of the illegitimate outsider in Western world governments like the United States has largely been influenced by ancient Greek ideals, (b) that a host of policies and intentional actions by power brokers create derision and hierarchies between “old” and “new” immigrant groups, and (c) neoliberal ideology couched in actions that aim “to protect the state” is nothing more than a recoding of traditional racist rhetoric that expands systemic racism. The author identifies the capabilities approach, …

Dying For A Diagnosis: The Impact Of Racial Discrimination In Healthcare, Danielle Owusu

Senior Theses

Previous studies have found that healthcare providers are affected by unconscious racial bias, reducing the quality of care and outcomes for African American patients (Yearby, 2010). This undergraduate study hypothesized when healthcare providers show more empathy, they provide higher quality care to their patients. Since African Americans face more discrimination on average, their chances for quality care is lower. Results reveal a positive correlation between empathy from healthcare providers and care administered to patients; furthermore, they reveal no significance found in discrimination of African American patients compared to other races. The study consisted of 93% female participants, which affects the …

Concurrent Surgery And Informed Consent, Andrew M. Weller

College Honors Program

This thesis seeks to construct an ethical course of action for concurrent surgery, a practice brought into the public eye by The Boston Globe, which argued against allowing one attending surgeon to oversee two cases on separate patients in different operating rooms. First, the common morality and its four main principles relevant to biomedical ethics will be described which will be subsequently used to show that concurrent surgery is allowed according to non-violation of the principle of non-maleficence through current empirical evidence, and supported by the principle of beneficence and justice. Next, the principle of respect for autonomy will be …