Bioethics and Medical Ethics Commons^™

Please Do Whatever It Takes To End Our Daughter's Suffering!, Stéphan Clément De Cléty, Marie Friedel, A A Eduard Verhagen, John D. Lantos, Brian S. Carter

Manuscripts, Articles, Book Chapters and Other Papers

What is the best way to care for a child with severe neurologic impairment who seems to be dying and is in intractable pain? Can we give sedation as we remove life support? Is it ethically permissible to hasten death? In the United States, 5 states have legalized assisted suicide (although only for competent adults). In Belgium and the Netherlands, euthanasia is legal for children under some circumstances. We present a case in which parents and doctors face difficult decisions about palliative care. Experts from Belgium, the Netherlands, and the United States then discuss how they would respond to such …

Moral Distress And The Health Care Organization, Andy Kondrat

Dissertations

A health care professional may experience moral distress when she believes she knows the ethical course of action in a given situation, but is unable to enact that plan, or must do otherwise. This dissertation argues that health care organizations have an ethical obligation to address moral distress in their health care professionals, and that common responses to moral distress are ethically insufficient due to their reliance on hierarchical solutions when hierarchies are, in fact, often a cause of moral distress. Thus, health care organizations, as moral agents, have a responsibility to find a non-hierarchical response to moral distress.

In …

Canadian Nurse Leaders' Experiences With And Perceptions Of Moral Distress: An Interpretive Descriptive Study, Jodi-Rae Kortje

Antioch University Dissertations & Theses

Moral distress in nursing has been studied across many care contexts, yet there is a paucity of research on the experience among health care leaders.The purpose of this study was to understand the experiences and perceptions of moral distress in nurse leaders.This study used an interpretive description approach interviewing 32 Canadian nurse leaders about their experiences and perceptions of moral distress within their role as a leader and nurse.A constant comparative and thematic analysis process revealed three thematic patterns:(a) leaders suffer moral distress in similar and different ways from their employees; (b) relationships matter in the midst of coping and …

Animal Mourning: Précis Of How Animals Grieve (King 2013), Barbara J. King

Animal Sentience

Abstract: When an animal dies, that individual’s mate, relatives, or friends may express grief. Changes in the survivor’s patterns of social behavior, eating, sleeping, and/or of expression of affect are the key criteria for defining grief. Based on this understanding of grief, it is not only big-brained mammals like elephants, apes, and cetaceans who can be said to mourn, but also a wide variety of other animals, including domestic companions like cats, dogs, and rabbits; horses and farm animals; and some birds. With keen attention placed on seeking where grief is found to occur and where it is absent …

Breaking The Silence: The Veterinarian’S Duty To Report, Martine Lachance

Animal Sentience

Animals, like children and disabled elders, are not only the subjects of abuse, but they are unable to report and protect themselves from it. Veterinarians, like human physicians, are often the ones to become aware of the abuse and the only ones in a position to report it when their human clients are unwilling to do so. This creates a conflict between professional confidentiality to the client and the duty to protect the victim and facilitate prosecution when the law has been broken. I accordingly recommend that veterinarian associations make reporting of abuse mandatory.

Beyond Pain—Controlling Suffering In Laboratory Animals, Bernard E. Rollin

Experimental Research and Animal Welfare Collection

No abstract provided.

A Phenomenological Study Of Anticipated Intimacy And Sexual Expression Needs Of Aging Male And Female Baby Boomers., Charles Shawn Oak

Electronic Theses and Dissertations

The purpose of this study was to understand the phenomenon of how heterosexual Baby Boomers define and understand intimacy, sexual expression, along expectations and desires relating to their respective expressions across the lifespan through their individual experiences and reflections. A set of guiding questions were used in a hermeneutic phenomenological qualitative research design. Data was gathered from thirteen subjects (n=13) using the Rappaport Time Line (RTL) that was used to develop individualized semi-structured interviews and follow-up interviews that were professionally transcribed. These were coded to identify emergent themes. Results of the study provided insight into the phenomenon of how heterosexual …

A Simulation To Improve The Clinical Nursing Instructor’S Teaching Of Ethics To Students In The Clinical Setting, Cynthia S. Randall Dnp

All Student Scholarship

Ethical knowledge and skill is crucial to the discipline of nursing and is considered foundational knowledge for nursing practice (American Nurses Association [ANA], 2008). Nurses who assume roles in clinical teaching may be clinically competent but may have limited nursing education experience or knowledge in clinical instruction. The purpose of this project was to improve the educational experience of clinical instructors in the teaching of ethics to students in the clinical setting. This DNP capstone was a quality improvement project with a mixed method design using simulation as a teaching strategy. Eight clinical instructors from a university based baccalaureate nursing …

Urging A Practical Beginning: Reimbursement Reform, Nurse-Managed Health Clinics, And Complete Professional Autonomy For Primary Care Nurse Practioners, Joy Luchico Austria

DePaul Journal of Health Care Law

No abstract provided.

Who Defines "Healthy"? Ethical Dilemmas Across Competing Interest Groups On Genetic Manipulation And Gene Patents, Haley Guion

DePaul Journal of Health Care Law

No abstract provided.

Lessons From Toxicology: Developing A 21st‑Century Paradigm For Medical Research, Gill Langley, Christopher P. Austin, Anil K. Balapure, Linda S. Birnbaum, John R. Bucher, Julia Fentem, Suzanne C. Fitzpatrick, John R. Fowle Iii, Robert J. Kavlock, Hiroaki Kitano, Brett A. Lidbury, Alysson R. Muotri, Shuang-Qing Peng, Dmitry Sakharov, Troy Seidle, Thales Trez, Alexander Tonevitsky, Anja Van De Stolpe, Maurice Whelan, Catherine Willett

Experimentation Collection

Biomedical developments in the 21st century provide an unprecedented opportunity to gain a dynamic systems-level and human-specific understanding of the causes and pathophysiologies of disease. This understanding is a vital need, in view of continuing failures in health research, drug discovery, and clinical translation. The full potential of advanced approaches may not be achieved within a 20th-century conceptual framework dominated by animal models. Novel technologies are being integrated into environmental health research and are also applicable to disease research, but these advances need a new medical research and drug discovery paradigm to gain maximal benefits. We suggest a new conceptual …

The Experiment Must Continue: Medical Research And Ethics In East Africa, 1940–2014, Melissa Graboyes

Ohio University Press Open Access Books

The Experiment Must Continue is a beautifully articulated ethnographic history of medical experimentation in East Africa from 1940 through 2014. In it, Melissa Graboyes combines her training in public health and in history to treat her subject with the dual sensitivities of a medical ethicist and a fine historian. She breathes life into the fascinating histories of research on human subjects, elucidating the hopes of the interventionists and the experiences of the putative beneficiaries.

Historical case studies highlight failed attempts to eliminate tropical diseases, while modern examples delve into ongoing malaria and HIV/AIDS research. Collectively, these show how East Africans …

Might Houses Of Worship Enable Currently Uninsured, Economically Disadvantaged Individuals To Obtain Affordable Health Care Insurance?, Nina J. Crimm

Journal of Civil Rights and Economic Development

No abstract provided.

Mid-Atlantic Ethics Committee Newsletter, Fall 2015

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The Flaws And Human Harms Of Animal Experimentation, Aysha Akhtar

Morality and Ethics of Animal Experimentation Collection

Nonhuman animal (“animal”) experimentation is typically defended by arguments that it is reliable, that animals provide sufficiently good models of human biology and diseases to yield relevant information, and that, consequently, its use provides major human health benefits. I demonstrate that a growing body of scientific literature critically assessing the validity of animal experimentation generally (and animal modeling specifically) raises important concerns about its reliability and predictive value for human outcomes and for understanding human physiology. The unreliability of animal experimentation across a wide range of areas undermines scientific arguments in favor of the practice. Additionally, I show how animal …

Clinically Integrated Networks: A Cooperation Analysis, M. Therese Lysaught

Institute of Pastoral Studies: Faculty Publications and Other Works

This analysis outlines key aspects that may be included in the infrastructure of clinically integrated networks. The paper then provides a moral analysis of these aspects using the principle of moral cooperation. While CINs may differ from each other in the details of how they are organized, the analysis concludes that clinically integrated networks, as a model, should pose no new problems from the perspective of Catholic teaching and may, in fact, provide a new answer to the challenges of partnering

with non-Catholic health care providers.

Magic Bullet, Karen Haydock

The Transdisciplinary STEAM+ Journal

Two of the most powerful types of corporations in the world today are those that produce pharmaceuticals and weapons. While the corporations are concerned with increasing their profits, we wonder if their products have any magical powers.

[India ink on rag paper]

This poster explores the military-industrial complex. The weapons industry profits through imperialism. The pharmaceutical industry profits through by taking advantage of people’s illnesses.

The poster has multiple interpretations, hopefully encouraging the viewer to participate by asking relevant questions, such as:

“What is that person drinking?”

”Are they pills or bombs?”

“Medicines cure us - how can a pill …

Vulnerability, Preventability, And Responsibility: Exploring Some Normative Implications Of The Human Condition, Daniel E. Wueste

Center for the Study of Ethics in Society Papers

Presented March 17, 2015. Papers presented for the Center for the Study of Ethics in Society Western Michigan University.

Does The Iranian Model Of Kidney Donation Compensation Work As An Ethical Global Model?, Jordan Potter

Journal of Health Ethics

Throughout the world, there is a massive global shortage of viable organs available for transplantation, and systems of cadaveric organ donation have thus far been unable to address this shortage. One potential remedy to this problem is to incentive live organ donation via cash incentives and other benefits, i.e. an organ sale, and this is the type of system Iran has used to effectively eliminate its national kidney waiting list since the late 1990s. In this article, the Iranian model of kidney donation compensation will be analyzed for its ability and effectiveness as an ethical global model, and this is …

Family Planning And Population Control In Developing Countries: Ethical And Sociocultural Dilemmas., Edward A. Komu M.D, Salome N. N. Ethelberg

Journal of Health Ethics

Do governments have the right to restrict individual freedom and right to have fewer or more children? Is it justifiable to control population in order to benefit society as a whole? Most of family planning and population control policies and programs in developing countries face resistant from the same people it aims to help. This can be mainly due to some ethical, socio-cultural beliefs, and moral values held by individuals and society as a whole. The challenges call for a need of family planning and population control programs to invest in examining ethical and socio-cultural dilemmas pertaining to these programs …

Csr Activity Of Tobacco Companies In Indonesia: Is It A Genuine Social Responsibility?, Harsman Tandilittin, Christoph Luetge

Journal of Health Ethics

The adoption of corporate social responsibility (CSR) programs in the tobacco industry has sparked a contentious debate in the international community. Tobacco industry’s CSR activities are honored by the government and Indonesian community with CSR awards due to their positive contributions. To assess the CSR activities of the tobacco companies and whether they are genuine forms of social responsibility or business motivation, we have collected the CSR activities and compared them with the negative impact of the tobacco industry in Indonesia. The CSR activities are in no way related to the negative impacts of tobacco in Indonesia. Therefore, CSR programs …

Ethical Documentation At The End Of Life, James T. Pathoulas

Lindmark Fellowship in Ethics

Patient autonomy is a basic tenet of ethical decision making in medicine. Individuals who are unable to participate in decision making at the end of life present a unique challenge to delivering ethical patient-­centered care. To ensure patient autonomy is upheld, providers are encouraged to use healthcare directives to guide clinical decision-­making. Healthcare directives are designed to uphold patient autonomy by indicating the desired scope of care at the end of life. While a particular type of healthcare directive, the advance care directive, is widely accepted, there are two common issues concerning its use: interpretation and accessibility. Issues with advance …

Compassionate Use Of Experimental Therapies: Who Should Decide?, Patricia J. Zettler

Faculty Publications By Year

In addition to being an example of unsubstantiated hype about regenerative medicine, the controversy around the Italy-based Stamina Foundation's unproven stem cell therapy represents another chapter in a continuing debate about how to balance patients' requests for early access to experimental medicines with requirements for demonstrating safety and effectiveness. Compassionate use of the Stamina therapy arguably should not have been permitted under Italy's laws, but public pressure was intense and judges ultimately granted access. One lesson from these events is that expert regulatory agencies may be the institutions most competent to make compassionate use decisions and that policies should include …

The Multifactorial Role Of The 3rs In Shifting The Harm-Benefit Analysis In Animal Models Of Disease, Melanie L. Graham, Mark J. Prescott

Biomedical Research and Alternative Methods Collection

Ethics on animal use in science in Western society is based on utilitarianism, weighing the harms and benefits to the animals involved against those of the intended human beneficiaries. The 3Rs concept (Replacement, Reduction, Refinement) is both a robust framework for minimizing animal use and suffering (addressing the harms to animals) and a means of supporting high quality science and translation (addressing the benefits). The ambiguity of basic research performed early in the research continuum can sometimes make harm-benefit analysis more difficult since anticipated benefit is often an incremental contribution to a field of knowledge. On the other hand, benefit …

College Student Understanding Of Informed Consent Terminology, Kishore Garapati

Master's Theses and Doctoral Dissertations

A good, understandable informed consent form (ICF) is key to ethical medical research, and the ICF is necessary according to United States federal regulation. Since they may be written in complex technical language, ICFs are often difficult for subjects to understand. The purpose of this research was to evaluate students' understanding of terminology commonly used in the ICF. An online research survey was sent to active students of Eastern Michigan University (EMU) during the winter 2015 semester. Questions were asked to evaluate the students' understanding of the correct meaning of the terms used in medical research. The majority of students …

Mid-Atlantic Ethics Committee Newsletter, Summer 2015

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Review Of Edison Bicudo, Pharmaceutical Research, Democracy And Conspiracy: International Clinical Trials In Local Medical Institutions, Roberto Abadie

Department of Sociology: Faculty Publications

The pharmaceutical industry is—along with the financial and weapons industries—one of the most globalized and profitable business domains. But they wouldn’t make any profits if they weren’t able to recruit research subjects to test an increasing number of drugs. This global trial economy creates its own assemblages of clinical trials, often run by hired contract research organizations (CROs), who fight among each other in a rat-race competition, promising quick and effective trials; at the same time, enterprising countries, hospitals, and doctors jump on the drug trial economy bandwagon by promising quick, endless access to a large pool of research subjects, …

Factors Associated With Belief In Conspiracies About Hiv/Aids Among Hiv-Positive African-American Patients, Andrew A. Zekeri, Youssouf Diabate

Professional Agricultural Workers Journal

Abstract

The purpose of this study is to examine factors associated with belief in conspiracies about HIV/AIDS among HIV-Positive African American patients. Survey data were collected from 256 African American patients living with HIV/AIDS attending two HIV clinics in Montgomery and Dothan, Alabama. The study used multiple regression analysis to examine how sociodemographic factors contribute to belief in conspiracies about HIV/AIDS. Education and age were significantly related to belief in conspiracies about HIV/AIDS among men and women. Beliefs in conspiracies about HIV/AIDS may be a barrier to HIV prevention among African Americans. Public health officials should work toward obtaining the …

Librarian Actions To Develop And Sustain Human Research Subject Protection: A Pilot Global Study, Charles J. Greenberg, Sangeeta Narang

Library Philosophy and Practice (e-journal)

The Institutional Review Board (IRB), also known as an Independent Ethics Committee (IEC), is the most widely adopted process to insure human participant protection. The IRB system is overburdened as human research studies and human participation has dramatically increased without a corresponding increase in reviewing clinicians or ethics staff. Librarian involvement in the IRB process is evident but uneven and unstudied on an international scale. A literature review and international survey attempted to provide professional practice context and librarian reflection on the extent of their involvement, roles, and responsibilities in the IRB or IEC institutional process. Survey results reveal that …

The First Shared Online Curriculum Resources For Veterinary Undergraduate Learning And Teaching In Animal Welfare And Ethics In Australia And New Zealand, Jane Johnson, Teresa Collins, Chris Degeling, Anne Fawcett, Andrew D. Fisher, Rafael Freire, Susan J. Hazel, Jennifer Hood, Jennifer K.F. Lloyd, Clive J.C. Phillips, Kevin J. Stafford

Professional Veterinary Ethics Collection

The need for undergraduate teaching of Animal Welfare and Ethics (AWE) in Australian and New Zealand veterinary courses reflects increasing community concerns and expectations about AWE; global pressures regarding food security and sustainability; the demands of veterinary accreditation; and fears that, unless students encounter AWE as part of their formal education, as veterinarians they will be relatively unaware of the discipline of animal welfare science. To address this need we are developing online resources to ensure Australian and New Zealand veterinary graduates have the knowledge, and the research, communication and critical reasoning skills, to fulfill the AWE role demanded of …