Bioethics and Medical Ethics Commons^™

Right-To-Die Cases: A New York Historical Perspective, Sol Wachtler

NYLS Law Review

No abstract provided.

Health Justice Denied Or Delayed At The End Of Life: A Crisis Needing Remedial Action, David C. Leven

NYLS Law Review

No abstract provided.

Give Me Liberty At My Death: Expanding End-Of-Life Choice In Massachusetts, Kathryn L. Tucker

NYLS Law Review

No abstract provided.

A New Life For Wrongful Living, Nadia N. Sawicki

NYLS Law Review

No abstract provided.

The Limits Of Autonomy: Force-Feedings In Catholic Hospitals And In Prisons, Ann Neumann

NYLS Law Review

No abstract provided.

Future Oversight Of Recombinant Dna Research: Recommendations Of An Institute Of Medicine Committee, Lawrence O. Gostin, Bruce M. Altevogt, Andrew M. Pope

Georgetown Law Faculty Publications and Other Works

The National Institutes of Health (NIH) established the Recombinant DNA Advisory Committee (RAC) in 1974 in response to public concerns about the safety of manipulating genetic material through recombinant DNA. The accumulation of 40 years of experience with gene transfer research has led to a better understanding of the risks. Yet, as gene transfer research has matured, the complexity of the overall regulatory environment has remained. Gene transfer research continues to be subjected to multiple layers of review: the Food and Drug Administration (FDA), institutional review boards, institutional biosafety committees, and the RAC. It is within the context of overlapping …

Cutting Out Worry: Popularizing Psychosurgery In America, Antonietta Louise Iannaccone

Scripps Senior Theses

We think of the lobotomy as utterly primitive and brutal; we shudder at the idea of it. The archetypal image of creepiness, violence, and unnecessary brutality was expressed in the book and movie One Flew Over the Cuckoo’s Nest. This procedure weighs heavy on America’s conscience but in 1945 the procedure was characterized as being as gentle as ‘cutting through butter’ and the therapeutic effect was described as ‘cutting out worry’. How did the lobotomy gain such widespread acceptance? One part of the answer is that Walter Freeman advocated for it not just among his colleagues, but through the popular …

Managing Conflict In Clinical Health Care With Diminished Reliance On Third Party Intervention: Forging An Ethical And Legal Mandate For Effective Physician-Patient Communication, Edward J. Bergman

Cardozo Journal of Conflict Resolution

The world of clinical medicine is rife with conflict among caregivers, patients and their surrogates. This should not surprise given medicine's scientific, psychological, and language complexities, high stakes, fragmentation of care, multiplicity of players, time constraints, institutional politics, cultural differences, competing philosophies and economic dimensions. "Hospital life with its byzantine array of moving parts layered atop the unpredictable rhythms of illness is a permanent state of flux."

Bioethics Mediation & The End Of Clinical Ethics As We Know It, Autumn Fiester

Cardozo Journal of Conflict Resolution

In this Article, I will not only argue that bioethics mediation is a superior approach for resolving ethics conflicts, but I will also defend the controversial position that it is the only ethically justifiable method for resolving values-based conflicts in a pluralistic society. Although it has so far been relegated to the status of mere handmaiden to conventional consultation, bioethics mediation-as its detractors have surmised-has the potential to end clinical ethics consultation as we know it.

Family, Faith/Religion, And African Americans' Decisions To Seek Lung Cancer Treatment, Carla Demetrius Williams

Walden Dissertations and Doctoral Studies

Lung cancer is the leading cause of cancer mortality in the United States, especially among African Americans, who have the lowest survival rate from this disease among all racial/ethnic groups. The aim of this qualitative study was to investigate how family support and religion/faith influence patients' decisions about seeking treatment for lung cancer. This study was guided by the medical decision-making model and used a phenomenological approach. Data were collected from male and female lung cancer patients (n = 15) who were being treated in a thoracic and cardiovascular surgery clinic in Greensboro, North Carolina using semi-structured interviews. All participants …

Patient Preference For Physician Prayer In Medical Situations, Blaine Mahlon Schlawin

Honors Program Theses

As medical issues present themselves in an individual’s life, some may resort to religion and spirituality. Because health care providers care for the individual, these practitioners need to be aware of the connections that occur within the realm of spirituality and medicine. The overall purpose of this study was to examine the attitudes of physician use of prayer during medical visits in a sample of adults. Specifically, four research questions were examined: Overall, do patients want their physicians praying for them? Overall, do patients prefer a certain type of physician prayer (i.e., active, silent or physician distant intercessory prayer)? Does …

The Separation Of Politics And Science, Joanna K. Sax

Faculty Scholarship

This article proposes that scientific inquiry regarding questions of fact should have an autonomous zone that is protected from politics. Although many scholars promote the idea that science is politicized, little empirical data exists to support this conclusion. This article contains an empirical study that demonstrates that the public received inaccurate information in the debate over a highly politicized and controversial area of scientific inquiry, embryonic stem cell research.

This article utilizes the data from the empirical study and public choice theory to explain that there are process defects; this economic model can help explain, but cannot be used to …

Public Health Emergencies: What Counts?, Lawrence O. Gostin

Georgetown Law Faculty Publications and Other Works

Vaccines and drugs to prevent and treat Ebola Virus Disease that have never been tested in humans, and in scarce supply raise profound ethical challenges. What if good evidence emerged demonstrating safety and efficacy of drugs? What would be an ethical method of allocating scarce beneficial resources? The apparent preference given to foreign aid workers over West Africans provoked a firestorm. In addition to discussing the ethical allocation of scarce drugs, this article also asks a more fundamental question: Why did it take nearly 40 years after the first Ebola outbreak in 1976 to launch clinical trials?

A Review Of “An Ethical Market In Human Organs,” By Charles A. Erin And John Harris, And A Proposed Solution To The Current Organ Shortage, Rachel Rattenni Fcrh '14

The Fordham Undergraduate Research Journal

In 2005, an Israeli man named Nick Rosen answered an ad in his local Tel Aviv newspaper searching for someone interested in selling a kidney. Through funding from the broker who placed the ad, Rosen was flown to New York and set up with a dialysis patient from Brooklyn. After Rosen and the dialysis patient passed a simple procedure for the screening of illegal organ sales by saying the two were old friends, the successful transplant surgery was performed at the esteemed Mount Sinai Medical Center in New York. The Brooklyn resident walked away never again needing to go on …

Genetic Sex Conditions And Redefining Sex, Jayce O'Shields

Student Scholarship

Western culture has a tendency to value binaries and discreet categories that separate its social structure and provide a sense of order and organization. The value placed on binaries and categories may be advantageous in some aspects, but when it starts to infringe upon the legal and medical rights of individuals not easily placed in either binary category, it can become less advantageous.

A baby is usually classified as either male or female shortly after birth, and all future legal, social, and economic actions and rights of that individual are more or less decided according to this classification. A problem …

Incorporating New Technologies Into Toxicity Testing And Risk Assessment: Moving From 21st Century Vision To A Data-Driven Framework, Russell S. Thomas, Martin A. Philbert, Scott Auerbach, Barbara A. Wetmore, Michael J. Devito, Ila Cote, J. Craig Rowlands, Maurice Whelan, Sean M. Hays, Melvin E. Andersen, M.E. (Bette) Meek, Lawrence W. Reiter, Jason C. Lambert, Harvey J. Clewell Iii, Martin L. Stephens, Q. Jay Zhao, Scott C. Wesselkamper, Lynn Flowers, Edward W. Carney, Tim P. Pastoor, Dan D. Petersen, Carole L. Yauk, Andy Nong

in Vitro Research Models Collection

Based on existing data and previous work, a series of studies is proposed as a basis toward a pragmatic early step in transforming toxicity testing. These studies were assembled into a data-driven framework that invokes successive tiers of testing with margin of exposure (MOE) as the primary metric. The first tier of the framework integrates data from high-throughput in vitro assays, in vitro-to-in vivo extrapolation (IVIVE) pharmacokinetic modeling, and exposure modeling. The in vitro assays are used to separate chemicals based on their relative selectivity in interacting with biological targets and identify the concentration at which these interactions …

Ethical Challenges And Solutions Involved In Reviewing A Protocol With Sex Offenders As Participants: The Concerns And Solutions Identified For Protecting A Highly Controversial Population, Hila Berger, Amy Krenzer, Nicole Bryan

Presentations and Proceedings

In reviewing research, the three basic tenets IRBs are expected to abide by are beneficence, justice and respect for persons. The IRB was challenged in meeting these tenets during the course of a recent review. Given the highly controversial participant population of sex offenders and the methodology initially proposed, there were a multitude of ethical challenges uncovered that required unique solutions. The protocol presented to the IRB was developed to investigate the use of networked technologies and communications for the purpose of human trafficking. To do so the researchers proposed recruiting “Johns” or individuals convicted of soliciting sex and interviewing …

Mid-Atlantic Ethics Committee Newsletter, Fall 2013

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

Drug Firms, The Codification Of Diagnostic Categories, And Bias In Clinical Guidelines, Lisa Cosgrove, Emily E. Wheeler

Counseling, School Psychology & Sport Faculty Publication Series

The profession of medicine is predicated upon an ethical mandate: first do no harm. However, critics charge that the medical profession’s culture and its public health mission are being undermined by the pharmaceutical industry’s wide-ranging influence. In this article, we analyze how drug firms influence psychiatric taxonomy and treatment guidelines such that these resources may serve commercial rather than public health interests. Moving beyond a conflict-of-interest model, we use the conceptual and normative framework of institutional corruption to examine how organized psychiatry’s dependence on drug firms has distorted science. We suggest that academic-industry relationships have led to the corruption of …

Variance In Patient Access To Support Persons By Race/Ethnicity And Language Preference: An Analysis Of Patient Survey Data, Andrew J. Jager, Matthew K. Wynia

Journal of Health Disparities Research and Practice

Regulatory and accreditation organizations have advocated open visitation policies and allowance of support persons of patients’ choosing, but it is unknown if support is allowed equitably. Data from hospitalized patients were analyzed to determine access to support persons, stratified by patient-reported race/ethnicity, language, sex, age, and education. A multivariate regression model was constructed using race and language, controlling for site and patient sex, education and age. Additionally, sites’ policies explicitly allowing support persons were correlated to reports of allowance of support persons. Among 1,196 respondents, 17% reported not being allowed a support person or being unsure. African American patients had …

The Unseen And Untold Issues Of Clinical Trials And Research Ethics In Pakistan., Shahan Waheed, Emaduddin Siddiqui

Department of Emergency Medicine

No abstract provided.

Review Of Ourselves Unborn: A History Of The Fetus In Modern America, By Sara Dubow, Rose Holz

Women's and Gender Studies Program: Faculty Publications

With the publication of the Bancroft Prize-winning Ourselves Unborn, Sara Dubow offers a long overdue analysis and historicization of what has become a central feature in battles over reproductive rights: the fetus. Drawing upon legal and legislative records as well as educational tracts, museum exhibits, medical textbooks and journals, personal memoirs, and the popular press, Dubow traces what she calls “fetal stories” (4) in America from the late nineteenth century through the early twenty-first. In so doing, she persuasively reminds her readers the following: First, that our understanding of the fetus is not simply a product of biology or theology. …

Can Acute Dermal Systemic Toxicity Tests Be Replaced With Oral Tests? A Comparison Of Route-Specific Systemic Toxicity And Hazard Classifications Under The Globally Harmonized System Of Classification And Labelling Of Chemicals (Ghs), Nigel P. Moore, David J. Andrew, Donald L. Bjerke, Stuart Creton, David Dreher, Thomas Holmes, Pilar Prieto, Troy Seidle, Tim G. Rowan

Experimentation Collection

Acute systemic toxicity data (LD50 values) and hazard classifications derived in the rat following oral administration and dermal application have been analysed to examine whether or not orally-derived hazard classification or LD50 values can be used to determine dermal hazard classification. Comparing the oral and dermal classifications for 335 substances derived from oral and dermal LD50 values respectively revealed 17% concordance, and indicated that 7% of substances would be classified less severely while 76% would be classified more severely if oral classifications were applied directly to the dermal route. In contrast, applying the oral LD50 values within the dermal classification …

Update - June 2013, Loma Linda University Center For Christian Bioethics

Update

In this issue:

-- Will You Be a Provider or a Professional?
-- The Jack Provansha Bioethics Lecture Opens LLU School of Medicine Alumni Convention
-- From the Director - One Generation to the Next
-- Animal Rights: A Call to Commitment
-- Vegetarianism: The Interface of Science & Values
-- Bioethics at the Alumni Postgraduate Convention
-- Obamacare and the Future of Loma Linda
-- Center's Bioethics Grand Rounds: Poetry at the Bedside

Hannah Arendt And Pregnancy In The Public Sphere, Katy Fulfer

Future Directions in Feminist Phenomenology

No abstract provided.

Feminist Bio-Phenomenology, Christina Schües

Future Directions in Feminist Phenomenology

No abstract provided.

Diffusion Of Polst Education In Maine: Successes, Challenges, And Opportunities, Mary Lou Ciolfi

Muskie School Capstones and Dissertations

POLST, Physicians Orders for Life Sustaining Treatment originted in Oregon in the 1990's and is a vehicle for recording patient health care choices near the end of life as actionable physician orders so choices are honored with greater clarity and frequency at the point of care. This capstone is about educating and encouraging clinicians and the public to engage in conversations surrounding POLST.

The Pluripotency Proposition: A Biological And Ethical Case For The Utilization Of Hipscs In Place Of Hescs, Drew Dickson

Senior Honors Theses

Human embryonic stem cell (hESC) research has spurred ethical controversy ever since it became feasible in 1998. The reason for this is due to the fact that hESC research requires the destruction of a human embryo, thereby causing the cessation of life for that developing human. Despite this unavoidable consequence, many advocates of hESC research hold to the belief that the embryo is not actually a human person, and therefore deem the destruction of the embryo as justifiable. Many advocates of hESC research also have pointed to the unprecedented medical potential of hESCs to argue in favor of their case. …

When Evil Met Science: Nazi Medicine And Eugenics, Ashley Corey

Honors Theses

During World War II, millions of innocent people were murdered in Nazi Germany. For Hitler and his followers, having a pure race meant having a strong, unified country, and Germany took this idea to extreme and disturbing lengths. Corruption filled the government at all levels. As physicians were the only people authorized to run the gas chambers, traditional healers became death symbols. The Nazis and their physicians used their power to manipulate and murder for the collective goals of the country, as well as the personal gains that came with the high-end job titles. As I reveal the history and …

Malpractice Claims For Endoscopy, Lyndon V. Hernandez, Dominic Klyve, Scott E. Regenbogen

Mathematics Faculty Scholarship

AIM: To summarize the magnitude and time trends of endoscopy-related claims and to compare total malpractice indemnity according to specialty and procedure.

METHODS: We obtained data from a comprehensive database of closed claims from a trade association of professional liability insurance carriers, representing over 60% of practicing United States physicians. Total payments by procedure and year were calculated, and were adjusted for inflation (using the Consumer Price Index) to 2008 dollars. Time series analysis was performed to assess changes in the total value of claims for each type of procedure over time.

RESULTS: There were 1901 endoscopy-related closed claims against …