Bioethics and Medical Ethics Commons^™

Pour Une Diffusion Éthique Des Connaissances De La Médecine Traditionnelle: L’Intersection De La Culture Yoruba Et Des Besoins Médicaux, Isabel Sala

CISLA Senior Integrative Projects

No abstract provided.

Medical-Legal Partnerships Reinvigorate Systems Lawyering Using An Upstream Approach, Kate L. Mitchell, Debra Chopp

Articles

The upstream framework presented in public health and medicine considers health problems from a preventive perspective, seeking to understand and address the root causes of poor health. Medical-legal partnerships (MLPs) have demonstrated the value of this upstream framework in the practice of law and engage in upstream lawyering by utilizing systemic advocacy to address root causes of injustices and health inequities. This article explores upstreaming and its use by MLPs in reframing legal practice.

Buprenorphine Use For Analgesia In Palliative Care, Leanne K Jackson, Ivy O Poon, Mary A Garcia, Syed Imam, Ursula K Braun

Center for Medical Ethics and Health Policy Staff Publications

Buprenorphine is a semi-synthetic long-acting partial µ-opioid receptor (MOR) agonist that can be used for chronic pain as a sublingual tablet, transdermal patch (Butrans®), or a buccal film (Belbuca®). Buprenorphine’s unique high receptor binding affinity and slow dissociation at the MOR allow for effective analgesia while offering less adverse effects compared to a full agonist opioid, in particular, less concern for respiratory depression and constipation. It is underused in chronic pain and palliative care due to misconceptions and stigma from its use in opioid use disorder (OUD). This case report discusses the unique pharmacology of buprenorphine, including its advantages, disadvantages, …

The Ethical Justification Of Medical Interventions Across The Spectrum Of Healthcare For Patients Preceding The Age Of Consent: The Tension Between Surrogate Consent And Minor Assent, Erin Scroggins

Electronic Theses and Dissertations

This dissertation, The Ethical Justification of Medical Interventions Across the Spectrum of Healthcare for Patients Preceding the Age of Consent: the Tension Between Surrogate Consent and Minor Assent, will aim to provide ethical justification for medical intervention for patients preceding the age of consent. To begin, decision-making for medical intervention in all forms will be examined. Followed by, beginning of life interventions into complex and controversial situations for medical intervention which then leads into end-of-life considerations for patients preceding the age of consent. These chapters will pose various ethical considerations for some more contentious dilemmas. It has been pondered …

Perinatal Ethics: The Role Of Ethics Consultation Around Parental Dilemmas Before And After Birth, Giulia Adele Dinicola

Electronic Theses and Dissertations

This dissertation, “Perinatal Ethics: the Role of Ethics Consultation around Parental Dilemmas Before and After Birth,” aims to examine the nuances of clinical ethics consultations in the field of perinatal ethics. Perinatal ethics entails ethical quandaries that emerge during a life-changing shift in prospective parents’ lives: pregnancy, childbirth, and the first days to months of their child’s life. Although pregnancy and childbirth often come with happy and joyful memories; this is not always the case. When fetal anomalies are diagnosed either with prenatal screening tests, or when maternal health complications develop during pregnancy, or when delivery-related emergencies occur during childbirth, …

The Contributions Of Philosophical Anthropology To Healthcare Ethics, Bura Koroba

Electronic Theses and Dissertations

The first principles of bioethics, autonomy, beneficence, nonmaleficence, and justice have contributed immensely to healthcare ethics. The procedural approach streamlines the decision-making process, protects vulnerable subjects, and fosters stability and trust in the patient-caregiver relationship. Yet, the principles are demonstrably insufficient, riddled with limitations and loopholes that could stand in the way of care.[i] Several recommendations have been proffered to remedy the deficiencies. Value ethics, for instance, has been touted as a proficient addendum to the foundations established by the principles. Still, these have not sufficiently addressed all arising issues in bioethics. Besides the challenges encountered in decision-making, opposing …

The Contribution Of Pope Francis’ Integral Ecology To Global Ethics, Salvatore Enzo Del Brocco

Electronic Theses and Dissertations

The defense of the dignity and inviolability of human life has always gained prominence in the doctrine of the Catholic Church. With Pope Francis' concept of integral ecology, Catholic bioethics is expanded to a broader understanding. His vision of integral ecology, global bioethics, and solidarity emphasizes the interconnectedness of all things and the importance of caring for one another and the planet. It calls us to recognize our common humanity and to work together for the common good by facing the numerous emerging problems of our times, which threaten the dignity of human life and the future life of the …

Transforming Chaplain Ethics: The Clinical Ethics Of Spiritual Care In A Pluralistic Healthcare Environment In The United States, Robert Alan Price

Electronic Theses and Dissertations

This dissertation, “Transforming Chaplain Ethics: The Clinical Ethics of Spiritual Care in a Pluralistic Healthcare Environment in the United States,” aims to examine the clinical ethics of religious and spiritual care provided by clinical chaplains for patients and families receiving treatment in a pluralistic healthcare context in the United States.

Clinical chaplains are more than clergypersons and they are more than clinicians; they are a highly specialized marriage of both worlds. There is a fundamental asymmetry between functioning as a leader in a local religious community or faith tradition and providing clinical spiritual care in a pluralistic healthcare environment. This …

Addressing Or Reinforcing Injustice? Artificial Amnion And Placenta Technology, Loss-Sensitive Care And Racial Inequities In Preterm Birth, Sophie L Schott, Faith Fletcher, Alice Story, April Adams

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

A Qualitative Interview Study To Determine Barriers And Facilitators Of Implementing Automated Decision Support Tools For Genomic Data Access, Vasiliki Rahimzadeh, Jinyoung Baek, Jonathan Lawson, Edward S Dove

Center for Medical Ethics and Health Policy Staff Publications

Data access committees (DAC) gatekeep access to secured genomic and related health datasets yet are challenged to keep pace with the rising volume and complexity of data generation. Automated decision support (ADS) systems have been shown to support consistency, compliance, and coordination of data access review decisions. However, we lack understanding of how DAC members perceive the value add of ADS, if any, on the quality and effectiveness of their reviews. In this qualitative study, we report findings from 13 semi-structured interviews with DAC members from around the world to identify relevant barriers and facilitators to implementing ADS for genomic …

Mortality In Medicine, Maren Dougherty

Honors Projects

Practitioners in the medical field attend to health issues across one’s lifespan from birth to death and everything in between. A common conflict in today’s practice of medicine is establishing the true function of medicine. The complete reliance on medicine to ward off death proliferates the biomedicalization of natural life processes, like death. Biomedicalization is the process in which medical authority and its accompanying technology begin to control other aspects of daily life. With medicine’s ultimate goal being to cure disease and fight death, it interferes with the inevitability of human mortality. End-of-life treatment can be taken too far without …

Chronic Schizophrenia Presenting With Psychogenic Polydipsia Masking Stage Iv Uterine Adenocarcinoma, Dakota B. Pastore, Kamayel Jaludi, Angelo Sica

Rowan-Virtua Research Day

Background: Psychogenic polydipsia (PPD) is a condition of excessive water intake and seeking behavior with a 6-20% prevalence among patients with psychiatric illnesses, commonly Schizophrenia. It remains unknown how often concomitant disease can mask other, more serious conditions in psychiatric patients.

Case Description: The patient is a 58-year-old Hispanic, white female with chronic schizophrenia complicated by multiple hospitalizations for hyponatremia secondary to PPD. The patient initially presented to the emergency department (ED) in 2016 with abdominal pain, was treated symptomatically and discharged. From 2020 to 2023, the patient was readmitted seven more times, with two suspected aspirin overdoses, an Ambien …

Accessibility To Gender Affirming Treatments For Transgender Patients In New Jersey, Tara Young, Tara Pellegrino

Rowan-Virtua Research Day

Background: The literature clearly indicates that gender affirming treatments, such as gender reassignment surgery, counseling, exogenous hormones, and feminization/masculinization surgery, are highly effective and beneficial for transgender patients.

Purpose: The purpose of this review was to assess the barriers to accessing gender affirming treatments in New Jersey.

Methods: This review utilized the PubMed database and Google searches to gather information. The search terms included LGBTQ healthcare, LGBTQ Medicaid, transgender treatment, transgender healthcare, top surgery New Jersey, New Jersey Medicare and Medicaid, and transgender Health Insurance in New Jersey.

Results: New Jersey State Medicaid covers both gender affirming surgery and …

Unveiling The Potential: The Role Of Ai-Enhanced Ecg In Cardiovascular Disease Detection, Alisha Vincent

Rowan-Virtua Research Day

Background: The Electrocardiogram (ECG) is a widely utilized, non-invasive, cost-effective cardiac test. Its integration with Artificial Intelligence (AI) has empowered it to become a potent screening tool and a predictor for various cardiovascular diseases, especially in asymptomatic individuals. Objective: This review investigates the utility of AI-powered ECG in early detection of cardiac conditions, focusing on conditions such as low ejection fraction (LEF), atrial fibrillation (AF), aortic valve stenosis (AVS), and cardiac amyloidosis (CA). Methods: A literature review spanning 2018 to 2024 was conducted, analyzing 10 articles - 3 on AF, 3 on AVS, 3 on LEF, and …

Spot The Signs - Comunicación Es Lo Más Importante, Daniel Rios, Victoria Wong Murray, Alexus Weatherspoon, Amy Palen, Kenneth W. Stagliano, Stephen M. Scheinthal

Rowan-Virtua Research Day

Opiate overdose is an unfortunately common risk factor for suicide; suicide attempts accounted for an estimated 30% of fatal opioid overdoses during the pandemic. As a result, the Rowan School of Osteopathic Medicine Department of Psychiatry developed an Integrated Mental Health Awareness and Suicide Prevention program targeted at members of the community and frontline workers to increase awareness and provide brief interventions, which demonstrated an improvement of 89% in our English-speaking attendees.

Spanish is the most common non-English language in New Jersey, with an estimated 1.3 million speakers. Hispanic patients also frequently experience culturally bound stigmas, so it is vital …

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Spot The Signs- 防范未然，及时干预- 培训, Kenny Kah-Keng Leng, Victoria Wong Murray, Alexus Weatherspoon, Amy Palen, Kenneth W. Stagliano, Stephen M. Scheinthal

Rowan-Virtua Research Day

Opiate overdose is an unfortunately common risk factor for suicide; suicide attempts accounted for an estimated 30% of fatal opioid overdoses during the pandemic, and patients with an episode of opiate overdose were at an 18 times higher risk of suicide in the following year. As a result, the Rowan School of Osteopathic Medicine Department of Psychiatry developed an Integrated Mental Health Awareness and Suicide Prevention program targeted at members of the community and frontline workers to increase awareness and provide brief interventions, which demonstrated an improvement of 89% in our English-speaking attendees.

Chinese is the second-most common non-English language …

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Colorblind Racial Attitudes And Emotion Dysregulation: Impact On White People’S Ethnocultural Empathy And Feelings Towards People Of Color, Vanessa L. Veltre, Alissa Hochman

Rowan-Virtua Research Day

Colorblind racial attitudes, which minimize the importance of race, have been identified as a barrier to understanding systemic racism and fostering empathy towards people of color (POC). This study aimed to examine the relationship between emotion dysregulation and White people's ethnocultural empathy and warmth towards people of color, and to explore the potential moderating role of colorblind racial attitudes.

The study utilized data from 511 White participants (ages 19-50) who completed the Difficulties in Emotion Regulation Scale (DERS), Colorblind Racial Attitudes Scale (CoBRAS), Scale of Ethnocultural Empathy (SEE), and a feeling thermometer scale measuring warmth towards POC. Participants were categorized …

Prevalence Of Traumatic Brain Injury Among The Guests At A Low-Barrier Homeless Shelter, Nicholas Ang, Jason Wasserman

Posters

Traumatic Brain Injury (TBI) is a significant public health concern, characterized by disruption of normal brain function due to head trauma, with common causes including automobile accidents, athletic injuries, and assault. TBI accounts for a substantial portion of injury-related deaths worldwide and is a leading cause of neurological disability. However, there's considerable variability in defining and measuring TBI, complicating prevalence comparisons. Studies indicate varying rates, with a particularly high prevalence among individuals experiencing homelessness, potentially due to increased vulnerability to trauma. The cognitive impairments associated with TBI, often manifesting years later, pose challenges, especially for marginalized populations like the homeless, …

Cancer Screening Guidelines In Midwest Adult Correctional Facilities, Stephen Greenwell, Jason Adam Wasserman

Posters

National cancer screening guidelines (CSGs) exist to promote early cancer detection, reducing mortality, morbidity, and cost. The incarcerated population is at increased risk for certain cancers, decreased cancer screening, and barriers to treatment. In this study we investigate how state and federal prison CSGs differ from the National Comprehensive Cancer Network’s (NCCN) CSGs.

Catholic Hospitals Should Permit Physicians To Provide Emergency Contraception To Rape Victims As An Act Of Conscientious Provision, Marlee Mason-Maready, Victoria Whiting, Abram Brummett

Posters

Some Catholic hospitals provide emergency contraception (EC) to rape victims, but some prohibit it based on institutional conscience and that it may act as an abortifacient.

We argue that the reasonable internal disagreement on this issue can be the basis for Catholic hospitals to accommodate physicians who may feel compelled by conscience to provide EC.

U.S. legal asymmetries protect conscientious objection (CO) in health care, but not conscientious provision (CP). Catholic hospitals can sanction or even fire physicians who provide EC.1, 2.

Ramifications of barriers to EC access and potential objections to this perspective are also discussed.

Impact Of Housing First Supportive Housing Provision On Healthcare Accessibility And Health Status Of Individuals Who Previously Experienced Homelessness, Aubrey Haughn, Tiffany Loh, Jason Adam Wasserman

Posters

• The 2020 AHAR report to Congress revealed about 580,000 people experience homelessness on a single night.
• Approximately 3 out of every 200 people have experienced homelessness.
• Individuals experiencing homelessness face higher risks of infectious diseases, injuries, mental health issues, substance abuse, and suicide.
• Individuals experiencing homelessness are 6-10 times more likely to have unmet healthcare needs compared to the general population.
• In contrast to a treatment-first approach, the housing first (HF) approach of supportive housing focuses on provision of immediate stable housing for individuals experiencing homelessness without preconditions regarding substance use.
• Avalon House Hickory Way are newly implemented HF apartments …

Perspectives Of A Permanent Supportive Housing Population On Their Trust In Sources Of Health Information, Experiences With Health Care Providers, And Navigation Of Health Information Amidst The Covid-19 Pandemic, Tiffany Loh, Jason Wasserman

Posters

Permanent supportive housing (PSH) has become the predominant housing intervention for addressing homelessness in the U.S.1 It provides o Unhoused adults with mental and substance use disorders long-term, affordable housing2 o Voluntary social support services.

Studies have found that the unhoused population experience mistreatment in health settings.3–6 o Some unhoused individuals expressed not being seen as human, feeling invisible to health providers, or treated as an experiment.

Limited research on sources of health information used by those who have experienced homelessness. o Allen et al. found that unhoused individuals refer to news media, word of mouth, the internet and social …

Critical Reflection And Place Based Medical Education In Bioethics, Humanism, And Professional Identity Formation: The Impact Of A Study Trip To Auschwitz, Maxwell Li, Ramona Stamatin, Hedy Wald, Jason Wasserman

Posters

Between 1939 - 1945, unethical and often ghastly human experimentation was conducted in Nazi concentration camps. Physicians working in the camps also performed selections of prisoners for work detail or immediate death. Ultimately, there was a significant amount of physician complicity in Nazism and the Holocaust, ie. the genocide of European Jewry. At the end of WWII, war crime trials against the doctors and scientists involved helped give rise to the Nuremberg Code of Ethics.

There are increasing calls for inclusion of education on medicine during the Holocaust in medical school curricula. A study trip to Poland with pre-trip study …

Relationships Between The Number Of Chaplain Visits And Patient Characteristics At A Large, Midwestern Suburban Teaching Hospital, Sarah E. Toates, Kevin D. Hickey

Posters

Hospital-based chaplaincy increases patient satisfaction and overall quality of life1 and has been shown to positively influence physical and mental health outcomes.2 Given that most inpatient chaplaincy departments operate with limited staff and resources, and that the vast majority (83%) of patients wish to discuss religion and spirituality with their health care team,3 understanding the activities of inpatient chaplains is essential to optimize the care chaplains provide to hospitalized patients. In general, the current medical literature lacks data to guide inpatient chaplains’ activities based on patient characteristics,4 thus, there is a need for an empirical evaluation of spiritual care departments’ …

The New Professional: Navigating The Journey: Finding Your Practice Philosophy As A New Dentist, Amrita Patel Dds

The Journal of the Michigan Dental Association

Dr. Amrita Patel highlights the importance of defining a practice philosophy as a new dentist. Self-reflection, mentorship, patient-centered care, continuous learning, and adaptability are crucial elements in this journey. Embracing personal values and ethics ensures authenticity and guides decision-making. The evolving nature of this philosophy underscores the need for flexibility and openness to change. Dentists can shape their professional identity and approach to patient care through introspection and experiential learning.

The Consequences Of Homophobia: Analysis Of Discriminatory Medical And Legislative Policies And Their Influence On Health Disparities, Kaiden J. Fandel

Honors Thesis

Are there specific roots that influence the introduction and incorporation of discriminatory medical policies? What are the sources of such stigma, discrimination, and prejudice, in what forms does such discrimination take place, and what negative impacts does such hatred have on health outcomes, quality of care, and health disparities? Through a review of existing literature on this topic, intertwining the examination of the evolution of discriminatory policies and other explanatory literature in the United States, this thesis aims to answer the questions above, and explain the roots of such homophobic discrimination and its prevalence in the United States. Through the …

Parent-Led Cognitive Behavioral Teletherapy For Anxiety In Autistic Youth: A Randomized Trial Comparing Two Levels Of Therapist Support, Andrew G Guzick, Sophie C Schneider, Minjee Kook, Julia Rose Iacono, Saira A Weinzimmer, Troy Quast, Sean M Olsen, Killian Rainey Hughes, Emily Jellinek-Russo, Amanda Perozo Garcia, Abigail Candelari, Leandra N Berry, Robin P Goin-Kochel, Wayne K Goodman, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Parent-led cognitive behavioral therapy (CBT) is an efficient, promising form of therapy that may be well suited for autistic youth with anxiety disorders, though to date it has been minimally tested. In this study, 87 autistic youth (7 to 13 years old) with anxiety disorders and their parents were randomized to two forms of parent-led CBT in which parents led their child through a guided CBT workbook across 12 weeks: one with low therapist contact (four 30-minute telehealth calls), and one with standard therapist contact (ten 60-minute telehealth calls). Anxiety, functional impairment, and autism features significantly declined across therapy, without …

Advancing Genomics To Improve Health Equity, Ebony B Madden, Lucia A Hindorff, Vence L Bonham, Tabia Henry Akintobi, Esteban G Burchard, Kellan E Baker, Rene L Begay, John D Carpten, Nancy J Cox, Valentina Di Francesco, Denise A Dillard, Faith E Fletcher, Stephanie M Fullerton, Nanibaa' A Garrison, Catherine M Hammack-Aviran, Vanessa Y Hiratsuka, James E K Hildreth, Carol R Horowitz, Chanita A Hughes Halbert, Michael Inouye, Amber Jackson, Latrice G Landry, Rick A Kittles, Jeff T Leek, Nita A Limdi, Nicole C Lockhart, Elizabeth O Ofili, Eliseo J Pérez-Stable, Maya Sabatello, Loren Saulsberry, Lorjetta E Schools, Jennifer L Troyer, Benjamin S Wilfond, Genevieve L Wojcik, Judy H Cho, Sandra S-J Lee, Eric D Green

Center for Medical Ethics and Health Policy Staff Publications

Health equity is the state in which everyone has fair and just opportunities to attain their highest level of health. The field of human genomics has fallen short in increasing health equity, largely because the diversity of the human population has been inadequately reflected among participants of genomics research. This lack of diversity leads to disparities that can have scientific and clinical consequences. Achieving health equity related to genomics will require greater effort in addressing inequities within the field. As part of the commitment of the National Human Genome Research Institute (NHGRI) to advancing health equity, it convened experts in …

Patient Interest In And Clinician Reservations On Polygenic Embryo Screening: A Qualitative Study Of Stakeholder Perspectives, D Barlevy, I Cenolli, T Campbell, R Furrer, M Mukherjee, K Kostick-Quenet, S Carmi, T Lencz, G Lázaro-Muñoz, S Pereira

Center for Medical Ethics and Health Policy Staff Publications

Purpose: We explored and compared perspectives of reproductive endocrinology and infertility specialists (REIs) and in vitro fertilization (IVF) patients regarding polygenic embryo screening (PES), a new type of preimplantation screening that estimates the genetic chances of developing polygenic conditions and traits in the future.

Methods: Qualitative thematic analysis of semi-structured interviews with US-based REIs and IVF patients.

Results: Clinicians and patients often held favorable views of screening embryos for physical or psychiatric conditions, though clinicians tended to temper their positive attitudes with specific caveats. Clinicians also expressed negative views about screening embryos for traits more frequently than patients, who generally …

Advancing Genomics To Improve Health Equity, Ebony B Madden, Lucia A Hindorff, Vence L Bonham, Tabia Henry Akintobi, Esteban G Burchard, Kellan E Baker, Rene L Begay, John D Carpten, Nancy J Cox, Valentina Di Francesco, Denise A Dillard, Faith E Fletcher, Stephanie M Fullerton, Nanibaa' A Garrison, Catherine M Hammack-Aviran, Vanessa Y Hiratsuka, James E K Hildreth, Carol R Horowitz, Chanita A Hughes Halbert, Michael Inouye, Amber Jackson, Latrice G Landry, Rick A Kittles, Jeff T Leek, Nita A Limdi, Nicole C Lockhart, Elizabeth O Ofili, Eliseo J Pérez-Stable, Maya Sabatello, Loren Saulsberry, Lorjetta E Schools, Jennifer L Troyer, Benjamin S Wilfond, Genevieve L Wojcik, Judy H Cho, Sandra S-J Lee, Eric D Green

Center for Medical Ethics and Health Policy Staff Publications

Health equity is the state in which everyone has fair and just opportunities to attain their highest level of health. The field of human genomics has fallen short in increasing health equity, largely because the diversity of the human population has been inadequately reflected among participants of genomics research. This lack of diversity leads to disparities that can have scientific and clinical consequences. Achieving health equity related to genomics will require greater effort in addressing inequities within the field. As part of the commitment of the National Human Genome Research Institute (NHGRI) to advancing health equity, it convened experts in …