Bioethics and Medical Ethics Commons^™

When Toxic Behaviors Sneak Into Practice, Amrita Patel, Dds

The Journal of the Michigan Dental Association

This article addresses the challenge for new dentists in identifying and managing toxic workplace behaviors. It details common red flags such as chronic negativity, poor communication, "blame culture," and excessive production pressure that compromises ethics. The author explains how these environments can lead to burnout and practicing defensively rather than confidently. The source emphasizes the importance of developing self-awareness, seeking external mentorship, and establishing professional boundaries. It concludes that recognizing when to leave an unhealthy practice is an act of professional self-respect and essential for long-term career satisfaction.

Post-Dobbs Realities: Ethical Imperatives For Data Transparency And Trust In Maternal Health Care, Faith E Fletcher, Sophie L Schott, Kelley Akhiemokhali, Kari White

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

When Systems Fail: The Impact Of Protocol On Physician Moral Distress, Aya Dudar

Clinical Research in Practice: The Journal of Team Hippocrates

Physicians often face the decision between following rigid hospital protocol and doing the right thing for the patient, creating moral distress and contributing to burnout. This letter describes a case in which an elderly patient with COVID-19 pneumonia and a DNI order developed worsening hypercapnia and required noninvasive ventilation. Despite clinical appropriateness, hospital policy prohibited BiPAP use in obtunded patients due to aspiration risk - even when the resident offered continuous bedside monitoring. This case highlights the ethical tension that arises when rigid hospital policies prevent physicians from making real-time exceptions in appropriate situations. Empowering physicians to make context-driven decisions …

Efficacy Of Etvax, A Vaccine Against Enterotoxigenic Escherichia Coli-Positive Diarrhoea In Gambian Children: A Double-Blind, Randomised, Placebo-Controlled, Phase 2b Trial, M Jahangir Hossain, Fatou Secka, Lady C Sanyang, Raifu Taiwo, Emmanuel C Okoh, Olubunmi A Olubiyi, Mbemba Drammeh, Emmanuel U Richard, Ahmed D Balami, Mama Drammeh, Samba Juma Jallow, Bakary Sonko, Paticia Ezedimbu-Michael, Jacinta Obiaduo, Ousman Secka, Joanna Kaim, Björn Sjöstrand, Agneta Lissmats, Nils Carlin, Umberto D'Alessandro, Ann-Mari Svennerholm, Thomas F Wierzba

Faculty and Staff Publications

Background: Enterotoxigenic Escherichia coli (ETEC) causes 75 million diarrhoea episodes with up to 42 000 deaths annually in children. To prevent ETEC in children, we aimed to evaluate the safety, immunogenicity, and efficacy of ETVAX, an oral, inactivated, whole-cell ETEC vaccine with toxoid and double-mutant heat-labile toxin adjuvant.

Methods: In this phase 2b, double-blind, placebo-controlled trial, Gambian children aged 6-18 months were recruited from four enrolment centres and block-randomised (1:1) via a computer-generated sequence, stratified by enrolment centres, to receive ETVAX or placebo on days 1, 15, and 90. Parents, staff, investigators assessing outcomes, and investigators analysing the data were …

The Racial Politics Of Early Dentistry And The Terrible “Toothache Blues”, Bronwen Mcveigh Phd

Journal of the American College of Dentists

In interwar America, the relatively young profession of dentistry was developing rapidly. As the government, health institutions, and social organizers focused more intently on notions of national wellness, questions about how to achieve a healthy smile—and what a healthy smile should look like—proliferated. Groups like the National Dental Association worked to establish rigorous standards of technique, define ethical behavior, and encourage dentists to develop business acumen, yet the surprising proliferation of blues songs about dubious dentists tricking unassuming clients, or about fraught love affairs allegorized by disastrous dental exams, highlights the equivocal nature of many developments in early dentistry.

This …

The Vipeholm Experiments: A Case Study Of Unethical Dental Research, Lainie Ross Md, Phd

Journal of the American College of Dentists

Modern-day research ethics training often begins with a discussion of the medical research atrocities committed by Nazi health care professionals and the resulting 10-principle Nuremberg Code, which is often considered to be the beginning of modern-day medical research regulations. It is occasionally mentioned that Nazi dentists also conducted unethical research in the concentration camps, and a few were brought to trial. In this manuscript, I compare two studies (one medical and one dental) conducted after World War II that violated the Nuremberg Code.

I describe and compare the well-known Willowbrook Hepatitis studies conducted by infectious disease doctors on vulnerable institutionalized …

The Mouth As A Mirror: A Parent- Hygienist’S Ethical Reflections On Oral Healthcare And Pompe Disease, Anika Atkins Ma, Rdh

Journal of the American College of Dentists

This reflective narrative explores the ethical tensions and emotional realities of a dental hygienist who is also the parent of a child with Pompe disease. Drawing from personal experience and care ethics philosophy, the author examines how traditional clinical frameworks—centered on autonomy, beneficence, and protocol— often fall short when addressing the needs of medically fragile children. The piece weaves in the work of care ethicists and pastoral ministry to embrace the philosophy of caregiving as presence, to suggest that oral healthcare must evolve to include responsiveness, context, and relationship-based decision-making. Through the dual lens of provider and parent, the narrative …

Restoring Trust: A Fair Chance At A Bright Smile And The Human Side Of School-Based Dentistry, Rubin Sorrell Ii, Mph, Dds

Journal of the American College of Dentists

The Fair Chance at a Bright Smile (FCAABS) program represents a humanistic, community- centered approach to dentistry that redefines access, education, and dignity in oral health. Developed and refined through a year-long pilot partnership with the San Francisco Unified School District, FCAABS integrates preventive dental care, oral health education, and career exposure for students from pre-kindergarten through high school. This manuscript argues that beyond clinical outcomes, FCAABS reveals a deeper truth: oral health is intrinsically social, emotional, and moral. It examines the program through the lens of the humanities and ethics, exploring how narrative, empathy, and cultural context inform both …

J Am Coll Dent 2026 92 2a

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care. The unexpectedly strong response to the call …

Artificial Intelligence In Medical Ethics Education: A Descriptive Study Of Eight Models In Multiple Choice Question Generation, John Obeid, Christopher Bobier, Alex Gillham, Adam Omelianchuk, Daniel Hurst

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Integrating artificial intelligence (AI) into medical education poses barriers and opportunities for medical educators. One of those opportunities is content creation for medical ethics assessment. Assessing the performance of AI in generating multiple choice questions (MCQs) in ethics that aligns with United States Medical Licensing Examination (USMLE) is important. The present study evaluates the performance of eight AI models-GPT-4 Turbo, GPT-3.5 Turbo 0125, o1 Mini, o1 Preview, GPT-4, Claude 3.5 Sonnet, Claude 3 Opus, and Gemini-in regard to the relevance, clarity, and accuracy of generated ethics-based MCQs.

Methods: Each of the eight models was tasked with generating two sets …

Designing Inclusive Newborn Sequencing Research: Insights From Parents In Underrepresented Communities, Maya C Del Rosario, Sheyenne A Walmsley, Barbara W Harrison, Crystal T Stephens, Bethany Zettler, Greysha Rivera-Cruz, Priyal Agrawal, Amy Brower, Stephanie Chigbu, Kurt D Christensen, Casie A Genetti, Richetta Givens, Nina B Gold, Inez V Reeves, Isabella Schichter, Habib Shariat, Sandra Simon, Hadley Stevens Smith, Melissa Uveges, Robert C Green, Ingrid A Holm, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Background: It is essential that studies of genomic sequencing (GS) in newborns and children include individuals from under-represented racial and ethnic groups (URG) to ensure future applications are equitably implemented. We conducted interviews with parents from URG to better understand their perspectives on GS research, develop strategies to reduce barriers to enrollment, and facilitate research participation.

Methods: Semi-structured interviews with 50 parents from URG.

Results: Nearly all parents said they would be interested in participating in an infant GS study. Parents were interested in participating in GS research for reasons including clinical utility, personal utility, and/or family health benefits. Deterrents …

The Consequences Of Attempted Human Perfection: Genetic Enhancement And Why It Is Immoral, Kiran S. Sajnani

Mako: NSU Undergraduate Student Journal

In the field of biomedical ethics, genetic enhancement—the alteration of human DNA to increase characteristics beyond normal function—is a highly contested topic. Genetic enhancement presents serious ethical issues, especially when gene therapy seeks to treat or prevent disease. This paper makes the consequentialist case that genetic enhancement, whether somatic or germline, is intrinsically unethical because of its ethical, societal, and systemic ramifications. The autonomy of future persons is violated by germline enhancement, which also runs the risk of deepening socioeconomic gaps and escalating intergenerational inequity. Even though it only affects the individual, somatic augmentation undermines human diversity and agency by …

The Ethical Limits Of Physician Autonomy In Reproductive Medicine, Isabel Martens

Honors Theses

In vitro fertilization is a relatively new medical practice that helps people who face infertility be able to reproduce. Reproductive medicine providers face ethical dilemmas often in their field, only some of which have standards of care. There are questions in the medical landscape pertaining to physician autonomy versus patient autonomy, which heavily apply to reproductive medicine providers. Patient autonomy is highly valued in medical ethics; however, physician autonomy should also be considered. When a physician decides who can and cannot reproduce, ethical considerations must be followed to maintain the practice of reproductive autonomy. Limited policies exist that manage reproductive …

Stakeholder Perspectives On Humanistic Implementation Of Computer Perception In Health Care: Qualitative Study, Kristin M Kostick-Quenet, Meghan E Hurley, Syed Ayaz, John D Herrington, Casey J Zampella, Julia Parish-Morris, Birkan Tunç, Gabriel Lázaro-Muñoz, Jennifer Blumenthal-Barby, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Background: Computer perception (CP) technologies-including digital phenotyping, affective computing, and related passive sensing approaches-offer unprecedented opportunities to personalize health care, especially mental health care, yet they also provoke concerns about privacy, bias, and the erosion of empathic, relationship-centered practice. At present, it remains elusive what stakeholders who design, deploy, and experience these tools in real-world settings perceive as the risks and benefits of CP technologies.

Objective: This study aims to explore key stakeholder perspectives on the potential benefits, risks, and concerns associated with integrating CP technologies into patient care. A better understanding of these concerns is crucial for responding to …

Reported Safety Practices Of Publicly Advertised Psychedelic Retreats, Amy L Mcguire, Logan Neitzke-Spruill, Jill O Robinson, Caroline S Beit, Nikita Singh, David S Mathai, Lynnette A Averill

Center for Medical Ethics and Health Policy Staff Publications

Importance: The availability of psychedelic retreats has grown to meet the demand for access to these substances. Despite centuries of use among Indigenous communities, psychedelics can pose serious risks for some users.

Objective: To determine safety precautions that retreat organizations that offer psychedelic substances currently use.

Design, setting, and participants: This qualitative study included structured interviews conducted by phone or email with representatives from 49 organizations publicly advertising psychedelic retreat offerings from July to October 2023. Organizations were eligible if they marketed their services in English, offered at least 1 psychedelic substance, and made contact information available online. Organizations were …

Guidance For Authors, Editors And Publishers On The Use Of Generative Ai, Christopher J. Smiley, Julie Frantsve-Hawley Phd, Michael Parks Jd, Ee, Francine Lynch Esq., D.Be, Kelly O'Brien, Ellen Thieme Mlis, Thomas Dodson Dds, Mph, Facs, David Foe, Chester Gary D.D.S., J.D., Kelly Lemke Dds, Ms, Jeffrey Platt Dds, Ms, Ba, Toni M. Roucka Rn, Dds, Ma, Facd, Hugh Wunderlich Dds

Individual Scholarship

This paper from AADEJ presents best-practice guidelines for the ethical use of generative artificial intelligence (GAI) and large language models (LLMs) in the creation, editing, and publication processes in dental writing and publishing. It examines how LLMs, such as ChatGPT, can enhance efficiency across writing and publishing workflows, while also identifying the operational risks associated with their design.

Key areas of focus include the implications of LLM algorithms and training data, particularly regarding the risks they pose to intellectual property, privacy, and the integrity of the profession’s literature. Additionally, the paper provides an overview of the legal, ethical, and copyright …

Suicidality, Self-Neglect, And Medical Refusal In Advanced Illness: An Ethical Case Report, Austin Supak, Sarah Greene, Madeline Adelman, Whitney Snyders

Continental and Mountain Divisions GME Resarch Day 2026

No abstract provided.

J Am Coll Dent 2026 92 2b

Journal of the American College of Dentists

This special issue of the Journal of the American College of Dentists responds to a growing but long-underrecognized demand for humanities and ethics in dental education, practice, and scholarship. It emerges from the work of the National Collaborative on Humanities and Ethics in Dentistry (NCHED), a multi-institutional partnership formed in 2023 to address the persistent exclusion of dentistry from broader health humanities conversations. Through national webinars and scholarly collaboration, NCHED has demonstrated substantial interest in ethical reflection, historical analysis, narrative inquiry, and the arts as essential to understanding oral health and dental care.

The unexpectedly strong response to the call …

Is Being A Shareholder ‘In Name Only’ A Problem?, Daniel Schulte Jd

The Journal of the Michigan Dental Association

This column addresses the legal risks for Michigan dentists entering "shareholder in name only" agreements with non-dentist entities. Michigan law requires dental practices to be owned by licensed dentists to ensure professional control over public healthcare. Arrangements where management companies or manufacturers can reclaim stock for a nominal fee effectively strip the dentist of true ownership. This lack of control can lead to ethical conflicts, such as pressure to sell specific appliances regardless of professional judgment. Engaging in such schemes may endanger a dentist's license by thwarting state laws intended to protect clinical independence.

Unpacking And Re-Imagining Dental Ethics With Anti-Oppressive And Interdisciplinary Praxis, Eleanor Fleming Phd, Dds, Mph, Ficd, Facd

Journal of the American College of Dentists

Dental ethics are assumed to be neutral in their intent. With a social contract grounded in liberalism and assumptions centering whiteness, the resulting ethics reinforce hierarchy, otherness, and inequities. Because concepts and practices are rarely neutral, dental ethics is embedded with biases, which results in it falling short of the demands of the 21st century and exacerbating health inequities rather than supporting efforts for health justice. This manuscript invites the reader to reflect critically and re-imagine dental ethics using anti-oppressive and interdisciplinary praxis. For the improvement of public health, the narrowing of inequities, and a functioning oral health system, the …

Dr. William Thomas Green Morton, Civil War Hero, Peter H. Jacobsohn Dds, Facd

Journal of the American College of Dentists

This article examines the overlooked Civil War contributions of Dr. William Thomas Green Morton, the dentist best known as the Father of Surgical Anesthesia. While Morton’s role in introducing ether anesthesia to surgery is well documented, his service as a volunteer anesthetist for the Union Army remains largely unrecognized in Civil War literature. Drawing on contemporary accounts, letters, and eyewitness descriptions, the article highlights Morton’s presence on major battlefields, where he administered ether to thousands of wounded soldiers. His work dramatically reduced surgical pain, improved morale, and marked the earliest example of organized military anesthesia in American history.

Call To Action: A Telebehavioral Health Framework For Counselor Development, Brittany G. Suggs, Brittany J. Bice-Urbach, Marlene M. Maheu, Kenneth P. Drude, Donna Ford, Jocelyn Novella, Bradford Felker, Donald M. Hilty

Counseling & Human Services Faculty Publications

The widespread implementation of telebehavioral health (TBH) services, accelerated by the COVID-19 pandemic, created an urgent need for standardized competencies in counselor education. Many practitioners report minimal formal training, leading to significant variability in competence and a concerning gap between their confidence and actual preparedness. This article issues a call to action for counseling programs to adopt the interprofessional TBH competency framework from the Coalition for Technology in Behavioral Science (CTiBS). This structured, evidence-based roadmap outlines knowledge and skills for competent, ethical TBH practice across seven domains and three progressive levels: novice, proficient, and authority. Adopting this framework will enhance …

Not Biological, But Built: Structural And Metabolic Pathways Driving Black Maternal Health Disparities In The United States, Alexandra I. Umegboh

CMC Senior Theses

Black infants in the United States are more than twice as likely to die before their first birthday than white infants, a disparity often attributed to genetics, behavior, or individual health choices. However, this idea is challenged by a key contradiction: African immigrant women consistently experience better birth outcomes than U.S.-born Black women despite being similarly racialized. This thesis investigates the origins of this reproductive advantage and the factors contributing to its decline over time. By drawing on epidemiological data, metabolic health research, and literature on African diasporic healing traditions, it argues that the “healthy immigrant effect” is not biological, …

Algorithmic Medicine And The Duty To Disclose: Informed Consent Through The Lens Of Radiology, Lee Rodriguez

Michigan Law Review

Informed consent is the law’s mechanism for protecting patient autonomy by requiring disclosure of facts that bear on the decision to accept or refuse care. Artificial intelligence now helps decide what is medically true for patients, yet informed consent law still assumes that diagnostic judgment is rendered by a human mind whose reasoning is at least in principle communicable. Radiology has become the leading setting for this tension. AI systems triage worklists, flag suspected abnormalities, and anchor first-pass impressions in ways that guide radiologists’ attention and, in practice, can coauthor diagnostic conclusions while remaining invisible to patients. When patients are …

Dental Professionalism In A Changing World: Challenges & Opportunities, Robert P. Iovino, Dds, Ma Dds, Ma

Journal of the American College of Dentists

This manuscript examines the erosion of traditional dental professionalism amid rising educational costs, declining membership in professional associations, and the growing influence of corporate ownership and private equity in dentistry. Drawing perspectives from economics, sociology, philosophy, law, and ethics, it traces the historical development of professional licensure and its role in safeguarding clinical autonomy, ethical integrity, and public trust. The analysis highlights how deregulation and profit-driven practice models challenge the profession’s social contract. The manuscript argues that preserving strong civic institutions, restrictive licensure standards, and humanities-informed education is essential to sustaining dentistry as a learned profession rather than a commodified …

Lessons On Generative Artificial Intelligence From The American Association Of Dental Editors And Journalists (Aadej), Christopher J. Smiley

Journal of the American College of Dentists

The American Association of Dental Editors and Journalists (AADEJ) recently released "Guidance for Authors, Editors and Publishers on the Use of Generative AI". Developed by an 11-member stakeholder panel, this guidance paper serves a dual purpose: It provides practical strategies for mitigating the risks that generative artificial intelligence (GAI) poses to professional writing and explains how GAI creates these risks. Understanding both the underlying vulnerabilities of GAI and how to address them is critical for users at all levels, from authors and reviewers to editors, publishers, and general users, to maintain the validity and reliability of their written work. This …

How Dentists Can Remain Advisors Of Merit To Their Patients, Daniel L. Orr Ii, Dds, Ms (Anesth), Phd, Jd, Md, Facd (Nevada Section Chair)

Journal of the American College of Dentists

This article examines how members of the dental profession can sustain their longstanding reputation as trusted advisors amid declining public confidence in major institutions. Grounded in ethical principles, informed consent, and professional self-regulation, dentistry has historically ranked among the most trusted professions. The discussion explores challenges to credibility, including media scrutiny, concerns about anesthesia safety, controversial treatment hesitancy, and debates over community water fluoridation. Emphasizing the concept of the “advisor of merit,” the author argues that continued trust depends on truthful communication, transparency about risks, respect for patient autonomy, and freedom from conflicts of interest in clinical and public health …

The History Of Dr. Suess And European Dentists From The Past: Relevant Lessons In Bioethics For Today, Howard A. Israel Dds, Facd

Journal of the American College of Dentists

The works of the author-illustrator Dr. Seuss evoke images of children’s books with moral themes, such as Yertle the Turtle and Horton Hears a Who. The life story of another Dr. Suess has remained relatively unknown. Walter Suess was an extremely talented dentist and musician in Austria. Brilliant and courageous, he became a victim of a morally depraved authoritarian regime and the absence of biomedical ethics during the reign of the Third Reich. The serendipitous discovery of the true story of Dr. Seuss and European dentists from this era offers lessons in bioethics relevant to today.

The Personal, Professional, And Practice: Integrating Health Humanities Into Dental Education, Margie Hodges Shaw Jd, Ma, Phd, Michael Yunker Dds, Nicholas Mercado Drph, Ms

Journal of the American College of Dentists

Dentistry’s evolution as a profession reflects both scientific progress and enduring tensions between commercial and service-oriented models of care. Despite long-standing commitments to ethical education, dental training continues to privilege technical mastery over professional identity formation, leaving some future practitioners underprepared for the ethical and relational complexities of clinical practice. This paper situates these challenges within the historical separation of dentistry and medicine and argues that integrating the health humanities into dental education can strengthen professional identity formation and clinical ethics competency. Using a case study, we demonstrate how biases, professional obligations, and patient trust intersect in practice. We introduce …

Healthcare Digital Twins: A Methodological Literature Review On Integrating Iot And Ai For Personalized Medicine And Predictive Care, Sara Shahnazinia, Mahsa Tavasoli, Abdolhossein Sarrafzadeh, Ali Karimoddini

Electrical & Computer Engineering Faculty Publications

Digital Twin (DT) technology has the potential to revolutionize healthcare delivery and enhance patient outcomes through personalized and precision medicine, simulation models for operations and interventions, and drug discovery. However, successful implementation of DTs in Internet of Things (IoT) and artificial intelligence (AI) healthcare is contingent upon addressing key challenges such as privacy, ethics, and robust data security. This paper presents a methodological literature review of DT applications in healthcare, systematically analyzing the current state of research, key enabling technologies, and implementation challenges. The review summarizes DT categorization approaches (application-based, technology-based, and real-time function-based); delineates core DT components such as …