Bioethics and Medical Ethics Commons^™

Moral Distress In Secondary School Athletic Trainers, Matthew J. Drescher, Matthew J. Rivera, Lindsey E. Eberman

Internet Journal of Allied Health Sciences and Practice

Moral distress is prevalent in healthcare and prolonged moral distress is directly linked to feelings of burnout and intent to leave the profession. Moral distress has been examined in other healthcare professions, including physician practice and nursing, but not in athletic training. Due to their likelihood to be isolated and have high patient loads, secondary school athletic trainers (SSATs) may experience moral distress. This study aimed to examine the experiences and perceptions of moral distress in SSATs. SSATs were recruited via email through the Athletic Training Locations and Services (ATLAS) database. A total of 603 SSATs completed the survey and …

A Caution Against Customized Ai In Healthcare, Kristin M Kostick-Quenet

Center for Medical Ethics and Health Policy Staff Publications

This article critiques the shift towards personalized AI in healthcare and other high-stakes domains, cautioning that without careful deliberation, customized AI systems can compromise the diversity and reach of human knowledge by restricting exposure to critical information that may conflict with users' preferences and biases. Customized AI should be applied with caution and intention where access to a wide and diverse range of perspectives is essential for impartial, informed decision making.

Us Military Veterans’ Perceived Concordance With Their Providers Regarding Persistent Physical Symptoms Prospectively Predicts Satisfaction With Care And Adherence To Care Plans, L Alison Phillips, Laura M Lesnewich, Katharine Bloeser, Yong Lin, Rachel L Boska, Justeen K Hyde, Peter J Bayley, Helena K Chandler, Matthew J Reinhard, Susan L Santos, Rachel Stewart, Drew A Helmer, Lisa M Mcandrew

Center for Medical Ethics and Health Policy Staff Publications

Background: Medically unexplained, persistent physical symptoms and syndromes are commonly seen in primary care. These are debilitating for patients and difficult to treat, causing frustration for patients and providers.

Purpose: This study investigates how well US military veterans with multiple persistent physical symptoms (PPS), called Gulf War illness (GWI), agree with their healthcare providers about their illness. This agreement, called perceived concordance, is hypothesized to influence veterans' satisfaction with care, adherence to care plans, and disability levels.

Methods: Participants were 230 veterans with GWI deployed to the 1990-1991 Gulf War who were recruited from Veteran Affairs primary care and War …

Does Holding Healthcare Providers Accountable For Every Mistake Improve Patient Safety, Or Does It Hinder Open Reporting And Learning?, Amir Arshia Emam Jomeh, Eleanor Roy

Journal of Health Ethics

Medical errors are a major cause of death and harm in healthcare, yet most go unreported due to fear of punishment. This essay explores whether holding healthcare workers fully accountable for every mistake improves safety or creates a harmful blame culture. Using the case of Dr. Hadiza Bawa-Garba, it shows how individual punishment can overlook deeper system failures, such as staff shortages and poor communication. The essay compares this with Denmark’s non-punitive reporting system, which encourages healthcare professionals to report errors without fear, leading to real improvements in patient safety. Blame cultures, on the other hand, discourage openness and violate …

Who Should Be Held Accountable In Technology-Induced Medical Errors? Evaluating The Roles Of Healthcare Providers, Technology Developers, And Hospital Systems, Eleanor Roy, Amir Arshia Emam Jomeh

Journal of Health Ethics

The integration of technologies such as artificial intelligence, electronic health records, and automated diagnostic systems has significantly altered clinical practice. While these tools enhance efficiency and diagnostic accuracy, they have also introduced new forms of medical error, raising complex questions about responsibility. This article examines the ethical dimensions of accountability in technology-induced harm by evaluating the roles of healthcare providers, technology developers, and hospital systems. Drawing on the four pillars of medical ethics; autonomy, beneficence, non-maleficence, and justice, it explores the overlapping responsibilities of each stakeholder and the challenges that arise when harm occurs. Through analysis of the Therac-25 radiation …

Capacity Determination And False Beliefs: A Case Study On The Application Of Evaluation Frameworks With Resulting Recommendations, Dessislava S. Fessenko

Journal of Health Ethics

False beliefs may interfere with medical decision-making by casting doubt about the patient’s decision-making capacity. The latter is typically assessed against a set of established criteria requiring the patient’s cognitive aptness for self-governance. I argue that a capacity determination solely based on these criteria may prove insufficient when the patient entertains false beliefs. I further illustrate how alternative evaluation frameworks are better suited to assess the impact of false beliefs on the patient’s state of mind, values, overall worldviews and pursuit of wellbeing, and therefore, for the actual moral significance of false beliefs. It appears prudent to integrate these alternative …

The Impact Of Medical Ethics On Healthcare Professionals And Patient Outcomes In Resource-Poor Settings: A Focus On Ethical Challenges And Solutions, Amir Arshia Emam Jomeh, Eleanor Roy

Journal of Health Ethics

Background: Developing countries face major challenges to their healthcare system such as resource scarcity and reduced patient autonomy amongst women. The strained healthcare system often leads doctors to compromise ethical protocols and reduce their standard of care.

Aims: To explain why medical ethics are important for healthcare professionals in the context of resource-poor countries.

Findings: Many healthcare professionals lack adequate knowledge of medical ethics in developing countries. In addition, doctors make difficult decisions such as patient prioritization and resource allocation without clear ethical guidance or protocols. Women also face diminished patient autonomy in developing countries, which has been linked to …

Should Medical Assisted Suicide Be Legalised Worldwide? A Critical Examination Of Ethical Justifications And Challenges In Contemporary Healthcare, Eleanor Roy, Amir Arshia Emam Jomeh

Journal of Health Ethics

The legalisation of medical assisted suicide (MAS) is a complex ethical issue at the intersection of autonomy, non-maleficence, and justice. This paper critically examines whether MAS should be legalised worldwide, evaluating ethical justifications, regulatory challenges, and societal risks. A primary argument in favour of MAS is patient autonomy, allowing individuals to make informed end-of-life decisions, particularly in cases of terminal illness and intractable suffering. MAS is also framed as a harm-reduction strategy, preventing patients from resorting to unsafe methods of suicide.

However, ethical concerns regarding coercion, socioeconomic disparities, and the "slippery slope" effect present significant opposition. Case studies from jurisdictions …

The Ethical Justification Of Application Of Long-Acting Reversible Contraception In Patients With Intellectual Disabilities, Kelly Savitri

Journal of Health Ethics

This paper explores the ethical justification for the use of Long-Acting Reversible Contraception (LARC) in patients with intellectual disabilities, particularly in scenarios where patients cannot provide informed consent. The tension between respecting autonomy and ensuring beneficence presents a complex challenge for healthcare providers. Drawing on historical context, current reproductive justice issues, and evolving societal attitudes towards individuals with intellectual disabilities, this essay argues for a semi-discrete model that recognizes the need to prioritize patient health and safety while valuing their autonomy. By examining the implications of both past and present practices, this study highlights the necessity for healthcare providers to …

Transformative Experiences, Anticipatory Regret, And Informed Consent, Elizabeth Lanphier, Shannon Fyfe

Scholarly Articles

Regret risk is not consistently part of information sharing within informed consent. Yet two kinds of decisions that often invoke concerns about future regret, abortion and sterilization, raise considerations for the role of regret in clinical decision-making and informed consent, particularly regarding decisions about potentially transformative experiences. We distinguish between first-personal and second-personal anticipatory regret and argue that first-personal anticipatory regret can play a productive role, but second-personal anticipatory regret can function in ways that are pernicious. Introducing second-personal anticipatory regret into medical informed consent processes is, we argue, not only not required for informed medical decision-making, but impermissible within …

Reproductive Autonomy In Immunological Intervention: Ethical Boundaries In Maternal-Fetal Immune Therapy, Marium Z. Rizvi

Journal of Health Ethics

Recent advances in immunology have broken barriers in reproductive medicine through immune-modulating therapies that support fertility and pregnancy. Treatments such as intravenous immunoglobulin (IVIG) and intralipid infusions are increasingly offered to patients with Recurrent Implantation Failure (RIF) or Recurrent Pregnancy Loss (RPL), conditions that result in miscarriages and failed IVF treatments (Pillarysetti et al., 2023). Maternal-fetal immunology reveals a delicate interplay between immune tolerance and defense: the maternal system must accept a genetically foreign fetus while preserving immunological protection. Disruptions in this balance are implicated in implantation disorders and pregnancy failure. As a result, immune-based therapies have emerged as promising …

Poner En Práctica Las Regulaciones Federales: Habilitando A Los Pacientes Dominio Limitado Del Inglés, Caitlyn Gailey

World Languages and Cultures Senior Capstones

This paper examines the gaps in the U.S. healthcare system that affect the Hispanic community, focusing on language barriers and cultural competence. It highlights the challenges faced by Limited English Proficiency (LEP) patients, who may struggle with medical terminology, leading to misdiagnosis and improper treatment. The paper advocates for culturally sensitive language services, including qualified interpreters, translated documents and signage in order to improve communication, patient satisfaction, and reduce medical errors. It calls for systemic changes to ensure equitable care for all patients, regardless of language or cultural background.

Los Inmigrantes Indocumentados Y Su Pelea Para La Salud Medica En Los Estados Unidos, Alejandro Del Rello

World Languages and Cultures Senior Capstones

This essay explores the critical issue of healthcare access for undocumented immigrants in the United States. Despite contributing significantly to the economy through labor and taxes, undocumented immigrants face systemic barriers to medical care, including lack of insurance, fear of deportation, and economic troubles. These barriers result in untreated illnesses, mental health struggles, and increased use of emergency services, which generate higher long-term costs. The paper argues for inclusive healthcare policies, such as Medicaid expansion and protections for patient privacy, to improve public health, reduce disparities, and enhance economic stability. Drawing from U.S. and international examples, the essay demonstrates that …

El Uso De Las Prácticas Curativas No Occidentales En Lugar De Y Dentro De La Cultura Biomédica, Lynda Gulledge

World Languages and Cultures Senior Capstones

This paper explores the difficulties that the Hispanic community faces when accessing healthcare in the United States, which emphasizes the use of biomedical culture. Topics such as cultural and linguistic barriers, past and present healthcare policies, and the use of non-Western medical practices are examined. Furthermore, this paper explores the history and use of curanderismo as an accessible and culturally appropriate form of healthcare. Lastly, the integration and acknowledgement of curanderismo in biomedical culture is explored and encouraged in order to create a more holistic healthcare experience for the Hispanic community.

Neurosurgical Praxis Guidelines During The Covid-19 Outbreak. Consensus-Based On Currently Available Literature., José Antonio Soriano Sánchez, Bárbara Nettel Rueda, José Alberto Israel Romero Rangel, Armando Alpizar Aguirre, Miguel Ángel Andrade-Ramos, Ulises García Dr., Diego Mendez Rosito, Jorge A. Santos, Sara Patricia Pérez Reyes, Julian Eduardo Soto Abraham, Jose E. Valerio Pascua, Marco Antonio Barajas Romero, Eduardo Díaz Juárez, Alma Griselda Ramírez Reyes, Maria Elena Gonzalez, Claudia Katiutska González Valdez, Félix Domínguez Cortinas, Noé Santiago Ramírez, Tenoch Herrada Pineda, Manuel Eduardo Soto García, Edgar Nathal Vera, Gustavo Melo Guzmán

Archives of Neurosurgery

INTRODUCTION: The World Health Organization recommended several strategies to contain the COVID-19 pandemic, including optimization of care for all patients, especially the seriously ill. Given the strain, the pandemic has posed on healthcare systems around the world, many neurosurgical associations have provided triage recommendations for patients to save resources for the pandemic. We aimed to provide practical recommendations based on specific illnesses requiring surgical procedures commonly performed by neurosurgeons on a life-threatening basis of patient illness. We consider this guideline will help neurosurgeons for the appropriate triage of patients on a daily-situation basis during this pandemic.

METHODS: The Mexican Society …

All About Euthanasia, Bhavna Bangalore

STEM for Success Showcase

The infographic details the practice of euthanasia. It explains euthanasia's history, legality, and process. The infographic also mentions way to support terminally ill patients that choose to undergo the procedure.

Acute Hepatitis B Infection In A Patient With Confirmed Immunity On Long-Acting Cabotegravir/Rilpivirine, William K B Boateng, Neil Carlin, Etan Spira, Maria E Szabela, Kosisochukwu J Ezeh

Faculty and Staff Publications

Long-acting injectable formulation of cabotegravir/rilpivirine (CAB/RPV) is a promising novel maintenance therapy for HIV infection. However, coinfection with active hepatitis B virus (HBV) infection is a contraindication to initiating this therapy. Despite guidelines, patients with HBV immunity can still contract acute HBV infection. We report a case of a 30-year-old man with HIV who transitioned from antiretroviral therapy to CAB/RPV and had confirmed HBV immunity. The patient, though asymptomatic, showed significantly elevated liver function tests (LFTs) before his monthly CAB/RPV injection. He was hospitalized and diagnosed with acute HBV infection. His LFTs improved, and he was taken off CAB/RPV and …

Confidentiality In Addiction Treatment: Navigating 42 Cfr Part 2 Within Human Services, Chaniece Winfield, Jessica Huffman

Counseling & Human Services Faculty Publications

Recent federal legislation, including the Mental Health Parity and Addiction Equity Act (MHPAE) and the Comprehensive Addiction and Recovery Act (CARA), has placed greater emphasis on quality integrated health care, with a focus on access, treatment options, and evidence-based practices. Changes to Federal 42 CFR privacy protections also impact individuals seeking substance use disorder treatment, either as a primary diagnosis or comorbidity. Human service professionals, as generalists in the behavioral health field, provide vital treatment, recovery, and prevention services for individuals with substance use and addictive disorders. This paper explores the implications of these legislative changes, particularly regarding privacy protections …

The Nohs 2024 Code Of Ethics Update, Kevin C. Snow, Christian Williams, Ed Neukrug, Kristin Barker, Kristin Ballard, Braxton A. Morrison, Leslie C.M. Mcclane, Meghan N. Morgan, Stephanie Collins

Counseling & Human Services Faculty Publications

The NOHS Ethics committee engaged in a revision of the Ethical Standards for Human Services Professionals (2024). This update focused on significant changes in the field of human services as they relate to a broad group of human services professionals. The article explores interviews with key members of the revision committee sharing their thoughts on the necessity for the current revision and the ever-present importance for human service professionals to understand and engage with the NOHS ethics code as an essential living document for the benefit of client well-being, to promote the integrity of the human services profession, and to …

“Nothing Is Going To Replace An In-Person Visit”: Canadian Long-Term Care Providers’ And Recipients’ Perspectives On When Telehealth For Physician Visits Is Not Appropriate, Tyler R Cole, Valorie A Crooks, Janice Sorensen, Sherin Jamal, Akber Mithani, Lillian Hung, Jeremy Snyder, Catherine Youngren

Faculty and Staff Publications

Background: Within long-term care (LTC) homes, telehealth use has been found to reduce unnecessary emergency department transfers, support the care needs of rural and underserved communities, and supplement in-person physician care. Despite these benefits, it is not well understood when telehealth is not an appropriate medium for providing physician care to residents with complex health needs. This knowledge gap must be addressed given the recent rise in telehealth use in LTC homes in many health systems following the COVID-19 pandemic, when virtual care use increased in many health care sectors to limit travel and in-person exposure risks, that is expected …