Bioethics and Medical Ethics Commons^™

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 …

Patients’ And Physicians’ Beliefs And Attitudes Towards Integrating Personalized Risk Estimates Into Patient Education About Left Ventricular Assist Device Therapy, Kristin M Kostick-Quenet, Benjamin Lang, Natalie Dorfman, Jerry Estep, Mandeep R Mehra, Arvind Bhimaraj, Andrew Civitello, Ulrich Jorde, Barry Trachtenberg, Nir Uriel, Holland Kaplan, Eleanor Gilmore-Szott, Robert Volk, Mahwash Kassi, J S Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Background: Personalized risk (PR) estimates may enhance clinical decision making and risk communication by providing individualized estimates of patient outcomes. We explored stakeholder attitudes toward the utility, acceptability, usefulness and best-practices for integrating PR estimates into patient education and decision making about Left Ventricular Assist Device (LVAD).

Methods and results: As part of a 5-year multi-institutional AHRQ project, we conducted 40 interviews with stakeholders (physicians, nurse coordinators, patients, and caregivers), analyzed using Thematic Content Analysis. All stakeholder groups voiced positive views towards integrating PR in decision making. Patients, caregivers and coordinators emphasized that PR can help to better understand a …

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 …

Public Attitudes, Interests, And Concerns Regarding Polygenic Embryo Screening, Rémy A Furrer, Dorit Barlevy, Stacey Pereira, Shai Carmi, Todd Lencz, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Importance: Polygenic embryo screening (PES) is a novel technology that estimates the likelihood of developing future conditions (eg, diabetes or depression) and traits (eg, height or cognitive ability) in human embryos, with the goal of selecting which embryos to use. Given its commercial availability and concerns raised by researchers, clinicians, bioethicists, and professional organizations, it is essential to inform key stakeholders and relevant policymakers about the public's perspectives on this technology.

Objective: To survey US adults to examine general attitudes, interests, and concerns regarding PES use.

Design, setting, and participants: For this survey study, data were collected from 1 stratified …

Family Accommodation In Children And Adolescents With Misophonia, Eric A Storch, Andrew G Guzick, Johann D'Souza, Jane Clinger, Daphne Ayton, Minjee Kook, Conor Rork, Eleanor E Smith, Isabel A Draper, Nasim Khalfe, Catherine E Rast, Nicholas Murphy, Marijn Lijfijjt, Wayne K Goodman, Matti Cervin

Center for Medical Ethics and Health Policy Staff Publications

Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared …

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 …

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 …

Ethical Concerns For Remote Computer Perception In Cardiology: New Stages For Digital Health Technologies, Artificial Intelligence, And Machine Learning, Kristin Kostick-Quenet, Jerry Estep, Jennifer S Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

No abstract provided.

Conscientious Objection: Understanding When And Why Primary Care Physicians Object To Providing Health Care To Transgender And Gender-Diverse Patients In An Appalachian Medical Center, Mili S. Patel, Kelley A. Jones, Laura Davisson, Elizabeth Miller, Nicole Kahn, Pamela J. Murray, Kacie M. Kidd

Journal of Appalachian Health

Introduction: Transgender and gender-diverse (TGD) individuals face barriers to accessing primary and gender-affirming care, especially in rural regions where a national shortage of medical providers with skills in caring for TGD people is further magnified. This care may also be impacted by individual providers’ strongly held personal or faith beliefs and associated conscientious objection to care.

Purpose: This study assesses the prevalence of conscientious objection to providing care and gender-affirming hormone (GAH) therapy to TGD individuals among physicians in an Appalachian academic medical center.

Methods: An anonymous, online, cross-sectional survey of physicians was distributed to resident and faculty physicians in …

Direct Implantation Of Patient Brain Tumor Cells Into Matching Locations In Mouse Brains For Patient-Derived Orthotopic Xenograft Model Development, Lin Qi, Patricia Baxter, Mari Kogiso, Huiyuan Zhang, Frank K Braun, Holly Lindsay, Sibo Zhao, Sophie Xiao, Aalaa Sanad Abdallah, Milagros Suarez, Zilu Huang, Wan Yee Teo, Litian Yu, Xiumei Zhao, Zhigang Liu, Yulun Huang, Jack M Su, Tsz-Kwong Man, Ching C Lau, Laszlo Perlaky, Yuchen Du, Xiao-Nan Li

Center for Medical Ethics and Health Policy Staff Publications

Background: Despite multimodality therapies, the prognosis of patients with malignant brain tumors remains extremely poor. One of the major obstacles that hinders development of effective therapies is the limited availability of clinically relevant and biologically accurate (CRBA) mouse models.

Methods: We have developed a freehand surgical technique that allows for rapid and safe injection of fresh human brain tumor specimens directly into the matching locations (cerebrum, cerebellum, or brainstem) in the brains of SCID mice.

Results: Using this technique, we successfully developed 188 PDOX models from 408 brain tumor patient samples (both high-and low-grade) with a success rate of 72.3% …