Bioethics and Medical Ethics Commons^™

Athletics

DePaul Magazine

DePaul University women’s tennis player Yuliya Kizelbasheva participates in Be The Match, an organization that finds stem cell and marrow donors for people with life-threatening blood cancers. DePaul senior Noelle Malkamaki wins gold in the Paralympic shot put competition. DePaul Athletics reframes its mission.

Discordant Cardiopulmonary Resuscitation At An Academic Midwest Medical Center- Prevalence And Solutions, Jeremy Payne, Anne Skinner, David Gannon, Jenenne A. Geske

Graduate Medical Education Research Journal

Background: Code status orders are important features of patient-centered clinical decisions, patient autonomy, and end-of-life care. Despite proper documentation of “do not resuscitate” (DNR) code status, hospitalized patients may be subjected to cardiopulmonary resuscitation (CPR) efforts that go against their wishes.

Purpose: The objective of this study was to identify and describe the population of hospitalized patients receiving discordant resuscitation efforts at a Midwest academic medical center utilizing electronic health records (EHR).

Method: The study included EHR records between 01/01/2011 and 01/01/2021 for hospitalized patients 19 years and older who experienced cardiac arrest (ICD-10 I46) and were documented as DNR. …

Degendering Parents On Birth Certificates, Timothy E. Murphy, Jennifer Parks

Philosophy: Faculty Publications and Other Works

Birth certificates typically designate parents as ‘mothers’ or ‘fathers’ although some U.S. states offer non-gendered designations. We argue that gendered characterizations offer scant legal or moral value and that states should move to degender parental status on birth certificates but retain that information in registrations of birth. Registrations of birth identify the person giving birth to a child, when and where, and they report demographic and health information useful for civic and public health purposes. Birth certificates typically report a child’s name, sex, date and location of birth, and parentage so far as known. As documents establishing parents’ standing in …

Well-Being And Resilience: A Survey Of Physician Needs During Covid-19, Delta, And Omicron, Melinda M. Wilding

Research Colloquium

Background: Physician moral distress during COVID-19, Delta, and Omicron has resulted in a decrease in self-care and a reduction in empathy for patients. Determining physician well-being and resilience assists clinicians in maintaining pliancy during times of uncertainty.

Methods: An IRB quantitative survey aims to illustrate levels of moral distress, self-care tactics, and physician fortitude during the three waves of the pandemic from 2020-2022. The questionnaire elicits responses regarding how physicians have pivoted to remain healthy during the pandemic, what measures physicians have engaged in maintaining empathy and ethics towards patients, and what physicians need in the future to retain self-care. …

Mid-Atlantic Ethics Committee Newsletter, Fall 2023

Mid-Atlantic Ethics Committee Newsletter

No abstract provided.

The Language Of Compassion: Hospital Chaplains' Compassion Capacity Reduces Patient Depression Via Other-Oriented, Inclusive Language, Jennifer S Mascaro, Patricia K Palmer, Madison Willson, Marcia J Ash, Marianne P Florian, Meha Srivastava, Anuja Sharma, Bria Jarrell, Elizabeth Reisinger Walker, Deanna M Kaplan, Roman Palitsky, Steven P Cole, George H Grant, Charles L Raison

Faculty and Staff Publications

Objectives: Although hospital chaplains play a critical role in delivering emotional and spiritual care to a broad range of both religious and non-religious patients, there is remarkably little research on the best practices or "active ingredients" of chaplain spiritual consults. Here, we examined how chaplains' compassion capacity was associated with their linguistic behavior with hospitalized inpatients, and how their language in turn related to patient outcomes.

Methods: Hospital chaplains (n = 16) completed self-report measures that together were operationalized as self-reported "compassion capacity." Next, chaplains conducted consultations with inpatients (n = 101) in five hospitals. Consultations were audio-recorded, …

“But My Mom Still Blinks When I Talk To Her” Understanding The Concept Of Social Death To Avoid Bias And Improve Goals-Of-Care Discussions At The End Of Life, Joelle Robertson-Preidler, Holland Kaplan

Faculty and Staff Publications

No abstract provided.

The Abortion Rights Of Teens In The Post-Dobbs Era, J. Shoshanna Ehrlich

Cardozo Journal of Equal Rights & Social Justice

The article examines the erosion of minors' abortion rights following the Supreme Court's Dobbs v. Jackson Women's Health decision, which overturned Roe v. Wade and Planned Parenthood v. Casey. It argues that the post-Dobbs legal landscape disproportionately harms vulnerable populations, particularly teens, by undermining judicial bypass options and intensifying restrictions on abortion access. The analysis critiques the inconsistent application of legal frameworks, such as the "mature minor" rule and emancipation doctrines, which fail to protect teens' autonomy. The article advocates for recognizing minors as constitutional persons with medical self-consent rights to counter these restrictions.

Rural-Urban Disparities In Video Telehealth Use During Rapid Mental Health Care Virtualization Among American Indian/Alaska Native Veterans, Isabelle S Kusters, Amber B Amspoker, Kristen Frosio, Stephanie C Day, Giselle Day, Anthony Ecker, Julianna Hogan, Jan A Lindsay, Jay Shore

Center for Medical Ethics and Health Policy Staff Publications

Importance: American Indian/Alaska Native veterans experience a high risk for health inequities, including mental health (MH) care access. Rapid virtualization of MH care in response to the COVID-19 pandemic facilitated care continuity across the Veterans Health Administration (VHA), but the association between virtualization of care and health inequities among American Indian/Alaska Native veterans is unknown.

Objective: To examine differences in video telehealth (VTH) use for MH care between American Indian/Alaska Native and non-American Indian/Alaska Native veterans by rurality and urbanicity.

Design, setting, and participants: In this cohort study, VHA administrative data on VTH use among a veteran cohort that received …

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Clinician Perspectives On Levels Of Evidence And Oversight For Deep Brain Stimulation For Treatment-Resistant Childhood Ocd, Michelle T Pham, Tiffany A Campbell, Natalie Dorfman, Laura Torgerson, Kristin Kostick-Quenet, Jennifer Blumenthal-Barby, Eric A Storch, Gabriel Lázaro-Muñoz

Center for Medical Ethics and Health Policy Staff Publications

Approximately 10-20% of children with obsessive-compulsive disorder (OCD) have treatment-resistant presentations, and there is likely interest in developing interventions for this patient group, which may include deep brain stimulation (DBS). The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful randomized controlled trials should be available before DBS treatment for a psychiatric disorder is considered "established." The FDA approved DBS for adults with treatment-resistant OCD under a humanitarian device exemption (HDE) in 2009, which requires that a device be used to manage or treat a condition impacting 8,000 or fewer patients annually in the United …

Ethics Education For Healthcare Professionals In The Era Of Chatgpt And Other Large Language Models: Do We Still Need It?, Vasiliki Rahimzadeh, Kristin Kostick-Quenet, Jennifer Blumenthal Barby, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

In this paper, we contend with whether we still need traditional ethics education as part of healthcare professional training given the abilities of chatGPT (generative pre-trained transformer) and other large language models (LLM). We reflect on common programmatic goals to assess the current strengths and limitations of LLMs in helping to build ethics competencies among future clinicians. Through an actual case analysis, we highlight areas in which chatGPT and other LLMs are conducive to common bioethics education goals. We also comment on where such technologies remain an imperfect substitute for human-led ethics teaching and learning. Finally, we conclude that the …

Professional Virtue Of Civility And The Responsibilities Of Medical Educators And Academic Leaders, Laurence B Mccullough, John Coverdale, Frank A Chervenak

Center for Medical Ethics and Health Policy Staff Publications

Incivility among physicians, between physicians and learners, and between physicians and nurses or other healthcare professionals has become commonplace. If allowed to continue unchecked by academic leaders and medical educators, incivility can cause personal psychological injury and seriously damage organisational culture. As such, incivility is a potent threat to professionalism. This paper uniquely draws on the history of professional ethics in medicine to provide a historically based, philosophical account of the professional virtue of civility. We use a two-step method of ethical reasoning, namely ethical analysis informed by pertinent prior work, followed by identifying the implications of clearly articulated ethical …

Spanish-Language Communication Of Covid-19 Information Across Us Local Health Department Websites, Isabelle S Kusters, Amanda M Gutierrez, Julianna M Dean, Mark Sommer, Anna Klyueva

Center for Medical Ethics and Health Policy Staff Publications

The COVID-19 pandemic has brought new urgency to a longstanding problem: the US health system is not well-equipped to accommodate the country's large limited English proficient (LEP) population in times of national emergency. We examined the landscape of Spanish-language COVID-19 website information compared to information in English provided by health departments of the top 10 cities by population in the USA. For each city, coders evaluated three score measures (amount of information, presentation quality, and ease of navigation) for six content types (general information, symptoms, testing, prevention, vaccines, and live statistics) across six delivery modes (print resources, website text, videos, …

Factors Associated With Internalizing And Externalizing Symptoms In A Clinical Sample Of Youth With Misophonia, Gabrielle M Armstrong, Rebecca L Greenberg, Orri Smárason, Renee M Frederick, Andrew G Guzick, Sophie C Schneider, Samuel D Spencer, Matti Cervin, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia …

Hope And Optimism In Pediatric Deep Brain Stimulation: Key Stakeholder Perspectives, Natalie Dorfman, Lilly Snellman, Ynez Kerley, Kristin Kostick-Quenet, Gabriel Lazaro-Munoz, Eric A Storch, Jennifer Blumenthal-Barby

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Deep brain stimulation (DBS) is utilized to treat pediatric refractory dystonia and its use in pediatric patients is expected to grow. One important question concerns the impact of hope and unrealistic optimism on decision-making, especially in "last resort" intervention scenarios such as DBS for refractory conditions.

Objective: This study examined stakeholder experiences and perspectives on hope and unrealistic optimism in the context of decision-making about DBS for childhood dystonia and provides insights for clinicians seeking to implement effective communication strategies.

Materials and methods: Semi-structured interviews with clinicians (n = 29) and caregivers (n = 44) were conducted, …

Patient Safety Workshop: A Graduate Medical Education Interprofessional Simulation Half-Day, Ans Albustamy, Roque Mifuji, Michelle Lopez, Teresa Villagomez, Chelsea Chang

Research Symposium

Introduction: As per the National Academy of Medicine, patient safety is considered indistinguishable from the delivery of quality health care, and is referred to as the foundation upon which all other aspects of quality care are built. Throughout the years, graduate medical education (GME) across the world has evolved to ensure the training of future medical professionals includes exposure to many of the elements that compose patient safety, such as implementing root cause analysis, systems thinking, and disclosing adverse events. University of Texas Rio Grande Valley (UTRGV) is the sponsoring institution for 19 GME programs across different specialties. As part …

Efficacy Of An Enterotoxigenic Escherichia Coli (Etec) Vaccine On The Incidence And Severity Of Traveler's Diarrhea (Td): Evaluation Of Alternative Endpoints And A Td Severity Score, Nicole Maier, Shannon L Grahek, Jane Halpern, Suzanne Restrepo, Felipe Troncoso, Janet Shimko, Olga Torres, Jaime Belkind-Gerson, David A Sack, Ann-Mari Svennerholm, Björn Gustafsson, Björn Sjöstrand, Nils Carlin, A Louis Bourgeois, Chad K Porter

Faculty and Staff Publications

The efficacy of an Oral Whole Cell ETEC Vaccine (OEV) against Travelers' Diarrhea (TD) was reexamined using novel outcome and immunologic measures. More specifically, a recently developed disease severity score and alternative clinical endpoints were evaluated as part of an initial validation effort to access the efficacy of a vaccine intervention for the first time in travelers to an ETEC endemic area. A randomized, double-blind, placebo-controlled trial followed travelers to Guatemala or Mexico up to 28 days after arrival in the country following vaccination (two doses two weeks apart) with an ETEC vaccine. Fecal samples were collected upon arrival, departure, …

Researching The Future: Scenarios To Explore The Future Of Human Genome Editing, Cynthia Selin, Lauren Lambert, Stephanie Morain, John P Nelson, Dorit Barlevy, Mahmud Farooque, Haley Manley, Christopher T Scott

Center for Medical Ethics and Health Policy Staff Publications

Background: Forward-looking, democratically oriented governance is needed to ensure that human genome editing serves rather than undercuts public values. Scientific, policy, and ethics communities have recognized this necessity but have demonstrated limited understanding of how to fulfill it. The field of bioethics has long attempted to grapple with the unintended consequences of emerging technologies, but too often such foresight has lacked adequate scientific grounding, overemphasized regulation to the exclusion of examining underlying values, and failed to adequately engage the public.

Methods: This research investigates the application of scenario planning, a tool developed in the high-stakes, uncertainty-ridden world of corporate strategy, …

A Pre-Medical Student’S Reconciliation Of Feminist Narratives Regarding Women’S Health: A Consideration Of Perspectives On Childbirth In The U.S., Laura Clayton

sprinkle: an undergraduate journal of feminist and queer studies

Many feminists argue that one major negative aspect of reproductive healthcare in the U.S. is the common over-medicalization of women during childbirth, including potentially unnecessary procedures such as cesarean-section and episiotomy. As a solution, they advocate for increased involvement of midwives in childbirth practices, as midwives allow women to give birth at home with minimal medical intervention. This paper analyzes the benefits of midwifery as well as the current increased risk associated with homebirth in the U.S. Additionally, it questions the damaging stigma associated with assumptions of cesarean-section as a suboptimal outcome. A false dichotomy has developed in our culture …