Bioethics and Medical Ethics Commons^™

Compassion Fatigue Seen In Ems Workers Treating Chronic Opioid Users, Amelia Kruse, Jason Wasserman

Posters

Opioid use and misuse has been rising nationwide since 1999, as have the number of opioid-related deaths. This has not been limited to illicit drug use, but accelerated by prescribing practices that have ignored concerns about addiction. Emergency services have seen an increasingly high volume of opioid overdose and injury patients, but little additional support to respond to this crisis. This study seeks to investigate EMS workers perceptions of the opioid crisis and the barriers they face to providing adequate response.

What Exactly Is A Patient's Best Interest, Saketh Akula, Joshua Jones, Jason Wasserman, Mark C. Navin, Abram Brummett

Posters

In any clinical setting, the patient’s preferences are respected and valued by the medical team. As clear as that may seem, that can be tough when considering all the perspectives of what makes up a patient’s best interest (BI), especially for a minor. In the literature, there is wide disagreement about the interpretation of BI. The primary goal of this project is to unearth the perspectives that play into a pediatric patient’s best interest and delineate how and whether family interests should be considered.

Differences In Rational And Relational Autonomy During End-Of-Life Care, Michael Balce, Mark C. Navin, Abram Brummett, Jason Wasserman

Posters

Within biomedical ethics, the principle of autonomy focuses on a patient’s right to make choices about his or her medical decisions and care. Along these lines, patients can then make decisions based on their own beliefs, attitudes, and customs, which is referred to as rational autonomy. However, shared-decision making is often more complicated than this, and patients often desire input from their spouse, family, and other trusted individuals, which is termed relational autonomy. These two concepts of autonomy drive different approaches to an individual’s perceptions and choices regarding medical-decision making during the end of one’s life.

The Ethics Of Medical Interventions Against Parental Consent, Corey Carney, Mark C. Navin, Jason Wasserman, Abram Brummett, Kaitlyn Hanson

Posters

Between an adult patient and physician they are the only two people that have a say in the patient’s medical treatment with the patient having the final say. In pediatrics, there is a patient, parent, and physician which adds a third party that is a proxy decision maker for the child but lacks absolute authority over the child’s treatment. The goal of this study is to give a sense of the diversity of the pediatric ethics literature regarding parent/physician disagreements and to address ambiguities about pediatric interventions.

Conceptualization Of Intervention In Pediatrics Systematic Review, Kaitlyn Hansen, Mark C. Navin, Jason Wasserman, Stephanie Swanberg

Posters

Navigating when to intervene against parents’ wishes is a difficult task in pediatrics. Different frameworks have been proposed, but disagreements remain. One problem debated about in pediatric intervention principles often refer to different kinds of interventions (e.g. calling Child Protective Services, consulting the Ethics Committee). This project reports results of a critical scoping review of recent bioethics literature about the concept of pediatric intervention principles.

Analyzing Medical Student Call To Action Letters Following 2020 Black Lives Matter Protests, Nick Mcmillen, Jason A. Wasserman

Posters

The Flexner Report, written in 1910, may have revolutionized medical education, but it also recommended and led to the closure of all but two Black medical schools. While recent decades have lead to increased attention to diversity and inclusion, representation of historically marginalized groups among students and faculty has been slow to materialize.

Black Lives Matter protests encouraged a national dialogue over the need for more effective DEI initiatives and increased antiracist material in medical school curricula. Organizations such as White Coats 4 Black Lives developed “Call to Action” letters to medical school administrations across the country.

'Best Interest' In Clinical Medicine: A Critical Scoping Review, Joshua R. Jones, Saketh Akula, Jason Wasserman, Mark Navin

Posters

The Best Interest Standard (BIS) has been a much-debated guidance principle in clinical ethics with ambiguous definition and application. In this study we focus on the conceptions of best interests that differ according to which kinds of interests are included. While there is wide agreement that ‘best interests’ include the physiological welfare of a patient, there is still substantial disagreement about which other interests are included in wider accounts of welfare, the balancing of those other interests, and whether interests are objective or subjective.

Conceptualization Of Effective Surrogate Decision Making, Zachary Armstrong, Michael Bourgoin, Abram Brummett, Jason Wasserman, Mark C. Navin, Stephanie Swanberg

Posters

Surrogate decision making is a key component in the hierarchy of medical decisions, whereby an assigned individual makes choices on behalf of a patient incapable of making the decision themselves. Although this is common in healthcare, there are still many questions about best surrogate practices and ethical credibility. This capstone project aspires to map these concepts and discuss issues related to the current landscape of surrogate decision making with regards to medical ethics through the use of a systematic literature review.

Medical Student Knowledge Of Physician Involvement In The Holocaust And The Importance Of Incorporating Holocaust Studies And Ethics Into Medical School Curricula, Megan Bricely, Jason Wasserman

Posters

A 2019 Claims Conference study demonstrated an alarming lack of knowledge about the Holocaust in the United States general population. There is currently no specific data on medical student knowledge of the Holocaust and the role that the medical community played. The goal of this study was to gather baseline data on medical student knowledge of the Holocaust and medicine’s involvement to demonstrate the need for Holocaust teaching in medical school.

Self-Triage Among Patients Who Are Homeless, Jimmy Clemmens, Jason Wasserman

Posters

People who are homeless present to urban emergency departments at a higher rate per 1000 people than those who are housed.1 With those added difficulties, people who are homeless frequently turn to Emergency Departments for primary, rather than only emergency, health care treatment.2,3 There is great need for investigation into the thought process for the self-triage of the patient who is homeless. This study was undertaken to survey adults at HOPE adult shelter about their ability to determine the most appropriate place to seek treatment for different common conditions of varying acuity, as well as to evaluate the efficacy of …

Outbreak Risks At Religious Schools: Prevalence Of Nonmedical Vaccination Exemptions Among Michigan Kindergartens, Flora Martz, Patrick Karabon, Mark C. Navin

Posters

Religious community membership is relevant to immunization policy, as in the case of 2019 US measles outbreaks clustered in Orthodox Jewish communities. US immunization policy focuses on school enrollment requirements, which apply both to public and private (usually religiously-affiliated) schools. Most US states exempt students from these requirements for nonmedical reasons, including religious reasons, though some states, including New York, California, and Maine, have recently eliminated nonmedical exemptions. This study uses 2017-18 data from the state of Michigan to illuminate relationships between nonmedical exemption (NME) rates and attendance at religious schools with the aim of providing information about high-value targets …

Conceptualization Of Evidence Used By Surrogate Decision-Makers To Determine A Patient’S Wishes, Michael Bourgoin, Zach Armstrong, Abram Brummett, Mark C. Navin, Jason Wasserman, Stephanie Swanberg

Posters

Many modern concepts within clinical bioethics can be conceptualized in various ways. This subjectivity is demonstrated when analyzing ideas in the literature about the types of evidence that can or should be used by surrogate decision-makers to determine a patient’s wishes. This project aims to explore normative claims on this topic in order to map out the current landscape of the various understandings of this concept.

Concern For Authenticity In Rational And Relational Autonomy, Joshua J. Daniel, Abram Brummett, Mark C. Navin, Jason A. Wasserman

Posters

The four principles of bioethics described by Beauchamp and Childress are beneficence, nonmaleficence, justice, and autonomy. Two definitions of autonomy are very commonly used: rational autonomy, which refers to a patient making decisions based on their own beliefs and customs, and relational autonomy, which refers to shared decision making with the input of a patient’s close trusted individuals. Beauchamp and Childress described autonomous actions as those with intention, understanding, and lack of controlling factors. A fourth component that is sometimes included is authenticity, or making decisions true to one’s self. The primary goal of this study is to determine whether …

The Meaning Of Pediatric Assent: A Critical Scoping Review, Natalie Liogas, Amelia Najor, Jason Wasserman, Stephanie Swanberg, Abram Brummett, Naomi Levanthal

Posters

The moral obligation to include children and adolescents in medical decisions has been long recognized. Soliciting pediatric assent is a component essential to this effort. Despite the AAP characterization of assent (AAP 1995; AAP 2016), there appears to be a lack of consensus regarding the operational and conceptual meanings of pediatric assent. This this critical scoping review provides an analysis of the varied meanings of pediatric assent in the clinical context.

Pediatric Assent In Clinical Practice: A Critical Scoping Review On The Ethical Justifications For Assent, Amelia Najor, Natalie Liogas, Jason Wasserman, Stephanie Swanberg, Abram Brummett, Naomi Laventhal, Mark C. Navin

Posters

Pediatric assent is an important ethical construct, yet there is little agreement on what precisely it means, including the ethical justifications for assent. The term is used to indicate everything from acquiescence to an analogue of informed consent itself. The primary goal of this study is to assess the range of ways that pediatric assent is specified in the clinical ethics literature, as well as what different conceptions intimate about its moral value. This systematic review will summarize the normative claims about pediatric assent in recent literature. Analysis will map divergent constructs and various moral and ethical justifications for pediatric …

Infertility: An Evaluation Of Treatment Modalities And Ethical Considerations, Elise Ferenczy

Senior Honors Theses

This thesis reviews a variety of options for treatment of infertility, along with ethical considerations for each. The basis for ethical concerns will be primarily a biblical worldview, as the goal is to support Christian couples in decisions regarding infertility treatment. The biblical worldview is outlined to provide readers with an understanding of its core principles, and the Bible is used as the primary source for ethical discussion. The most common etiologies of infertility are outlined, followed by treatment modalities grouped by category. While some modalities present very few ethical concerns, others require careful consideration in many regards. Many of …

The Human Role In Artificial Intelligence, Christopher J. Smiley Dds

The Journal of the Michigan Dental Association

The success of AI requires human involvement to ensure that it is used safely and effectively. Transparency, collaboration, and standardization are necessary.

The Ethical Dilemmas Epigenetic Editing In Utero Presents To Christians, Victoria Hendrix

Senior Honors Theses

The development of CRISPR epigenetic editing technology was initially impactful due to its potential for disease treatment. However, despite the potential benefits of epigenetic technology, there exist ethical dilemmas surrounding its use in utero. The review of the ethical dilemmas of epigenetic editing in utero from a Christian perspective showed that research in epigenetic editing is promising, yet fraught with peril. The basic ethical issues of epigenetic editing in utero stem from its inaccuracy, lack of research concerning its effects on offspring, an incomplete understanding of gene interactions, and its connection to eugenics. The ethical concerns particularly relevant to Christians …

Ethical Hazards Of Health Data Governance In The Metaverse, Kristin Kostick-Quenet, Vasiliki Rahimzadeh

Center for Medical Ethics and Health Policy Staff Publications

Metaverse-enabled healthcare is no longer hypothetical. Developers must now contend with ethical, legal and social hazards if they are to overcome the systematic inefficiencies and inequities that exist for patients who seek care in the real world.

Reflections On The Use Of Patient Records: Privacy, Ethics, And Reparations In The History Of Psychiatry, Jonathan Sadowsky

Faculty Scholarship

One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in …