Bioethics and Medical Ethics Commons^™

Delivery Of The Immune System: Understanding The Development Of The Human Immune System Based On Birth Mode, Sara Abbas

Faculty Curated Undergraduate Works

The creation of the immune system starts from the womb. The expecting mother plays an immense role outside of the genetic influence in developing a neonate’s immune system. The mode of birth has a substantial impact, as the neonate’s initial moments can have lasting impacts on the making of a proper immune system. A mother should have the choice in choosing between a vaginal birth or a cesarean section and this paper looks to provide aid in the decision process by contrasting the two modes in terms of immunological impact, especially as the rate of c-sections climb (1,2). The approach …

Personal Autonomy And Self-Determination Are Crucial For Professionalism In Healthcare, Jason M. Organ, Heather F. Smith, Paul A. Trainor, Kari Allen, Joy Y. Balta, Amy C. Beresheim, Danielle Brewer-Deluce, Kirsten M. Brown, Anne M. Burrows, Kelsey T. Byers, Jessica N. Byram, Andrew S. Cale, Melissa A. Carroll, Thomas Champney, Jon Cornwall, Manisha R. Dayal, Valerie B. Deleon, Martine Dunnwald, Christopher Ferrigno, Gabrielle M. Finn, Glenn M. Fox, Pamela L. Geller, Geoffrey D. Guttmann, Noah Harper, Kelly M. Harrell, Adam Hartstone-Rose, Sabine Hildebrandt

School of Medicine Faculty Publications

No abstract provided.

Public Opinion And Support On Physician Assisted Suicide, Emma Gottschalk

Political Science Theses and Capstones

I investigate the connection between public opinion and physician assisted suicide, using data in the SPSS data set from 2021. The strength of support a person feels towards PAS and what influenced that view is studied, religious affiliation, age, sex, education level, income, race, and region are considered in the study. The data set was collected through surveys that willing persons over the age of 18 completed. I analyze who is more willing to support PAS and why. I find that religion has a huge impact on public support for PAS, while other factors like education, sex, age and race …

Where Do We Draw The Line? The Ethical Dilemma Involved In Genetic Engineering And Gene Therapy, Amber Schrag

Senior Honors Theses

Genetic engineering and gene therapy are greatly disputed in our time. With the advancement of technology, one has the power to manipulate genes in the body, which raises the questions: What is our role in this? Is there a limit to this power, or should there be? This paper reviews the uses of this technology and evaluates the ethics from a scientific and Biblical point of view. It is concluded that using gene therapy to help cure diseases is very beneficial in both the scientific and Biblical realm as it is restoring individuals back to health and wholeness.

Things That Make You Go Hmm: Myths And Misconceptions Within Cognitive-Behavioral Treatment Of Obsessive-Compulsive Disorder, Samuel D Spencer, Jordan T Stiede, Andrew D Wiese, Andrew G Guzick, Matti Cervin, Dean Mckay, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

The past four decades have yielded a robust body of evidence supporting the efficacy and effectiveness of cognitive-behavioral therapy (CBT) as a gold-standard treatment for obsessive-compulsive disorder (OCD) across the lifespan. Exposure and response prevention (E/RP) has been identified as a key component of this approach. Despite robust research support for CBT with E/RP, several myths and misconceptions continue to proliferate in both research and practice settings. Such myths and misconceptions are concerning, as they lack empirical basis, may hinder widespread dissemination and implementation of CBT for OCD, and run contrary to the practice of evidence-based psychological medicine. Focusing on …

Jurisgenerative Tissues: Sociotechnical Imaginaries And The Legal Secretions Of 3d Bioprinting, Roxanne Mykitiuk, Joshua Shaw

Articles & Book Chapters

Three-dimensional ‘bioprinting’ is under development, which may produce living human organs and tissues to be surgically implanted in patients. Like tissue engineering and regenerative medicine generally, the process of bioprinting potentially disrupts experience of the human body by redefining understandings of, and becoming actualised in new practices and regimes in relation to, the body. The authors consider how these novel sociotechnical imaginaries may emerge, having regard to law’s contribution to, as well as its possible transformation by, the process of 3D bioprinting. The authors draw on Gilbert Simondon and corporeal, material feminists to account for these disruptions as ‘ontogenetic,’ in …

The Revolutionary Genome Editor: Crispr-Cas9 Systems, Grace Spade

Senior Honors Theses

Genetic engineering is the modification of an organism's genetic material to alter its traits through adding, deleting, or changing specific genes. CRISPR-Cas9 systems are groundbreaking tools for genetic engineering, in short utilizing a molecule called RNA to guide a protein called Cas9 to a specific location in DNA to add, delete, or replace genes. The history of how the CRISPR-Cas9 systems came into existence, how it was adapted from a natural defense system in bacteria, and its mechanism of action in both are explained. Its applications, both present and future, competing genetic modifiers, advantages and disadvantages, and the ethical dilemmas …

In Vitro Gametogenesis: A Research Timeline And Implications For The Future Of Assisted Reproductive Technology, Nicole Buckley

Senior Honors Theses

The novel reproductive technology, In Vitro Gametogenesis (IVG), includes the process of obtaining mature viable germ cells from pluripotent stem cells. To do so, embryonic stem cells and induced pluripotent stem cells are specified to primordial germ cells and differentiated to form gametes that undergo further maturation, which subsequently may undergo in vitro fertilization to form an embryo. With this capability, IVG holds the power to provide a novel treatment option for human infertility. As of now, research has been conducted on mice successfully, and with limited success in humans. Future research will likely focus on discovering the species-specific differences …

The Ethical Challenges Of Newborn Screening Programs In The United States, Devin Donovan

Senior Theses

Newborn screening programs have been mandated throughout the United States since the 1960s, and technological advancements have allowed for their evolution into the essential public health entities they are today (Arnold 558). These programs screen newborns for a variety of congenital and genetic conditions in all states, but each state varies in conditions screened and policies for collecting and using samples. Residual blood spots are a key component of these programs because they are often used for secondary purposes, such as for quality assurance and public health or biomedical research (Botkin et al. 121). Ethical challenges have arisen related to …

"Life Unworthy Of Life" Aktion T4: The First Nazi Genocide, Alexander M. Remington

Student Publications

Though usually viewed as a prelude to the Holocaust, the T4 euthanasia program was a distinct genocide carried out by the Third Reich’s doctors. Allowing themselves to be corrupted by eugenics and Nazi policy, the perpetrators of the Nazi euthanasia killings transformed themselves from healers to murderers. Despite public resistance led by Bishop Clemens von Galen which resulted in the cancellation of the T4 program, Nazi doctors took it upon themselves to continue euthanizing patients until the end of the war, emphasizing the legitimacy that euthanasia had acquired. The history of the T4 program, its perpetrators, and resisters is critical …

Moral Injury To Inform Analysis Of Post-Traumatic Stress Disorder, Amanda Julia Manea

Senior Theses

Post-traumatic stress disorder (PTSD) is a mental health condition that almost one out of ten veterans struggle with. Although the National Center for PTSD has made extensive progress in characterizing and developing new treatments for PTSD, most veterans still experience symptoms of PTSD following treatment. Novel avenues of investigation, such as developing algorithms to review electronic health record (EHR) data and better understanding moral injury, are being pursued to address the gap that still exists when it comes to treating veterans. Moral injury is the individual evaluation of exposure to a potentially morally injurious event (PMIE) and can lead to …

Key Drivers Of Family-Level Utility Of Pediatric Genomic Sequencing: A Qualitative Analysis To Support Preference Research, Hadley Stevens Smith, Emily S Bonkowski, Raymond Belanger Deloge, Amanda M Gutierrez, Alva M Recinos, Tara A Lavelle, David L Veenstra, Amy L Mcguire, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Given that pediatric genomic sequencing (GS) may have implications for the health and well-being of both the child and family, a clearer understanding of the key drivers of the utility of GS from the family perspective is needed. The purpose of this study is to explore what is important to caregivers of pediatric patients regarding clinical GS, with a focus on family-level considerations. We conducted semi-structured interviews with caregivers (n = 41) of pediatric patients who had been recommended for or completed GS that explored the scope of factors caregivers considered when deciding whether to pursue GS for their child. …

Are Human Papillomavirus Knowledge And Vaccine Uptake Associated With Hiv Status And Social Determinants Of Health In Young Sexual Minority Men?, Trisha L Amboree, Alan G Nyitray, John Schneider, Nick Gargurevich, Jacky Kuo, Elizabeth Y Chiao, Lu-Yu Hwang, Kayo Fujimoto

Center for Medical Ethics and Health Policy Staff Publications

This brief report examines the relationship, if any, between human immunodeficiency virus (HIV) status, and individual-level and socio-sexual partner-level factors of social determinants of health (SDOH) that are associated with human papillomavirus (HPV) knowledge and vaccine uptake in young sexual minority men (YSMM). We used data from 126 YSMM recruited by network-based sampling during 2015-2016 in Houston, Texas. Descriptive statistics and regression analyses were conducted to test the association between HIV status, SDOH, and HPV knowledge and vaccine uptake. Those living with HIV had lower odds of knowledge of HPV-associated anal cancer (OR: 0.43, 95% CI: 0.18-0.97) and knowledge of …

International Society For Prenatal Diagnosis 2022 Debate 3-Fetal Genome Sequencing Should Be Offered To All Pregnant Patients, Ignatia B Van Den Veyver, Yuval Yaron, Zandra C Deans

Center for Medical Ethics and Health Policy Staff Publications

Prenatal trio exome sequencing (ES) has become integrated into the care for pregnant women when the fetus has structural anomalies. Details regarding optimizing indications for prenatal exome sequencing, its detection rates with different categories of fetal anomalies, and principles of interpretation of pathogenicity of sequence variants are still under investigation. However, there is now growing consensus about its benefits for finding the cause of fetal structural anomalies. What is not established, is whether exome or genome sequencing (GS) has a place in the care of all pregnant women. This report is a summary of the debate on this topic at …

Development And Pilot Testing Of Internet-Delivered, Family-Based Cognitive Behavioral Therapy For Anxiety And Obsessive-Compulsive Disorders In Autistic Youth, Andrew G Guzick, Sophie C Schneider, Amanda B Perozo Garcia, Minjee Kook, Rebecca L Greenberg, David Riddle, Morgan Mcneel, Servando Rodriguez-Barajas, Michelle Yang, Blake Upshaw, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Cognitive behavioral therapy adapted for autistic youth with anxiety and/or OCD has a strong evidence base, but few have access. A 12-week family-based, Internet-delivered cognitive behavioral therapy (iCBT) program for 7-15 year-old autistic youth with anxiety and/or OCD was developed as a potential method to address this problem. Quantitative and qualitative feedback from stakeholders (parents, youth, clinicians) was gathered on an initial draft of content before conducting a pilot trial. This feedback suggested high quality, engagement, usability, and informativeness of the material. Suggestions were incorporated into the treatment program that was tested in a pilot trial. Eight families were randomized …

An Induced Annual Modulation Signature In Cosine-100 Data By Dama/Libra’S Analysis Method, Govinda Adhikari, Nelson Carlin, Jaejin Choi, Seonho Choi, Anthony Ezeribe, Luis Eduardo França, Chang Hyon Ha, In Sik Hahn, Sophia J Hollick, Eunju Jeon, Jay Hyun Jo, Han Wool Joo, Woon Gu Kang, Matthew Kauer, Bongho Kim, Hongjoo Kim, Jinyoung Kim, Kyungwon Kim, Sunghyun Kim, Sun Kee Kim, Won Kyung Kim, Yeongduk Kim, Yong-Hamb Kim, Young Ju Ko, Doo Hyok Lee, Eun Kyung Lee, Hyunseok Lee, Hyun Su Lee, Hye Young Lee, In Soo Lee, Jaison Lee, Jooyoung Lee, Moo Hyun Lee, Seo Hyun Lee, Seung Mok Lee, Yu Jin Lee, Douglas Leonard, Bruno B Manzato, Reina H Maruyama, Robert J Neal, James A Nikkel, Stephen L Olsen, Byung Ju Park, Hyang Kyu Park, Hyeonseo Park, Kangsoon Park, Se Dong Park, Ricardo L C Pitta, Hafizh Prihtiadi, Sejin Ra, Carsten Rott, Keon Ah Shin, Andrew Scarff, Neil J C Spooner, William G Thompson, Liang Yang, Gyun Ho Yu

Faculty and Staff Publications

The DAMA/LIBRA collaboration has reported the observation of an annual modulation in the event rate that has been attributed to dark matter interactions over the last two decades. However, even though tremendous efforts to detect similar dark matter interactions were pursued, no definitive evidence has been observed to corroborate the DAMA/LIBRA signal. Many studies assuming various dark matter models have attempted to reconcile DAMA/LIBRA's modulation signals and null results from other experiments, however no clear conclusion can be drawn. Apart from the dark matter hypothesis, several studies have examined the possibility that the modulation is induced by variations in detector's …

Do Adolescent Patients Have A Right To Be Informed About Fertility Preservation Options By Virtue Of The Conventions On The Rights Of The Child?, Giulia Adele Dinicola

Graduate Student Research Symposium

The 1989 United Nations Convention on the Rights of the Child not only states that children should be heard in matters of their concern according to their age and maturity, but also that children should have a right to have access to information. However, when it comes to medical indications, a consensus has not been reached on whether parents should disclose healthcare complications to their adolescent child. Adolescent disclosure becomes even more controversial when related to non-lifesaving procedures. In the United States, one child in 285 children is diagnosed with cancer every year, but thanks to improvements in medicine, the …

The Hermeneutics Of Nudging: The Reciprocity Between Transhumanism And Nudging, Ian Doherty

Graduate Student Research Symposium

This paper investigates and evaluates the implications of nudging someone toward transhumanism. Transhumanism offers a path to alleviate suffering and transcend our physical and mental limitations. Transhumanist technologies consist of alterations like genetic modification, neural implants, and molecular nanotechnology. These technologies are meant to give people full morphological freedom over their bodies. Although transhumanism remains a largely unknown movement, this is where nudge theory can help raise its prominence. Nudge theory aims to help people make better choices, and aid them in making better decisions related to their health and lifestyle. If paired correctly, transhumanism seems to be a perfect …

Hervs And Cancer-A Comprehensive Review Of The Relationship Of Human Endogenous Retroviruses And Human Cancers, Erik Stricker, Erin C Peckham-Gregory, Michael E Scheurer

Center for Medical Ethics and Health Policy Staff Publications

Genomic instability and genetic mutations can lead to exhibition of several cancer hallmarks in affected cells such as sustained proliferative signaling, evasion of growth suppression, activated invasion, deregulation of cellular energetics, and avoidance of immune destruction. Similar biological changes have been observed to be a result of pathogenic viruses and, in some cases, have been linked to virus-induced cancers. Human endogenous retroviruses (HERVs), once external pathogens, now occupy more than 8% of the human genome, representing the merge of genomic and external factors. In this review, we outline all reported effects of HERVs on cancer development and discuss the HERV …

Pressure, Motion, And Conformational Entropy In Molecular Recognition By Proteins, José A Caro, Kathleen G Valentine, Taylor R Cole, A Joshua Wand

Faculty and Staff Publications

The thermodynamics of molecular recognition by proteins is a central determinant of complex biochemistry. For over a half-century, detailed cryogenic structures have provided deep insight into the energetic contributions to ligand binding by proteins. More recently, a dynamical proxy based on NMR-relaxation methods has revealed an unexpected richness in the contributions of conformational entropy to the thermodynamics of ligand binding. Here, we report the pressure dependence of fast internal motion within the ribonuclease barnase and its complex with the protein barstar. In what we believe is a first example, we find that protein dynamics are conserved along the pressure-binding thermodynamic …