Bioethics and Medical Ethics Commons^™

The 10-Year Functional Outcome Of Ponseti Treatment Of Idiopathic And Arthrogrypotic Clubfeet With An Age-Matched Control, Chris Church, Nicole Wang, Stephanie Butler, Jose J Salazar-Torres, John Henley, Freeman Miller, Nancy Carlin, Maureen Donohoe, L Reid Nichols

Faculty and Staff Publications

Background: The Ponseti method is accepted as an effective primary conservative treatment for idiopathic clubfoot (IC) using serial casting, percutaneous Achilles tenotomy, and prolonged bracing. The outcomes of its use in treating rigid clubfoot in arthrogryposis are unclear. This study assesses the outcomes of the Ponseti method in children with IC and arthrogrypotic clubfoot at an average age of 10 years.

Methods: Outcomes of the Ponseti method were retrospectively studied in ambulatory children ages 8.0 to 12.9 years in the gait lab between 2004 and 2024. Children were excluded due to the presence of nonidiopathic or nonarthrogryposis-related clubfoot and history …

Accreditation Standards Must Protect Trainees: Creating Ethical Fellowship Programs, Anna D Goff, Ryan J Dougherty, Joelle Robertson-Preidler

Faculty and Staff Publications

No abstract provided.

Real-World Use Of Classic And Non-Classic Psychedelics In Hispanic/Latino Adults With Obsessive-Compulsive Disorder: International Findings From The Latino Study, David S Mathai, Jill O Robinson, Kevin Wagner, Logan Neitzke-Spruill, Dayan Berrones, Jacey L Anderberg, Renee M Frederick, Vanessa Zavala Cruz, Josselyn S Muñoz, Latin American Trans-Ancestry Initiative For Ocd Genomics, Brazilian Obsessive-Compulsive Spectrum Disorder Working Group;, Carolyn I Rodriguez, Lynnette A Averill, James J Crowley, Eric A Storch, Amy L Mcguire

Center for Medical Ethics and Health Policy Staff Publications

Objective: Despite growing research on the potential mental health benefits of psychedelics, there has been limited study of these drugs in populations with obsessive-compulsive disorder (OCD) and with Hispanic and Latin American (H/L) ancestry.

Methods: Demographic and clinical assessments were conducted as part of the Latin American Trans-ancestry Initiative for OCD genomics (LATINO) Study in H/L participants with OCD living throughout the Americas. Self-reported data on the prevalence of naturalistic psychedelic use and associated outcomes on OCD symptoms were collected in a subsample of 2,639 adults. Descriptive statistics and regression analyses were used to assess psychedelic use, predictors of use, …

Parental Expectations Of Pediatric Care For Children, Brenan T. Cash, Jacquelyn D. Wiersma-Mosley, Donia Timby, Laura Herold

Discovery, The Student Journal of Dale Bumpers College of Agricultural, Food and Life Sciences

Access to childhood pediatrics is a major factor for a full and healthy childhood for all children from adolescence to adulthood. However, the physical health aspect has been the main focus of most primary care clinics, and there is little focus on mental health. Mental health issues, which involve anxiety, depression, and post-traumatic stress, are more prominent than they have ever been, as up to 30% of children have experienced mental health issues that involve post-traumatic stress disorder, especially during the pandemic years. This study employed a non-experimental, quantitative analysis utilizing online closed-ended survey questions. Caretakers were offered an anonymous, …

Combined Annual Modulation Dark Matter Search With Cosine-100 And Anais-112, N Carlin, J Y Cho, J J Choi, S Choi, A C Ezeribe, L E França, C Ha, I S Hahn, S J Hollick, S B Hong, E J Jeon, H W Joo, W G Kang, M Kauer, B H Kim, H J Kim, J Kim, K W Kim, S H Kim, S K Kim, W K Kim, Y D Kim, Y H Kim, Y J Ko, D H Lee, E K Lee, H Lee, H S Lee, H Y Lee, I S Lee, J Lee, J Y Lee, M H Lee, S H Lee, S M Lee, Y J Lee, D S Leonard, N T Luan, V H A Machado, B B Manzato, R H Maruyama, R J Neal, S L Olsen, H K Park, H S Park, J C Park, J S Park, K S Park, K Park, S D Park, R L C Pitta, H Prihtiadi, S J Ra, C Rott, K A Shin, D F F S Cavalcante, M K Son, N J C Spooner, L T Truc, L Yang, G H Yu, J Amaré, J Apilluelo, S Cebrián, D Cintas, I Coarasa, E García, M Martínez, Y Ortigoza, A Ortiz De Solórzano, T Pardo, J Puimedón, M L Sarsa, C Seoane

Faculty and Staff Publications

The annual modulation signal, claimed to be consistent with dark matter as observed by DAMA/LIBRA in a sodium-iodide based detector, has persisted for over two decades. COSINE-100 and ANAIS-112 were designed to test the claim directly using the same target material. COSINE-100, located at Yangyang Underground Laboratory in South Korea, and ANAIS-112, located at Canfranc Underground Laboratory in Spain, have been taking data since 2016 and 2017, respectively. Each experiment published its respective results independently. In this Letter, we present the results of an annual modulation search as a test of the signal observed by DAMA/LIBRA with the first three …

Ethical Issues Involved In Solid Organ Xenotransplantation., Daniel J Hurst, Chris Bobier, Luz A Padilla

Rowan-Virtua School of Osteopathic Medicine Departmental Research

Xenotransplantation (specifically, genetically modified pig-to-human transplant of organs, tissues, or cells) clinical trials are set to begin in the United States after decades of pre-clinical studies and recent decedent and compassionate use investigations. This article provides a primer on the key ethical issues attendant with this emerging therapy. We explore four central areas of concern: (i) the use of animals to meet human transplant needs, as well as their welfare since they are housed in non-natural conditions, (ii) the risk of infectious disease transfer from the porcine graft to the human recipient, known as xenozoonosis, (iii) patient selection criteria for …

Dementia As A Critical Lens On The Role Of Narrative In Medical Training And Practice, Erin Gentry Lamb

Faculty Scholarship

Narrative holds an important place within medicine and medical education, but an uncritical use of narrative can have troubling consequences for the care of patients who have limited or no capacity for self-narration, such as those living with dementia. We argue that the guiding principles in the use of narrative within medicine and medical education must be inclusivity and opportunity. We illustrate how medical training can benefit from a more inclusive definition of narrative, and we present a selection of innovative approaches to narrative coming out of literary studies, narrative gerontology, and medical and health humanities that focus on metaphor, …

A Qualitative Exploration Of Child, Caregiver, And Clinician Perspectives On Mental Health In Children With Osteogenesis Imperfecta, Justin H Qian, Andrew D Wiese, Clarissa Gonzalez, Whitney S Shepherd, Hannah Cho, Gianna M Colombo, Julia M Morales, Selena Guo, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Kara Ayers, Members Of The Bbdc, Marie-Eve Robinson, Chaya N Murali, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Osteogenesis imperfecta (OI) is a heritable connective disorder with clinical manifestations including bone fragility and short stature. Previous research identified psychosocial themes related to mental health among children with OI and their caregivers, such as independence, social isolation, depression, and anxiety. Several studies have also examined clinicians of individuals with OI for their perspectives on mental health among their patients. However, no known studies have compared psychosocial themes among all three participant groups concurrently. This qualitative study examined mood and anxiety, along with risk and protective factors, from perspectives of youths, parents, and clinicians. Semi-structured interviews were conducted, which were …

Cosine-100 Full Dataset Challenges The Annual Modulation Signal Of Dama/Libra, Nelson Carlin, Jae Young Cho, Jae Jin Choi, Seonho Choi, Anthony C Ezeribe, Luis Eduardo França, Chang Hyon Ha, In Sik Hahn, Sophia J Hollick, Eunju Jeon, 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, Doohyeok 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, Yujin Lee, Douglas S Leonard, Nguyen Thanh Luan, Vitor Hugo De Almeida Machado, Bruno B Manzato, Reina H Maruyama, Robert J Neal, Stephen L Olsen, Byung Ju Park, Hyang Kyu Park, Hyeonseo Park, Jong-Chul Park, Kangsoon Park, Se Dong Park, Ricardo L C Pitta, Hafizh Prihtiadi, Sejin Ra, Carsten Rott, Keon Ah Shin, David F F S Cavalcante, Min Ki Son, Neil J C Spooner, Lam Tan Truc, Liang Yang, Gyun Ho Yu

Faculty and Staff Publications

For over 25 years, the DAMA/LIBRA collaboration has claimed to observe an annual modulation signal, suggesting the existence of dark matter interactions. However, no experiment using different target materials has observed a dark matter signal consistent with their result. To address this puzzle, the COSINE-100 collaboration conducted a model-independent test using sodium iodide crystal detectors, the same target material as DAMA/LIBRA. Analyzing data collected over 6.4 years by the effective mass of 61.3 kilograms, with improved energy calibration and time-dependent background modeling, we found no evidence of an annual modulation signal, challenging the DAMA/LIBRA result with a confidence level greater …

The Ethics Of Clinical Ethics, Matthew Shea

Center for Medical Ethics and Health Policy Staff Publications

The concept ethics defines health care ethics as a professional practice. Yet the meaning of "ethics" is often unclear in the theory and practice of clinical ethics. Clarity on this matter is crucial for understanding the nature of clinical ethics and for debates about the professional identity and proper role of ethicists, the sort of training and skills they should possess, and whether they have ethics expertise. This article examines two different ways the ethics of clinical ethics can be understood: Real Ethics, which consists of objective moral norms grounded in moral truth; and Conventional Ethics, which consists of conventional …

Eugenics And Polygenic Embryo Screening: Public, Clinician, And Patient Perceptions Of Conditions Versus Traits, Dorit Barlevy, Rémy A Furrer, Asha Kalapatapu, Abigail Martinez, Todd Lencz, Shai Carmi, Gabriel Lázaro-Muñoz, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Purpose: Polygenic embryo screening (PES) estimates an embryo's genetic chances of developing complex conditions (eg, cancer) and traits (eg, height). Stakeholders have raised concerns that PES promotes eugenic practices and ideology.

Methods: We surveyed a nationally representative sample of the US public on approval of screening embryos for 12 conditions and 12 traits and examined the association between disapproval and concern about eugenics. We also conducted semistructured interviews with US-based reproductive endocrinology and infertility specialists and patients undergoing in vitro fertilization on their perspectives toward PES.

Results: Among the US public (n = 1423), disapproval of screening embryos for traits …

Governance Of Polygenic Embryo Screening: A Qualitative Study On The Perspectives Of Clinicians And Patients, Jason Bach, Jonathan Frumovitz, Dorit Barlevy, Rémy A Furrer, Abigail Martinez, Ana Battaglino, Shai Carmi, Todd Lencz, Gabriel Lázaro-Muñoz, Stacey Pereira

Center for Medical Ethics and Health Policy Staff Publications

Objective: To investigate the perspectives of stakeholders on their attitudes toward potential regulation of polygenic embryo screening (PES), a new form of preimplantation genetic testing that is used to screen embryos for the genetic chances of developing medical conditions and nonmedical traits involving hundreds or thousands of genes.

Design: We conducted individual, semistructured interviews and analyzed transcripts using thematic analysis.

Subjects: Twenty-seven US-based reproductive endocrinology and infertility specialists and 26 patients who were currently undergoing in vitro fertilization or had within the past five years.

Main outcome measures: Repeating ideas and patterned responses were organized into themes and subthemes.

Results: …

Factors Associated With Adolescents' Self-Efficacy To Meet With Their Health Care Provider Alone, Albert C Hergenroeder, Blanca Sanchez-Fournier, Cassandra Enzler, Mary Majumder, Beth H Garland, Constance M Wiemann

Center for Medical Ethics and Health Policy Staff Publications

Adolescents with special health care needs (ASHCNs) must develop self-management skills to effectively transition into adult-based care. This requires having the self-efficacy to meet with their health care provider independent of caregivers. This study aims to identify the factors associated with self-efficacy in meeting with a provider alone among ASHCN preparing for this transition.Eighty-three English-speaking 18-year olds with renal, gastrointestinal, neurologic, or rheumatologic diseases, and their English- or Spanish-speaking caregivers were recruited at a large children's hospital, and completed a one-time assessment as the historical control group for a larger intervention study. The main outcome measure was self-efficacy to meet …

Ethics Committees In Outpatient Medical Practice: A Scoping Review, Milan Arya, Tyler Cholankeril, Marlowe Bogino, Meghan Crnic, Niharika Sathe, Isha M. Di Bartolo

Cooper Rowan Medical Journal

Introduction: This scoping review consolidates existing research on outpatient ethics committees (OECs). While inpatient or hospital ethics committees are well-researched and established, OECs are scarce in number and have received less attention from scholars, ethicists, and physicians, despite the increase in outpatient care utilization over the past two decades.

Methods: We conducted a scoping review following the JBI Manual for Evidence Synthesis. Key information sources included MEDLINE PubMed, Embase, and Academic Search Complete. Gray literature searching was conducted through Web of Science Database, keyword searching in Google Scholar, and backward citation searching was utilized. Relevant articles were screened …

Analyzing The Role Of Ai In Resident Education: An Evaluation Of Chatgpt On Ophthalmology Trainee Examination Questions By Subtopic, Kimberly Cartagena, Simran Ohri, Carolina Ramos, Yaxel Levin-Carrion, Alexandra Sanchez, Marko Oydanich, Albert S. Khouri

Journal of Academic Ophthalmology

Background: ChatGPT is a large-scale language model trained on various datasets to learn, analyze, and generate human-like answers to user’s questions. To assess its applicability to medical education, more information is required to understand whether its analyses can provide accurate and coherent responses to questions. The aim of this study was to characterize ChatGPT responses to ophthalmology questions according to subtopic to determine where the system might be used reliably in resident education and where its performance remains weak.

Methods: Ophthalmology questions were obtained from a widely utilized study resource, OphthoQuestions. Thirteen sections, each with a differing ophthalmic …

Osteogenesis Imperfecta And The Family: A Qualitative Analysis Of The Experiences Of Family And Caregivers, Gianna M Colombo, Andrew D Wiese, Amelia E Mercado, Whitney S Shepherd, Michelle Fynan, Kara Ayers, W Conor Rork, Kristin M Kostick-Quenet, Dianne Nguyen, Sophie C Schneider, Julia M Morales, Saniah I Kazimi, Hannah E Cho, Members Of The Bbdc, Chaya N Murali, Marie-Eve Robinson, Brendan Lee, V Reid Sutton, Eric A Storch

Center for Medical Ethics and Health Policy Staff Publications

Introduction: Osteogenesis imperfecta (OI) describes a group of rare, heritable bone disorders causing bone fragility, tendency to fracture with minimal trauma, and chronic pain due to abnormal collagen synthesis. Limited research exists on the psychosocial impact of OI during childhood on caregivers and families.

Purpose: This study aimed to understand caregiver experiences, existing social support provided for families affected by OI, and the impact of OI on family life.

Method: Thirteen caregivers of individuals with OI participated in semistructured interviews. Researchers coded, abstracted, and analyzed qualitative data to develop themes on the psychosocial impact of OI on the family unit. …

Artificial Intelligence Policies In Bioethics And Health Humanities: A Comparative Analysis Of Publishers And Journals, Christopher Bobier, Daniel Rodger, Daniel Hurst

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Rapid advancements in artificial intelligence (AI) pose novel ethical and practical challenges for scholarly publishing. Although AI-related policies are emerging in many disciplines, little is known about the extent and clarity of AI guidance in bioethics and health humanities journals.

METHODS: A search of publicly available journal lists from the American Society for Bioethics and Humanities, Health Humanities Consortium, and Association for Medical Humanities was supplemented with Google Scholar's top 20 bioethics journals ranked by h5-index. This yielded 54 unique journals, of which 50 remained after excluding those without a functional website or recent publications. AI policies were reviewed …

Pilot Survey Of Attitudes Toward Xenotransplantation Among Nursing Students In London, Uk., Daniel Rodger, Luz A. Padilla, Daniel J. Hurst, David K C Cooper, Gilberto Buzzi, Antonio Ríos

Rowan-Virtua School of Osteopathic Medicine Departmental Research

BACKGROUND: Solid organ xenotransplantation has been approved for clinical trials in the United States. Because of the role of nurses in patient decision-making, it is important to understand the attitudes of the future nursing workforce toward xenotransplantation. This pilot study aimed to investigate the attitudes of adult nursing students toward xenotransplantation.

METHODS: A cross-sectional survey design was used. The online pilot survey was completed by 33 undergraduate adult nursing students at one university in London, England. A minority of the hospitals that students may have had a clinical placement in had a transplant unit. The protocol for this study was …

Teaching Pathographies Of Mental Illness, Nathan Carlin, Angela Gomez, Margarita Ortiz

Faculty and Staff Publications

This paper describes the content and evolution of a fourth-year course for medical students on teaching pathographies of mental illness. (It is a follow-up to Nathan Carlin's Pathographies of Mental Illness that appeared as an Element in the Bioethics and Neuroethics series published by Cambridge University Press.) The course originally centered on classic (and some contemporary) memoirs; however, responding to student evaluations, newer material now ensures more diversity, with material written by women and people of color, and describes the difference that can make.

The Climate Is Changing Should Clinical Ethics Change, Too?, Joelle Robertson Preidler, Keisha Ray

Faculty and Staff Publications

No abstract provided.