The Online Journal of Health Ethics is a multidisciplinary journal, which seeks to publish original research findings in the field of Public Health ranging from General Practice Nursing to behavioral health or public health and policy. The purpose of this journal is to provide a forum for the expression of ethics related to health in a scholarly format. Works to be considered for publication include, but are not limited to, article reviews, poems, letters to editors, book reviews, commentaries, short stories, full length articles, and case studies from authors in Nursing, Public Health and Policy, Nutrition, Social Work, and other disciplines that work with or are committed to improving the lives of individuals from a holistic worldview.


The library contains articles of the Online Journal of Health Ethics as of 1(2004) to current.

Recent Submissions

  • Dedication

    Sheila P. Davis (The Aquila Digital Community, 2020-04-10)
    This issue is dedicated to all those involved in the battle with COVID-19.
  • Euthanasia of the Coronavirus - COVID-19

    Sheila P. Davis (The Aquila Digital Community, 2020-04-01)
    At the time of this editorial, COVID-19, aka the Novel Coronavirus, has wrecked havoc and left in its path of destruction, death, unemployment, the instability of nation’s economies, misery, uncertainty, despair, and a fear regarding what the new tomorrow will look like. And, perhaps more importantly, the question of who will be here tomorrow lingers. Now classified as a pandemic, this virus has resulted in over 1,381,014 cases worldwide with 78,269 deaths to date. Presently, Louisiana and Detroit are emerging as the next hot spots behind New York as the fastest rate of increase for COVID-19 cases in the world. Were the virus or threat thereof not enough, there are well-documented shortages of personal protective equipment (PPE) such as gowns and masks used by healthcare workers. As such, there are growing reports of healthcare workers in some areas wearing as protective gear, trash bags and disposable masks normally worn for one day, being worn for 5-6 days. This editorial discusses the possibility of healthcare workers also being tasked with the practice of euthanasia by having to choose who will live based upon age.
  • Ethical Guidelines for the Treatment of Patients with Suspected or Confirmed Novel Coronavirus Disease (COVID-19)

    DePergola, Peter A., II (The Aquila Digital Community, 2020-01-01)
    This white paper provides basic ethical guidelines for treating patients with suspected or confirmed coronavirus disease (COVID-19). It responds to the need from healthcare organizations to address the moral considerations inherent to caring for this patient population, particularly in the context of scarce resource allocation, the imposition of limits to individual freedoms, and de facto social distancing. These guidelines are not narrowly prescriptive, but recognize the need of decision makers to transform this guidance into specific decisions. Ethical decision making assumes that such judgments will be based on current scientific knowledge, that effectiveness of interventions is carefully assessed, and that transparency of the process is evident. As specific decisions are considered, processes should be in place for identifying which ethical issues were addressed, how guidelines were used, how decisions affected the community, and what lessons can be shared with other decision makers. In this way, these guidelines will continue to be an interactive, working document.
  • Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity

    Gellert, George A., MD, MPH, MPA (The Aquila Digital Community, 2020-01-01)
    Ethical imperatives critical to effective disease control in the coronavirus pandemic: Recognition of global health interdependence as a driver of health and social equity George A. Gellert MD, MPH, MPA ABSTRACT Decades into the era of emerging infectious diseases, the 2019-2020 coronavirus pandemic has caught the world, and the United States in particular, poorly prepared to engage effective public health disease prevention and control measures. In part, this reflects poor public health planning, response, logistical preparation and pandemic readiness, and complacency by governments and disease control agencies. In terms of future responses to emerging infection pandemics, these deficiencies can be readily addressed by engaging well established and proven methods of public health disaster and epidemic preparedness planning and mobilization. In part, however, the disastrous 2020 coronavirus disease control response, in the United States but elsewhere, reflects longstanding indifference to essential ethical imperatives, gaps and deficiencies in public policy that extend well beyond public health disease control activities and strategies per se. These imperatives are reviewed and discussed. A key underlying feature, operationally and from an ethical viewpoint, is a chronic failure to understand and actively manage the fundamental global health interdependence that exists among individuals in every jurisdiction or community, including municipal, state, national and international/global. Local, national and global public health interdependence, though existing and ignored for decades, must become the central strategic, operational and ethical recognition for effective coronavirus disease control, and should inform current pandemic response and planning for inevitable future emerging infection outbreaks. Key Words: Coronavirus pandemic, SARS-Cov-2, COVID-19, coronavirus disease control, ethical issues, global health interdependence, social inequity, racial inequity, economic inequity
  • Ethical Strange Fruit

    Sheila P. Davis (The Aquila Digital Community, 2019-01-01)
    Editor's introduction to Volume 15, Issue 2 of the Online Journal of Health Ethics.
  • Supporting Mental Wellness in the Public Service Professions

    McQueston, Reilly L.; DePergola, Peter A., II (The Aquila Digital Community, 2019-01-01)
    The nature of the work of public service professionals – understood in the present context as including, but not limited to, police officers, firefighters, emergency medical technicians, paramedics, emergency dispatchers, and telecommunicators – exposes them to great amounts of suffering and trauma. Mental wellness is wavering for many in the field, and progressive, holistic support is needed. Public service professionals receive remarkable amounts of training to meet competencies within their role, but they are not provided with the same level of training to protect and serve themselves. Many factors contribute to decreased mental wellness in public service professionals, including the stoic culture, short staffing, low pay, and lack of public service resources. Against the argument that adequate and thorough mental health support is perceived to be expensive and a personal responsibility for individuals to seek if they need it, this paper argues that, given the staggering statistics regarding suicide, depression, and PTSD, the availability of resources, and the cost saving effects that promoting mental wellness and retaining employees has for companies, society’s approach to mental health must change. Moreover, the mental health of first responders in particular is a moral responsibility that must be supported through extensive education, community outreach, and the establishment and maintenance of a non-punitive culture.
  • Fake Medical News: The Ethics and Dangers of Health Product Advertising Disguised as Real News

    Gellert, George A. (The Aquila Digital Community, 2019-01-01)
    Leading national newspapers in the US, challenged financially by the transition from paper to electronic media, are allowing drug and medical product advertisers to format their advertisements to appear like actual, authentic news articles. This news mimicry is intended to deceive consumers, and often makes claims of clinical efficacy and safety that are not evidence based and substantiated. An example of such an advertisement is presented and the clinical implications are considered, including recommendations to public health leadership organizations.
  • The Socio-Economic Impact of the Disproportionate Occurrence of Asthma in the State of Mississippi: Should Reporting be Mandated?

    Gray, Lolita D (The Aquila Digital Community, 2019-01-01)
    The state of Mississippi continues to experience a disproportionate occurrence of asthma among its citizens and various associated socioeconomic impacts. The objective of this study seeks to gauge the perception of the participants in regards to this asthma disparity. Specifically, research questions seek responses to following: 1) Will mandated, systematic reporting of asthma occurrences among socioeconomically disadvantaged communities effectively address the asthma disparity and lead to a better quality of life? and 2) Will mandated, systematic reporting of asthma increase the socioeconomic impact among these communities? This cross-sectional study employs a case study methodology utilizing various research techniques, i.e. interviews, surveys, and statistical data reports. Overall, for each question presented, the participants’ responses indicate, significantly and positively, 1) Mandated, systematic reporting of asthma reporting should be implemented, and 2) This mandate can lead to a decrease in asthma disparity and result in a better quality of life among these communities. Key Words: Asthma Asthma Disparity Health Disparity Public Policy Chronic Illness
  • Hippocratic Values in an Era of Nuclear Asymmetry: Should U.S. Public Health Prepare for Nuclear War with North Korea?

    Gellert, George A. (The Aquila Digital Community, 2019-01-01)
    Objectives: Advancements in North Korean nuclear weapons have heightened tensions and increased risk for nuclear war. U.S. public health agencies are investing resources in nuclear attack preparation. Analyses assess the impact and value of existing protective public health strategies for limited nuclear exchange. Methods: Projections of fatality/injury from a North Korean nuclear strike within North Asia and explosive impact mapping are used to assess the potential impact of an attack on major U.S. urban centers. Results: A nuclear strike on the 20 largest U.S. urban centers would place 38.1% of Americans at risk. With 1-3 missiles of 250 kiloton yield deployed to each, 9.7 million fatalities and 16.8 million injuries would result, impacting 8.2% of the population. Extrapolation of Seoul-Tokyo impact data, assuming public sheltering reduces mortality 50%, indicates 4.7-9.4 million Americans could be killed. Local medical-public health personnel/infrastructure to care for survivors would be destroyed. Conclusions: Public health measures may not meaningfully decrease U.S. mortality/injury from a limited nuclear strike. Medical-public health leaders must ensure U.S. leaders comprehend the public health disaster resulting after even limited nuclear attack, and advocate against current shifts in U.S. nuclear policy toward first use and expanded nuclear scenarios with lower use thresholds.
  • Informed about Informed Consent: A Qualitative Study of Ethics Education

    Zhong, Rocksheng; Northrop, John K.; Sahota, Puneet K.C.; Glick, Henry B.; Rostain, Anthony L. (The Aquila Digital Community, 2019-01-01)
    Informed consent is a foundational concept in modern medicine. Despite physicians’ ethical and legal obligations to obtain informed consent, no standard curriculum exists to teach residents relevant knowledge and skills. This paper presents a qualitative study of residents at one academic medical center. The authors conducted focus groups with trainees in the Departments of Internal Medicine, Emergency Medicine, and Ob/Gyn and analyzed their responses using rigorous qualitative methods. Four themes emerged: First, participants agreed that informed consent and decision-making capacity were relevant in many clinical situations. Second, participants varied widely in their understandings of consent. Third, current resident training was insufficient. Fourth, more training was needed. These results add to the growing literature that ethics education in residency is desired and useful. The findings will help educators craft instruments assessing the prevalence and degree of deficiencies related to informed consent competencies and aid in the development of a model curriculum.
  • The Bionic Brain: Pragmatic Neuroethics and the Moral Plausibility of Cognitive Enhancement

    DePergola, Peter A., II (The Aquila Digital Community, 2019-01-01)
    The seemingly infinite possibilities of contemporary neuroscience span from the augmentation of memory, executive function, appetite, libido, sleep, and mood, to the maturation and development of emotional health and personality. These prospects hint at the capacity to alter neurocognitive conceptions of reality. They also mark the unavoidable inculcation of nuanced individual responses, perhaps radical, to these “tailor- made” perceptions. Hence, there exists certain neuroethical, and even more generally, existential risks within this fascinating and expeditious enterprise. The primary question in the context of present-day neurotechnology is not what can be done, but what should be. To that end, this paper examines the concepts of memory, executive function, and emotional health and personality in the context of neurocognitive enhancement and posits the argument that neurocognitive enhancement can be justified as morally plausible in its potential to edify the caliber of overall cognition, and thus contribute to the ability to make pragmatically, robust moral decisions on the conditions that it (1) promotes general moral character, (2) compliments human nature, and (3) effects a deeper sense of individual and social identity.
  • The Morality of Same Sex Marriage: How Not to Globalize a Cultural Anomie

    Akpan, Chris O. (The Aquila Digital Community, 2017-01-01)
    The question of the morality of same-sex marriage has become quite prevalent in the 21st century. Some western cultures believe that same-sex marriage is morally defensible and can be legalized. Using the human right fad and political might, they subtly engineer the globalization of this phenomenon. This move has been strongly opposed mostly by ‘developing’ nations and some churches across nations. The argument of such group is that same-sex marriage is immoral, unnatural and ungodly. This paper defends the thesis that same-sex marriage cannot morally be defended successfully. It shows that same-sex marriage is not exclusively a western phenomenon but has been in practice for a long time even in some African cultures; though in some subtle way. It argues that in whatever way it is practiced same-sex marriage is a cultural anomie: and more or less an elixir and alibi, aimed at concealing immorality. The paper concludes that it is wrong for some cultures to attempt a globalization of this cultural anomie especially by hinging its morality on the human right doctrine. The paper is expository, speculative, critical and evaluative in approach.
  • Leadership in the Health Sector: A Discourse of the Leadesrhip Model of Utilitarianism

    Udofia, Dr. Christopher Alexander (The Aquila Digital Community, 2017-01-01)
    This research work with the title, “Leadership in the Health Sector: A Discourse of the Leadership Model of Utilitarianism,” is concerned with examining the appropriateness of Utilitarianism as a leadership model that may be employed and utilized by leaders in the public health industry. The research is predicated on the proposition that leadership is as much a problem in the health industry as it is for all humanity. Most leaderships fail due to the employment of inappropriate leadership theories. The appropriateness of any leadership model can only be determined after the model has been subjected to adequate critical analysis. Hence this research adopts the philosophical methods of exposition and criticism in unravelling its subject matter. This research is significant in exposing a leadership model with an underlying ethical content which can serve as a paradigm for leadership and decision making in the health industry. The paper identifies the control and management of HIV/AIDS as well as the enhancement of National Health Insurance Scheme (NHIS) coverage in third world countries as critical health issues that can be strengthened through the adoption of the leadership paradigm of utilitarianism. The paper concludes that the utilitarian normative axiom of the greatest happiness for the greatest number will ultimately lead to the engendering of democratic culture in the policy and decision making processes bordering on health issues. However, the work cautions that the majority principle enshrined in axiom of utilitarianism is all too vulnerable to abuse by any leader with a totalitarian bent. Hence a leader who adopts utilitarianism as a normative principle is advised against allowing the good of the majority to always supersede and dominate that of the minority.
  • Right or Duty: A Kantian Argument for Universal Healthcare

    Crisp, Joseph (The Aquila Digital Community, 2017-01-01)
    Much of the political rhetoric about healthcare in the United States is couched in terms of healthcare as a right or entitlement. Healthcare as a right, like all welfare rights, carries with it the obligation to pay for it. This paper proposes that healthcare be considered, not a right, but rather a duty within the framework of a Kantian approach to ethics. The categorical imperatives of rational beings include the duties of self-preservation and self-development. As a precondition for these duties, health is essentially bound up with the nature and duties of physical, rational beings. The complexity of healthcare ensures that virtually all persons will need the services of others, and the expense of healthcare can exceed the resources even of those who are insured. Therefore, a just society has a moral duty to ensure access to healthcare to all of its members.
  • The Confluence of Philosophy And Biology: An Excavation of Philosophical Issues in Molecular and Developmental Biology

    Mendie, Patrick Johnson; Emmanuel Bassey Eyo (Ph.D) (The Aquila Digital Community, 2016-01-01)
    Philosophical evaluations have played an influential role in the growth and development of molecular and developmental biology to ensure that every individual is born healthy, born wanted and has the privilege to fulfil his or her potentials for a life free from disease and disability. This is why it becomes necessary for biologists to carefully understand human genes, evolution, cells and general human anatomy to fulfil this project. During this process, they are faced with challenges where they also lack the foundation on how to solve them. This challenge gave birth to a philosophical excavation of molecular and developmental biology. This paper is an attempt to expose that philosophy is a major tool in proffering possible solutions to issues related to biology through one of the new dimension in philosophy namely philosophy of biology. It is one of the most exciting new areas in the field of philosophy which is attracting much attention in the contemporary philosophical studies. In this paper, we posit that issues in molecular and developmental biology will be of success when the fundamental tools of philosophy are being taken into consideration cognizant that philosophy and biology viz-a-viz philosophy of biology, can be seen as a single inquiry into the nature of man-well-being.
  • Noetic Propaedeutic Pedagogy as a Panacea to the Problem of Abortion

    Bisong, Peter B. (The Aquila Digital Community, 2016-01-01)
    This work is instigated by the increase in the number of countries that have legalized abortion and the ones debating over the issue. Even most countries where abortion is illegal like Nigeria are experiencing increase in cases of abortion. The author is worried that the danger of abortion is seemingly not taken note of by stakeholders, thereby leading him to believe alongside Asouzu that the constraining mechanisms have clouded the minds of men, and impeding them from seeing reality in a complementary way. The noetic propaedeutic pedagogy as propounded by Asouzu is the self-conscious retraining of the mind to overcome bifurcation and polarization. It is recommended as a way of correcting this defective mindset, so as to make the mind better fit to see reality in a complementary mode, and thereby help it to see the need to accord respect and rights to the foetus.
  • Charles Dickens’ Hard Times and the Academic Health Center: A Tale of the Urban Working Poor and the Violation of a Covert Covenant, an American Perspective

    Papadimos, Thomas J., M.D., M.P.H. (The Aquila Digital Community, 2006-01-01)
    Charles Dickens’ novel “Hard Times” focuses on the struggles of urban workers in 19th century England. The situations of workers in 21st century America are not dissimilar thus making Dickens’ commentary and characters applicable to the contemporary socioeconomic scene. The number of uninsured or underinsured poor in America is rising. AHCs must go beyond their traditional mission of patient care, education and research and embrace the local neighborhoods they serve. The urban location, technical expertise, and educational mission of many AHCs make them ideally suited to assist urban populations that are at great health risk. Many Academic Health Centers (AHCs) in America found their origins in working class neighborhoods, such as those described by Dickens, and today are surrounded by the urban poor. An argument is made that AHCs have a moral obligation to these neighborhoods; it is an implied, or covert, covenant that they are obliged to honor.
  • Ebola Scare and Measles Resurgence: Mandatory Isolation/quarantine and Vaccination

    Aita, Mark C, MD; Ragland, Takeem T, MA (The Aquila Digital Community, 2015-01-01)
    Public outcry for radical isolation and quarantine policies followed the first Ebola diagnosis in the United States when Eric Duncan, upon his return home Oct 2014 from West Africa, then in the midst of a catastrophic Ebola epidemic, tested positive for Ebola. Likewise, the Dec 2014 Disneyland measles outbreak unleashed an angry backlash against parents who refused to have their children vaccinated; and there was public momentum to repeal all legal exemptions to mandatory vaccination of school children. This paper presents an ethical and legal analysis to adjudicate the issue which is at stake in both controversies; namely the inherent conflict between individual rights v. public health when the nation is threatened by serious communicable disease. It presents reasoned arguments, weighing duty-based v. consequence-maximizing ethical principles of right action through application of the felicity calculus (net utility). And the paper demonstrates how the metaethical theory of emotivism is operative in formation and expression of public sentiment which fueled the ethical and legal deliberations.
  • At a Crossroads: Social Work, Conscientious Objection, and Religious Liberty Laws

    Mongan, Philip (The Aquila Digital Community, 2018-05-01)
    Recently several states have passed legislation allowing conscientious objection for social workers. Due to the potential impact on the profession that these policies carry, it is critical that this issue be explored and discussed within the social work profession. This article examines the arguments for and against conscientious objection, discusses the use of conscientious objection in other professions, and the explores the potential options and consequences for social work. The argument is made that the profession of social work should seek to define itself and its values related to conscientious objection before outside forces make the decision for us.
  • Health Beliefs of Muslim Women and Implications for Health Care Providers: Exploratory Study on the Health Beliefs of Muslim Women

    Walton, Lori Maria, PhD, DPT; Akram, RDMS, BS, Fatima; Hossain, BBA, Ferdosi (The Aquila Digital Community, 2014-01-01)
    Abstract: Purpose: This study investigated specific health beliefs of Muslim women and their decision to access and follow through with health care provider evaluation and treatment. Design and Methods: This was a cross-sectional prospective research design aimed at exploring the beliefs, perceptions, and attitudes of Muslim women living in USA toward health. A purposive sampling of fourteen (n=14) Muslim women who volunteered to take part in this study completed a survey of health beliefs, attitudes, and perceptions constructed from Purnell's cultural competence model. Results: Results suggest that Muslim women perceive specific health beliefs as important and may have an effect on their participation in medical and health evaluation and treatment. Conclusion and Discussion: Health beliefs of Muslim women should be considered and future research explored in for health care practice.

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