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.

News

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

Recent Submissions

  • Abbey and George

    Gunn, Jennie A (The Aquila Digital Community, 2020-10-27)
    Abbey and George discuss their beliefs regarding abortion in a light hearted manner. Both are aborted fetuses. Abbey was aborted by induction, and George by spontaneous. The pros and cons of abortion, the effects, and the use of fetal cells in research are presented in play format. Abbey is a devout Christian, and George is an atheist. The play allows the reader to hear both sides of the topic.
  • Winners and Losers in the American Political Debates of the Nation’s Health: An Ethical and Moral Dilemma

    Davis, Dr. Sheila P. (The Aquila Digital Community, 2020-10-19)
    The third and final issue of the Online Journal of Health Ethics for 2020 presents two poignant articles that are rankled with current health ethics and moral issues as the world races to a resolve for the COVID pandemic. There appears to be no easy, quick-fix solutions to the pandemic that has claimed over 1.11 million lives worldwide in this first wave. The Gellert article addresses his view of the U.S. government’s political response and the Gunn article presents an ethical perspective of the emerging promised vaccine to halt the virus.
  • An Epidemiological View of the 2020 U.S. Presidential Election: COVID-19 and the Ethics of Science Denial

    Gellert, George A., MD, MPH, MPA (The Aquila Digital Community, 2020-10-19)
    COVID-19 is exploiting U.S. political and cultural polarization in the first presidential election to be driven by epidemiology and public health. Medical science is on the ballot as Americans’ views on economic re-opening fracture according to party affiliation. The difference between pro aggressive versus incremental re-opening, mask wearing and social distancing is rooted in respect for, or denial of, the science of epidemiological pandemic disease control. Political leaders at multiple levels, and in particular the president, have politicized the wearing of face masks and so intentionally obscured and misinformed the public regarding the objectively and scientifically proven value of these protective measures. The presidential election rests at a fundamental level upon an individual choice of whether to accept or “believe” value-neutral, evidence-based science or an unethical decision to be swayed by political disinformation. The persistent and highly dysfunctional political and cultural polarization of the U.S. is now enabling and reinforcing the ethics of science denial, while driving the nation’s public health fate and near- to medium-term economic outcomes. However, mask wearing, social distance and sheltering are not political expressions, and the right to freedom of expression does not include behaviors that produce or could produce serious, and in the case of this pandemic, deadly impact on other citizens. One does not have the right to forms of political or other expression that kill or make ill other individuals.
  • Open letter to all readers, reviewers, and authors

    Davis, Dr. Sheila P. (The Aquila Digital Community, 2020-10-27)
    Open Letter for all Readers, Reviewers, and Authors of the Online Journal of Health Ethics
  • What's the flap about coronavirus?

    Dhara, V. Ramana (The Aquila Digital Community, 2020-01-01)
    This is a haiku about the vectors, modes of transmission and spread of SARS, MERS, and SARS-CoV-2
  • Patient advocacy: A tool for resolving ethical issues for patients that use the emergency department for chronic care management

    Baskin, LaWanda (The Aquila Digital Community, 2020-01-01)
    The current state of scientific knowledge on using the emergency department (ED) for chronic care management indicates that using the ED for chronic care management creates health disparities and burdens healthcare systems. Ethical concerns also arise because patients use the ED for chronic care management. This article discusses health literacy, self-care behaviors, and social support and the presence of patient suffering, nonmaleficence, and beneficence in patients who seek care for chronic care management in the ED. Patient advocacy as a tool to lessen these ethical issues is further discussed. Eighty-six participants were used in a cross-sectional correlational predictive study. Findings indicated that predictive relationships exist between health literacy, social support, and self-care behaviors and using the ED for chronic care management in the sample population. Key implications from this research are the need for patient advocacy to improve health literacy, self-care behaviors, and social support among patients with chronic conditions.
  • Summer 2020 Ethical Issues

    Davis, Dr. Sheila P. (The Aquila Digital Community, 2020-01-01)
    Summer 2020 Ethical Issues in the Online Journal of Health Ethics
  • The George Floyd of healthcare

    Davis, PhD, FNP-c, FAAN, LSM-BC, Sheila P.; Davis, MD, Gary (The Aquila Digital Community, 2020-01-01)
    Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.
  • Tuskegee syphilis study not America's only medical scandal: Chester M. Southam, MD, Henrietta Lacks, and the Sloan-Kettering research scandal

    Vernon, Leonard F (The Aquila Digital Community, 2020-01-01)
    The words “human medical experimentation” conjure up visions of Nazi medicine, which has come to exemplify the worst evils in the history of humankind. Places like Auschwitz and Dachau, where human life was cheap and test subjects plentiful were used as laboratories. In 2010 the US government apologized to Guatemala for allowing U.S. doctors to infect Guatemalan prisoners and mental patients with syphilis 65 years earlier, while acknowledging dozens of similar experiments in the United States. These included studies that often involved making healthy people sick. such as in the Tuskegee syphilis study. These experiments were often life threatening and took place with the direct approval and/or supervision of some of the country’s most prestigious research institutions and some of the leading medical researchers. Among these was the prestigious cancer research center in New York City, Sloan Kettering Hospital and its director of cancer research Chester Southam, MD.
  • Presumed consent and priority allocation systems for organ donation legislation in the United States: Making the moral case

    Shapiro, Anna K.; DePergola, Peter A., II (The Aquila Digital Community, 2020-01-01)
    In recent decades, developed nations, such as the United States, have seen the gap between the demand and the supply of transplantable organs widen, despite national campaigns intended to promote donor registration. This organ shortage crisis has deprived thousands of a basic quality of life and has caused a substantial increase in the cost of alternative medical care such as dialysis. In an attempt to address the shortage, some countries have instituted explicit “opt-out” and “priority allocation” policies that operate under the principle of presumed consent and offer higher priority on transplantation lists to registered donors. This paper seeks to justify such legislation, exploring the ethical implications and highlighting the potential benefits of an opt-out and priority allocation organ donation system. It argues that such policies should be made a legislative priority in order to strengthen the national organ donation system of the United States.
  • Allocation of resources and health professionals’ burden during the COVID-19 pandemic: Reflections on advanced directives, informed consent and social perception in Mexico

    Herrera-Ferrá, Karen; Souza-García, Leonardo; Muñoz-Torres, Antonio (The Aquila Digital Community, 2020-01-01)
    One of the main problems in the COVID-19 pandemic is the insufficient availability of resources. This deficiency has resulted in emotional and moral burdens of health professionals. Decisions are having to be made as to who will live and who will die. Moreover, given the global impact of this pandemic, negative impacts are heightened in low and middle-income countries such as Mexico. Authors focus on two issues related to, but not exclusive, to the Mexican healthcare system in an attempt to partially address scarce resources and health professionals’ burden. First, is the empowerment of patients’ autonomy through the incorporation of advanced directives (i.e. non-resuscitate order, the use of intensive care unit and/or ventilator) within informed consent. And, second, the socio-cultural perception of risk as relevant for public engagement on protective behavioral patterns. We argue that addressing these issues could possibly lessen the burden of healthcare professionals, and bring about greater autonomy among the public.
  • 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.
  • 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.
  • 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.
  • 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.

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