• "Forward" Commentary

      Davis, Sheila P., Ph.D., RN (The Aquila Digital Community, 2004-01-01)
    • "I Felt What was Happening in Our Country [USA] with Race was So Much Scarier than the [COVID-19] Virus.” Black Lives Matter Protesters’ Beliefs and Practices During the COVID-19 Pandemic

      Arana-Chicas, Evelyn; Jones, Brooke D.; Cartujano-Barrera, Francisco; Cupertino, Ana Paula (The Aquila Digital Community, 2021-12-01)
      This study describes the COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the U.S. Participants completed a survey on following COVID-19 guidelines and answered interview questions. Twenty participants were enrolled. Mean age was 29 and most were female (80%) and black (75%). Participants almost always wore their masks (75%) and washed their hands (85%) while protesting. Most reported rarely social distancing (55%) and not being concerned about COVID-19 (55%). Themes included: 1) Fighting for social justice, 2) Protesting is more important than COVID-19, 3) Unable to social distance, 4) Masks mostly worn, 5) Protests sparked global movement, and 6) Increasing awareness of injustices. Our results suggest that protestors understand the importance of preventing the spread of COVID-19 and follow guidelines, but there are suggestions that some protestors do not consistently adhere to these guidelines. Results may contribute to policies that control the spread of COVID-19.
    • "The Box" and the Dark Night of the Soul: An Autoethnography from the Force of Losing a Child in the Delivery Room

      Pinon, Santiago, Jr (The Aquila Digital Community, 2016-01-01)
      From the perspective of parents who have lost children in labor and delivery rooms due to miscarriages, stillbirths, or who were born too early, the author argues that health care personnel including administrators, nurses, and doctors must be held accountable to the ethical responsibilities of caring for the parents of the children who have died. Based on the fact that administrators market their services to pregnant couples and promise to provide care, health care workers are ethically responsible to provide continued compassion.
    • A Call for Liberty and Justice for All: Unraveling the Complexities in 2021

      Davis, Dr. Sheila P. (The Aquila Digital Community, 2021-12-01)
      This Preface summarizes the articles in this issue. Seven articles are presented with center on liberty and justice for all populations discussed.
    • A Case Study: The Nurse Researcher in the Home Setting

      Lovelace Ray, Wendy (The Aquila Digital Community, 2015-08-03)
      The expansion of home health nursing over the past two decades has resulted in the increase of nursing research in home settings.. Many healthcare organizations have adopted a customer service approach in which the patient is viewed as a guest. The role of the nurse in the home care setting has also been described in the literature as guest. Other studies have reported that patients, as well as nurses, view nurses as a guest while care is being provided in the home setting. This potentially creates conflicting role expectations between the patient and the research nurse in home care settings. Ethics of care and ethics of justice are two divergent, yet complimentary, ethical frameworks that allow researchers to act appropriately to meet competing demands in the home setting. The purpose of this paper is to analyze a case study involving implementing research conducted in the home setting.
    • A Holistic Approach of Care for the Hearing Impaired Patient

      Kemker, Brett E., Ph.D.; Goshorn, Edward L., Ph.D.; Sumrall, Virginia, Ph.D., RN; Marx, Charles G., AuD (The Aquila Digital Community, 2011-11-08)
      Theory of Health as Expanding Consciousness, as it applies to hearing impairment, requires that, for an individual to see health as the pattern of the whole, one needs to be able to see that disease or impairment is not a separate entity, but rather a manifestation of the evolving pattern of person-environment interaction (Newman, 2008). In the typical diversity training programs for health care professionals, diversity generally pertains to culture and ethnicity (Radler, 1999). However, the authors suggest that we should consider individuals with disabilities as an element of diversity training. Caring for patients with hearing loss including practical and ethical considerations for best possible outcomes is discussed.
    • A Hospice Dilemma Commentary

      Bishop, Sandra B., DNS, RN (The Aquila Digital Community, 2008-11-17)
      Hospice has undergone a metamorphosis sense it's coming to the United States in the late 1970's. This is an opinion on the ethics of the dynamic changes that are occurring.
    • A New Start: Rebirth of The Online Journal of Health Ethics

      Davis, Sheila P. (The Aquila Digital Community, 2010-01-01)
    • A Study on Legal and Ethical Issues Surrounding Health Practitioner Pro Bono Services

      Khan, Lori, MS, CLT, DPT (The Aquila Digital Community, 2010-12-14)
      The purpose of this paper is to explore the legal and ethical implications of pro bono health care services in the United States and abroad. The research regarding volunteer or pro bono health services has focused mainly on physician involvement in volunteer medical services, or pro bono health services, with research showing only 39% of physicians, compared to 30% of general public, taking part in volunteer services to patients and the community (Grande, D, and Armstrong, K, 2007). Historically, pro bono services were derived from the Canons of Professional Ethics in 1908 and evolved into the Model Code of Professional Responsibility in 1969 and finally the Model Rules of Professional Conduct in 1983. The World Health Organization developed the Commission on the Social Determinants of Health in 2005, which include the following goals: (1) Improving living conditions (2) Addressing the inequitable distribution of power, money, and resources, and (3) Measuring and understanding the related problems (WHO, 2008). In the final report, the four areas of concern included socioeconomic factors, patient health care accessibility, health care rationing, and patient advocacy. Pro bono health services are one method of addressing the health care accessibility and socioeconomic factors surrounding the current dilemma in health care.
    • A Tragic Miscommunication: Ethical Decision Making in Burns Care

      Kong, Victor Y., MBChB, Ph.D. (The Aquila Digital Community, 2012-04-23)
      Patients with extensive burns injuries are often given a poor prognosis. Those who survive after an initial early resuscitation phase often require extensive operative and critical care input, a prolonged hospital stay, and associated significant complications. The overwhelmingly high volume of patients already using the resource-stricken burns care service places extreme pressure on clinicians in respect of decisions they make about who should and should not be resuscitated. In this paper, we present the case of a young woman who sustained significant burn injuries, and discuss the ethical dilemmas encountered during the subsequent management of her care.
    • A Translational Intervention for Reducing Infant Mortality in Mississippi: A Move to Eliminate Health Disparities

      Rachel, Marcia, Ph.D.; Tucker, Laura, MSN; Graham, Juanita, MSN (The Aquila Digital Community, 2008-11-17)
      Therapeutic, technological, and medical advances have contributed to improve Infant Mortality Rates in the United States over the last 100 years. However, there are still geographical and racial disparities and challenges, and infant mortality remains higher in the Unites States than in many other developed countries. A formal death review process can identify causal, contributory and potentiating factors related to infant deaths. This article describes use of the PDSA Model for Improvement to develop a strategy for change that will result in reducing the Infant Mortality Rate within an organization.
    • Abandoning Anonymity

      Relph, Amanda, M.S. (The Aquila Digital Community, 2011-04-20)
      In the arena of bioethics and reproductive science, anonymity among sperm donors has been a hot topic. Currently, donors are granted anonymity in an attempt to protect autonomy and shield privacy. But at what cost? This article examines the other side of the debate: the children that, as a result, have little to no access to literally half of their family. Not only does this have serious mental and emotional implications, it also represents a serious ethical dilemma in terms of the autonomy, health, and well-being of the child.
    • 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.
    • African Americans’ Trust and the Medical Research Community

      Mokwunye, Nneka O., MA (The Aquila Digital Community, 2006-01-01)
      African Americans have been victims in many of the medical atrocities involving human subject research. It is well established that African Americans are less likely to enroll in research protocols and have more distrust of the medical field than any other ethnic group due to the Tuskegee Syphilis Study. Researchers must be responsible for creating a trustworthy environment. The creation of a cultural competency curriculum designed specifically for training researchers is warranted and will help open the communication barrier between researcher and participant. Trust must be created before the distrust of the medical research community will be resolved. This paper describes successful recruitment strategies that help foster a trusting environment and increase enrollment. Enrollment increase will help lead to understanding disparities and creating solutions.
    • Agency and Health Policies

      Lopez Barreda, Rodrigo (The Aquila Digital Community, 2021-12-01)
      In the current medical ethics literature, the concept of agency is receiving growing attention. Nevertheless, many of those definitions are narrow in scope. This article intends to provide a deeper understanding of this concept, allowing for its use in clinical practice and public health policies. First, it revises the current concept of agency and some of its shortcomings. Then, the article presents two philosophical accounts of agency, identifying three relevant features, namely time-extended organised planfulness, endorsement of their own actions, and identification with the activity. Lastly, the article depicts how those features may help in the application of agency to the analysis of health issues by means of a number of examples at the individual and collective levels. When analysing health issues, the health status is a key component, but the process that brought about the outcome must be examined; agency informs about this procedural dimension.
    • 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.
    • 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.
    • An Ethical Analysis of Contemporary Healthcare Practices and Issues

      Breen, Gerald Mark, M.A.; Loyal, Michael, M.A.; Littleton, Vanessa, R.N.; Seblega, Binyam, M.B.A.; Paek, Seung Chun, M.S.; Meemon, Natthani, M.A.; Ellis, Nancy, Ph.D.; Wan, Thomas T.H., Ph.D. (The Aquila Digital Community, 2008-11-17)
      The purpose of this analysis is to examine specific segments of healthcare policy and practice, applying various ethical perspectives. We examine the economic and political influences that surround ethical behavior in health services, as well as how practitioners, patients, and families respond and act as a result of such influences. We then delve into the fundamental principles that guide ethical behavior by medical practitioners, including the Hippocratic Oath and vows of medical professionalism. Further, we analyze disparities in healthcare provisions based on gender, race, and ethnicity. Ethical theory is weaved into each of these sections, as the philosophical and ethical writings of prominent scholars illuminate how the conditions of contemporary healthcare administration are affected by the injustices and political influences that pervade the entire health services industry.
    • An Ethical Analysis of Reproductive Tourism and Technologies from a Multi-dimensional Lens

      Lyzwinski, Lynnette Nathalie, BA, M.Phil. Candidate (The Aquila Digital Community, 2013-01-04)
      The permeation of reproductive technologies and reproductive tourism across boundaries of the globe has resulted in a global debate surrounding their moral and ethical viability. The purpose of this paper is to objectively assess the morality inherent in reproductive technologies by examining the perspectives of women seeking them and subjects providing them and by analyzing multiple ethical lenses. It will first aim to determine whether these technologies should be universally accessible to all couples within a given country and whether the private provision of these treatments creates unethical inequities in accessibility. It will then seek to determine whether crossing borders to seek these therapies when they are inaccessible in a given country may be ethically justified.
    • An Ethical Comparison of the COVID-19 National Disease Control Performance of China, Canada and the U.S. in the First Year of the Pandemic

      Gellert, George A; Gellert, Gabriel L. (The Aquila Digital Community, 2021-12-01)
      Objective: First year government pandemic control performance is compared in China, Canada and the USA to understand the ethical bases of different population outcomes achieved. Methods: Comparative analysis of ethical underpinnings and implications of pandemic performance includes degree of authoritarian power deployed to mitigate disease spread; benefits of single payer health care; impact of socioeconomic, racial/ethnic and health care inequities; anti-government sentiment/distrust; national leadership engagement; and science denial. Results: National COVID-19 response efforts vary according to the extent to which they leveraged autocratic tactics, from China whose highly autocratic first year pandemic performance was emulated, through liberal democracies like Canada where ethical compromises were largely avoided, to the USA where federal government abandonment of public health ethics produced one of the deadliest pandemic first year performances. Conclusions: Examining the ethics of pandemic disease control practices can lessen risk of repeated pandemic performance failures, and associated avoidable morbidity/mortality in future pandemics.