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Item Attitudes About the Use of Newborn Dried Blood Spots for Research: A Survey of Underrepresented Parents(Elsevier, 2015-09) Hendrix, Kristin S.; Meslin, Eric M.; Carroll, Aaron E.; Downs, Stephen M.; Department of Pediatrics, IU School of MedicineObjective To identify the relative importance of factors that impact parents’ attitudes toward use of their child’s dried newborn blood spots for research purposes. Methods Respondents were parents aged 18 and older with at least one child aged 17 or younger born in Indiana visiting an urban pediatrics clinic. They were asked to rate the acceptability of hypothetical scenarios involving the research use of blood spots. Three pieces of information varied between the scenarios: 1) who would be conducting the research; 2) whether the child’s identity would be linked to the spots; and 3) whether and how often the parents’ consent would be sought before the research began. Results A total of 506 predominantly black and low-income parents completed the survey. The conjoint analysis model showed good fit (Pearson’s R = 0.998, P < .001). The rank order of factors affecting parents’ attitudes was: 1) consent (importance score = 64.9), 2) whether the child’s identity was linked to the spot (importance score = 19.4), and 3) affiliation of the researcher using the spots (importance score = 14.6). Respondents preferred being asked for their consent each time their children’s spots would be used. They preferred that the children’s identity not be linked to the spots and that the research be conducted by university researchers, though these issues had less impact on attitudes than consent. Conclusions Parents strongly prefer that consent be sought for each use of their children’s blood spots. These findings have implications for future research and policy-making decisions.Item The Beginning of Personhood: A Thomistic Biological Analysis(Wiley-Blackwell Publishing Ltd., 2000-04) Eberl, Jason T.“When did I, a human person, begin to exist?” In developing an answer to this question, I utilize a Thomistic framework which holds that the human person is a composite of a biological organism and an intellective soul. Eric Olson and Norman Ford both argue that the beginning of an individual human biological organism occurs at the moment when implantation of the zygote in the uterus occurs and the “primitive streak” begins to form. Prior to this point, there does not exist an individual human organism, but a cluster of biological cells which has the potential to split and develop as one or more separate human organisms (identical twinning). Ensoulment (the instantiation of a human intellective soul in biological matter) does not occur until the point of implantation. This conception of the beginning of human personhood has moral implications concerning the status of pre-implantation biological cell clusters. A new understanding of the beginning of human personhood entails a new understanding of the morality of certain medical procedures which have a direct affect on these cell clusters which contain human DNA. Such procedures discussed in this article are embryonic stem cell research, in vitro fertilization, procured abortion, and the use of abortifacient contraceptives.Item A case for using eponyms in anatomy to teach bioethics(American Association for Anatomy, 2021-11) Organ, Jason M.; Mussell, Jason C.; Anatomy and Cell Biology, School of MedicineItem Converging Concerns: Feminist Bioethics, Development Theory, and Human Rights(University of Chicago Press, 2003) Donchin, AnneItem Evolution of a discipline-The changing face of anatomy(Wiley, 2022-04) Organ, Jason M.; Comer, Amber R.; Health Sciences, School of Health and Human SciencesThis special issue is unlike any other special issue published in this journal's history. You will not find the types of original research in anatomy and evolutionary biology that you are accustomed to seeing adorning the pages of The Anatomical Record. Instead, the articles included cover the past and future of the discipline of anatomy broadly and of the American Association for Anatomy (AAA) more narrowly, and through two specific rhetorical frames: ethics; and diversity, equity, and inclusion. The articles in this issue are divided into two sections. The first section traces the history of anatomy and addresses many of the ethical dilemmas we face as a result of that history. The second section sets the stage for how the discipline and the AAA move forward to create a more diverse, equitable, and inclusive future for students, teachers, colleagues, and everyone else we touch through our work as anatomists. While this is only the beginning of our reconciliation with our past, the future certainly looks bright.Item Is there a global bioethics? End-of-life in Thailand and the case for local difference(2006-10) Stonington, Scott; Rattanakun, PhinitDebates the universal application of bioethical principles, using an example where a Thai physician refuses to remove life support from a brain dead patient.Item Open Wound: The Tragic Obsession of Dr. William Beaumont(2012-10-02) Karlawish, JasonItem Physician understanding and application of surrogate decision-making laws in clinical practice(Taylor & Francis, 2016) Comer, Amber Rose; Gaffney, Margaret; Stone, Cynthia L.; Torke, Alexia; Department of Health Sciences, School of Health and Rehabilitation SciencesBackground: Although state surrogate laws are the most common way surrogate decision makers are identified, no studies have been conducted to determine physician understanding of these laws or how these laws are utilized during clinical practice. The purpose of this study is to better understand how surrogate decision-making laws function in practice. Methods: A cross-sectional survey of 412 physicians working in Indiana hospitals was conducted between November 2014 and January 2015 to determine physicians' knowledge of Indiana's surrogate decision-making law and physicians' approaches to hypothetical cases using the law in clinical practice. Results: Fewer than half of physicians (48%) were able to correctly identify all legally allowable surrogate decision makers. Of those physicians who knew the law, nearly all of them (98%) indicated that they would violate the law during clinical practice by allowing nonlegal surrogates such as grandchildren to make medical decisions. Conclusions: A majority of physicians endorse relying on surrogates who have strong ties to the patient but are not legally allowable in Indiana. It is possible that these decisions reflect sound ethical reasoning even though they are illegal. Due to the narrow construction of some state surrogate decision laws, physicians may be placed in the position where they must either choose to follow medical ethical principles or the law. To alleviate these issues, state surrogate decision laws need to be amended to include a broader list of surrogates, such as extended family and close friends.Item Poetry "Found" in Illness Narrative: A Feminist Approach to Patients' Ways of Knowing and the Concept of Relational Autonomy(2009-10-29T14:29:25Z) Kauffman, Jill Lauren; Brand, Peggy Zeglin; Capshew, James H.; Gunderman, Richard B.; Schultz, Jane E.This project contributes to the improvement of the healing encounter between physician and patient and broadens the scope of medical ethics via application of a methodology that creatively communicates patient experience. Contemporary medical training and socialization can create emotional distance between patients and physicians, which has both positive and negative effects. A physician’s “detached concern” often renders patients’ ways of knowing irrelevant to their care. This has a negative effect on patient autonomy, trust, and the healing encounter in general. Herwaldt (2008) developed a pedagogical tool of distilling patient interviews in narrative form into “found poems,” in which the patient experience is expressed in verse; Herwaldt contends that the resulting poems hold the possibility of cultivating empathy in medical practitioners. My research extends Herwaldt’s work with a new set of ten patients currently in cancer treatment, translating their stories of illness into verse. The resulting poems have the potential to empower patients by legitimizing their narrative or experiential ways of knowing as complementary to physician perspectives and approaches to treatment. Clinical and feminist ethics are similar in their attention to case context, empathy, and legitimacy of narrative. However, there are aspects of feminist ethical theory that are not thoroughly delineated in clinical ethics—specifically, attention to power imbalances in medical structures and variations in ethical perspectives. When the poems are examined using a feminist bioethical framework, patients are empowered by expanding both the idea of justice and the principlist definition of autonomy to include the feminist conception of relational autonomy.Item Prenatal Screening: Quality Control and the Genetics Gateway(2007-08-17T18:38:47Z) Huerter, Mary Elise; Eberl, Jason T.; Schwartz, Peter H.; Schneider, William H. (William Howard), 1945-This thesis critically evaluates the progress of prenatal genetic testing, and how it, along with concurrent social pressures (such as the goal of having the ideal child) may have altered parental decision-making, autonomy, and attitudes toward children. Distinctive to this thesis is the analysis of prenatal genetic testing with a view of the eugenic history of genetics and public health initiatives in maternal health. This thesis will describe what current genetic screening pursuits may indicate with this historical understanding. I will discuss the dynamics of these subjects, and how they correspond with current social demands for perfection and the growing commodification of children. With this analysis I will attempt to shed greater light upon how our current prenatal screening technologies can modify the parent/child relationship, and what this may mean as medical science and technology advance. This thesis will be organized in a three-chapter format, providing a historical viewpoint and analysis of salient ethical issues.