Theses and Dissertations
This collection includes both ASU Theses and Dissertations, submitted by graduate students, and the Barrett, Honors College theses submitted by undergraduate students.
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Description
With new trends in drug development and testing, it must be determined whether the current state of balance of ethos (the moral norm) and regula (the legal framework) can successfully protect patients while keeping the door to scientific innovation open. The rise of the Clinician Investigator (CI) in both academic and private research introduces a challenge to the protection of subjects in the conflicting dual role of physician and scientist. Despite the constant evolution of regulation and ethical standards, questions about the roles' combined effectiveness in relation to this challenge persist. Carl Elliot describes the suicide of a patient-subject enrolled in an industry-funded physician-run anti-psychotic pharmaceutical drug trial in a 2010 Mother Jones article. Elliot provides a personal account of discrepancies seen in the ethical principles of beneficence, respect for subjects and justice. Through analysis of the problems presented in the case as a model for potential dangers in clinical research, the effectiveness of ethics and law in protecting human subjects is examined. While the lag between ethical standard and regulation has historically shown to cause similar issues, the misconception of current regulation and ethical standards may be contributing to the decrease in subject protections. After IRB approval of subject protections in the research protocol, CIs have been shown to downgrade their responsibility to maintaining ethos through the course of the trial. And, despite their experience in patient-centered ethos as a physician, CIs may be inclined to substitute these values for the ethos of a researcher, with the goal to avoid therapeutic misconception. Maintaining personal responsibility for subjects beyond regulatory structure, and promoting the welfare of the subjects in regards to the ethical standard of research investigators, will provide added security for subjects and decrease opportunity for exploitation in future research.
ContributorsWaddell, Amanda (Author) / Robert, Jason S (Thesis advisor) / Ellison, Karin (Committee member) / Fuse Brown, Erin C. (Committee member) / Arizona State University (Publisher)
Created2012
Description
Abortion is a controversial topic internationally. Most current debates about abortion concern when, if at all, it should be legal. However, researchers have shown many times that after an abortion ban, maternal and infant mortalities rise significantly, as women who seek out abortions do so regardless of abortion legality. So, is it possible to reduce abortions in a population without delegalizing abortion and, if so, how? Why do some countries have higher abortion rates than others in the presence of the same law?This dissertation answers both questions. First, I present historical evidence in the first comprehensive comparative analysis of all 15 post-Soviet countries, which have very similar abortion laws originating from the Union of Soviet Socialist Republics (USSR). Second, I use those findings to build the first agent-based model (ABM) of unintended pregnancies in a hypothetical artificial population.
USSR was the only country in the world to complete its demographic transition through abortion instead of modern contraception, and the Soviet government passed the first law in the world to allow abortion upon request in 1920. After the USSR dissolution in 1991, post-Soviet countries maintained very similar abortion laws, but had very different abortion rates for most years. Analysis of fertility data from post-Soviet countries shows that the prevalence of some specific contraceptive methods, namely the rhythm method (r = 0.82), oral pill (r = 0.56), and male condom (r = 0.51) are most strongly correlated with high abortion rates, and that sex education is a factor that reduces the rates in otherwise similar countries (p = 0.02).
The ABM shows that even basic sex education results in fewer abortions than no sex education or abstinence-based sex education (p < 0.01). In scenarios without sex education, basic quality of post-abortion contraceptive counseling (PACC) is better than no PACC or low-quality PACC at reducing abortions (p < 0.01). Still, the higher the quality of sex education or PACC, the fewer abortions in the artificial population. The ABM is adaptive and policy makers can use it as a decision-support tool to make evidence-based policy decisions regarding abortion, and, potentially, other sociobiological phenomena with some adjustments to the code.
ContributorsZiganshina Lienhard, Dina A. (Author) / Maienschein, Jane (Thesis advisor) / Gaughan, Monica (Thesis advisor) / Laubichler, Manfred (Committee member) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2023