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- All Subjects: bioethics
- Creators: Ellison, Karin
- Resource Type: Text
Philosophers have articulated that a promise contains a moral obligation to fulfill it because of others’ expectations created by that promise. As the US government made its first promises in early treaties with AI/AN tribes and subsequently made promises in the years since, it is morally obligated to fulfill those promises, be they lying promises or not, because of resulting expectations. Yet, the US government has historically acted to restrict the rights of AI/AN—rights that include access to health services—through assimilation, separation, or termination policies. Further, the policies of the US government have kept the AI/AN populations socioeconomically impoverished, dependent on the US government for basic needs, and susceptible to health-compromising conditions.
Using case studies, this dissertation looks not only at the policies and events that directly affected health services and health status, but also at how those policies and events contributed to health outcomes and the expectations of AI/AN. Given the history of the US government in fulfilling (or not fulfilling) its promises, this dissertation examines the expectations of AI/AN for their own future health outcomes under the policy of self-governance.
The basic goal of preclinical animal research is to improve understanding of human disease and treatment. Mandates for sex-inclusive research – both in preclinical animal work and in human clinical trials – have prompted discussions about the ethics and functionality of sex-inclusive research. Authors of peer review research articles and opinion pieces have varying opinions regarding sex-inclusive preclinical animals research. The arguments that support sex inclusion in animal research include: a) sex inclusive research in the preclinical animal model stage saves money further down the road in research, b) new understanding in hormonal variation in both male and female mice undercuts a notion that male mice are simpler research subjects, and c) sex-inclusive research is needed for improved treatment and diagnosis for male and female humans down the road. Arguments against inclusive research include: a) increased research cost and time, and b) sex-inclusive preclinical animal research is not useful, and may be harmful, to the development of personalized medicine. Weighing the different arguments present in the conversation regarding sex inclusive research, sex inclusive research is clearly important and necessary moving forward for cost efficiency, scientific discovery, and movement towards precision medicine.