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Description
Corporations in biomedicine hold significant power and influence, in both political and personal spheres. The decisions these companies make about ethics are critically important, as they help determine what products are developed, how they are developed, how they are promoted, and potentially even how they are regulated. In the last fifteen years, for-profit private companies have been assembling bioethics committees to help resolve dilemmas that require informed deliberation about ethical, legal, scientific, and economic considerations. Private sector bioethics committees represent an important innovation in the governance of emerging technologies, with corporations taking a lead role in deciding what is ethically appropriate or problematic. And yet, we know very little about these committees, including their structures, memberships, mandates, authority, and impact. Drawing on an extensive literature review and qualitative analysis of semi-structured interviews with executives, scientists and board members, this dissertation provides an in-depth analysis of the Ethics and Public Policy Board at SmithKline Beecham, the Ethics Advisory Board at Advanced Cell Technology, and the Bioethics Committee at Eli Lilly and offers insights about how ideas of bioethics and governance are currently imagined and enacted within corporations. The SmithKline Beecham board was the first private sector bioethics committee; its mandate was to explore, in a comprehensive and balanced analysis, the ethics of macro trends in science and technology. The Advanced Cell Technology board was created to be like a watchdog for the company, to prevent them from making major errors. The Eli Lilly board is different than the others in that it is made up mostly of internal employees and does research ethics consultations within the company. These private sector bioethics committees evaluate and construct new boundaries between their private interests and the public values they claim to promote. Findings from this dissertation show that criticisms of private sector bioethics that focus narrowly on financial conflicts of interest and a lack of transparency obscure analysis of the ideas about governance (about expertise, credibility and authority) that emerge from these structures and hamper serious debate about the possible impacts of moving ethical deliberation from the public to the private sector.
ContributorsBrian, Jennifer (Author) / Robert, Jason S (Thesis advisor) / Maienschein, Jane (Committee member) / Hurlbut, James B (Committee member) / Sarewitz, Daniel (Committee member) / Brown, Mark B. (Committee member) / Moreno, Jonathan D. (Committee member) / Arizona State University (Publisher)
Created2012
Description
Nearly seven decades ago, the US government established grants to the states for family planning and acknowledged the importance of enabling all women to plan and space their pregnancies, regardless of personal income. Since then, publicly-funded family planning services have empowered millions of women, men, and adolescents to achieve their childbearing goals. Despite the recognized importance of subsidized family planning, services remain funded in a piecemeal fashion. Since the 1940s there have been numerous federal funding sources for family planning, including the Title V Maternal and Child Health Services Program, Office of Economic Opportunity grants, Title XX Social Services Program, Title X Family Planning Program, Medicaid, and the State Children’s Health Insurance Program, alongside state and local support. Spending guidelines allow states varying degrees of flexibility regarding allocation, to best serve the local population. With nearly two billion dollars spent annually on subsidized family planning, criticism often arises surrounding effective local program spending and state politics influencing grant allocation. Political tension regarding the amount of control states should have in managing federal funding is exacerbated in the context of family planning, which has become increasingly controversial among social conservatives in the twenty-first century. This thesis examines how Arizona’s political, geographic, cultural, and ethnic landscape shaped the state management of federal family planning funding since the early twentieth century. Using an extensive literature review, archival research, and oral history interviews, this thesis demonstrates the unique way Arizona state agencies and nonprofits collaborated to maximize the use of federal family planning grants, effectively reaching the most residents possible. That partnership allowed Arizona providers to reduce geographic barriers to family planning in a rural, frontier state. The social and political history surrounding the use of federal family planning funds in Arizona demonstrates the important role states have in efficient, effective, and equitable state implementation of national resources in successfully reaching local populations. The contextualization of government funding of family planning provides insight into recent attempts to defund abortion providers like Planned Parenthood, cut the Title X Family Planning Program, and restructure Medicaid in the twenty-first century.
ContributorsNunez-Eddy, Claudia (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / O'Neil, Erica (Committee member) / Arizona State University (Publisher)
Created2018
Description
In the fifteen years between the discovery of fetal alcohol syndrome (FAS) in 1973 and the passage of alcohol beverage warning labels in 1988, FAS transformed from a medical diagnosis between practitioner and pregnant women to a broader societal risk imbued with political and cultural meaning. I examine how scientific, social, moral, and political narratives dynamically interacted to construct the risk of drinking during pregnancy and the public health response of health warning labels on alcohol. To situate such phenomena I first observe the closest regulatory precedents, the public health responses to thalidomide and cigarettes, which established a federal response to fetal risk. I then examine the history of how the US defined and responded to the social problem of alcoholism, paying particular attention to the role of women in that process. Those chapters inform my discussion of how the US reengaged with alcohol control at the federal level in the last quarter of the twentieth century. In the 1970s, FAS allowed federal agencies to carve out disciplinary authority, but robust public health measures were tempered by uncertainty surrounding issues of bureaucratic authority over labeling, and the mechanism and extent of alcohol’s impact on development. A socially conservative presidency, dramatic budgetary cuts, and increased industry funding reshaped the public health approach to alcoholism in the 1980s. The passage of labeling in 1988 required several conditions: a groundswell of other labeling initiatives that normalized the practice; the classification of other high profile, socially unacceptable alcohol-related behaviors such as drunk driving and youth drinking; and the creation of a dual public health population that faced increased medical, social, and political scrutiny, the pregnant woman and her developing fetus.
ContributorsO'Neil, Erica (Author) / Maienschein, Jane (Thesis advisor) / Hurlbut, James (Committee member) / Ellison, Karin (Committee member) / Wetmore, Jameson (Committee member) / Arizona State University (Publisher)
Created2016
Description
The purpose of the study was to determine the level and type of public policy involvement among registered nurses (RN) who are members of the Arizona Nurses Association (AzNA). Furthermore, the aim of the study was to identify the knowledge base and motivation of nurses and their involvement in public policy as well as the barriers and benefits. A 20- item survey was sent to all of the members of AzNA. There were 39 responses used in the analysis. The highest reported public policy activities in which the nurses had participated were: voted (90%), contacted a public official (51%), and gave money to a campaign or for a public policy concern (46%). Lack of time was the most frequently reported barrier to involvement and improving the health of the public was the most frequently reported benefit to involvement. The number of public policy education/information sources and the highest level of education positively correlate to the nurses' total number of public policy activities (r = .627 p <0.05; r = .504, p <0.05). Based on the results of stepwise linear regression analysis, the participants' age, number of education/information sources, and efficacy expectation predict 68.8% of involvement in public policy activities. The greater the number of education/information sources, the greater the number of public policy activities nurses report having participated in.
ContributorsHartman, Mykaila Corrine (Author) / Stevens, Carol (Thesis director) / Munoz, Aliria (Committee member) / Link, Denise (Committee member) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor) / Barrett, The Honors College (Contributor)
Created2015-12