Matching Items (4)
Filtering by
- All Subjects: Law
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
Description
The National Wilderness Preservation System (NWPS) is a collection of more than 800 areas designated as wilderness under the Wilderness Act of 1964. The Act defines wilderness as an “area where the earth and its community of life are untrammeled by man, where man himself is a visitor who does not remain.” Wilderness lands are supposed to be pristine examples of nature where the overseeing agency has not allowed any post-designation development. The language of the act describes land designated as wilderness as “untrammeled” by people, discounting thousands of years of human influence. It also discounts the potential effect of surrounding lands and visitors on the wilderness. The management of these lands falls to all four federal land management agencies, and they each had – and still have – their own organizational perspectives on the Wilderness Act and their agency’s role in its implementation. Although the Act provided criteria for designating and managing wilderness, concrete guidance is lacking. This ambiguity has allowed a rift to emerge between those who believe that wilderness should be actively managed and those who believe that wilderness should be preserved and left alone as much as possible. The diversity of views and agency approaches have created administrative divides between wilderness lands and other land types. In parallel, the introduction of subsequent environmental laws have placed additional legal boundaries on the land, creating parcels next to and within wilderness that are subject to different uses and requirements. This study, which marshals dozens of expert interviews and explores a series of wilderness cases across the United States, focuses on several unanticipated challenges of stewarding the NWPS in the 21st Century. These include: the impacts of public land parceling due to legal obligations; how statuary ossification affects current interpretations of the various laws bearing on wilderness lands; and ultimately how land managers and agencies – who are looking toward a future of increased anthropogenic impacts on wildlife biodiversity and endangered/threatened species on wilderness lands – approach these challenges.
ContributorsFacemire, Challie Renee (Author) / Minteer, Ben A (Thesis advisor) / Ellison, Karin (Thesis advisor) / Bradshaw, Karen (Committee member) / Hahn, Beth (Committee member) / Budruk, Megha (Committee member) / Arizona State University (Publisher)
Created2022
Description
Intake of alcohol, tobacco, and illicit substances such as marijuana and methamphetamine during pregnancy can have significant deleterious effects on a developing fetus and the resulting infant. The existence of substance-exposed newborns also has negative impacts on society as a whole; these include financial burdens placed on taxpayers and the additional time and resources required by health care professionals, social workers, and law enforcement authorities to properly care for such infants. Existing literature show a strong correlation between prenatal care and improved birth outcomes, including abstinence from or reduction of prenatal substance abuse. The Health Start Program in the state of Arizona attempts to mitigate the incidence of substance-exposed newborns, among other goals, by employing community health workers who identify high-risk pregnant and postpartum women, inform these women about how to receive prenatal care services, educate them on appropriate prenatal and neonatal care, and provide program and referral services to both pregnant and postpartum women. Community health workers interact directly with women most at-risk for prenatal substance abuse and should be well-versed in the understanding of the complex issues related to substance-exposed newborns. In an attempt to discover, analyze, and compile those complex issues with which community health workers should be knowledgeable, this project explores existing federal regulations regarding substance-exposed newborns, compares Arizona’s regulations to Minnesota’s, Virginia’s, and Washington’s, and analyzes prevailing literature in the field about the various implications associated with screening and reporting substance-exposed newborns to law enforcement authorities. After an intensive literature review, this project concludes that the Health Start Program needs a comprehensive resource document which enumerates federal and select state policies, landmark cases involving substance-abusing pregnant women and the precedence set by each, and recommendations from medical and public health experts. The document should also provide clear guidelines by which each stakeholder should abide and why, and recommend potential best practices the state of Arizona could adopt into law based on other state policies which have proven to be effective.
ContributorsTantibanchachai, Chanapa (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Thesis advisor) / Coursen, Cristi (Committee member) / Arizona State University (Publisher)
Created2015