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Morality of the Past: How Two Committees Judged Past Human Subject Experiments

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In 1996, President Clinton ordered the formation of the Advisory Committee on Human Radiation Experiments (ACHRE), which undertook to evaluate the morality of a myriad of secret and publicized radiation experiments ranging from 1944 to 1974. The goal of this

In 1996, President Clinton ordered the formation of the Advisory Committee on Human Radiation Experiments (ACHRE), which undertook to evaluate the morality of a myriad of secret and publicized radiation experiments ranging from 1944 to 1974. The goal of this thesis is to analyze the ways in which that committee formed moral evaluations and the extent to which its strategies related to a broader historical and philosophical discourse. Here I attempt to describe two specific techniques of simplification the committee deploys in order to make a retrospective moral analysis possible. Although the techniques comprise specific problems, frameworks, subjective perspectives, and conceptual links, their unifying principle is the field of choices the techniques produce. In the first technique I outline, I argue that by focusing on the problem of historical relativism, the committee gains a platform through which it would be granted flexibility in making a distinction between moral wrongdoing and blameworthiness. In the second technique of simplification I outline, I argue that the committee's incorporation of a principle to reduce uncertainty as an ethical aim allow it to establish new ways to reconcile scientific aims with moral responsibility. In addition to describing the structure of these techniques, I also demonstrate how they relate to the specific experiments the analysts aim to evaluate, using both the ACHRE experiments as well as the Nuremberg Trial experiments as my examples. My hope is not to show why a given committee made a particular moral evaluation, or to say whether a decision was right or wrong, but rather to illustrate how certain techniques open up a field of choices that allow moral analysts to form retrospective moral judgments.

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2015-05

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Making better students: ADHD in higher education and the biopolitics of stimulant medication

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According to my 2016 survey of ASU undergraduate students, 33% have used stimulant medications (e.g. Adderall or Ritalin) without a prescription to study. I view this practice as a step towards cognitive enhancement, which is the deliberate application of biotechnology

According to my 2016 survey of ASU undergraduate students, 33% have used stimulant medications (e.g. Adderall or Ritalin) without a prescription to study. I view this practice as a step towards cognitive enhancement, which is the deliberate application of biotechnology to radically alter the human condition. From a foresight perspective, the ability to actively improve human beings, to take our evolutionary destiny into our own hands, may be a turning point on par with agriculture or the use of fossil fuels. The existential risks, however, may be greater than the benefits—and many of the most radical technologies have made little documented progress.

I turn to an actual example where people are trying to make themselves marginally better at academic tasks, as a guide to how future transformative development in human enhancement may be incorporated into everyday practice. This project examines the history and context that led to the widespread use of stimulant medication on college campuses. I describe how Attention Deficit Hyperactivity Disorder (ADHD), for which stimulant medication is prescribed and diverted, governs students, negotiates relationships between parents and school authorities, and manages anxieties resulting from a competitive neoliberal educational system. I extend this archeology of ADHD through the actions and ethical beliefs of college students, and the bioethical arguments for and against human enhancement. Through this work, I open a new space for an expanded role for universities as institutions capable of creating experimental communities supporting ethical cognitive enhancement.

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2016

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How Factors like 1800’s Gender Expectations, Misconceptions, and Moral Traditions Shaped US Women’s Reproductive Medical Care

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In the last 200 years, advancements in science and technology have made understanding female sexual function and the female body more feasible; however, many women throughout the US still lack fundamental understanding of the reproductive system in the twenty-first century.

In the last 200 years, advancements in science and technology have made understanding female sexual function and the female body more feasible; however, many women throughout the US still lack fundamental understanding of the reproductive system in the twenty-first century. Many factors contribute to the lack of knowledge and misconceptions that women still have. Discussing sexual health tends to make some people uncomfortable and this study aims to investigate what aspects of somewhat recent US history in women’s health care may have led to that discomfort. This thesis examines the question: what are some of the factors that shaped women’s reproductive medicine in the US from the mid 1800s and throughout the 1900s and what influence could the past have had on how women and their physicians understand female sexuality in medicine and how physicians diagnose their female patients in the twenty-first century. A literature review of primary source medical texts written at the end of the 1800s provides insight about patterns among physicians at the time and their medical practice with female patients. Factors like gendered expectations in medical practice, misconceptions about the female body and behaviors, and issues of morality in sex medicine all contributed to women lacking understanding of sex female reproductive functions. Other factors like a physician’s role throughout history and non-medical reproductive health providers and solutions likely also influenced the reproductive medicine women received. Examining the patterns of the past provides some insight into some of the outdated and gendered practices still exhibited in healthcare. Expanding sexual education programs, encouraging discussion about sex and reproductive health, and checking gendered implicit bias in reproductive healthcare could help eliminate echoes of hysteria ideology in the twenty-first century medicine.

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Date Created
2019

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Between persuasion and coercion: situating mandatory influenza vaccination policy of healthcare personnel (HCP)

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Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent

Vaccinations are important for preventing influenza infection. Maximizing vaccination uptake rates (80-90%) is crucial in generating herd immunity and preventing infection incidence. Vaccination of healthcare professionals (HCP) against influenza is vital to infection control in healthcare settings, given their consistent exposure to high-risk patients like: those with compromised immune systems, children, and the elderly (Johnson & Talbot, 2011). Though vaccination is vital in disease prevention, influenza vaccination uptake among HCP is low overall (50% on average) (Pearson et al., 2006). Mandatory vaccination policies result in HCP influenza vaccination uptake rates substantially higher than opt-in influenza vaccination campaigns (90% vs. 60%). Therefore, influenza vaccination should be mandatory for HCP in order to best prevent influenza infection in healthcare settings. Many HCP cite individual objections to influenza vaccination rooted in personal doubts and ethical concerns, not best available scientific evidence. Nevertheless, HCP ethical responsibility to their patients and work environments to prevent and lower influenza infection incidence overrules such individual objections. Additionally, mandatory HCP influenza vaccination policies respect HCP autonomy via including medical and religious exemption clauses. While vaccination as a prevention method for influenza is logically sound, individuals’ actions are not always rooted in logic. Therefore, I analyze HCP perceptions and actions toward influenza vaccination in an effort to better explain low HCP uptake rates of the influenza vaccine and individual objections to influenza vaccination. Such analysis can aid in gaining HCP trust when implementing mandatory HCP influenza vaccination policies. In summary, mandatory HCP influenza vaccination policies are ethically justified, effective, scientifically-supported method of maximizing HCP influenza vaccine uptake and minimizing the spread of the influenza virus within healthcare settlings.

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Date Created
2016