Matching Items (62)

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A History and Analysis of Drug Labeling Policy for Pregnant and Lactating Women and Women's Involvement in Clinical Drug Research from 1970 to 2014

Description

The inherent risk in testing drugs has been hotly debated since the government first started regulating the drug industry in the early 1900s. Who can assume the risks associated with trying new pharmaceuticals is unclear when looked at through society's

The inherent risk in testing drugs has been hotly debated since the government first started regulating the drug industry in the early 1900s. Who can assume the risks associated with trying new pharmaceuticals is unclear when looked at through society's lens. In the mid twentieth century, the US Food and Drug Administration (FDA) published several guidance documents encouraging researchers to exclude women from early clinical drug research. The motivation to publish those documents and the subsequent guidance documents in which the FDA and other regulatory offices established their standpoints on women in drug research may have been connected to current events at the time. The problem of whether women should be involved in drug research is a question of who can assume risk and who is responsible for disseminating what specific kinds of information. The problem tends to be framed as one that juxtaposes the health of women and fetuses and sets their health as in opposition. That opposition, coupled with the inherent uncertainty in testing drugs, provides for a complex set of issues surrounding consent and access to information.

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2018-05

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Testing the Human Small Intestine under Different Preservation Conditions Segmentally with a Look Into the Ethics of Health Insurance Involvement

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Intestinal Transplant is becoming more prevalent with time as an powerful alternative to other therapies for intestinal failure such as parenteral nutrition. The small intestine is an organ especially susceptible to ischemia, or the lack of blood and oxygen supply

Intestinal Transplant is becoming more prevalent with time as an powerful alternative to other therapies for intestinal failure such as parenteral nutrition. The small intestine is an organ especially susceptible to ischemia, or the lack of blood and oxygen supply to an organ. I studied ischemia at Yale Medical School in the lab of Dr. John Geibel. The purpose of this study was to find which kind of solution best protects the intestine from ischemia as well as which segments of the intestine are more susceptible to ischemic damage. This was done by cold static storage as well as through perfusing the organ with a unit developed in the lab called the Intestinal Perfusion Unit (IPU). Intestines were procured from deceased donors following the protocol for handling human specimen and then flushed with either the University of Wisconsin (UW) solution or the Histidine-tryptophan-ketoglutarate solution (HTK). It was found that the jejunum is more susceptible ischemia than the ileum. It was also found that in the jejunum, when using UW solution there was less damage then when using HTK. Clinically, this means that in transplant, if the ileum part is used, there is less risk for ischemic damage. The potential applications of this research raise many ethical issues related to organ transplantation more broadly. The ethical issues include but are not limited to: consent, distribution and need-based donation, transplant tourism, and cost and access. The costs for transplant are exorbitant for the average American. Private insurance companies and Medicare have no policy for intestinal transplant and are therefore not covering many patients in need. In this thesis, I briefly explore the role of insurance companies in the equitable distribution of innovative medical interventions.

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2018-05

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The Definition of Death According to Neurological Criteria: A Product of Medical Advancement and Reasons for Controversy over Accurate Diagnosis

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The concept of when human death occurs had for most of history been determined by criteria for cardiac death, defined as the cessation of a heartbeat and respiration. However, in the mid-1900's, a new definition of death emerged in the

The concept of when human death occurs had for most of history been determined by criteria for cardiac death, defined as the cessation of a heartbeat and respiration. However, in the mid-1900's, a new definition of death emerged in the form of brain death, characterized by an irreversible cessation of brain and brainstem function. This definition was needed after resuscitation of the heart was made possible and a growing number of patients were in a state of ventilatory support but had undetectable brain function. The success of organ transplantation and the growing need for more organ procurements further reinforced the advantage of using neurological criteria to declare death. These advancements in medicine have created a need for a definition of death other than cardiac death and have led to the acceptance of brain death, though it is still the subject of controversy. It has been attacked as a concept with weak scientific foundations and ethical justifications, since the brain itself is not well understood and the definition is used to the advantage of the organ donation system. Those in opposition to the use of neurological criteria to pronounce death argue that it is not always correctly detected and is conceptually incoherent. It would help to resolve this point of controversy if accurate methods to detect brain death were standardized for all physicians to use when declaring death, so that no declarations could be termed inaccurate or incomplete. The definition of brain death needs more rigorous and updated scientific backing in its ability to be detected if it is to be imposed upon individuals by law, as it is in the United States. It is also possible that new research and developments in medical treatments will make the current definition of death subject to change, and understanding the underlying problems of the current definition of brain death will help eliminate issues in a new definition of death.

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2018-05

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Commodifying the Womb: Ethical Concerns of Assisted Reproductive Technologies through a Marxist Lens

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Whether legal, banned or unregulated, states and nations are reconsidering the morality and legality of the practice of surrogacy. Though many advocate for the absolute right to this practice, there are serious ethical concerns about the practice of surrogacy. Using

Whether legal, banned or unregulated, states and nations are reconsidering the morality and legality of the practice of surrogacy. Though many advocate for the absolute right to this practice, there are serious ethical concerns about the practice of surrogacy. Using critical theory, this thesis examines the relationships between the systems and people who have fostered a space where assisted reproductive technologies (ARTs) thrive. A theoretical analysis of Karl Marx and his literature on women and reproduction adds more comprehensive depth to the last four decades of literature on surrogacy. I respond to Marx and contemporary researchers with a recommendation: surrogacy should be regulated (and not necessarily banned) across states and nations. I also suggest that future discussions should point to market-inalienability as a tool to guide discussion on the state of surrogacy. I argue surrogacy is synonymous with purchasing children. If we are able to have clearer conversations about the ways in which children are treated as commodities, then we can start to understand the ways in which other forms of conception and childbearing practices are also problematic and exploitative.

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2018-05

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Sex Trafficking in the US: A Case Study of the Stories We Tell and Who they Exclude

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In the current political moment, sex trafficking is an issues that has gained increased political and media attention. This thesis first analyzes the stories that are told about sex trafficking in policy and the media. Analyzing these stories help us

In the current political moment, sex trafficking is an issues that has gained increased political and media attention. This thesis first analyzes the stories that are told about sex trafficking in policy and the media. Analyzing these stories help us make sense of whose voices, experiences, and needs we listen to, and in relief, whose we do not. Through a case study that evaluates the research, policy work, and advocacy being conducted through the Office of Sex Trafficking Intervention Research at ASU, I first explore how they are dominating the conversation about sex trafficking in Arizona. I offer four critiques on STIR's approach to sex trafficking. First, I critique the language that STIR uses, and the implications of explaining this social issue as sex trafficking instead of survival sex. I then critique the policy and responses around the experiences of LGBTQ youth, and how the theory of dynamic nominalism informs the way we should represent LGBTQ youth in research. Through analyzing specific responses to sex trafficking prevention that STIR offers, such as calling 911, I will explore the need for intersectionality to protect the wellbeing of youth of color. Lastly, through theoretical critiques of neoliberalism, I will explore the ways in which STIR's research, advocacy, and trainings neglect to explore the systems youth must navigate and exist in, and how those systems fail. Through each of these unique critiques, we notice different silences and important considerations that are missing from the work that is dominating the discussion of sex trafficking in the US. Ultimately, this thesis does not argue that we should not care about sex trafficking, but instead argues we need to care more. It explores the ways that acknowledging the complexity and nuance of this great social problem can provide the ability to create meaningful solutions that care for and listen to youth.

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2018-05

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The Role of the Pharmaceutical Industry in America's Current Opioid Crisis

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The current American opioid crisis is seeing an exponential number of fatalities. The opioid epidemic is a problem with massive scope, and while no clear reason has been identified, many causal relationships have been linked to its genesis. This thesis

The current American opioid crisis is seeing an exponential number of fatalities. The opioid epidemic is a problem with massive scope, and while no clear reason has been identified, many causal relationships have been linked to its genesis. This thesis examines the role of the pharmaceutical industry in perpetuating the abuse rates we see today. Topics of sociological norms and values, economic incentives that benefitted private business practices, and political-legal means of restitution and market completion are examined to make sense of specific mechanisms that the pharmaceutical industry took advantage of, and the future trajectory of what is to come from the industry as well. Combined with policies (or, lack thereof) that do not provide adequate checks against opioid marketing strategies and incentives, governmental interferences come too little, too late in attempting to solve the issue.

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2018-05

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Publication Guidelines and the Use of Qualitative versus Quantitative Data in the Reporting of Research in Elsevier’s Animal Behaviour

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Many journals provide guidelines for their publications, which outline the expectations for authors when submitting an article for publication. Although these guidelines have become common practice for some journals, there is little written regarding the impact that these guidelines have

Many journals provide guidelines for their publications, which outline the expectations for authors when submitting an article for publication. Although these guidelines have become common practice for some journals, there is little written regarding the impact that these guidelines have on the reporting of research. This paper aims to provide insight regarding the question of “How do journal guidelines address the reporting of data in scientific journals?” This study does not measure the impact that guidelines have had on the reporting of research and instead aims to use the established methodology of document analysis to develop a new instrument for helping understand how and whether publication guidelines impact the reporting of data. The work conducted to develop this methodology involved analysis of the language used in publication guidelines and its potential impact on the use of qualitative versus quantitative data in the reporting of animal behavior research. The topic was chosen as animal behavior research often requires the use of both quantitative and qualitative observations when reporting. In this study, we examined the differences in publication guidelines outlined by the Elsevier’s Animal Behaviour between the years 1960 and 2019, to identify any potential influence of the journal’s publication guidelines on the reporting of scientific research in Animal Behaviour. This study highlights three emerging themes (data presentation, types of research topics and paper types) and identifies supporting language in the guidelines that address the use of qualitative and quantitative terms in the reporting of scientific research.

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2019-12

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Dams, Displacement, and Health: Reviewing Impacts of Large Dams on Displaced Communities

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This paper explores the impacts of dam-induced displacement on the health of populations. By the start of the 21st century, an estimated 40-80 million people worldwide were forced to resettle due to the construction of large dams. The process of

This paper explores the impacts of dam-induced displacement on the health of populations. By the start of the 21st century, an estimated 40-80 million people worldwide were forced to resettle due to the construction of large dams. The process of displacement and resettlement is connected to numerous social impacts on communities such as decreases in household income, natural resources, and social connectivity, but less seems to be known about specific health impacts. Analyzing literature in a formal review allowed for increased understanding about what information already exists in published research regarding the connections between dams, displacement, and health. Some negative health impacts as a result of forced displacement were identified, including increases in infectious disease transmission, depression, and mortality rates as well as losses of food and water sources. However, the small amount of cases found in the literature review when compared to the massive scale of dam development worldwide indicates a gap in knowledge in the dam industry and research field specifically about the health of the vast majority of populations forcibly displaced by dams. Health impacts must be considered and systematically studied in dam projects involving displacement to fully understand the needs of resettled populations and move towards equitable processes in development projects worldwide.

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2020-05

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Scalpel Slaves and Surgical Sculptors: Cosmetic surgery, management of the media and the implications of commercialized medicine

Description

Of the over 17 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2016, women accounted for over 90% of patients and nearly 70% of all patients were white. The goal of cosmetic surgery is to surgically

Of the over 17 million surgical and minimally-invasive cosmetic procedures performed in the United States in 2016, women accounted for over 90% of patients and nearly 70% of all patients were white. The goal of cosmetic surgery is to surgically restructure a healthy body part to more closely represent the contemporary ideal of what defines a particular gender. For example, femininity being linked to large breasts and small waist-to-hip ratio maintains binary heteronormative standards of what female body should look like. Plastic surgeons rely on advertising to attract patients for their businesses, since insurances do not cover elective cosmetic procedures. The ethical dilemma with this medical profession is with establishing aesthetic criteria for categorizing which bodies are considered normal and which are deviant. To understand the role of the physician in perpetuating cultural standards of beauty and promote surgery through their advertising, a random sample of 5 board-certified plastic surgeons from Scottsdale, AZ 85258 was obtained, focusing primarily on the images and textual content of their web pages. Of the 50 images sampled, nearly 75% of images portrayed white women. Women of color did not present in any of the photos. 52% of the home page images sexualized female clients using seductive posing and lingerie and promoted femininity using makeup and long hair. The language used in these websites criticized the presurgical female body and suggested that only physicians could eradicate their deficiencies, thereby normalizing cosmetic surgery as a means of beauty enhancement and maintaining the cultural superiority of doctors. 60% of websites failed to include adequate description of surgical risk. By choosing cosmetic surgery, women are negotiating their lives and acting as agents, even under circumstances that they cannot control such as the withholding of information, minimizing of risk or the social context and its corresponding pressures. Although the forewarning of surgical risk is rarely effective as a deterrent, it is the responsibility of the physician to provide the patient with all the information to the best of their ability so that they can decide what's best for their present circumstance, although rarely taken under conditions of perfect knowledge or absolute freedom from societal pressures. The American Society of Plastic Surgeons should work in conjunction with the Better Business Bureau's National Advertising Review Council to mediate regulatory solutions and increase public assurance in the credibility of advertising, perhaps an initiative similar to that of advertising for the cigarette industry. A pledge from the cosmetic surgery industry in conjunction to the Hippocratic Oath of the American Medical Association, which outlines the physician's responsibility to the patient within the context of advertising and marketing, could strengthen social responsibility and foster stronger, more honest relationships between surgeons and consumers.

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2017-05

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Physician and Medical Ethics Committee Members' Perceptions of Death with Dignity in Arizona

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Death with Dignity is a concept that initially began as a set of philosophical and ethical principles that sought to define what it meant to die a "good" death that was reasonable to the person experiencing the dying process. This

Death with Dignity is a concept that initially began as a set of philosophical and ethical principles that sought to define what it meant to die a "good" death that was reasonable to the person experiencing the dying process. This dying process is terminal illness, or any condition that cannot be cured and who's ultimate prognosis is death. Today, Death with Dignity still embodies this, but it is also a set of legal and medical treatments and practices that can be used to aid terminal patients in accomplishing a "good" death. The Death with Dignity treatment options that are chiefly discussed in this study are patient withdrawal of care, patient control of pain medications, and physician-assisted suicide. Physician-assisted suicide is legal in six states in the US excluding Arizona. Considering that Oregon is the first state to pass a Death with Dignity Act and that it is the precedent for all other Acts, this study sought to understand the differences in perception of physician-assisted suicide between Arizona and Oregon in the pursuit of clarifying what barriers are still in place in Arizona to passing a Death with Dignity act. To ask the question of "Do physicians and ethics committee members in Arizona support Death with Dignity in the forms of patient control of pain medications, withdrawal of treatment, and physician-assisted suicide?", a literature review was conducted to determine important national and local perceptions of physician-assisted suicide and Death with Dignity, a 14-question, structured survey was created with the identified concerns, and it was distributed to Arizona health care workers by email and in person. This survey was approved by ASU's Institutional Review Board. This survey found that 100% of participants would vote for a Death with Dignity Act in Arizona if it were on a ballot measure. 76% of participants would aid a terminally-ill and eligible patient in physician-assisted suicide under some circumstances if it were legal in Arizona, and 24% of participants would never aid a patient in physician-assisted suicide. The concerns with physician-assisted suicide that were marked most important by Arizona healthcare workers were that hospice is a better option for the terminally ill and that physician-assisted suicide may be misused with disadvantaged persons. The most important factors of terminal illness that influence views of physician-assisted suicide marked by Arizona healthcare workers were the amount of pain the patient is expected to experience in the end of life, the amount of pain that can be relieved for the patient, the expected quality of life of the patient, and the patient's right to autonomy in healthcare. The significant differences between Oregon and Arizona in this study were the importance of expected mental decline of patient, patient's wishes that differ from family's, and hospice being a better option than suicide in influencing views of physician-assisted suicide. These differences could be deemed hurdles to Death with Dignity legislation in Arizona. This study recommended addressing those differences in public education and medical education and seeking Death with Dignity legislation via ballot measure.

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2017-05