Matching Items (38)
Description
American Indian literature is replete with language that refers to broken or hollow promises the US government has made to American Indians, one of the most prominent being that the US government has not kept its promises regarding health services for American Indians/Alaska Natives (AI/AN). Some commenters refer to treaties between tribes and the US government as the origin of the promise for health services to AI/AN. Others point to the trust relationship between the sovereign nations of American Indian tribes and the US government, while still others assert that the Snyder Act of 1921 or the Indian Health Care Improvement Act (IHCIA) contained the promise for health care. While the US has provided some form of health care for AI/AN since the country was in its infancy, and continues to do so through the Indian Health Service, the promise of health services for AI/AN is not explicit.
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.
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.
ContributorsDrago, Mary (Author) / Maienschein, Jane (Thesis advisor) / Ellison, Karin (Committee member) / Herkert, Joseph (Committee member) / Hurlbut, James (Committee member) / Robert, Jason (Committee member) / Trujillo, Michael (Committee member) / Arizona State University (Publisher)
Created2016
ContributorsSavarese, Erica (Author) / Robert, Jason (Thesis director) / Hurlbut, Ben (Committee member) / Verrelli, Brian (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2013-05
Description
The use of medical scribes in emergency departments has been associated with faster patient discharge times, increased numbers of patients treated, and improved patient satisfaction ratings in previous research studies and has also been correlated with improved levels of physician satisfaction as well as a high degree of gratification from scribes. For this paper, I examined the nature of scribing, essentially analyzing the role of the scribe in modern healthcare, and the effects of the occupation on the medical field. Though a shortage of prior research regarding medical scribing persisted, the data I received here mirrored some of the results from earlier studies, specifically those which proclaimed that physicians admit to increased work efficiency when accompanied by scribes. Unlike prior studies, however, this thesis presents novel information regarding scribes‘ perspectives of the profession, including some of the complaints they possess, which are most notably long and irregular shifts, far commute distances, and low wages. Through my research, which relied heavily on interviews and surveys and less heavily on EMR-simulating examinations, scribes were discovered to have a greater average typing speed (64 wpm) than physicians (30 wpm) and performed better in three drills that simulated different manners of patient charting. It was the opinion of all physicians that scribes were beneficial—both to them as physicians and to patients. Though scribes represented varying opinions about their role, the majority (9/11) of those who were interviewed classified scribing as a somewhat stressful job but also stated that they were mostly satisfied with their position.
ContributorsAguirre, Abel (Author) / Robert, Jason (Thesis director) / Maienschein, Jane (Committee member) / Ellison, Karin (Committee member) / Barrett, The Honors College (Contributor) / College of Liberal Arts and Sciences (Contributor) / School of Life Sciences (Contributor)
Created2012-12
Description
Memory augmentation will play a vital role in the development of our future. The predicted introduction of downloadable brains will be the first of many neurocognitive technologies that will alter our lives at both the societal and individual levels. These technologies can affect everything from educational institutions to the judicial system, meanwhile raising issues such as autonomy, human psychology, and selfhood. Because of its tremendous potential, memory augmentation and its implications should thoroughly be examined.
ContributorsKim, Jinkyu (Author) / McGregor, Joan (Thesis director) / Robert, Jason (Committee member) / Helms Tillery, Stephen (Committee member) / Barrett, The Honors College (Contributor) / Division of Educational Leadership and Innovation (Contributor) / Harrington Bioengineering Program (Contributor)
Created2013-05
Description
The development of computational systems known as brain-computer interfaces (BCIs) offers the possibility of allowing individuals disabled by neurological disorders such as Amyotrophic Lateral Sclerosis (ALS) and ischemic stroke the ability to perform relatively complex tasks such as communicating with others and walking. BCIs are closed-loop systems that record physiological signals from the brain and translate those signals into commands that control an external device such as a wheelchair or a robotic exoskeleton. Despite the potential for BCIs to vastly improve the lives of almost one billion people, one question arises: Just because we can use brain-computer interfaces, should we? The human brain is an embodiment of the mind, which is largely seen to determine a person's identity, so a number of ethical and philosophical concerns emerge over current and future uses of BCIs. These concerns include privacy, informed consent, autonomy, identity, enhancement, and justice. In this thesis, I focus on three of these issues: privacy, informed consent, and autonomy. The ultimate purpose of brain-computer interfaces is to provide patients with a greater degree of autonomy; thus, many of the ethical issues associated with BCIs are intertwined with autonomy. Currently, brain-computer interfaces exist mainly in the domain of medicine and medical research, but recently companies have started commercializing BCIs and providing them at affordable prices. These consumer-grade BCIs are primarily for non-medical purposes, and so they are beyond the scope of medicine. As BCIs become more widespread in the near future, it is crucial for interdisciplinary teams of ethicists, philosophers, engineers, and physicians to collaborate to address these ethical concerns now before BCIs become more commonplace.
ContributorsChu, Kevin Michael (Author) / Ankeny, Casey (Thesis director) / Robert, Jason (Committee member) / Frow, Emma (Committee member) / Harrington Bioengineering Program (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / Barrett, The Honors College (Contributor) / School for the Future of Innovation in Society (Contributor) / Lincoln Center for Applied Ethics (Contributor)
Created2016-05
Description
This thesis attempts to use psychoneuroimmunology (PNI) as a lens for examining different immune and autoimmune disorders, as well as psychological function and dysfunction. Through this examination, it is hypothesized that PNI could point to an accurate theoretical framework for describing the mind-body relation, or at the very least gain a deeper respect for showing the complexity of consciousness and health. Conversely, an appropriate view of the mind-body relation should provide a sound theoretical framework for PNI research.
ContributorsJording, Colten (Author) / Hoffman, Steven (Thesis director) / Robert, Jason (Committee member) / Lewis, Candace (Committee member) / Barrett, The Honors College (Contributor) / School of Life Sciences (Contributor)
Created2023-05
Description
In vitro embryogenesis is a revolutionary technology were researchers are able to culture stem cells, currently from mice, and differentiate the culture into an embryo showing key developmental characteristics. This technology has extensive medical benefits through creating a collection of genetically identical tissues and organs from which patients can receive treatment options. However, there are significant ethical objections to growing an embryo simply to destroy it and take its tissues and organs. Using ethical discussions of in vitro fertilization and abortion ethics, I was able to develop a framework to begin to solve these ethical discussions by identifying several physiologic reductions, which instead make a reservoir of tissue rather than a rational being.
ContributorsSoderblom, Tanner (Author) / Hurlbut, Ben (Thesis director) / Robert, Jason (Committee member) / Barrett, The Honors College (Contributor) / School of Mathematical and Statistical Sciences (Contributor) / School of Molecular Sciences (Contributor)
Created2023-05
Description
Moral status questions, (who and what counts morally) are of central concern to moral philosophers. There is also a rich history of psychological work exploring the topic. The received view in psychology of moral status accounts for it as a function of other mind perception. On this view, entities are morally considerable because they are perceived to have the right sort of minds. This dissertation analyzes and tests this theory, pointing out both empirical and conceptual issues with the received view. The results presented show that important moral intuitions (for example about unjustifiable interpersonal killing) cannot be explained by appealing to other mind perception. Some alternative views of the psychology of moral status are presented, as well as avenues for further research.
ContributorsLaTourelle, Jonathan Jacob (Author) / Creath, Richard (Thesis advisor) / Van Gelderen, Elly (Thesis advisor) / Robert, Jason (Committee member) / Ellison, Karin (Committee member) / Becker, D. Vaughn (Committee member) / Arizona State University (Publisher)
Created2022
Description
This dissertation investigates the convergence of the nation-state, biomedicine and (bio)capital around the construction of sickle cell disease as a subaltern disorder in the caste-based society of India. It inquires how sickle cell disease that developed evolutionarily due to environmental factors—and that is also globally racialized as a “Black disease”—has come to be associated with subaltern communities, particularly the indigenous, traditionally non-Hindu Adivasi communities of India. Such a subaltern association characterizes Adivasi biologies as inherently genetically “risky” thereby providing a biopolitical mandate to the Hindu-majoritarian Indian State to carry out biomedical interventions through promissory biocapital in the name of democratic inclusion. I center on the illness narratives of subaltern sickle cell sufferers to highlight how the caste-ization of sickle cell bodies in biomedical and policy discourses, and the attendant biocapital prospecting of subaltern biologies, are nonetheless challenged by communities through their lived experiences. Viewing this association from the Adivasi standpoint—marked by continuous dispossession and displacement—illuminates not only the biopolitical governance of subaltern reproduction by the Indian State. A primary objective of my dissertation project is also to use precarity as an epistemic site for interrogating the scopes and limits of a novel biopower formed by the nexus between the State, national biomedicine and transnational biocapital. This dissertation is therefore an attempt at unearthing the subjugated knowledges of Adivasi communities regarding alternative modes of existing in the world that continuously resist the assimilatory power of race, caste and capital. In ethnographically centering narratives of suffering among doubly (socially/economically) marginalized communities, the project illuminates the contradictions between public health measures that emphasize on sickle cell management through biomedical technologies of reproductive screening and the material conditions of sickle cell sufferers struggling to access basic medical care. This dissertation therefore juxtaposes policy interventions against community articulations of reproductive freedom that posits community health work as the fulcrum for developing reproductively just ecologies. At the same time, in utilizing multi-modal and multi-sited ethnographic methods, the project also contributes towards developing decolonial and digital ethnographic methods that are attentive to the aggravated precarity of marginalized communities in a pandemic prone world.
ContributorsDas, Sanghamitra (Author) / Smith, Lindsay A. (Thesis advisor) / Quan, H.L.T. (Committee member) / Maienschein, Jane (Committee member) / Prasad, Indulata (Committee member) / Robert, Jason (Committee member) / Arizona State University (Publisher)
Created2023
Description
Prior to the first successful allogeneic organ transplantation in 1954, virtually every attempt at transplanting organs in humans had resulted in death, and understanding the role of the immune mechanisms that induced graft rejection served as one of the biggest obstacles impeding its success. While the eventual achievement of organ transplantation is touted as one of the most important success stories in modern medicine, there still remains a physiological need for immunosuppression in order to make organ transplantation work. One such solution in the field of experimental regenerative medicine is interspecies blastocyst complementation, a means of growing patient-specific human organs within animals. To address the progression of immune-related constraints on organ transplantation, the first part of this thesis contains a historical analysis tracing early transplant motivations and the events that led to the discoveries broadly related to tolerance, rejection, and compatibility. Despite the advancement of those concepts over time, this early history shows that immunosuppression was one of the earliest limiting barriers to successful organ transplantation, and remains one of the most significant technical challenges. Then, the second part of this thesis determines the extent at which interspecies blastocyst complementation could satisfy modern technical limitations of organ transplantation. Demonstrated in 2010, this process involves using human progenitor cells derived from induced pluripotent stem cells (iPSCs) to manipulate an animal blastocyst genetically modified to lack one or more functional genes responsible for the development of the intended organ. Instead of directly modulating the immune response, the use of iPSCs with interspecies blastocyst complementation could theoretically eliminate the need for immunosuppression entirely based on the establishment of tolerance and elimination of rejection, while also satisfying the logistical demands imposed by the national organ shortage. Although the technology will require some further refinement, it remains a promising solution to eliminate the requirement of immunosuppression after an organ transplant.
ContributorsDarby, Alexis Renee (Author) / Maienschein, Jane (Thesis advisor) / Robert, Jason (Thesis advisor) / Ellison, Karin (Committee member) / Arizona State University (Publisher)
Created2020