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Online Journal of Health Ethics
Number of Followers: 0  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1551-4218
Published by U of Southern Mississippi Homepage  [2 journals]
  • A Doctor's Sabbatical on a Pirate Ship

    • Authors: V. Ramana Dhara
      Abstract: This is a fantasy poem about a doctor and his adventures with piracy on the high seas.
      PubDate: Wed, 03 Aug 2022 11:55:21 PDT
       
  • Community Based Rehabilitation Programs for Resettled Muslim Women
           Refugees

    • Authors: Lori Maria Walton PhD; DPT, MScPT, MPH(s et al.
      Abstract: According to the 2021 report from the United Nations High Commissioner for Refugees, 82.4 million people were forcibly displaced because of violence, wars, or persecution and over 26.4 million are currently living with refugee status. Displacement and resettlement trauma are associated with chronic disease onset and poor cognitive, physical, and mental health outcomes for refugee populations. To mitigate some of the deleterious effects of resettlement trauma, we propose a community-based rehabilitation program (CBRP) framework that is culturally sensitive, trauma-informed and focused on the vulnerabilities of women. The purpose of this novel CBRP framework is to address health inequities among a vulnerable refugee population through program development, with a focus on: (1) active participation of the refugee community throughout all levels of program planning; (2) intersectional, gender-focused analysis of power and privilege within the community and host country aimed at reducing barriers and improving access to quality CBRP programs for women; (3) trauma-informed, team-oriented, resilience programming to improve cognitive, physical, and mental health outcomes and prevent chronic disease. This paper will also discuss the need for gender transformative interventions to address specific health inequities related to CBRP feasibility and access, cultural and social influences, acceptability, and related laws and policies.Key Words: Refugee Health, Muslim Women, Community-based Rehabilitation Programs, Physical Activity
      PubDate: Wed, 03 Aug 2022 11:55:09 PDT
       
  • Reciprocity and Priority Allocation System for Organ Transplant: An
           Ethical Analysis

    • Authors: Gordon Wong et al.
      Abstract: How to increase the supply of organs donations for transplant is a critical issue in healthcare. Although recently xenotransplantation has received much publicity, it may be years before this becomes clinically viable. The Reciprocity and Priority Allocation (RPA) System currently used in Israel and a few other countries may be a reasonable approach to increase organ donation in the foreseeable future. For this approach to be accepted by the public, a robust analysis on its ethical implications is needed. This paper applies two formal ethics frameworks to analyze the implication of the RPA system.
      PubDate: Wed, 03 Aug 2022 11:55:00 PDT
       
  • Financial Incentives and Healthcare: A Critique of Michael Sandel

    • Authors: Mark Peacock
      Abstract: The use of financial incentives in healthcare calls for ethical examination. Michael Sandel's influential work represents such examination and is subject to critical analysis in this paper. Sandel focuses on monetary payments to persuade patients to lose weight, give up smoking etc. but also on the much-discussed case of giving drug addicts money in return for their consent to be sterilized. He offers two separate objections to financial incentives, one based on coercion, the other on corruption. I argue that Sandel's corruption objection to commodification is insufficient to ground the objection he has to financial incentives in healthcare. Whatever strength his corruption objection has comes from his coercion objection.
      PubDate: Wed, 03 Aug 2022 11:54:53 PDT
       
  • Ethical considerations of telehealth: Access, inequity, trust, and overuse

    • Authors: Monica O'Reilly-Jacob et al.
      Abstract: In the U.S. healthcare system, telehealth is increasingly present and demands ethical assessment. On the one hand, telehealth increases access to healthcare services for some at-risk populations (e.g., people suffering from mental illness and addictions) and in specific contexts (e.g., rural). On the other hand, telehealth widens the digital divide and can lead to overuse of services. Furthermore, because it is still unclear how telehealth influences trust between patients and primary care clinicians, connecting relationship science and human communication research can inform critical reasoning. Finally, healthcare policy is advancing toward the wide adoption of telehealth. Hence, it is urgent to address these ethical issues and invest in further research.
      PubDate: Wed, 03 Aug 2022 11:54:45 PDT
       
  • Ethical implications of COVID-19 surveillance in Karnataka using Nancy
           Kass Framework

    • Authors: Apurva Jain et al.
      Abstract: Numerous public health hurdles, including pandemics such as COVID-19, have led to concerns about community health practices in relation, necessitating the application of an ethical perspective. International research ethics guidelines are only used in a restricted range of contexts of public health. As a result, a variety of frameworks have been established to assist ethical analysis of public health concerns. In this study, we have used the Nancy Kass framework for analyzing COVID-19 surveillance in Karnataka state of India, which is a six-step approach that can assist public health practitioners in evaluating the ethical consequences of interventions, policy initiatives, services, and so on. In order to supervise the compliance of home quarantine, the government of Karnataka mandated uploading selfies as a digital tracking surveillance measure for the COVID-19 outbreak. However, these measures raised several ethical questions, especially related to an individual’s privacy, confidentiality, autonomy, and liberty. An established state surveillance mechanism with includes enforced measures for data security along with the moral duty of an individual to protect the health of the community can probably balance the principles of ethics.
      PubDate: Wed, 03 Aug 2022 11:54:36 PDT
       
  • 2022: Global Ethical Think Tank

    • Authors: Sheila A. Davis PhD
      Abstract: Editor's introduction to Volume 18, Number 1 of the Journal of Health Ethics.
      PubDate: Wed, 03 Aug 2022 11:54:32 PDT
       
  • Is There a Doctor in the House' Medical Ethics and the Doctoral
           Honorific

    • Authors: Kenneth R. Pike et al.
      Abstract: The proliferation of professional doctorates has reinvigorated debate over the use of the doctoral honorific. Doctorate holders are often addressed as “doctor” in academic contexts, but idiomatic American English associates “doctor” with physicians—licensed clinicians with doctoral degrees in medicine. The possibility of patient confusion has historically justified proscription of the doctoral honorific by others, including nurses, but recently such proscriptions have been withdrawn. An examination of history, language, and ethical reasoning leads us to conclude that, in the context of patient interaction, clinicians should eschew the doctoral honorific entirely. We think it appropriate for professionals to rely on training-pathway titles as part of their professional duty to inform. In particular, we argue that licensed clinicians with doctoral degrees in medicine should embrace the title of “physician.”
      PubDate: Fri, 17 Dec 2021 08:14:08 PST
       
  • Including a Chaplain and Culturally Sensitive Notary in End-of-Life and
           Earlier Difficult Healthcare Issues

    • Authors: John Stonestreet
      Abstract: Would patients and families benefit from a Doctor Body Cam' Linked from www.DoctorBodyCam.com, this article explores innovations providing accountability for ethical communication surrounding major healthcare decisions. One of the greatest challenges physicians face is living up to their own ideals, let alone others’ expectations, for high-stakes doctor-patient/family communication, especially at the end of life. From emotional strains to time limitations, a multiplicity of factors obfuscates the pursuit of excellence in this vital endeavor. Evidence suggests that, like nearly every other sector of healthcare and society, African American patients and families are most likely to get the short end of the physician communication stick. Drawing on the current literature, this piece makes a compelling case for the inclusion of third-party specialists to take some of the communication load off of overworked physicians in end-of-life discussions and earlier difficult healthcare issues. A more team-oriented approach to the interdisciplinary art of patient/family-provider health communication surrounding complex issues and treatment decisions may be a win-win for everyone involved.
      PubDate: Fri, 17 Dec 2021 08:14:01 PST
       
  • Sexual Minority Rights Are Not Just for the West: Health and Safety
           Considerations in Africa

    • Authors: Robert Scott Stewart Ph.D. et al.
      Abstract: In a recent article, C.O. Akpan argues that it is “unnatural for a man to sleep with a man as with a woman, and the idea of marriage in this sense is an abomination” (“The morality of same-sex marriage: How not to globalize a cultural anomie,” Online Journal of Health Ethics, 13(1), 2017, p. 9). Arguments in favor of same sex marriage, he claims, are “driven and motivated by the human right fad” (p. 9) that is inappropriate for African countries.We argue that the specific arguments Akpan employs against the morality of homosexuality and same-sex marriage are flawed. Our paper also presents evidence that human rights are not simply a fad, nor are they of concern and appropriate only to the West. Finally, we examine the case in South Africa, the only African nation to include LGBTQ+ rights in its constitution. In particular, we show that by doing so, South Africa has increased the health and safety not only the LGBTQ+ community, but of the nation’s citizens at large.
      PubDate: Fri, 17 Dec 2021 08:13:51 PST
       
  • Agency and Health Policies

    • Authors: Rodrigo Lopez Barreda
      Abstract: In the current medical ethics literature, the concept of agency is receiving growing attention. Nevertheless, many of those definitions are narrow in scope. This article intends to provide a deeper understanding of this concept, allowing for its use in clinical practice and public health policies. First, it revises the current concept of agency and some of its shortcomings. Then, the article presents two philosophical accounts of agency, identifying three relevant features, namely time-extended organised planfulness, endorsement of their own actions, and identification with the activity. Lastly, the article depicts how those features may help in the application of agency to the analysis of health issues by means of a number of examples at the individual and collective levels. When analysing health issues, the health status is a key component, but the process that brought about the outcome must be examined; agency informs about this procedural dimension.
      PubDate: Fri, 17 Dec 2021 08:13:45 PST
       
  • An Ethical Comparison of the COVID-19 National Disease Control Performance
           of China, Canada and the U.S. in the First Year of the Pandemic

    • Authors: George A. Gellert et al.
      Abstract: Objective: First year government pandemic control performance is compared in China, Canada and the USA to understand the ethical bases of different population outcomes achieved.Methods: Comparative analysis of ethical underpinnings and implications of pandemic performance includes degree of authoritarian power deployed to mitigate disease spread; benefits of single payer health care; impact of socioeconomic, racial/ethnic and health care inequities; anti-government sentiment/distrust; national leadership engagement; and science denial.Results: National COVID-19 response efforts vary according to the extent to which they leveraged autocratic tactics, from China whose highly autocratic first year pandemic performance was emulated, through liberal democracies like Canada where ethical compromises were largely avoided, to the USA where federal government abandonment of public health ethics produced one of the deadliest pandemic first year performances.Conclusions: Examining the ethics of pandemic disease control practices can lessen risk of repeated pandemic performance failures, and associated avoidable morbidity/mortality in future pandemics.
      PubDate: Fri, 17 Dec 2021 08:13:36 PST
       
  • Health Inequality as a Socially Created Complex System

    • Authors: Michele Battle-Fisher
      Abstract: Brought to light by COVID-19, and the Black Lives Matter and Twitter #BlackBioethics movements, bioethics as a discipline has not intentionally accounted for distributive justice in its scholarship. Modern society exhibits gross disparities that affect marginalized populations who suffer amid social, financial, physical and emotional stressors. While marginalized groups that are underserved are not monoliths, disparity persists in disadvantaged communities regardless of social and economic strata. Disparity is the epitome of injustice. The overemphasis on proximal determinants demonstrates ill placed overemphasis on personal culpability whilst ignoring systemic factors that result in structural injustice. The sciences of complexity and systems thinking move healthcare beyond historically ingrained heuristics that more often than not entrench disparities meant to be reversed. This paper sets out the argument that the application of complexity and systems as a groundwork for culturally inclusive bioethics by framing health disparities as structurally and morally complex.
      PubDate: Fri, 17 Dec 2021 08:13:30 PST
       
  • "I Felt What was Happening in Our Country [USA] with Race was So Much
           Scarier than the [COVID-19] Virus.” Black Lives Matter Protesters’
           Beliefs and Practices During the COVID-19 Pandemic

    • Authors: Evelyn Arana-Chicas et al.
      Abstract: This study describes the COVID-19 prevention practices and beliefs of Black Lives Matter protesters in the U.S. Participants completed a survey on following COVID-19 guidelines and answered interview questions. Twenty participants were enrolled. Mean age was 29 and most were female (80%) and black (75%). Participants almost always wore their masks (75%) and washed their hands (85%) while protesting. Most reported rarely social distancing (55%) and not being concerned about COVID-19 (55%). Themes included: 1) Fighting for social justice, 2) Protesting is more important than COVID-19, 3) Unable to social distance, 4) Masks mostly worn, 5) Protests sparked global movement, and 6) Increasing awareness of injustices. Our results suggest that protestors understand the importance of preventing the spread of COVID-19 and follow guidelines, but there are suggestions that some protestors do not consistently adhere to these guidelines. Results may contribute to policies that control the spread of COVID-19.
      PubDate: Fri, 17 Dec 2021 08:13:20 PST
       
  • A Call for Liberty and Justice for All: Unraveling the Complexities in
           2021

    • Authors: Dr. Sheila P. Davis
      Abstract: This Preface summarizes the articles in this issue. Seven articles are presented with center on liberty and justice for all populations discussed.
      PubDate: Fri, 17 Dec 2021 08:13:14 PST
       
  • Abbey and George

    • Authors: Jennie A. Gunn
      Abstract: Abbey and George discuss their beliefs regarding abortion in a light hearted manner. Both are aborted fetuses. Abbey was aborted by induction, and George by spontaneous. The pros and cons of abortion, the effects, and the use of fetal cells in research are presented in play format. Abbey is a devout Christian, and George is an atheist. The play allows the reader to hear both sides of the topic.
      PubDate: Tue, 27 Oct 2020 14:10:02 PDT
       
  • An Epidemiological View of the 2020 U.S. Presidential Election: COVID-19
           and the Ethics of Science Denial

    • Authors: George A. Gellert MD; MPH, MPA
      Abstract: COVID-19 is exploiting U.S. political and cultural polarization in the first presidential election to be driven by epidemiology and public health. Medical science is on the ballot as Americans’ views on economic re-opening fracture according to party affiliation. The difference between pro aggressive versus incremental re-opening, mask wearing and social distancing is rooted in respect for, or denial of, the science of epidemiological pandemic disease control. Political leaders at multiple levels, and in particular the president, have politicized the wearing of face masks and so intentionally obscured and misinformed the public regarding the objectively and scientifically proven value of these protective measures. The presidential election rests at a fundamental level upon an individual choice of whether to accept or “believe” value-neutral, evidence-based science or an unethical decision to be swayed by political disinformation. The persistent and highly dysfunctional political and cultural polarization of the U.S. is now enabling and reinforcing the ethics of science denial, while driving the nation’s public health fate and near- to medium-term economic outcomes. However, mask wearing, social distance and sheltering are not political expressions, and the right to freedom of expression does not include behaviors that produce or could produce serious, and in the case of this pandemic, deadly impact on other citizens. One does not have the right to forms of political or other expression that kill or make ill other individuals.
      PubDate: Tue, 27 Oct 2020 14:09:52 PDT
       
  • Winners and Losers in the American Political Debates of the Nation’s
           Health: An Ethical and Moral Dilemma

    • Authors: Dr. Sheila P. Davis
      Abstract: The third and final issue of the Online Journal of Health Ethics for 2020 presents two poignant articles that are rankled with current health ethics and moral issues as the world races to a resolve for the COVID pandemic. There appears to be no easy, quick-fix solutions to the pandemic that has claimed over 1.11 million lives worldwide in this first wave. The Gellert article addresses his view of the U.S. government’s political response and the Gunn article presents an ethical perspective of the emerging promised vaccine to halt the virus.
      PubDate: Tue, 27 Oct 2020 14:09:43 PDT
       
  • Open letter to all readers, reviewers, and authors

    • Authors: Dr. Sheila P. Davis
      Abstract: Open Letter for all Readers, Reviewers, and
      Authors of the Online Journal of Health Ethics
      PubDate: Tue, 27 Oct 2020 14:09:34 PDT
       
  • The George Floyd of healthcare

    • Authors: Sheila P. Davis; PhD, FNP-c, FAAN, LSM-BC et al.
      Abstract:
      Authors explore the infamous murder of an unarmed black man, George Floyd, and juxtaposition it to systemic racial practices in healthcare as documented by the Institute of Medicine Report: Unequal Treatment. The current COVID-19 pandemic is presented as a situation which has the potential to ignite unresolved discriminatory healthcare practices. Proposed are policies which could possibly mitigate this phenomenon.
      PubDate: Mon, 31 Aug 2020 08:04:56 PDT
       
 
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