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Accomplishments

2nd Conference of the International Association for Education in Ethics, May 21-23, Ankara, Turkey

Some of our students were accepted to present their papers at the international conference of IAEE in May. 

Aiyub Alwehaibi is presenting: "A-daily-dose-of-ethics Teaching Method in Hospitals"

Here is the accepted abstract:
Background:
In hospital settings, ethical issues are the consequential factors in quality of patient care; if they are not approached and resolved in appropriate path, they could cause negative impacts on hospitals' cultures, operations, reputations, and economics, as well as hospital staff. In the United States, many teaching methods are adopted in hospitals in the form of conferences, case-based courses, or discussion sessions about recent difficult or uncertain situations. In general, most of the methods work efficiently; nevertheless, there are a number of hindering factors that prevent those programs from optimizing their effectiveness, such as the pressure of time for physicians and healthcare personnel, insufficient foundation of ethics knowledge, lack of a systematic discussion derived from moral reasoning and ethical theories for ethics situations, and low awareness of culture, race, and ethnicity.

Purpose: In attempt to provide a supplementary tool to optimize the effectiveness of other ethical teaching methods while saving time, reducing cost and educating persistently, a-daily-dose-of-ethics method is an appropriate method that presents many benefits to ethics teaching in hospitals.

Method: The method aims to all audiences who directly interact with patients, patient's families, or other patients' caregivers. In this method, the teaching is implemented in the form of pop-up multiple-choice questions, once and at the first time logging in computer in the day/shift. After the answer is chosen, brief rationales for every choice will appear on the screen. If necessary, a hyperlink that redirects to reference link, documents, and contact information of ethics committee members should be included. Multiple levels of certificates may be designated, after completing all the levels, the person will receive a certificate of completion the ethics teaching course in the hospital, which may benefit for his or her professional practice reference.

Conclusion: The method is suggested as a universal model, the hospital may adjust the content and method according to its own philosophy and policy. Adopting this method will help the hospital raise and promote awareness of ethics among hospital staff, improve ethical practice throughout hospital, as well as to prevent the recurrence of the ethics conflicts. The method may also benefit hospitals in rural areas where often face shortage of trained ethicists.

Rabee Toumi is presenting: "Academic Healthcare Organizations: Moral Agency & Ingraining the Ethics of Patient Safety in Trainees"

Here is the accepted abstract: 
In this presentation, it will be argued that educational healthcare organizations have an added layer to their responsibilities because of their position as academic entities. Therefore, they have to be aware of the morality they may ingrain in their trainees, especially in regards to patient safety. To support this argument, the presentation will start by exploring the ethical dilemmas that every healthcare institution has to face; two examples will be discussed to elaborate more on the issue, namely conflict of interests and conflict of conscience. I will then briefly consider graduate medical education in the context of academic organizations. Becoming a physician is not only about accumulating information but is also a transformational process that takes place in the context of interacting with other colleagues and learning from them. Therefore, exploring the hidden curriculum in educational healthcare organizations is relevant to recognize its positive and negative effects on the moral integrity of future practitioners. All the discussion will lead to an applicable issue that has attracted much attention recently, namely patient safety. The importance of this issue will be discussed to emphasize the necessary systemic approach to mend it. Building a culture of safety will be examined and projected on graduate medical education to recognize the pertinent important aspects, whether through teaching ethics in residency or structuring medical training to enforce safety measures.

Recently Published by our Students in Peer-reviewed Journals

Alex Dubov has just published these articles:

"The concept of governance in dual use research." Medicine, Healthcare and Philosophy. Online First.
Abstract: The rapid advance of life science within the context of increased international concern over the potential misuse of findings has resulted in the lack of agreement on the issues of responsibility, control and collaboration. This progress of knowledge outpaces the efforts of creating moral and legal guidelines for the detection and minimization of the risks in the research process. There is a need to identify and address normative aspects of dual-use research. This paper focuses on the issues of safety and global collaboration in life science research by highlighting the importance of openness, enabling policies and cooperative governance. These safeguards are believed to reduce the risks related to the misuse of science while enabling the important research to move forward. The paper addresses the need for a better definition of dual use concept and, based on the historical precedents, explores the moral concerns and governmental strategies of dual-use research. The three necessary moves in addressing the issue of security in life sciences are suggested: the move from constraining to enabling types of policies, the move from secrecy to openness, and the move from segregation to integration of the public voice.

 

"Moral Justification of Phase 1 Oncology Trials" Journal of Pain and Palliative Care Pharmacology (volume 28 issue 2)
Abstract: This article attempts to answer the following normative questions: Can one consider the design of phase 1 studies ethically appropriate due to the unfavorable ratio of risks and benefits? What are some ethical safeguards for phase 1 oncology research? A comparative review of literature contributed to the consolidation of the proposed ethical framework for phase 1 oncology trials. This framework gives a special attention to issues of therapeutic misconception and vulnerability. The benefits and dangers associated with the enrollment in trials are described as well as the absence of alternatives, treatment-specific optimism, and vagueness in factual presentation during the informed consent process. The notion of therapeutic misconception is contrasted with optimism despite realism that stems from psychological, cultural and religious factors and not necessarily from the lack of information. Close attention is given to the possible ways in which the inherent uncertainty and resulting cognitive biases may affect the informed consent process and the definition of therapeutic misconception. The article ends with recommendations for an ethical way of enrolling palliative patients in early stages of oncology research giving special attention to provision of adequate consent, protection of vulnerability and avoidance of therapeutic misconception.

 

Rabee Toumi has just published this article:

"Globalization and health care: global justice and the role of physicians." Medicine, Health Care and Philosophy 17, no. 1 (2014): 71-80.
Abstract: In today's globalized world, nations cannot be totally isolated from or indifferent to their neighbors, especially in regards to medicine and health. While globalization has brought prosperity to millions, disparities among nations and nationals are growing raising once again the question of justice. Similarly, while medicine has developed dramatically over the past few decades, health disparities at the global level are staggering. Seemingly, what our humanity could achieve in matters of scientific development is not justly distributed to benefit everyone. In this paper, it will be argued that a global theoretical agreement on principles of justice may prove unattainable; however, a grass-roots change is warranted to change the current situation. The UNESCO Declaration on Bioethics and Human Rights will be considered as a starting point to achieve this change through extracting the main values embedded in its principles. These values, namely, respecting human dignity and tending to human vulnerability with a hospitable attitude, should then be revived in medical practice. Medical education will be one possible venue to achieve that, especially through role models. Future physicians will then become the fervent advocates for a global and just distribution of health care.

 

  

10th International Conference for Clinical Ethics Consultation, April 24-26, 2014, Paris, France

Some of our students were accepted to present at the conference in April.

Michael AfolabiMichael O. Afolabi is presenting: "Patients as Bargaining Chips in Industrial Strikes: Some Ethical Reflections"

Here is the accepted abstract:
Industrial strike actions increasingly occur in the health sector across the world, though their frequency seems higher in developing countries. However, healthcare-related strike actions raise several ethical issues. Specifically, this is because they negate the telos of healthcare which involves fostering the medical good of society. On the other hand, entering into the caring professions goes with certain moral obligations in exchange for societal latitude for the power and privilege to practice. Against this conceptual background, this paper examines and explores the ethics of using patients as bargaining chips in healthcare disputes. Employing the notion of reciprocal beneficence, the paper argues that the impropriety of strikes is couched in a deontological understanding of the nexus around the duty to society, patients and professional interests. On this note, the paper advocates a patient-centered panacea vis-à-vis striking a moral balance between perceived conflicts of duty, contextual reality and the needs of the sick. Since healthcare constitutes an instinctual and institutional response to the ubiquitous phenomenon of illness, it is important that health professionals re-examine their moral commitments to society generally and to patients in particular in the light of strike actions.

Shelley Kobuck is presenting "Elder Abuse in the U.S.: When the Family Mutes the Voice of the Patient"

Here is the accepted abstract:
The topic of elder abuse in the United States is one that creates great emotion and is typically associated with long term health care institutions and services such as nursing homes, assisted living facilities, and professional home health care workers. What doesn't receive as much focus is the prevalence of elder abuse from the patient's very own family members. Because of the reticence for the elderly to report such abuses it is difficult to capture the true pervasiveness but in a study reported by the National Center for Elder Abuse (2011) it was estimated that between 7.6% and 10% of the elderly people studied were victims of some form of elder abuse primarily from someone within their own family. The notion that family members are predisposed to care and caring attributes simply due to the genetic or legal relationship designation is a flawed one. When elder abuse occurs from the family, the voice of the patient is muted. The patient's wishes are no longer given preference and the best interests of the patient are no longer honored. This presentation will look beyond patient rights and utilize an ethics of care approach to support patient autonomy in family elder abuse within the U. S. welfare and legal systems. Elder abuse will be defined by the varying types of actions or inactions that fall within the parameters for abuse along with the facts and figures to show the occurrences. Patient rights and the legal guidelines for decision-making on the part of the patient will be discussed as it relates to setting a foundation for potential exploitation. An ethics of care will be analyzed as a virtue in care and caring with a comparison to the rights and justice approaches that currently exist. Lastly, a summary of proposals for prevention, identification, and protections for the elderly will be covered.

Aiyub Alwehaibi is presenting: "Application of the Rule of Intention (Niyya) to Justify the Patients' Decisions for End-of-Life Care in Islamic Perspective"

Here is the accepted abstract:
In Islamic societies, Islamic law (Sharia'h), established upon the Holy Qur'an and Sunnah, is the legal foundation for all individual and communal matters in daily activities. Besides, bioethics and religion are not two separable elements in Islamic societies, which explains why reference to the Sharia'h plays such a significant role in Islamic bioethics. Any opinions regarding bioethics should remain anchored to the Sharia'h to be legitimate; otherwise, they risk losing credibility, or even losing the possibility of being presented in public. On the other hand, intention (Niyya) is a central concern in Sharia'h as being stated in the hadith "Actions are defined by intentions, and to every person what he intends." In general, Muslim jurists treat intent as definitive of human actions most of the time.
Not different from other societies, in Islamic societies, decision making in caring for terminally ill patients is a stressful duty for all involved parties. The attitudes, however, towards the issues vary among healthcare professionals, patients, patients' families, and religious authorities since each party also holds other obligations in addition to embracing the religion. Therefore, medical professionals must not only make medical decisions upon their professional ethics but also consider and respect for the patients' or their families' preferences and values. Additionally, acknowledging each involved party's intention would possibly justify or oppose to any course of actions in making decisions for end-of-life care. In Islamic perspective, euthanasia is disproved while palliative care is approved for its goals to improve the quality of patients' lives and to relieve the suffering.

Graduate Student Research Symposium

October 25th, 2013, Duquesne University

CONGRATULATIONS to our Alex Dubov for winning the Center for Catholic Intellectual Tradition & Spiritan Studies Award on his presentation "Religious Coping in the ICU". Here is a link to his winning presentation.

 Other students from the Center for Healthcare Ethics also presented during the Inaugural Graduate Student Research Symposium which took place on October 25th, 2013. Here is a link to the Symposium's website.

 Shelley Kobuck
"The Ethical Principle of Cooperation as a Determinant of Moral Agency in Nursing Home Leadership"

 Aiyub Alwehaibi
"Application of the Rule of Intention (Niyya) to justify End-of-Life Decision Making in Islamic Perspective"

Barbara Postol
"An ethical analysis of the concept of disease mongering and its effect on healthcare, research, and patient safety"