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

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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.
Date Created
2018-05
Agent

The Pharmaceutical Industry and the Opioid Epidemic: The Case of Purdue Pharma and OxyContin

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Description
This thesis elucidates the responsibility of the pharmaceutical industry for the current opioid epidemic, an epidemic which caused over 40,000 American deaths in 2016 alone. Twenty years prior, Purdue Pharma unleashed an extended-release formulation of the opioid oxycodone: OxyContin. With

This thesis elucidates the responsibility of the pharmaceutical industry for the current opioid epidemic, an epidemic which caused over 40,000 American deaths in 2016 alone. Twenty years prior, Purdue Pharma unleashed an extended-release formulation of the opioid oxycodone: OxyContin. With this, Purdue began a highly aggressive advertising campaign with the primary intention of guaranteeing the success of this drug; however, in doing so, they often neglected to ensure that the information they were propagating was wholly accurate. Previous reform attempts aimed at mollifying this crisis have ultimately fallen short, as they have failed to recognize the true extent of Purdue Pharma's involvement, especially with regard to the underlying issues that led to the initiation and progression of the epidemic. Future improvements should be targeted at the reform of regulatory agencies and insurance companies, as well as the cultural attitudes regarding pain and pain treatment that have been cultivated over the last several years. Ultimately, however, these reforms will likely prove to be insufficient unless the failings of the current healthcare system, including the pharmaceutical industry, are also taken into account.
Date Created
2018-05
Agent

Increasing Access to Medical Care Through Scope of Practice Laws

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Description
This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of

This paper sought to answer the question of how to improve the American healthcare system. The Affordable Care Act aimed to do this by increasing access to insurance. What this has done, however, is exacerbate the already rising rate of physician shortages. As a way to fix this problem, it is suggested that state legislatures and the federal government adopt the rising trend of expanding scope of practice to the extent of the care providers' certification. This is a movement has garnered support throughout the country and 20 states already allow for nearly autonomous practice by advanced practice nurses (APNs). This paper looked at systematic review, peer-reviewed papers, state/federal legislation and labor statistics to demonstrate how this move could increase access to healthcare providers as well as decrease cost by nearly 25%. This paper also evaluated how to formalization of nursing education has had positive impacts on the French healthcare system. Additionally, it evaluated a more specific look at Arizona and used data provided by the Arizona Board of Nursing and The Arizona Medical Board to make a compelling argument as to why this is a viable option for solving the disparity between rural and urban healthcare. The conclusion of the paper was to push policy makers to make the statutory constraints of the profession closer to the certification the people receive in their education as opposed to relying on case law. Additionally, it would be helpful to use technological innovations, like project echo, to help these professionals practice in rural areas. This will ultimately lead to a healthcare system that better serves the needs of all populations, as well as decreasing the overall cost of care.
Date Created
2018-05
Agent

How Summer Camps Can Aid Palliative Care for Cancer Patients

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Description
The rate of cancer incidence is a morbid figure. Twenty years ago, 1 in 2 men and 1 in 3 women were predicted to be afflicted by cancer throughout their lifetime (Cancer Facts & Figures- 1998). In 2017, the rate

The rate of cancer incidence is a morbid figure. Twenty years ago, 1 in 2 men and 1 in 3 women were predicted to be afflicted by cancer throughout their lifetime (Cancer Facts & Figures- 1998). In 2017, the rate remains the same ("Cancer Statistic Center"). Every year, more people are affected by cancer, which is a physiologically, psychologically, emotionally and socially devastating disease. And yet the language and metaphors we use to describe cancer focus our attention on the "fight" of the heroic individual against the brutal disease or on finding a cure. Despite this narrow rhetoric, there are many meaningful, supportive, and palliative measures designed to substantively and holistically care for cancer patients, beyond their medical treatment. Many of these interventions help the patient feel supported (and less alone in this "battle") by building robust communities. In this thesis, I argue the summer camps for children affected by cancer are meaningful interventions that offer palliative care throughout their treatment by creating support networks with peers going through similar medical procedures. Drawing on anecdotal evidence from three cancer camps and a detailed literature review of a subset of palliative interventions designed to promote well-being, this thesis proposes a new model for a summer camp that focuses on emotional processing emotional expression, positive psychology in order to improve palliative care for cancer patients.
Date Created
2017-12
Agent

How We Live and Die: A Qualitative Analysis of the Relationship between Healthcare Experiences and Perspectives on Physician-Assisted Suicide

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Description
Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition

Physician-assisted suicide occurs when a physician facilitates a patient's death by prescribing a lethal medication that they understand will be used for the purpose of ending the patient's life. It is a highly contentious subject and, with the recent addition of California to the list of states that allow physician-assisted suicide, is an increasingly relevant subject. Physician-assisted suicide is rarely framed as a healthcare experience, despite being a choice in the process of end-of-life care. The research seeks to bring together the debates about physician-assisted suicide with conversations about health care experiences. The experiences and perspectives of young people are particularly valuable to evaluate now, as their voices will soon be the leaders in the debate over physician-assisted suicide. Within this research, there is an underlying theme of independence of individuals that is present through both the literature review and the body of data collected and analyzed. The study found that there was no significant relationship between the quality of a person's healthcare and their perspectives about physician-assisted suicide.
Date Created
2016-05
Agent

Maturity and the Right to Refuse Treatment for Cancer: Considering the Societal, Biological, and Legal Implications of Allowing a Minor to Make a Complex Medical Decision

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Description
Treating a minor diagnosed with cancer is a difficult situation. However, cases in which doctors and the patient's family disagree about the proper course of treatment present complex scenarios when it comes to patient care. The forced treatment of Cassandra

Treating a minor diagnosed with cancer is a difficult situation. However, cases in which doctors and the patient's family disagree about the proper course of treatment present complex scenarios when it comes to patient care. The forced treatment of Cassandra Callender came as a result of challenging interactions between the patient, the medical establishment, and the state. While the Connecticut Supreme Court mainly considered Cassandra's maturity and her mother's actions when deciding this case, there were more factors contributing to Cassandra's quality of care than her ability to make decisions. An evaluation of these factors demonstrates important implications for ensuring a minor receives the best care. Cassandra wished to pursue a means of treatment that would have fewer serious side effects than chemotherapy, but her assessment of her prognosis was markedly different than that of her doctors. While it is clear that Cassandra did not fully grasp the likelihood of death without chemotherapy treatment, her perspective should not have been fully ignored. The forced treatment inflicted serious (though short term) harm. To understand the full context of this case, this paper considers relevant legal doctrine, decision-making capabilities of minors, the problems and perils of chemotherapy, the role of the media, and the doctor-patient relationship. Developing a perspective based on these facets of Cassandra's case is important in determining how to facilitate the best interaction between doctor and patient and to make sure that future cases aid the patient and his or her family to make the best decision given the situation. Even when there is no consensus about what is best for a patient, more consideration must be given to the patient's perspective, beyond attempting to solely extend life.
Date Created
2016-05
Agent

Diagnosing Autism Spectrum Disorder: Implications for Research, Medicine, and Patients

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Description
Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that is becoming increasingly common. Autism does not yet have a known etiology, nor a definitive diagnostic test, thus making diagnosis a difficult and rarely uniform task. Currently, ASD is behaviorally

Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental disorder that is becoming increasingly common. Autism does not yet have a known etiology, nor a definitive diagnostic test, thus making diagnosis a difficult and rarely uniform task. Currently, ASD is behaviorally diagnosed based on criteria defined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Recently, a change was made in the criteria from more lenient criteria in DSM-IV-TR, to more narrow criteria laid out by the DSM-V, which supersedes the DSM-IV-TR. This drastic change raised many questions and debates about which set of criteria are better. The more lenient criteria offers a more inclusive diagnosis giving greater access to therapies; while the narrow diagnostic criteria excludes some individuals, creating a more uniform diagnosis that's easier to use in research. This thesis analyzes the change in diagnostic criteria from the DSM-IV-TR to the DSM-V and the effects of these changes on the practices of diagnosis. In addition, it explores the implications of this change for the families of children with autism and for those involved in autism research, examining their respective opinions and interests pertaining to narrow verses broad diagnostic criteria. Building on this analysis, the thesis offers recommendations about diagnostic criteria should be set. It argues that the wellbeing of patients takes priority over the interests of researchers, and thus diagnosis should be done in a way that offers the best prognosis for all children who suffer from autistic symptoms.
Date Created
2016-12
Agent

A participatory Technology Assessment: Engaging ASU student's ideas about genome editing

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Description
Advancements in science and technology, particularly in the field of genome editing, hold significant potential to change how future generations will treat disease and may fundamentally change what it means to be human. There are concerns by scientists and non-scientists

Advancements in science and technology, particularly in the field of genome editing, hold significant potential to change how future generations will treat disease and may fundamentally change what it means to be human. There are concerns by scientists and non-scientists about how to explore the values and perceptions of the public regarding the implications of new technologies. Use of participatory Technology Assessment (pTA) has arisen as a type of interactive group discussion to disseminate information about technology and collect non-scientists' perceptions of the value, impact or usefulness of a technology and potential ethical issues or consequences to be considered. There is no one size fits all model of pTA; several are discussed in this paper, but there are similarities between them such as the structure of engagement or recruitment criteria. It is important to note a difference in public understanding of science and public engagement with science as it relates to the structure and execution of pTA. This study was undertaken to evaluate pTA as a tool to explore perceptions, values and opinions regarding a case study of CRISPR-Cas9, a tool for genome editing, among ASU Barrett undergraduate students.
Date Created
2016-12
Agent

The Many Faces of Corporate Social Responsibility

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Description
Corporate social responsibility (CSR) is a fascinating and complex topic. There is consensus that companies both make a large impact on the world and have a responsibility beyond profits. The challenge with this responsibility is that determining businesses' responsibility and

Corporate social responsibility (CSR) is a fascinating and complex topic. There is consensus that companies both make a large impact on the world and have a responsibility beyond profits. The challenge with this responsibility is that determining businesses' responsibility and measuring the impact remains unclear. Scholars most often point to the early to mid 1900s as its starting point and the increased economic growth and workers' unions occurring in the 1950s as one of the reasons for scholars paying more attention to the topic. This thesis project analyzes current examples of CSR from Starbucks and IBM. These companies have reputations for their positive CSR practices. Both companies' availability of information, the vast number of their CSR practices, and efforts to measure the impact set them apart. IBM and Starbucks stand out because of the sheer volume of CSR activities they have, and when examined closely, the mixed, primarily good, impact of these activities is revealed. Having a high number of CSR practices alone does not equate to doing CSR well. Instead, companies' CSR should be examined based on both the number of practices and their impact. Considering both of these metrics will help consumers, as well as other stakeholders, better evaluate the success or failure of CSR in a business.
Date Created
2017-05
Agent

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

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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.
Date Created
2017-05
Agent