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.

This project will explain the positive impact and effectiveness of Sarbanes-Oxley on corporate responsibility, and through that lens, examine how to make certain subchapters of Title 42, "the Sunshine Act", concerning healthcare fund tracking more transparent and without conflicts of interest. There will be an analysis of the implementation of the Sarbanes-Oxley Act in corporate America and the impact it had on corporate responsibility. There will be a comprehensive review of the history of both the Sarbanes-Oxley Act and the Sunshine Act, along with their origins, stakeholders, and impact on their respective industries. Suggestions to improve certain current United States Code subchapters and subsequent regulations will be announced considering the success that has come from Section 404 of Sarbanes-Oxley.

While the transition from sectarian to allopathic medicine was almost entirely beneficial due to our perceived value in the type of evidence and transparency that science provides, key values within sectarian practice were lost in this transition. Attention to these values helps us better understand the role and treatment of patients in modern medicine. Modern scientific physicians have proven the inefficacy of sectarian treatments by scientific practices, but the efficacy of exact sectarian remedies may not have bearing on the importance of sectarian values. These values were: medical simplicity, harmlessness in treatment, independence from physicians and accessibility of treatment. A more in-depth analysis of sectarian values allows us to understand that while the values of allopathic medicine have become ubiquitous, it has not always been that way. It is time to consider the validity in the sectarian values we have abandoned; this analysis was one of many on medicine's imminent developmental horizon. This realization allows us to call into question the importance of our current practicing values, and the necessity that they continue to stand alone.

The purpose of this thesis project is to analyze the legalization of physician-assisted suicide (PAS) as an option for the terminally ill in the United States from a rule-utilitarian perspective. The moral theory of utilitarianism is a consequentialist theory that judges the moral permissibility of an action or rule based on the best possible outcomes. Rule-utilitarianism conforms an action to an articulated moral rule that leads to the greatest good whereas act-utilitarianism only considers the best possible consequences on a case-by-case basis. Since legalization of PAS is a policy that requires passage of laws, rule-utilitarianism is more appropriate compared to act-utilitarianism. Euthanasia is a controversial topic worldwide that dates as far back as the 5th century BC with the Greeks and Romans. Comparing the euthanasia then and now, the nations are slowly but surely reconsidering the policies regarding PAS. There are both benefits and harms that the paper addresses. The possible benefits include the prevention of elongation of suffering, both physically and psychologically, respect for the patient autonomy, the right to die with dignity, and the decriminalization of the innocents. The potential harms include undermining the integrity of the medical profession and the aim of medicine, violation of the Hippocratic Oath, targeting of the vulnerable population, unmotivating the efforts to develop and improve better palliative and hospice care, and the slippery slope argument, which implies that the legalization of PAS would eventually set the precedence to legalizing voluntary active euthanasia and nonvoluntary euthanasia. Overall, the moral calculus that the paper provides comes to the conclusion that the benefits outweigh the harms.

My thesis project, "An Ethical Evaluation of the Practice of Psychiatric Patient Boarding in the Emergency Department" sets out to address a relatively nameless problem in the healthcare system in the United States. This problem is the boarding of psychiatric patients in emergency departments nationwide. What is psychiatric patient boarding? This term refers to the increasingly common practice of care provided to psychiatric patients upon arrival at an emergency department. When inpatient psychiatric beds or services are not available, "boarding" is performed by simply storing mentally ill patients in hallways or other emergency room areas while they wait for the availability of psychiatric treatment, which may take hours, or in more extreme cases has been cited to last for days at a time (Alakeson et. al, 2010). While any individual can expect to wait a prolonged period of time for medical care in the increasingly overcrowded emergency departments, the psychiatric patient experience is astonishingly unique. A psychiatric patient presenting, or arriving, at the ED in crisis can often times find him or herself not only waiting hours to be admitted and assessed as a medical patient would, but with a limited and ever attenuating supply of psychiatric treatment rooms and services, these patients will often times be harbored in an ED room designed for short-term medical treatment without care until psychiatric services become available. Patients can be left waiting for days for an in-patient vacancy; all the while not receiving true psychiatric treatment and in some cases being held against their will in a chaotic environment far from conducive for treatment of a mental health ailment. In this analysis, I will discuss and review aspects of psychiatric patient boarding from various literature, such as why boarding occurs from a hospital and historical standpoint, negative implications of boarding for psychiatric and medical patients, and the burden placed on the hospital when practicing psychiatric boarding. To learn further on the topic, I will share the results from 14 semi-structured, qualitative interviews performed with ED healthcare professionals, being physicians, charge nurses, nursing staff, and certified nursing assistants or patient safety advocates. This portion of my investigation is designed to offer a perspective that the literature cannot, being a first hand outlook on psychiatric boarding from those working on the front line, focusing on topics of all aspects, such as causation, consequences for all involved parties, and proposed solutions.

The first global estimate of maternal mortality in 1985 revealed that over half a million women die each year due to pregnancy related causes. Although a relatively small figure compared to the deaths attributed to such diseases as malaria and HIV, this was new data. New data meant attraction from powerful international agency leaders, which eventually led to the formation of a global effort called the Safe Motherhood Initiative (SMI). In turn, the global SMI provided the framework for the World Health Organization's (WHO) Millennium Development Goal 5 (MDG 5). Both of these global campaigns, which were largely implemented through advocacy efforts, adopted time sensitive goals aimed specifically to decrease maternal mortality. Although the placement of maternal health on the public health agenda was an extraordinary accomplishment for women's health advocates, a historical examination of safe motherhood efforts will reveal that these advocacy techniques would not keep maternal health on the public health agenda. Over two decades of unsuccessful efforts to reduce maternal mortality have shown that advocacy efforts are not the answer to actually decreasing maternal mortality ratios. Due to the intrinsic difficulties in measuring maternal mortality, and the public health sector's emphasis in prioritizing the political agenda based on such measurements, maternal health has arguably fallen in last place on the agenda. This thesis will explore how the concern for mothers influenced the formation of MDG 5, and how MDG 5 has been translated into local practices. A case study of the Pan American Health Organization's advocacy effort also called the Safe Motherhood Initiative explores the underlying, culturally complex problems that are hindering progress of MDG 5. The results show that the lack of comprehensive reproductive health services for women is not only due to poor health systems in place, which is what many safe motherhood 5 efforts have attempted to address, but also due to cultural traditions and laws on sexual and reproductive health forbidding women to obtain the care they need to survive.

The nonmedical use of prescription ADHD medications by American college students for the purpose of enhancing academic performance has been well-documented for more than a decade. A closer look at this trend through the lens of biomedicalization theory shows us that this behavior, which is often dismissed as a simple abuse of the system by deviant young people, is consistent with broader trends in post-modern medicine and health. The goal of this project was to describe the biomedicalization of studying by illustrating the historical, sociocultural, and politico-economic roots of nonmedical stimulant use by college students in the United States. An online survey was administered to students at ASU and responses from students studying in the College of Liberal Arts and Sciences (n=233) were analyzed. A 12.4% lifetime prevalence of illicit stimulant use was found among the sample population. Thematic analysis was performed on students' open-ended commentary and several themes related to the biomedicalization framework were uncovered including Necessity, Identity, Inextricability from academia, and Trust in the system. Through these themes it was found that many of the theorized transitions of biomedicalization were visible in the data set, confirming the idea that nonmedical stimulant use is embedded in the complex network of processes that represents post-modern medicine today.

While there is extensive information available about organizations that receive donated organs for transplant, much less is known about those that accept tissue and whole bodies for medical education and research. Throughout the United States, nontransplant anatomical donation organizations exist within an ambiguous sector of the donation industry, unencumbered by federal regulations. Although these companies adhere to the Uniform Anatomical Gift Act, the lack of a single entity responsible for overseeing their operations has led to public skepticism and animosity among competing businesses. Legislation has the potential to legitimize the industry. For it to be successful, however, the intricacies of a complex market that deals directly with the movement of human remains and intangible issues of human integrity and morality, must be thoroughly understood.

With advances in biotechnology, personalized medicine has become an ever-expanding field. Even with so much growth, the critics equally match the proponents of personalized medicine. The source of their disagreement is rooted in the concept of empowerment. This analysis utilizes the personal genomics company 23andMe and their relationship with the Federal Food and Drug Administration to illustrate varying views of empowerment. Specifically, the case study focuses on the ability to provide direct-to-consumer health reports to patients independent of physicians. In doing this, larger issues of what is at stake in personalized medicine are uncovered. These include but are not limited to: who determines what individuals get empowered and what information is determined good versus bad.

Breast cancer affects hundreds of thousands of women a year in the United States, and kills tens of thousands. African-American women experience a lower incidence of breast cancer, yet they die at twice the rate of Caucasian women. This disparity demonstrates the ineffectiveness of mammography at decreasing mortality in women at higher risk of late stage diagnosis. In this paper I argue that the continued support of the predominating idea that the benefits of mammograms strictly outweigh their negative effects may be a factor in the continued racial disparity in breast cancer mortality between African-American and Caucasian women. In addition, I will argue that mammograms are less effective for African American women because they are predisposed to later stage diagnosis and the accompanying poorer mortality prognosis due to higher-risk environments caused by varied socio-political status. My claims are supported by studies of incidence rates, survivorship versus mortality rates, screening usage rates, late stage and early stage diagnosis rate, tumor type, and the effects of socioeconomic status on stage of diagnosis. In particular, mortality rates have not decreased parallel with increased mammogram usage, especially in African-American women. Although early stage diagnosis has drastically increased, late stage-diagnosis remains unchanged and higher in African-American women. Tumor types vary by race, and African American women tend to have tumors that are highly prolific and more likely to be metastatic. Socioeconomic factors are more of a marker for breast cancer disparities than race, however race and socio-political structures that embody racism are often intersected.