Civil litigation and medical malpractice both seem to be plagued by similar misperceptions. The general public, lawyers, physicians and our elected officials are all in considerable error regarding the reality behind civil litigation. The perception is that there are an increasing number of claims filed, and that in those cases that are filed the plaintiff is likely to win and be awarded a large sum of money. Regarding medical malpractice, in particular, is the belief that such litigation increases the over-all costs of healthcare by a significant dollar amount through the costs of litigation as well as the increasing instances of defensive medicine. Physicians further state that it is the absurd awards all too common in medical malpractice cases that are to blame for the out of control increases seen in medical malpractice premiums. These increases in premiums are said to have forced a large number of physicians out of practice that will hurt the general public's access to health care. These perceptions are at least reinforced by the media coverage that reports on the rare multimillion-dollar cases and from reports by insurance companies and physicians, in their attempt to lower their business costs by decreasing medical malpractice insurance premiums. By understanding the prevalence of such misperceptions, the truth behind the claims, and how such misinformation reaches the public and has spread to all levels of society, empirical data must be presented to the public in order to overcome the misperceptions.

Vaccine opposition is a growing problem in developed countries where dropping vaccination rates threaten general public health by laying the foundation for resurgence and reemergence of previously eradicated infectious diseases. This thesis argues that the current movement is only the most recent incarnation of opposition that has co-evolved with vaccine practices for the duration of their mutual histories. Part one provides a historical context for the current movement using the example of the development and deployment of the smallpox vaccine as a representative timeline of vaccine acceptance and opposition. Part two describes the current movement in the United States and the United Kingdom, interprets the reasons for the conclusions drawn by vaccine-concerned parents, and provides a framework for public health officials to approach the issues.

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.

The knowledge of medical genetics is currently used with prenatal testing, and the advancements in the field of behavioral genetics may someday allow for its use with prenatal testing as well. The use of prenatal procedures for medical phenotypes has its own implications and should these techniques be used for behavioral phenotypes, such implications can also apply. The complexity of behavior in terms of the factors that may affect it, along with the way it is conceptualized and perceived, adds further implications for prenatal testing of it. In this thesis, I discuss the qualitative, quantitative, and historical facets of prenatal testing for medical and behavioral phenotypes and the undercurrent of eugenics. I do so by presenting an example of the medical phenotype (cystic fibrosis) as a case for envisioning the implications of medical phenotypes before delving into examples of behavioral phenotypes (aggression, impulsivity, extraversion, and neuroticism) in order to explore the implications shared with those for medical phenotypes as well as those unique to it. These implications then set the foundation for a discussion of eugenics, and the considerations for how behavioral genetics with prenatal testing may give way to a modern form of it.

In a world in which technologies proliferate at a rapid rate, it is no surprise that the medical device industry has grown in leaps and bounds. This surge in medical technology, especially implantable medical technology, has altered the modern operating room, transforming surgery from a technique-driven activity into a technology-driven profession. This reliance upon technologies has fostered close ties between physicians and the medical device industry and within this relationship, medical device representatives play an integral role. This paper will investigate the relationship that exists between physicians and the medical device industry along with the potential conflicts of interest that may result due to this relationship. I will focus in particular on orthopedic medical devices due to media attention as a result of a 2007 Department of Justice settlement involving the leading orthopedic companies. This case proved instrumental in highlighting previously unknown instances in which conflicts of interest were occurring in the medical device industry.

Fibromyalgia is a multi-systemic syndrome linked to musculoskeletal pain, fatigue, nausea, and other comorbid syndromes and chronic illnesses. However, difficulties evaluating and managing acute fibromyalgia symptoms may cause individuals to present to the emergency department for pain control or further diagnostic workup. However, oligoanalgesia (the undertreatment of pain) detrimentally affects an individual's treatment while in the emergency department. Furthermore, social factors known to influence pain management, such as race, age, or past medical history, affect the diagnostic treatment and evaluation of fibromyalgia patients. As such, ethical evaluation of case studies will indicate how emergency physicians can better manage pain treatment in the emergency department.

There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.

There is growing concern among physicians, scholars, medical educators, and most importantly among patients, that science and technology have begun to eclipse fundamental attributes, such as empathy in the doctor-patient relationship. As a result, “humanism” in medicine has been a widely debated topic—how to define it, how to promote it, whether it can be taught, and how to qualify (much less quantify) its value in the practice of medicine. Through this research project I sought to better understand the role of humanities coursework in American medical school curricula, and determine whether there was a relationship between the integration of humanities coursework and the maintenance or enhancement of empathy levels in medical students. I reviewed literature with three objectives. (1) To better understand the influential social and political factors of pervasive reforms in US medical school curricula at the beginning of the 20th century, which led to science exclusive pedagogy in physician training (2) To become familiar with the works of iconic personalities in the history of American medical school pedagogy, paying special attention to attitudes and claims describing the role of humanities coursework, and the concept of humanism in the practice of medicine. (3) To observe the discourse underway across a variety of disciplines with regard to the current role of humanities coursework in medical curricula. My research shows that empathy is an essential attribute in the healing relationship, which benefits patients, physicians and improves health outcomes. Despite the importance of empathy, current physician training is documented as eroding empathy levels in medical students. Though the definition of ‘humanities’ in the context of medical school curricula remains vague and even contradictory, support for integration of humanities coursework is growing as an effective intervention for maintaining or enhancing levels of empathy.

Noninvasive prenatal testing using cell-free fetal DNA (CffDNA) testing is a rapidly developing area in prenatal diagnosis. Fetal genetic testing can occur with a simple maternal blood sample, since CffDNA can be found in maternal plasma. Thus, no harm is caused to mother or fetus to obtain this genetic information, providing significant benefits for those users. How the test should be integrated in existing prenatal programs has yet to be seen. CffDNA testing is an exciting technology and has attracted attention from many stakeholders, yet the lack of regulation and guidance has left legal, ethical, and social questions unanswered. This paper outlines a number of those issues expressed in the present literature on the matter.

Scientists, lawyers, and bioethicists have pondered the impact of scientifically deterministic evidence on a judge or jury when deciding the sentence of a criminal. Though the impact may be one that relieves the amount of personal guilt on the part of the criminal, this evidence may also be the very reason that a judge or jury punishes more strongly, suggesting that this type of evidence may be a double-edged sword. 118 participants were shown three films of fictional sentencing hearings. All three films introduced scientifically deterministic evidence, and participants were asked to recommend a prison sentence. Each hearing portrayed a different criminal with different neurological conditions, a different crime, and a different extent of argumentation during closing arguments about the scientifically deterministic evidence. Though the argumentation from the prosecution and the defense did not affect sentencing, the interaction of type of crime and neurological condition did.