Annotated bibliography wk 2 hsci journal

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Creating an annotated bibliography calls for the application of a variety of intellectual skills: concise exposition, succinct analysis, and informed library research.

  1. First, choose an ethical dilemma topic (from Chapter 2 of the textbook). This is to be the same topic that will be used for the Week 4 Ethical Reasoning Paper.   
  2. Next locate books, periodicals, and journal articles that may contain useful information and ideas on your ethical dilemma topic.
  3. Briefly examine and review each item.
  4. Choose a minimum of ten credible, scholarly publications that provide a variety of perspectives on your topic to use in this annotated bibliography assignment.  
  5. Cite each of the ten using APA style making sure to include an APA formatted cover page too.
  6. Under each citation, write a concise annotation (approximately 150 words per citation) that summarizes the central theme and scope of the book, periodical, or article.
  7. Include a minimum of one to two sentences to address each of the following: (a) evaluate the authority or background of the author, (b) comment on the intended audience, (c) compare or contrast this work with another you have cited, (d) critically evaluate how this work informs your bibliography topic.
  8. Make sure to review the grading rubric (linked within the Deliverables table) for more detailed information before starting to work on this assignment. 

Chapter 2


Ethical Dilemmas

No right is held more sacred, or is more carefully
guarded, by the common law, than the right of
every individual to the possession and control of
his own person, free from all restraint or
interference of others, unless by clear and
unquestioned authority of law.

—Union Pac. Ry. Co. v. Botsford

Learning Objectives (1 of 2)

• Describe various historical events that have had
an impact on the resolution of ethical dilemmas.

• Describe common ethical dilemmas and the
various ethical issues that have in many
instances divided many segments of the
population. Topics include:
– Abortion
– Sterilization
– Artificial insemination

Learning Objectives (2 of 2)

• Topics include:
– Surrogacy
– Organ donations
– Research, experimentation, and clinical

– Human genetics
– Stem cell research

Ethical Dilemmas

• Ethical dilemmas arise in situations where a
choice must be made between unpleasant

• Occur when a choice involves giving up
something good and suffering some bad.
– Should I choose life knowing an unborn child

will be born with severe disabilities?

Noteworthy Historical Events (1 of 11)

58,000–68,000 BC: Neanderthal burial sites
(evidence of belief in an afterlife)

1932–1972: Tuskegee Study of Syphilis

1933–1945: Holocaust

1946: Military Tribunal for War Crimes

1949: International Code of Medical Ethics

1954: Guidelines on Human Experimentation

First kidney transplant

Noteworthy Historical Events (2 of 11)

1960s: Cardiopulmonary resuscitation

1964: WHO guidelines for biomedical research

1968: Harvard Ad Hoc Committee on Brain Death

1970: Patient as a Person

1971: Kennedy Institute of Ethics established

1972: Informed consent (Canterbury v. Spence)

1973: Women’s right to abortion (Roe v. Wade)

Noteworthy Historical Events (4 of 11)

1974: National Research Act

1975: First successful cloning of frogs

1976: Substitute judgment (Karen Ann Quinlan)

First living will legislation enacted

1978: Commission for the Study of Ethical

Problems in Medicine

Noteworthy Historical Events (5 of 11)

1980: Hemlock Society formed to advocate for
physician-assisted dying.

1983: First durable power of attorney legislation

Compassion and Choices

1987: Unethical experiments on children

Noteworthy Historical Events (6 of 11)

1990: Patient Self-Determination Act
Cruzan could have feeding tube removed
Kevorkian assists terminally ill patients in

Timothy Quill and prescription for death

Derek Humphry’s book Final Exit
Radiation experiments on unknowing


Noteworthy Historical Events (7 of 11)

1993: Patient’s wishes honored
1994: Oregon’s Death with Dignity Act

Michigan makes physician-assisted suicide

1996: HIPAA

Cloning of Dolly

Fourteenth Amendment and the terminally ill

Noteworthy Historical Events (8 of 11)

1997: Physician-assisted suicide

Kevorkian charged with murder

Supreme Ct. rules states may enact

assisted suicide laws
1998: Oregon voters reaffirm Death with Dignity

Kevorkian administers lethal injection

Michigan voters ban physician-assisted

Noteworthy Historical Events (9 of 11)

1999: Kevorkian convicted of second-degree
Oregon has 23 assisted-suicide deaths

2000: Seven myths about end-of life care
2001: President’s Council on Bioethics created

Oregon Assisted Suicided Act challenged
District Court judge upholds Oregon Death

with Dignity Act
Oregon assisted suicides: 129 since 1991

Noteworthy Historical Events (10 of 11)

2002: Attorney General appeals District Ct. ruling

2003: Human gnome system fully sequence

Oregon assisted suicide cases: 42

2004: Death with Dignity Act upheld

2005: Hospital allowed to remove life support

2006: Court upholds Death with Dignity Act

Court blocks Bush attempt to punish doctors

Morning after pill

Noteworthy Historical Events (11 of 11)

2009: Right to know end-of-life options

2010: California legislation to build organ registry

2013: Info and referral service for kidney donors

2018: Seven states have death with dignity acts

One state death with dignity by court order


The termination of pregnancy by the removal or
expulsion from the uterus of a fetus or embryo
before it is viable.

Abortion: Ethical and Legal Issues (1 of 6)

• Rights of the woman
– Autonomy

• Rights of the fetus
• Rights of the spouse
• Rights of the state

– Protecting life

Abortion: Ethical and Legal Issues (2 of 6)

• When does life begin?
• Who decides?
• Who protects the unborn fetus?
• What are the rights of the child or woman who

has been raped?
• What are the rights of the spouse?

Abortion: Ethical and Legal Issues (3 of 6)

• Should the principles of autonomy and right to
self-determination prevail?

• Should an abortion be considered murder?
– Is preventing a birth that might have otherwise

occurred a form of killing?
• What are the religious implications?

Abortion: Ethical and Legal Issues (4 of 6)

• Is an abortion for mere convenience morally

• Should a child or woman who has been raped
have a right to abortion?

• What role should education play in the woman’s
decision to undergo an abortion?

Abortion: Ethical and Legal Issues (5 of 6)

• What alternatives should the woman be
educated about (e.g., the choice of adoption)
before undergoing an abortion?

• At what age should the decision to abort be that
of the mother?

• Should the feelings of guilt that may accompany
an abortion and how those feelings may haunt
the mother through the years be explained?

Abortion: Ethical and Legal Issues (6 of 6)

• Should the feelings that might occur after giving
birth be explained to the victim of a rape (e.g.,
anger and resentment)?

• When does control over one’s body begin, and
when does it end?


U.S. Supreme Court Decisions

Woman’s Right to Privacy
Roe v. Wade (1973)

• Right to abortion
• Recognition of state role in protecting the unborn

– First trimester: Abortion decision between
woman and physician.

– Second trimester: State may reasonably
regulate abortion procedure.

– Third trimester: State may prohibit all
abortions except those deemed necessary to
protect maternal life or health.

Abortion Restrictions Struck Down

• Abortion committee review
• Abortion counseling
• Undue burden rule

Abortion: Funding Issues

– Denial of financial assistance for elective

– Funding not required for therapeutic

– Funding bans unconstitutional in California.
– Funding discrimination prohibited in Arizona.
– Refusal to fund abortion counseling not


Abortion: Spousal Consent

• Interest insufficient
– Poe v. Gerstein (1975)
– Florida’s Therapeutic Abortion Act
– Husband’s consent not necessary for abortion

• Husband’s required consent unconstitutional
– Doe v. Zimmerman (1975)
– Written consent of husband for abortion not


Abortion: Parental Consent

• Competent persons under 18 years
• Incompetent persons
• Parental notification permitted
• Emancipated minor
• Parental notification not required

Abortion: Informed Consent

• The Fifth U.S. Circuit Court of Appeals
determined that a Texas law requiring a
pregnant mother to undergo an ultrasound prior
abortion is constitutional. Although a pregnant
woman cannot be compelled to view the
ultrasound image, the physician is required to
describe what the image shows.

States May Protect Fetus
Colautti v. Franklin (1979)

• States may seek to protect a fetus that a
physician has determined could survive outside
the womb.

Abortion Rights Narrowed: Webster v.
Reproductive Health Services (1989)

• Missouri statute upheld:
– Public employees and public facilities may not

be used in performing or assisting in abortions
unnecessary to save the mother’s life.

– Physicians should conduct viability tests
before performing an abortion.

Partial Birth Abortion: Women’s Med.
Prof. Corp. v. Voinovich (1998)

• Court denied certiorari for first partial birth case
to reach federal appellate courts.

• 6th Circuit Court of Appeals held statute banning
any use of D&X procedure unconstitutionally

Partial Birth Abortion Ban Struck Down:

Stenberg v. Carhart (2000)

• Supreme Court struck down Nebraska ban on
“partial birth abortion.”

• Supreme Court found it an unconstitutional
violation of Roe v. Wade.

Partial Birth Abortion Ban

• National Abortion Fed’n v. Gonzages
– Partial-Birth Abortion Ban Act was found

unconstitutional because it lacked any
exception to preserve the health of the
mother, where such exception was
constitutionally required.

Texas Restrictions on Women’s Rights
Violated U.S. Constitution

• Supreme Court reviewed Texas Ambulatory
Surgery Center requirements and found two
provisions violated the Constitution:
– A physician must have admitting privileges at

a hospital that is located no further than 30
miles from where the abortion is performed.

– Minimum standards for an abortion facility
must be equivalent to the minimum
standards adopted under for ambulatory
surgical centers.

State Abortion Statutes: South Carolina

• 24-hour waiting period not burdensome.
• Abortions after 20 weeks prohibited.

– Exception if the mother’s life is in jeopardy.
– No exceptions for rape or incest.
– Physicians who perform illegal abortions can

face a $10,000 fine and up to 3 years in

Abortion: Law and Morality

• The obligation of society is to define the liberties
of all and not to mandate one’s own moral code.

• The courthouse is not the proper forum to
address abortion issues that have no legal

• Conflicting beliefs.
• Matters of philosophy, ethics, theology.


• Sterilization: Termination of the ability to produce
– Elective: Voluntary sterilization.
– Therapeutic: Performed to preserve life or

– Eugenic: Involuntary sterilization.

• Described in statutes
• Mentally deficient
• Feeble-minded

Negligent Sterilization

The improper performance of sterilization can
result in lawsuits based on such theories as
wrongful birth, wrongful life, and wrongful



A claim that but for a breach of duty by the
defendant(s) (e.g., improper sterilization), the child
would not have been born.

Wrongful Life

Wrongful life claims are initiated by the parent(s) or
child based on harm suffered as a result of being

Wrongful Conception

• A claim by parents of unexpected child based on
allegation that conception resulted from a
– Negligent sterilization procedure
– Defective contraceptive device

Artificial Insemination (1 of 2)

• Injection of seminal fluid into a woman to induce

• Homologous artificial insemination
– Semen of spouse used to impregnate

• Heterologous artificial insemination
– Semen from donor other than husband

Artificial Insemination (2 of 2)

• Consent
• Confidentiality


• Method of reproduction whereby a woman
agrees to give birth to a child for another party.

• Surrogate may be
– Child’s genetic mother
– Gestational carrier

Surrogacy: Ethical and Legal Issues

• Legal right to enter a surrogacy contract
• Parental rights of the commissioning couple
• Long-term effects of surrogacy contracts
• Psychological impact on child

Organ Donations (1 of 2)

• Federal regulations require:
– Protocols regarding an organization’s organ

procurement responsibilities
– Specific notification duties
– Requirements informing families of potential

– Sensitivity in dealing with families
– Educating hospital staff on organ donation
– Timely donation and transplantation

Organ Donations (2 of 2)

• Uniform Anatomical Gift Act adopted in 50

• Provisions for making available, acceptance,
and use of anatomic gifts.

• Who lives? Who dies? Who decides?
• Failure to obtain consent.
• Altruism vs. sale of organs.

Research, Experimentation,
and Clinical Trials (1 of 2)

• Ethical principles
– Respect for person
– Beneficence

• Hippocratic Oath: Physicians act to benefit

– Justice
– Autonomy

Research, Experimentation,
and Clinical Trials (2 of 2)

• Right to try experimental drugs
• Office of Research Integrity
• Food and Drug Administration
• Institutional review board
• Informed consent
• Experimental subject’s Bill of Rights
• Patient responsibilities
• The Cures Act


• Each person to be treated equally.
• How should each person be treated?

– According to need?
– According to value to society (societal

– According to merit?

Nuremberg Code and
Declaration of Helsinki

• International code of ethics that governs human

• Result of Nazi medical atrocities.
• Requires human subjects be fully informed.

Federal Regulations

• The federal government controls experiments
– Drugs
– Medical devices
– Medical procedures

Conducting Clinical Trials

• Organization must provide for:
– Education in ethical decision-making
– Nurse participation in ethical decision-making
– Ongoing monitoring of approved protocols

Institutional Review Board

• Federal regulations require a hospital-based
institutional review board (IRB).

• IRB functions:
– Review proposed research studies.
– Approve protocols for research.
– Conduct research oversight.

Informed Consent (1 of 2)

• Organization must:
– Disclose risks, benefits, and treatment

– Determine competency of patient consent.
– Obtain written consent from patient.

Informed Consent (2 of 2)

• Organization must:
– Disclose treatment costs.
– Educate staff on

• Potential side effects of treatments.
• Implementation of protocols.
• Monitoring of protocols.

Human Genetics

• The study of inheritance as it occurs in human
beings. It includes:
– Stem cell research
– Clinical genetics

• Genetic disease markers
– Molecular genetics

Genetic Information
Nondiscrimination Act (1 of 2)

• Law prohibits discrimination on basis of genetic
information with respect to the availability of
health insurance and employment.

• Prohibits group health plans and insurers from
denying coverage to a healthy individual based
on genetic predisposition to develop a specific

Genetic Information
Nondiscrimination Act (2 of 2)

• Prohibits employers from using genetic
information when making hiring, firing, job
placement, or promotion decisions.

Genetic Markers

• A genetic marker is a gene or DNA sequence
that has a known location on a chromosome and
can be associated with a particular gene or trait.

• Genetic markers can identify certain diseases.

Stem Cell Research

• Use of embryonic stem cells to create organs
and various body tissues.

• Highly controversial issue generally involving
religious beliefs.

• Fears as to how far scientists might go in their
attempts to create.


• Deadliest epidemic in human history.
• First case appeared in literature in 1981.
• More than 21 million people have died from

• Is caused by human immunodeficiency virus

• HIV is highly contagious bloodborne virus.
• Destroys body’s capacity to ward off bacteria.

Spread of AIDS

• Body fluids
– Vaginal secretions
– Semen
– Breast milk

• Blood transfusions
• AIDS and Healthcare workers

Confidentiality: Disclosure of
Physician’s HIV Status

A physician cut his hand with a scalpel while he
was assisting another physician. Because of the
uncertainty that blood had been transferred from
Doe’s hand wound to the patient through an open
surgical incision, he agreed to have a blood test for
HIV. His blood tested positive for HIV and he
withdrew himself from participation in further
surgical procedures.

• Discuss the ethical and legal issues.

Confidentiality: Ethical Issues

• Physician’s right to privacy versus patient’s right
to know.

• Utilitarianism
– Advocates the greatest good for the greatest

• Conscientiousness

– A person who has moral integrity and a strict
regard for doing the right thing

Confidentiality: Legal Decision

Failure to notify the patients at risk could result
in the spread of the HIV virus to other
noninfected individuals through sexual contact
and through exposure to other body fluids. Doe’s
name was not revealed to the patients, only the
fact that a resident physician who participated in
their care had tested HIV-positive. “No principle
is more deeply embedded in the law than that
expressed in the maxim Salus populi suprema
lex . . . (the welfare of the people is the supreme

AIDS Education

• Provide educational materials for patients and

• Universal protocols.
• Strictly adhere to handwashing protocols.
• Safely handle all body fluids.

– Adhere to OSHA requirements.

Review Questions (1 of 5)

1. Discuss under what circumstances ethical
dilemmas arise.

2. Discuss the controversy over the Supreme
Court decision in Roe v. Wade.

3. What ethical principles surround the abortion
issue? Discuss these principles.

4. Do you agree that individual states should be
able to impose reasonable restrictions or
waiting periods on women seeking abortions?
Who should determine what is reasonable?

5. Should a married woman be allowed to abort
without her husband’s consent?

6. Discuss the arguments for and against partial
birth abortions.

7. Why is the medical issue of abortion an
example of legislating morality?

8. What is artificial insemination? What questions
should be asked when considering artificial

Review Questions (2 of 5)

9. Discuss the importance of organ donations.

10.Describe the ethical considerations that should
be addressed before conducting research on
human subjects.

11.Why is it important that written consent be
obtained from each patient who participates in
a clinical trial?

12.What is sterilization, as discussed in this
chapter? Do you agree that eugenic
sterilization should be allowed? Explain your

Review Questions (3 of 5)

13.Describe the distinctions among wrongful birth,
wrongful life, and wrongful conception.

14.Discuss the moral dilemmas of these concepts.

15.Describe the controversy over surrogacy.

16.Discuss why there is controversy over genetic
markers and stem cell research.

17.What is AIDS, and how is it spread?

Review Questions (4 of 5)

18.Discuss the controversy that can occur when
considering a patient’s right to know whether a
caregiver has AIDS and the caregiver’s right to
privacy and confidentiality.

Review Questions (5 of 5)

  • Chapter 2
  • Quote
  • Learning Objectives (1 of 2)
  • Learning Objectives (2 of 2)
  • Ethical Dilemmas
  • Noteworthy Historical Events (1 of 11)
  • Noteworthy Historical Events (2 of 11)
  • Noteworthy Historical Events (4 of 11)
  • Noteworthy Historical Events (5 of 11)
  • Noteworthy Historical Events (6 of 11)
  • Noteworthy Historical Events (7 of 11)
  • Noteworthy Historical Events (8 of 11)
  • Noteworthy Historical Events (9 of 11)
  • Noteworthy Historical Events (10 of 11)
  • Noteworthy Historical Events (11 of 11)
  • Abortion
  • Abortion: Ethical and Legal Issues (1 of 6)
  • Abortion: Ethical and Legal Issues (2 of 6)
  • Abortion: Ethical and Legal Issues (3 of 6)
  • Abortion: Ethical and Legal Issues (4 of 6)
  • Abortion: Ethical and Legal Issues (5 of 6)
  • Abortion: Ethical and Legal Issues (6 of 6)
  • Abortion U.S. Supreme Court Decisions
  • Woman’s Right to Privacy Roe v. Wade (1973)
  • Abortion Restrictions Struck Down
  • Abortion: Funding Issues
  • Abortion: Spousal Consent
  • Abortion: Parental Consent
  • Abortion: Informed Consent
  • States May Protect Fetus Colautti v. Franklin (1979)
  • Slide 31
  • Slide 32
  • Slide 33
  • Partial Birth Abortion Ban Unconstitutional
  • Texas Restrictions on Women’s Rights Violated U.S. Constitution
  • State Abortion Statutes: South Carolina
  • Abortion: Law and Morality
  • Sterilization
  • Negligent Sterilization
  • Wrongful Birth
  • Wrongful Life
  • Wrongful Conception
  • Artificial Insemination (1 of 2)
  • Artificial Insemination (2 of 2)
  • Surrogacy
  • Surrogacy: Ethical and Legal Issues
  • Organ Donations (1 of 2)
  • Organ Donations (2 of 2)
  • Research, Experimentation, and Clinical Trials (1 of 2)
  • Research, Experimentation, and Clinical Trials (2 of 2)
  • Justice
  • Nuremberg Code and Declaration of Helsinki
  • Federal Regulations
  • Conducting Clinical Trials
  • Institutional Review Board
  • Informed Consent (1 of 2)
  • Informed Consent (2 of 2)
  • Human Genetics
  • Genetic Information Nondiscrimination Act (1 of 2)
  • Genetic Information Nondiscrimination Act (2 of 2)
  • Genetic Markers
  • Stem Cell Research
  • AIDS
  • Spread of AIDS
  • Confidentiality: Disclosure of Physician’s HIV Status
  • Confidentiality: Ethical Issues
  • Confidentiality: Legal Decision
  • AIDS Education
  • Review Questions (1 of 5)
  • Review Questions (2 of 5)
  • Review Questions (3 of 5)
  • Review Questions (4 of 5)
  • Review Questions (5 of 5)

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