Bioethics, Law and Medical Professionalism 2019 Projects

Project Title: Effect of Combining Media Forms in Advanced Directives

Faculty Mentor’s Name: Dr. Ray Moseley
Email: rmoseley@UFL.EDU

Student’s Name: Andrew Hood

Project Description:

Patient centered care at the end of life or during times of incapacitation is a difficult task to manage and it is for these situations that advance directives are necessary. They are a patient’s final way of communicating their final wishes for care. Traditionally these wishes and requests have been conveyed via written requests and forms. Unfortunately, it can be very difficult for families and surrogates to come to terms with and understand the written wishes of the patient. With the advent of easily used video recording devises and secure storage platforms, a new and possibly superior method of conveying patient desires has emerged. Video recorded advance directives are an easy and manageable way to record and share a patient’s wishes with their families.

This method may lead to a paradigm shift with regard to the documentation and execution of a patients desired care. This also offers patients a way to quite literally speak and advocate for themselves while incapacitated. This is important as it is the healthcare providers job to ensure that the care provided is in line with the patient’s wishes and beliefs. If the video formatted advance directives are efficacious this may also be a step towards increasing utilization of and accessibility to advance directives. Eventually this format change holds the potential to ensure every patient has the opportunity to make their request for care known. Therefore, the purpose of this study is to determine opinions on the usefulness of video advance directives in treatment decisions, managing stress, and communication.

Project Title: Impact of Media Order on Advance Directive Comprehension

Faculty Mentor’s Name: Dr. Ray Moseley
Phone: (352)273-5155

Student Name: Rebekah Fitzpatrick

Project Description:

Project will be developed in accordance with student interest in various areas of bioethics. Contact me and we can develop a project that can be accomplished during the 10-week period over the summer.

Potential research topics include:
1. Advanced Directives/Living Wills
2. Technological Solutions to Clinical Bioethical Problems
3. Video Advance Directives
4. Techniques for Asking for Informed Consent
5. Regulatory/IRB Aspects of Research
6. Clinical Bioethics Consulting (i.e. models, techniques, format, consulting practices)
7. Any other issues in Bioethics

Project Title: Re-examining the Constitutional Right to Die

Faculty Mentor’s Name: Prof. Lauren Solberg

Student’s Name: Amber Henry

Project Description:

Washington vs. Glucksberg and Vacco v. Quill established decades ago that there is not a constitutional right to physician-assisted suicide. However, the expanding number of states legalizing physician-assisted suicide, the extension of the dying process due to advancements in end of life care, and the high value we place in patient-centered care on patient autonomy invite a timely discussion on physician-assisted suicide. Thus, the time has come for the Supreme Court to re-examine the right to die. Indeed, scholars in law and bioethics such as Norman Cantor have recently suggested that our changing approaches to patient care and patient autonomy, as well as improved technology for extending life may warrant such a re-examination. If the right to physician-assisted were to be held as a protected right under the U.S. Constitution, or if the volume of states legalizing physician-assisted suicide continues to grow, there may be implications for the existing statutory provisions among the states that have legalized it and for the states that may consider legalization.

The growing legalization of physician-assisted suicide, and potential protection under the U.S. Constitution, may encourage evolution of the current statutory provisions among the states that have already legalized physician-assisted suicide. The regulation of physician-assisted suicide in states that pass laws legalizing it in the future may regulate it differently than states do currently as a result of the increased legalization around the United States.

The aim of this project is to analyze the right to die in the context of analogous cases in which the Supreme Court held that the U.S. Constitution provides for such rights as privacy, marriage, and contraception.

We will analyze the shared statutory provisions in states that have legalized physician-assisted suicide, including capacity, self-administration, residency, and terminal illness. While examining these provisions, we will consider the rationale for them and evaluate whether they would pass constitutional muster if physician-assisted suicide were protected under the U.S. Constitution. Additionally, we will examine whether these provisions could evolve as more states legalize physician assisted suicide, without a holding that it is a constitutional right. Professor David Sloss discussed this in a Stanford Law Review article written in 1996, before the first physician-assisted suicide statute was in effect.

We note this is not a paper advocating for or against the legalization of physician-assisted suicide or a commentary on the ethics of it. It is an analysis of the legislation and accompanying ethical issues surrounding it.

Project Title: Developing and Evaluating Student-Led Social Justice Education for Medical Students

Faculty Mentor’s Name: Dr. Catherine Striley

Student’s Name: Aparna Sethumadhavan

Project Description:

There is a growing demand for the integration of social justice education into medical school curricula. The intention behind this is to foster the development of physicians who are culturally sensitive, socially conscious, and empathetic to people of all backgrounds. As health disparities are a well-known problem in healthcare and public health, it is important to educate future healthcare professionals to be cognizant of these issues and know how to address them throughout their career. Many healthcare professionals have argued that the fundamental issue behind health disparities and health inequities is social justice.

However, many medical schools do not incorporate such courses into their mandatory curriculum, and a lack of knowledge about addressing health inequity and health injustice can greatly affect patient care. One study of fourth year medical students at UCSF showed that while students could recognize health disparities, they lacked the education to find productive ways of addressing them. As more medical students have become aware of this gap in their education, they have pushed for and helped create social justice courses in their medical schools.

The findings of this study will contribute to better understanding the needs of medical students at the University of Florida related to a health justice curriculum as well as assess the potential for a sustainable student-led social justice module.