Philosophical Issues in Nursing PDF

Philosophical Issues in Nursing (Weeks 1 - 5) What is the focus of PHI 1370 - Philosophical Issues in Health Care?/ Exploring philosophical questions about human nature and ethical dilemmas in healthcare. What is philosophy?/The study of general and fundamental questions about right and wrong, exis...

Philosophical Issues in Nursing (Weeks 1 - 5) What is the focus of PHI 1370 - Philosophical Issues in Health Care?/ Exploring philosophical questions about human nature and ethical dilemmas in healthcare. What is philosophy?/The study of general and fundamental questions about right and wrong, existence, ethics, knowledge, values, mind, and reasoning. Philosophers explore the meaning of life. When did ethics become central to modern healthcare?/In the 20th century. What is the guiding principle of medical ethics derived from the Hippocratic Oath?/ "Above all, do no harm." Why is ethics important for vulnerable populations in healthcare?/To assess potential harm, prevent abuse, and address power imbalances between practitioners and patients. Why is ethics important in healthcare?/ It helps guide decision-making, protect patient rights, ensure fair resource allocation and holistic approaches to care. What are the two types of philosophical issues in healthcare?/Conceptual issues (gaps or inconsistencies in defining a topic or concept) and ethical issues (moral conflicts requiring decisions about right and wrong). Why do moral principles and theories exist?/To help determine right and wrong actions and create moral obligations. Why are moral principles necessary?/ Some actions lack clear moral definitions, and principles provide guidance in ethical decision-making. What is the primary function of moral principles?/To guide decisions on what is right and wrong in various situations. What are moral theories?/Frameworks that address right, wrong, and obligation to act, aid in resolving healthcare moral dilemmas. How do moral theories differ from moral principles?/Theories explain why actions are right or wrong, while principles provide flexible guidelines. Theories are comprehensive, universal, without exceptions and aid in resolving complex ethical issues while principles can be overridden depending on the situation. What is the role of moral codes in healthcare?/They provide basic rules but lack depth in complex situations, and are simple lists of rights and wrong without context. What are the components of a good moral theory?/It should align with our moral sense and not cause moral conflict, be consistent with our moral judgments in different scenarios, be helpful in determining what is the right act, and should help solve disagreements and reduce moral distress. What is consequentialism?/ A theory that judges morality based on the outcomes of actions, process to reach the outcome is irrelevant. What is non-consequentialism?/A theory that focuses on the moral reasoning behind actions, not just outcomes, considers the process rational for morality, and rejects consequentialism. What is utilitarianism?/A consequentialist theory stating actions are right if they maximize happiness. It values intellectual, emotional, and artistic pleasures equally with physical ones. What are the two types of utilitarianism?/Act utilitarianism (evaluates individual actions that maximizes happiness) and Rule utilitarianism (establishes general rules to maximize happiness). What are the principles of Utilitarianism?/ morality should aim to maximize happiness, and actions that do not produce happiness are considered wrong. What is a major criticism of rule utilitarianism?/It can collapse into act utilitarianism if rules are overly broad. Without rules, clarity and guidance are lost. Society benefits from rules providing structure for ethical decision-making Who developed Kantian ethics and when?/Immanuel Kant (1724–1804). Where was the founder of Kantian ethics born and lived?/ born in Konigsberg, Prussia, strict protestant upbringing What are the features of Kantian ethics? Everyone is morally equal. Rule apply universally. Moral worth comes from actions done with goodwill. Rationality underspin morality. What is the Categorical Imperative?/A moral principle stating that actions should follow universal moral laws. What are the importance of categorical imperative?/Universality ensures morality is objective(e.g if lying is wrong for one , it is wrong for all), and consistent and provides a framework for ethical decision-making Why is Kantian ethics considered universal?/It applies moral rules consistently to all people in all situations. Who is W.D Ross? / What is W.D. Ross's ethical theory is called?/Moral pluralism and rejected one single moral principle. Does not believe that one single property could define right or wrong actions.Ross ethics combines Kantian ethics with Utilitarianism. What are prima facie moral principles?/ Ethical rules that should be followed unless a stronger moral reason overrides them. Conflicts require intuitive judgment to prioritize(e.g lying to prevent harm). No rule is absolute and moral context matters. What is a challenge of Ross’s theory?/Determining which duty takes priority in conflicting situations. Explaining intuitive knowledge and moral capacity What is virtue ethics?/A moral theory focusing on character and the cultivation of virtues like generosity, compassion, honesty and integrity What are challenges in applying virtue ethics?/It can be difficult to determine which virtues are most important in complex situations. Deciding moral actions in extreme cases like war and determining which virtues are the most important to cultivate. What is care ethics?/ An approach that emphasizes relationships, empathy, and care over abstract moral rules.Rules do not guide morality Who founded feminist ethics?/Carol Gilligan (1982). What are the features of feminist ethics?/contrast male ethics like reason, rules, abstraction, with feminist ethics like involvement , attachment and concern. Emphasizes nurture over nature; society shapes individuals. Critiques mainstream ethics for undervaluing community, peace and interdependence. How does feminist ethics differ from traditional ethics?/It prioritizes relationships, attachment, and community over abstract principles. What does feminist ethics critique in mainstream moral theories?/ The undervaluing of interdependence and emotional engagement. What is autonomy?/The right to control one’s own decisions and life. What is the importance of autonomy? It promotes happiness and reflects free will and human uniqueness. How has autonomy changed in healthcare history?/Patients once had to obey medical authority but now have greater rights in decision-making. What are internal and external constraints on autonomy?/ Internal: Addictions, mental health issues. External: Laws, medical policies. What is paternalism?/The practice of making decisions for others based on perceived best interests. How was paternalism historically applied in medicine?/ Doctors made decisions without patient input, under the "doctor knows best" mindset. Define beneficence./Acting in the best interest of others to promote well-being. Define non-maleficence./The duty to avoid causing harm. What ethical dilemma arises between beneficence and non-maleficence?/ Balancing risks and benefits, such as in medical treatments. What is justice in healthcare?/Ensuring fairness in treatment and resource allocation. What is the difference between equality and equity?/Equality: Everyone gets the same resources. Equity: Resources are distributed based on need. What is moral distress?/ The experience of knowing the right ethical action but being unable to take it. How can moral distress affect healthcare workers?/ It can lead to emotional strain, poor morale, and burnout. What is moral resilience?/The ability to recover and maintain integrity after experiencing moral distress. What is a personal philosophy of healthcare?/ A statement outlining values and ethical beliefs in medical practice. How does a personal philosophy benefit healthcare professionals?/It guides decision-making and helps maintain motivation. What are key steps in writing a personal philosophy?/Reflect on values, define strengths, and consider long-term impact.​ What is the duty of care in nursing advocacy? / Obligation to prioritize patient welfare. What does justice mean in nursing advocacy? / Advocating for equal access to resources. What is moral courage in nursing? / Standing up for what is ethically right. What are the daily roles of frontline nurse advocates? / Ensuring informed consent, safeguarding patient safety, addressing patient concerns. Give an example of a frontline nurse advocacy situation. / Advocating for pain management for a patient. How do nurses collaborate in interdisciplinary teams for advocacy? / They work with physicians and other health professionals to improve patient care. What are some common challenges faced by nurse advocates? / High workload, institutional barriers, ethical dilemmas. How can institutional resistance impact nurse advocacy? / It can delay or prevent policy changes that improve patient care. What is an example of a successful nursing advocacy initiative? / Any campaign or policy change that improved patient care or nurse working conditions. What is the White Shoe Advocacy Campaign? / A campaign supporting nursing advocacy. How does the media contribute to nursing advocacy? / It amplifies advocacy campaigns through social media, news, and television. What is the role of public engagement in advocacy? / Encouraging community support for nursing advocacy issues. What role do professional nursing associations play in advocacy? / They support and guide advocacy efforts for nurses and patients. What are three key areas nurses advocate for in policy? / Work-life balance, safe environments, career development. How do nurses advocate for safer work environments? / By pushing for proper PPE and workplace safety policies. How do nurses advocate for health equity? / By addressing barriers for marginalized populations. Why is advocacy for Indigenous health important? / It helps address unique health challenges within Indigenous communities. What ethical framework guides nursing advocacy? / The CNA Code of Ethics. What is an advocacy model? / A step-by-step approach for systematic advocacy efforts. What are three key skills for effective nurse advocacy? / Communication, negotiation, collaboration. What are two modern examples of nurse advocacy? / Pandemic responses (PPE/vaccine access) and mental health funding campaigns. What are common barriers to nurse advocacy? / Resistance to change, funding limitations, institutional pushback. How do nurses collaborate with other professionals in advocacy? / They work with physicians, therapists, and social workers to align patient care priorities. What is an example of successful interdisciplinary advocacy? / Joint advocacy for new hospital equipment. How can nurses build their advocacy skills? / Through continuing education, networking, and leadership opportunities. What are three major advocacy issues in nursing today? / Racism in healthcare, rural health access, and technological equity. What are three common tools used in nursing advocacy? / Social media, public speaking, policy briefs. Why is policy brief writing important for nurse advocacy? / It documents evidence to present to decision-makers. Why is research important in advocacy? / It strengthens advocacy efforts by providing evidence-based solutions. What are common research topics in nursing advocacy? / Disparities in healthcare access, nursing burnout. What are the five steps in designing an advocacy campaign? / Identify the issue, build a team, create a plan, execute, and evaluate. How is the success of an advocacy campaign measured? / Through pre- and post-campaign evaluations. What is an example of a current advocacy effort in nursing? / Campaign for improved nurse-to-patient ratios. What strategies are used in this campaign? / Data collection, public awareness, legislative outreach. What qualities make an effective nurse advocacy leader? / Vision, resilience, communication. How does mentorship contribute to advocacy? / It helps build future nurse advocates. What are three key focus areas for the future of nursing advocacy? / Community health, global health, workforce sustainability. How do nurses participate in global health advocacy? / By supporting vaccine equity and participating in international health missions. What are three ways nurses can influence policymakers? / Lobbying, joining coalitions, presenting evidence-based arguments. What are three barriers to successful advocacy? / Knowledge gaps, lack of institutional support, persistence challenges. What is an example of legislative change influenced by nurse advocacy? / Any law or policy change improving working conditions or patient care. What is an ethical challenge nurses face in advocacy? / Balancing individual vs. systemic needs in resource allocation. Why is confidentiality important in advocacy? / It protects patient privacy while advocating for their needs. What are common advocacy efforts for mental health? / Raising awareness, increasing funding, reducing stigma.  What is a positive outcome of mental health advocacy? / Greater public acceptance and access to care. How can nurses engage patients in advocacy? / By including their voices in care planning. What is shared decision-making in advocacy? / Collaborating with patients for better outcomes. How is social media used in nursing advocacy? / Through hashtags, online campaigns, and virtual mobilization. What are challenges of digital advocacy? / Digital literacy and accessibility issues. What are three self-care strategies for nurse advocates? / Mindfulness, peer support, counseling. Why is self-care important for advocates? / To balance advocacy work with personal well-being. Why is diversity and inclusion advocacy important in healthcare? / It addresses systemic inequities and improves access for marginalized groups. What are two strategies for promoting diversity in nursing? / Increasing leadership opportunities and improving education programs. What are long-term goals for nursing advocacy? / Creating equitable and sustainable healthcare systems. How can nurses prepare for the future of advocacy? / By taking on leadership roles and staying informed on key issues. How can nurses get involved in advocacy? / Joining professional organizations, participating in campaigns, educating peers. Why is it important for every nurse to advocate for change? / Because nurses have firsthand experience and influence in healthcare Walter Freeman / An American psychiatric physician known for pioneering the lobotomy procedure to treat mental health conditions. Why is Walter Freeman considered a villain? / He performed unethical lobotomies without anesthesia, causing significant harm, including deaths and severe side effects, without scientific backing. What were the ethical concerns about Freeman’s lobotomy procedure? / He did not provide a scientific basis for the procedure and performed it without anesthesia, inducing seizures instead. What was the historical context of Freeman’s work? / Mental health treatment was not well understood, and he did not test on animals before human experimentation. What were the consequences of Freeman’s lobotomies? / 490 deaths, a 15% fatality rate, and severe side effects including epilepsy, dementia, and personality changes. What long-term impact did Freeman’s work have on medical practice? / Lobotomies declined with the introduction of psychiatric medications, and informed consent became legally required. Who was Andrew Wakefield? / A former physician from the UK who falsely claimed a link between the MMR vaccine and autism. Why is Andrew Wakefield considered a villain? / He manipulated data, spread misinformation, and caused widespread vaccine hesitancy, leading to outbreaks of preventable diseases. What ethical violations did Wakefield commit? / He conducted invasive experiments on children without ethical clearance and had financial conflicts of interest. What were the consequences of Wakefield’s fraudulent research? / He lost his medical license, manipulated the public into vaccine hesitancy, and contributed to outbreaks of preventable diseases. How is Wakefield’s case viewed in medical history? / It is considered one of the most serious cases of medical fraud. Who was J. Marion Sims? / A 19th-century American physician known as the "Father of Modern Gynecology" who conducted unethical experiments on enslaved women. Why is J. Marion Sims considered a villain? / He performed surgeries without anesthesia or consent on enslaved women, violating ethical medical practices. What unethical practices did Sims engage in? / He performed surgeries without anesthesia and did not obtain consent from his patients. What was the impact of Sims’ experiments? / His work contributed to gynecological advancements, but it also created lasting mistrust in healthcare among marginalized communities. How has Sims’ legacy been re-evaluated? / His statue was removed in 2018, and recognition was given to the women he experimented on: Lucy, Anarcha, and Betsy. Who was Harold Shipman? / A UK doctor who murdered approximately 284 patients over 30 years. Why is Harold Shipman considered a villain? / He abused his medical authority to kill vulnerable elderly patients for personal gratification. What methods did Shipman use to kill his patients? / He administered fatal drug overdoses and over prescribed medications. What changes in medical practice resulted from Shipman’s crimes? / Increased oversight of doctors, changes to prescribing practices, and stricter death certification procedures. What was Shipman’s fate? / He was convicted in 2000 and later died by suicide in prison. Who was Edward Livingston Trudeau? / A physician who pioneered tuberculosis treatment and founded the Adirondack Cottage Sanatorium. Why is Edward Livingston Trudeau considered a hero? / He made groundbreaking discoveries about tuberculosis and dedicated his career to saving lives through environmental therapy. What was Trudeau’s groundbreaking experiment? / He discovered that fresh mountain air helped tuberculosis patients recover, leading to environmental therapy. What long-term impact did Trudeau’s work have? / He became the president of the National Association for the Study and Prevention of Tuberculosis, later known as the American Lung Association. Who was Clara Barton? / A nurse and founder of the American Red Cross in 1881. Why is Clara Barton considered a hero? / She provided life-saving care on the battlefield, advocated for humanitarian aid, and revolutionized emergency response systems. What challenges did Barton face in her career? / Wage disparity, lack of formal nursing education, and government resistance to establishing the Red Cross. What innovations in care did Barton introduce? / Pre-planned emergency supply organization, triaging strategies, and providing care regardless of race or political affiliation. What is Barton’s long-term impact? / She revolutionized disaster response, emergency medicine, and humanitarian aid. Who is Barry Marshall? / An Australian gastroenterologist who discovered Helicobacter pylori as the cause of gastric ulcers. Why is Barry Marshall considered a hero? / His discovery transformed the treatment of gastric ulcers, turning a chronic condition into a treatable disease. How did Marshall prove his discovery? / He ingested H. pylori himself to demonstrate its effects on the stomach, leading to a Nobel Prize-winning breakthrough. What was the impact of Marshall’s work? / Gastric ulcers, once a chronic condition, are now treatable with antibiotics. Who was Jonas Salk? / A virologist who developed the first successful polio vaccine. Why is Jonas Salk considered a hero? / He eradicated polio in many parts of the world and made vaccines safer, saving millions of lives. What obstacles did Salk face in his career? / He came from a lower-class immigrant family, had limited lab facilities, and disliked public attention. What was Salk’s long-term impact? / His vaccine eradicated polio in many parts of the world, and his research led to advancements in influenza and AIDS treatment. How did Salk approach vaccine development differently? / He used a "killed" virus instead of a live virus to create a safer vaccine. Who was Luigi Mangione? / An engineer who murdered a healthcare CEO to protest the high cost of health insurance. Why is Luigi Mangione considered a vigilante? / He took extreme, illegal action to highlight an issue, believing that violence was the only way to force systemic change. What was Mangione’s motive? / He believed that exposing the corruption of the healthcare system would spark reform. What ethical controversy surrounds Mangione’s actions? / While he sought to bring attention to healthcare injustice, his use of murder was unethical. What impact did Mangione’s actions have on policy? / His actions caused social outrage but did not lead to significant healthcare reform. Who was Edward Jenner? / An English physician who developed the first smallpox vaccine. Why is Edward Jenner considered a vigilante? / He saved millions of lives but conducted unethical experiments on children without their consent. How did Jenner created the smallpox vaccine? / He injected an 8-year-old boy with material from a cowpox lesion, then exposed him to smallpox, which the boy did not contract. What was the long-term impact of Jenner’s work? / His discoveries led to the eradication of smallpox and the advancement of immunology. What is the WHO definition of vaccine hesitancy?/A delay in acceptance or refusal of vaccines despite availability of vaccination services. Why are healthcare workers important in vaccine advocacy?/They are trusted sources of health information and play a key role in public health promotion. What are the three components of the WHO’s 3 Cs model?/Confidence, Complacency, and Convenience. Define "Confidence" in the context of vaccine hesitancy./ Trust in vaccine safety, effectiveness, and the healthcare system. What does "Complacency" mean regarding vaccines?/Low perceived risk of vaccine-preventable diseases. How does "Convenience" affect vaccine hesitancy?/Availability and accessibility of vaccines influence vaccine uptake. What are the four ethical principles related to vaccine hesitancy?/ Autonomy, Beneficence, Non-maleficence, and Justice. How does "Autonomy" relate to vaccine hesitancy?/It respects individual decision-making on vaccination. Explain "Non-maleficence" in the context of vaccines./ Ensuring vaccine safety to avoid harm. What is the tension between individual rights and collective responsibility in vaccine mandates?/Balancing personal freedom with public health safety. Name two historical vaccination campaigns discussed in the presentation./Smallpox vaccination and Polio vaccination campaigns. What impact did the 1998 Wakefield study have on vaccine hesitancy?/It falsely linked the MMR vaccine to autism, fueling distrust. What was the significance of the documentary ‘DPT: Vaccine Roulette’ (1982)?/It highlighted alleged adverse effects of the DPT vaccine, contributing to public fears. Which demographic group of healthcare workers is more likely to be vaccine-hesitant?/Older healthcare workers. Name three factors contributing to vaccine hesitancy among healthcare workers./Perceived risks of side effects, distrust in pharmaceutical companies, and belief in natural immunity. What ethical concerns arise from vaccine mandates for healthcare workers?/ Conflicts between personal beliefs and professional duties. How does healthcare worker hesitancy impact society?/It can amplify public mistrust and decrease community vaccination rates. Give an example of a disease outbreak linked to vaccine hesitancy./Measles outbreaks. How can cultural and religious concerns about vaccines be addressed?/Through respectful dialogue, engaging leaders, and tailored messaging. What is a major psychological barrier to vaccination?/ Fear of needles and adverse reactions. What role does leadership play in reducing vaccine hesitancy?/ Influencing workplace culture and promoting evidence-based information. Name two successful strategies in vaccine advocacy./ Peer-to-peer education and tailored interventions for healthcare workers. What role do government policies play in supporting vaccination?/ Implementing mandates and ensuring equitable access. How can technology help address vaccine hesitancy?/By countering misinformation through digital tools and social media campaigns. Why is vaccine trust lower among Indigenous populations?/ Due to historical mistrust from unethical medical practices.  What are community-led solutions for improving vaccine acceptance among Indigenous groups?/ Involvement of Indigenous healthcare workers and culturally sensitive approaches.​ What was a key finding in the California study on personality and vaccine hesitancy?/High conscientiousness correlated with higher vaccine uptake, while neuroticism was linked to fear of side effects.​ What are the three personality archetypes identified in the study?/ "Cautious Skeptic," "Confident Accepter," and "Passive Doubter."​ What does the E.T.H.I.C.S. acronym stand for? /Examine the situation and values/Think about the Code of Ethics and Standards of Practice/Hypothesize all possible decisions or options/Identify the consequences of each option/Consult with others/Select an action, document the process, and get support/Advocate for change if required or indicated What is end-of-life care? / Care provided in the last days to weeks of life; distinct from palliative care. What is palliative care? / Palliative care is an approach aimed at improving the quality of life of patients and families facing life-threatening illnesses. It focuses on the prevention and relief of suffering and begins at the time of diagnosis for terminal diseases. What are comfort measures (comfort care)? / Medical interventions and medication aimed at maximizing comfort and allowing natural death. What is hospice care? / Free standing facility that provides End-of-life care in a residential setting, sometimes at home ("hospice-at-home"). What is palliative sedation therapy / Palliative sedation therapy is a last resort for symptom management in patients experiencing significant distress at end-of-life. It involves administering medication to sedate the patient until they are comfortable. What is Medical Assistance in Dying (MAiD) / MAiD and palliative care may both be part of a person’s care plan, but they are distinct practices. MAiD refers specifically to situations where a medical practitioner or nurse practitioner, at the individual’s request: (a) Administers a substance that causes their death, or/(b) Prescribes a substance for the individual to self-administer to end their own life. What are goals of care conversations / Goals of care conversations are discussions between the patient, family, and healthcare team to ensure the patient’s values and wishes for life-sustaining treatments are prioritized. What is informed consent? /Permission granted by a patient after receiving all necessary information about a treatment, including its risks and benefits, as well as the consequences of accepting or refusing it. What is capacity in medical decision-making? / A patient’s ability to understand the information needed to make a decision and fully comprehend the consequences of that decision. What is the first clinician’s role in MAiD Procedure? / Oversees the provision of MAiD, which may include receiving the request, conducting the first eligibility assessment, and administering or prescribing the drug protocol. What is the second clinician’s role in MAiD? / Provides an independent second opinion confirming eligibility and must not be connected to the first clinician. What is Choice 1: All Available Measures? / A choice where all possible measures, such as breathing machines, feeding tubes, and CPR, are used to keep you alive as long as possible, usually in the ICU or hospital. What are the advantages of All Available Measures? / Chance of extending life, constant care from a medical team. What are the disadvantages of All Available Measures? / May not extend life, low quality of life, hard to manage pain, low chance of leaving the hospital after CPR, must decide when to stop treatment. What is Choice 2: Limited Interventions? / A choice focusing on comfort while avoiding the ICU, allowing for some medical interventions like CPR if desired, with pain and suffering well managed. What are the advantages of Limited Interventions? / Low risk of pain and complications. What are the disadvantages of Limited Interventions? / No use of intensive measures like breathing machines. What is Choice 3: Comfort Measures Only? / A palliative care approach that addresses physical, psychological, and spiritual suffering while accepting that the illness is incurable. Most patients die at home. What are the advantages of Comfort Measures Only? / High quality of life, greater satisfaction with care, support for caregivers and family before and after death. What are the disadvantages of Comfort Measures Only? / No life-saving measures will be attempted, even if they might extend life; side effects from pain medications. What is Choice 4: No Care? / A choice where all treatments are refused, and pain is managed independently, though it may be difficult for others to accept or support this decision. What are the advantages of No Care? / Total control over treatment and care as long as the patient can communicate. What are the disadvantages of No Care? / Difficult to manage pain. What is Choice 5: Stopping Eating and Drinking? / A choice where food and drink are stopped to speed up death when other measures are not available or legal, typically occurring at home. What are the advantages of Stopping Eating and Drinking? / No feelings of hunger or thirst as death approaches. What are the disadvantages of Stopping Eating and Drinking? / Intense hunger at first, requires strong willpower, can take 2 weeks or longer for death to occur. What is Choice 6: Palliative Sedation? / A medical approach where doctors use medication to sedate the patient to relieve pain, which may speed up death. What are the advantages of Palliative Sedation? / Effective at limiting pain. What are the disadvantages of Palliative Sedation? / Limited or no communication. What is Choice 7: Physician Aid in Dying? / A choice where doctors prescribe a pill for the patient to take if they are terminally ill (expected to live less than six months) and capable of making their own decisions. What are the advantages of Physician Aid in Dying? / Works quickly to make the patient unconscious, painless death, control over date and time of death. What are the disadvantages of Physician Aid in Dying? / Requires establishing residency in a legal state, limited chance to change mind after taking the pill, bad taste. What is Choice 8: Euthanasia? / A choice where a doctor administers the life-ending medication instead of the patient, typically in countries where euthanasia is legal. What are the advantages of Euthanasia? / The patient does not need to take the drug themselves, control over date and time of death. What are the disadvantages of Euthanasia? / Expensive to travel to a country where euthanasia is legal, no opportunity to reverse decisions if communication is lost. What is Choice 9: Suicide? / A choice where the individual chooses to end their own life, which can be devastating for loved ones and is illegal in many places. What are the advantages of Suicide? / Can be carried out on the individual’s own terms, immediate success if completed. What are the disadvantages of Suicide? / Once started, it usually cannot be stopped, chance of being unsuccessful, possible pain and suffering from injuries. Dr. Jack Kevorkian ("Dr. Death") Who was the American pathologist and euthanasia activist known for advocating physician-assisted suicide? / Dr. Jack Kevorkian. What did Jack Kevorkian believe about terminal patients? / He believed in a terminal patient’s right to die by physician-assisted suicide. How many patients did Kevorkian assist in dying? / 130 patients. What happened to Jack Kevorkian in 1999? / He was convicted of murder. What controversial idea did Kevorkian propose regarding death row inmates? / He suggested that inmates on death row should be able to consent to medical experimentation under complete anesthesia as a form of execution instead of conventional methods outlined in the law. What was Kevorkian’s stance on organ donation from death row inmates? / He advocated that organs from executed inmates should be harvested for those awaiting organ donation. What medical experiment did Kevorkian conduct involving blood transfusion? / He experimented with transfusing blood from recently deceased patients into live patients. What did Kevorkian write about in his articles? / He wrote a series of articles discussing his views on ethics and euthanasia. What was Jack Kevorkian’s first physician-assisted death? / Janet Adkins, a 54-year-old woman diagnosed in 1989 with early-onset Alzheimer’s disease died in 1990. Was Kevorkian charged with murder for assisting Janet Adkins' death? / Yes, but the charges were dropped on December 13, 1990, because Michigan had no law against assisted suicide at the time. What happened to Kevorkian’s medical license after assisting in physician-assisted suicide? / His medical license was revoked, and he was forbidden from practicing medicine or engaging with patients. How many more patients did Jack Kevorkian assist in ending their lives after Janet Adkins? / He helped 129 more patients end their lives. What percentage of the people Kevorkian assisted were not terminally ill? / 60% of the people he assisted were not terminally ill. How many of Kevorkian’s patients never complained of pain? / 13 patients never reported experiencing pain. What criticism did Kevorkian face regarding his counseling process? / His counseling was criticized for being too brief, as 19 people died less than 24 hours after consultation, and 5 of them had a history of depression. What medical evaluations did Kevorkian fail to conduct? / He failed to send 17 patients for pain consultations and often did not obtain full medical histories. What were the two devices Kevorkian used for assisted death? /Thanatron (Death Machine): A device that released lethal chemicals intravenously when the patient pressed a button./Mercitron (Mercy Machine): A gas mask connected to a canister of carbon monoxide, allowing the patient to inhale the gas. What significant event occurred on November 22, 1998, involving Jack Kevorkian? / He allowed CBS News 60 Minutes to air a videotape he recorded on September 17, 1998, showing the voluntary euthanasia of Thomas Youk, a 52-year-old in the final stages of Lou Gehrig’s Disease (ALS). What did the video of Thomas Youk’s euthanasia depict? /Fully informed consent from Youk./ Kevorkian personally injected the lethal substance (previously, patients self-administered)./ Kevorkian daring authorities to press charges against him. What legal action was taken against Kevorkian on November 25, 1998? / He was charged with second-degree murder and delivery of a controlled substance that he was not permitted to possess due to his revoked medical license. How did Kevorkian handle his trial? / On March 26, 1999, during jury deliberations on first-degree murder charges, he fired his legal team and chose to represent himself. What was Kevorkian’s sentence? / After a 2-day trial, he was found guilty and sentenced to 10-25 years in prison, serving 8 years before his release. How did Thomas Youk’s family view Kevorkian’s actions? / They described his work as humane and not murder. What was Jack Kevorkian’s famous quote? / “Dying is not a crime.” What were Jack Kevorkian’s birth and death dates? / May 26, 1928 – June 3, 2011. What are the three major legal cases related to Medical Assistance in Dying (MAiD) in Canada? / Rodriguez v. Canada/Carter v. Canada/Truchon v. Canada Who was Sue Rodriguez? / A Canadian woman diagnosed with amyotrophic lateral sclerosis (ALS) in 1991, a disease that rapidly affects voluntary muscle movement and leads to paralysis. What symptoms did Sue Rodriguez experience as ALS progressed? / Loss of speech, inability to chew and swallow, loss of control over breathing, and paralysis of all extremities. What legal action did Sue Rodriguez take regarding assisted suicide? / She fought for the legal right to have a physician assist in ending her life when she chose. What was the legal status of assisted suicide in Canada at the time? / Assisted suicide was illegal in Canada and punishable by up to 14 years in prison. Globally, it was only legal in Switzerland. When did Rodriguez first challenge the law in court? / In December 1992, she took her case to the Supreme Court of British Columbia, arguing that Section 241(b) of the Criminal Code violated her Charter rights (Sections 7, 12, and 15). What was the outcome of Rodriguez's case in British Columbia? / She lost her case on December 29, 1992, along with all subsequent appeals. What happened on March 8, 1993? / Rodriguez applied to have her case heard by the Supreme Court of Canada. What was the Supreme Court of Canada's ruling on September 30, 1993? / In a 5-4 decision, the court ruled that Section 241(b) was valid and did not violate the Canadian Charter of Rights and Freedoms. What was the most important legal issue in Rodriguez’s case? / Section 7 of the Charter, "Everyone has a right to life, liberty and security of the person and the right not to be deprived thereof except in accordance with the principles of fundamental justice." What argument did the majority of judges make in upholding Section 241(b)? / They acknowledged that Rodriguez’s right to security of the person was violated, causing her physical and emotional suffering. However, they ruled that upholding Section 241(b) protected human life and vulnerable populations from being pressured into assisted suicide. What impact did Sue Rodriguez’s case have on assisted suicide laws? / Although she did not change legislation, her legal battle paved the way for future challenges that eventually led to the legalization of Medical Assistance in Dying (MAiD) in Canada. How did Sue Rodriguez die? / On February 1994, at the age of 43, she ended her life with the assistance of an anonymous physician. NDP MP Svend Robinson was by her side, supporting her cause. What was Sue Rodriguez’s famous quote? / “If I cannot give consent to my own death, whose body is this? Who owns my life? Whose life is it, anyway?” Who was Kathleen (Kay) Carter? / A Canadian woman, 89 years old, who suffered from spinal stenosis, a terminal condition that severely affected her mobility. Why did Kay Carter travel to Switzerland? / She was wheelchair-bound and sought medical assistance in dying (MAiD), which was illegal in Canada at the time. She died on January 15, 2010, becoming the 10th canadian to die of medically assisted suicide. What did Kay Carter do before she died? / She dictated a letter with the help of her daughters, and 120 copies were mailed across Canada from Switzerland to advocate for the right to die with dignity. What was Kay Carter’s final message? / "I have chosen to die with dignity... I and I alone made the choice to pursue this path. My journey to Zurich was filled with laughter and fond reminiscing... It is important to me to share with you that I have chosen to die with dignity... Do not mourn my passing, but rejoice, as I have, in our shared memories." How did Kay Carter’s case lead to a legal challenge? / In 2011, the BC Civil Liberties Association challenged the Supreme Court of Canada, representing the families of Kay Carter and Gloria Taylor, another woman suffering from a debilitating condition. What was the Supreme Court’s ruling on February 6, 2015? / The court ruled unanimously (9-0) to allow medically assisted suicide for competent adults who: Consented to terminate their life/Had a grievous medical condition that caused enduring suffering Why did the Supreme Court rule that Section 241 was unconstitutional? / It violated Section 7 of the Canadian Charter of Rights and Freedoms, which guarantees the right to life, liberty, and security of the person. What did the Supreme Court require after its ruling? / It allowed one year for the government to create legislation to regulate medically assisted suicide. What law was passed as a result of Carter v. Canada? / On June 17, 2016, Bill C-14 was enacted, legalizing Medical Assistance in Dying (MAiD) in Canada. Who was Jean Truchon? / A Canadian man with cerebral palsy who argued on June 13, 2017 that MAiD laws were too strict and violated the Canadian Charter of Rights and Freedoms. What did Jean Truchon challenge in MAiD laws? / He challenged the "reasonably foreseeable" death requirement in Bill C-14 and Quebec’s rule that a person must be "at end of life" to qualify for MAiD. What was the ruling in Truchon v. Canada? / On September 12, 2019, Justice Christine Baudouin ruled that requiring a "reasonably foreseeable death" and being "at end of life" violated the Charter of Rights and Freedoms and struck them down. How was "reasonably foreseeable natural death" previously defined? / Determining how long a patient has left is difficult and not based on a fixed timeframe (no set days or weeks)./The patient must have a condition with a prognosis approaching the end of life. What action did the government take after the Truchon ruling? / The government was given six months to amend the legislation. How did the COVID-19 pandemic affect the implementation of new MAiD laws? / Due to delays and extensions caused by COVID-19, the amendments took longer than expected. What law was passed in response to Truchon v. Canada? / Bill C-7, which was passed on March 17, 2021, brought Canada’s MAiD laws in line with the Truchon decision by removing the "reasonably foreseeable death" requirement. When did Jean Truchon die? / He died by MAiD in Montreal on April 7, 2020, at the age of 51. What was Jean Truchon’s final request? / "I ask that you try to understand me and not to judge me." What are the four stages of MAiD approval? / Determine Eligibility/Ensure Safeguards are Met/ Obtain Consent/ Provide Medical Assistance in Dying What are the eligibility criteria for MAiD? /18+ years old/Capable of making their own healthcare decisions/Grievous and irremediable medical condition/Voluntarily requested MAiD/ Provided informed consent What are the safeguards for those whose death is reasonably foreseeable?/Written request signed by an independent witness/Two independent practitioners confirm eligibility/Final consent before administration What safeguards exist for those without a foreseeable natural death? /90-day assessment period/Must be informed of alternative treatments/Independent review of eligibility What medications are used in MAiD? /Midazolam, Propofol, Rocuronium (primary drugs)/ Backup kit with anxiolytics, analgesics, and cardiotoxic agents What is Bill C-7? / A Canadian law that amended MAiD (Medical Assistance in Dying) legislation by removing the requirement that a patient’s natural death be "reasonably foreseeable." When did Bill C-7 come into effect? / March 17, 2021. What major change did Bill C-7 introduce? / It removed the "reasonably foreseeable natural death" requirement, expanding MAiD eligibility to patients whose natural death is not imminent but who still experience unbearable suffering. What conditions remain excluded from MAiD under Bill C-7? / Cases where mental illness is the sole underlying medical condition were excluded from eligibility. When was Bill C-7 scheduled for review? / March 17, 2023, by an expert panel. How does Bill C-7 structure MAiD approvals? / It introduced two tracks for approval: For patients whose natural death is reasonably foreseeable (faster approval process)./For patients whose natural death is NOT reasonably foreseeable (stricter safeguards). Why were two tracks for MAiD approval introduced? / To provide additional safeguards for those whose natural death is not reasonably foreseeable, ensuring they receive thorough assessments before approval. What is a slippery slope in MAiD discussions? / The concern that expanding MAiD laws may lead to coercion or unintended consequences. What are examples of controversial MAiD cases? /Sophia (51, environmental allergies) – Approved for MAiD due to lack of chemical-free housing./Sue (65, cancer & stroke) – Family opted for treatment despite her scheduled MAiD./Fred (79, COPD) – Religious hospital unaware he was being discharged for MAiD that day. Which country first legalized assisted dying? / Switzerland in 1942. How many MAiD provisions have occurred in Canada since 2016? / 31,664 cases. What reporting requirements exist for MAiD in Canada? / Practitioners must report all cases to Health Canada and the Coroner.  Additional Materials WEEK 1 Optional: Haddad, Lisa M., and Robin A. Geiger. "Nursing ethical considerations." (2018). Expert testimony must be objective, accurate, and evidence-based, with ethical concerns arising from unsupported or biased opinions and "forum shopping" by attorneys. Courts assess admissibility based on Daubert criteria (peer review, testability, error rate, and acceptance in the scientific community), and experts may testify without examining a patient if opinions are well-supported. Medical societies set guidelines for ethical, unbiased testimony, ensuring experts have relevant, up-to-date expertise. Accurate documentation is crucial to support testimony and establish the standard of care. Podcast: Philosophize this! Episode #168 Introduction to An Ethics of Care Carol Gilligan challenged Kohlberg's theory of moral development, critiquing his view that women had lower moral development, based on his male-focused research. She introduced the "ethics of care," which emphasizes moral reasoning through relationships and context, in contrast to the justice-oriented ethics in traditional theories. The podcast also explores how gender roles influence moral reasoning, with women often socialized to prioritize care and relationships, while men focus on justice. The ethics of care has broader implications for a more holistic understanding of morality in society. Kohlberg's theory of moral development outlines three main levels of moral reasoning: 1.​ Pre-conventional: Moral reasoning is based on self-interest, avoiding punishment, and seeking rewards. 2.​ Conventional: Morality is driven by societal norms, laws, and the desire to gain approval from others. 3.​ Post-conventional: Moral reasoning is guided by abstract principles like justice, equality, and human rights, even if they conflict with laws or societal rules. It's Complicated: A Podcast about Healthcare Ethics in Practice In the podcast "It's Complicated: A Podcast about Healthcare Ethics in Practice", several key themes and topics are explored that highlight the complexity of healthcare ethics: 1.​ Ethical Dilemmas in Healthcare – The podcast dives into real-world ethical challenges healthcare workers face, such as balancing patient autonomy with medical advice, addressing end-of-life care decisions, and navigating conflicts between patients' rights and medical recommendations. 2.​ Patient-Centered Care – Emphasizing the importance of prioritizing the patient’s values, preferences, and needs when making healthcare decisions, while also respecting their autonomy and informed consent. 3.​ Interdisciplinary Collaboration – The importance of collaboration between different healthcare professionals (doctors, nurses, social workers, etc.) in making ethical decisions that are comprehensive and patient-centered. 4.​ Social Work’s Role in Healthcare Ethics – Highlighting the significant role social workers play in addressing ethical concerns, particularly in advocating for vulnerable populations and facilitating discussions around complex ethical issues. 5.​ Cultural Competency and Ethics – The podcast touches on how healthcare providers must be culturally competent when navigating ethical issues, respecting cultural differences, and addressing disparities in healthcare access. 6.​ Legal and Ethical Boundaries – Discussions about the intersection of law and ethics, particularly in situations where legal and ethical principles may conflict, such as in cases involving minors, consent, or mental health. Each episode generally involves expert insights and real-life examples to demonstrate how ethics influence healthcare practice and decision-making, offering guidance for professionals on how to navigate these complex issues. WEEK 2 ONA = Ontario Nurses Association RNAO = Registered Nurse Association Ontario CNO = College of Nursing Ontario WEEK 4 Podcast: Maya Goldenberg - Vaccine hesitancy and public trust in healthcare Maya Goldenberg's work on vaccine hesitancy and public trust in healthcare focuses on the social, psychological, and cultural factors that shape public attitudes toward vaccination and the healthcare system. Key points from her research include: 1.​ Vaccine Hesitancy: Goldenberg discusses vaccine hesitancy as a complex issue, where individuals' reluctance or refusal to vaccinate is influenced by a mix of personal beliefs, misinformation, political polarization, and distrust of healthcare systems and authorities. 2.​ Public Trust in Healthcare: Trust in healthcare institutions and professionals is critical in addressing vaccine hesitancy. Goldenberg highlights that healthcare systems need to build and maintain public trust by being transparent, culturally sensitive, and responsive to the concerns of the public. 3.​ Misinformation and Disinformation: A significant factor contributing to vaccine hesitancy is the spread of misinformation and disinformation, particularly on social media. Goldenberg underscores the importance of countering these narratives with clear, evidence-based information. 4.​ Socioeconomic and Cultural Factors: Hesitancy is not universal. It varies across different demographic groups, including based on factors like socioeconomic status, education, race, and ethnicity. Goldenberg suggests that understanding these differences is crucial to tailoring effective vaccine communication. 5.​ Ethical Considerations: Goldenberg also reflects on the ethical dilemmas in addressing vaccine hesitancy, especially concerning autonomy, coercion, and public health imperatives. She suggests that strategies to overcome vaccine hesitancy should respect individuals' rights while promoting collective health goals. 6.​ Communication Strategies: Goldenberg advocates for strategies that are empathetic, trust-building, and collaborative rather than confrontational. Acknowledging concerns and engaging in dialogue is key to overcoming vaccine hesitancy. Her work highlights the importance of fostering trust and using thoughtful, inclusive Vaccine Hesitancy and Healthcare Providers – Concise Notes 1. Introduction ​ Vaccination is essential but hesitancy remains a challenge. ​ Hesitancy affects various groups, including healthcare providers (HCPs). ​ Some medical practices refuse unvaccinated patients, while others try to maintain trust. 2. Key Findings ​ HCPs Influence Vaccination Decisions: Patients trust their recommendations. ​ HCPs Who Vaccinate Themselves: More likely to recommend vaccines. ​ Confidence & Knowledge Matter: Higher awareness leads to stronger advocacy. ​ Barriers to Vaccine Promotion: Lack of training, time constraints, and workload pressures. ​ Public Health vs. Personal Choice: Some HCPs prioritize autonomy over public health concerns. 3. Solutions & Interventions ​ Education & Training: Improve vaccine knowledge among HCPs. ​ Workplace Policies: Encourage or mandate HCP vaccinations. ​ Support Systems: Strengthen trust between HCPs and health authorities. ​ Communication Tools: Equip HCPs to address vaccine hesitancy effectively. 4. Conclusion ​ HCPs play a critical role in vaccine acceptance. ​ Addressing hesitancy requires education, policy support, and public trust. ​ More resources are needed to help HCPs navigate vaccine-related concerns. Vaccine Hesitancy Among Healthcare Workers – Concise Study Notes 1. Overview ​ Vaccine hesitancy exists among healthcare workers (HCWs) despite their medical training. ​ Hesitancy affects public trust in vaccines and influences patient decisions. ​ The COVID-19 pandemic intensified discussions around vaccine acceptance and mandates. 2. Factors Contributing to Hesitancy ​ Safety Concerns – Worries about side effects, new vaccine technology, and long-term risks. ​ Efficacy Doubts – Skepticism about effectiveness, especially with emerging variants. ​ Mistrust in Institutions – Doubts about pharmaceutical companies, governments, and regulatory bodies.  ​ Speed of Development – Concerns that vaccines were approved too quickly. ​ Personal Autonomy – Resistance to mandates, feeling coerced into vaccination. ​ Alternative Immunity Beliefs – Preference for natural immunity over vaccination. ​ Social & Political Influences – Political beliefs, peer pressure, and media misinformation. 3. Impact on Public Health ​ HCW hesitancy reduces patient trust in vaccines. ​ Unvaccinated HCWs pose risks to themselves and patients. ​ Resistance among HCWs can contribute to broader societal vaccine skepticism. 4. Strategies to Increase Vaccine Acceptance ​ Education & Communication – Clear, science-based messaging tailored to HCW concerns. ​ Institutional Support – Encouraging leadership involvement, peer discussions, and incentives. ​ Easy Access to Vaccines – On-site vaccination, paid leave for vaccination. ​ Addressing Misinformation – Combat social media myths with reliable data. ​ Balanced Policies – Considering incentives and requirements without coercion. 5. Conclusion ​ HCWs play a key role in vaccine promotion but also experience hesitancy. ​ Addressing concerns through education, support, and policy adjustments is essential. ​ Effective interventions must be multi-faceted and adaptable to HCW-specific concerns. 🚀 This condensed summary covers the key aspects of HCW vaccine hesitancy for your exam. Let me know if you need further simplifications! WEEK 5 Vaccine Hesitancy Among Healthcare Workers – Concise Study Notes 1. Overview ​ Vaccine hesitancy exists among healthcare workers (HCWs) despite their medical training. ​ Hesitancy affects public trust in vaccines and influences patient decisions.  ​ The COVID-19 pandemic intensified discussions around vaccine acceptance and mandates. 2. Factors Contributing to Hesitancy ​ Safety Concerns – Worries about side effects, new vaccine technology, and long-term risks. ​ Efficacy Doubts – Skepticism about effectiveness, especially with emerging variants. ​ Mistrust in Institutions – Doubts about pharmaceutical companies, governments, and regulatory bodies. ​ Speed of Development – Concerns that vaccines were approved too quickly. ​ Personal Autonomy – Resistance to mandates, feeling coerced into vaccination. ​ Alternative Immunity Beliefs – Preference for natural immunity over vaccination. ​ Social & Political Influences – Political beliefs, peer pressure, and media misinformation. 3. Impact on Public Health ​ HCW hesitancy reduces patient trust in vaccines. ​ Unvaccinated HCWs pose risks to themselves and patients. ​ Resistance among HCWs can contribute to broader societal vaccine skepticism. 4. Strategies to Increase Vaccine Acceptance ​ Education & Communication – Clear, science-based messaging tailored to HCW concerns. ​ Institutional Support – Encouraging leadership involvement, peer discussions, and incentives. ​ Easy Access to Vaccines – On-site vaccination, paid leave for vaccination. ​ Addressing Misinformation – Combat social media myths with reliable data. ​ Balanced Policies – Considering incentives and requirements without coercion. 5. Conclusion ​ HCWs play a key role in vaccine promotion but also experience hesitancy. ​ Addressing concerns through education, support, and policy adjustments is essential. ​ Effective interventions must be multi-faceted and adaptable to HCW-specific concerns. 🚀 This condensed summary covers the key aspects of HCW vaccine hesitancy for your exam. Let me know if you need further simplifications!  rE.T.H.I.C.S. Framework – Study Notes 1. Examine the Situation and Values ​ Gather all relevant facts and evidence. ​ Identify if an ethical dilemma exists: ○​ Are there conflicts in values and beliefs? ○​ Are there laws, policies, or ethical standards guiding the decision? ​ Consider the values of: ○​ Client ○​ Society ○​ Organization ○​ Personal and professional ethics 2. Think About the Code of Ethics and Standards of Practice ​ Identify applicable ethical guidelines and workplace policies. ​ Review relevant legislation (e.g., healthcare acts, consent laws, privacy laws). ​ Ensure alignment with professional codes of conduct. 3. Hypothesize All Possible Decisions or Options ​ List all potential courses of action. ​ Avoid immediate judgment or bias. ​ Consider various perspectives before narrowing options. 4. Identify the Consequences of Each Option ​ Evaluate risks and benefits. ​ Assess impact on all stakeholders. ​ Ensure alignment with ethical principles and best practices. 5. Consult with Others ​ Seek advice from: ○​ Colleagues, supervisors, or managers. ○​ Ethical advisors, legal consultants, or professional organizations. ​ Ensure decisions are well-informed and justified. 6. Select an Action and Document the Process ​ Choose the most ethically sound decision. ​ Maintain thorough documentation of: ○​ Decision-making process.  ○​ Implementation plan. ○​ Necessary support measures. ○​ Client or decision-maker consent. 7. Advocate for Change if Needed ​ Use professional judgment in advocating for improvements. ​ Engage with management or policymakers if ethical concerns require system-level changes. ​ Ensure ethical practices align with professional standards and societal expectations. 🚀 This structured approach ensures ethical decision-making in professional settings. Let me know if you need further refinements! Walter Freeman – An American psychiatric physician known for pioneering the lobotomy procedure. He performed unethical lobotomies without anesthesia, causing significant harm, including deaths and severe side effects, without scientific backing, in a time when mental health treatment was poorly understood. His procedures led to a 15% fatality rate and severe consequences such as epilepsy, dementia, and personality changes. His work declined with the introduction of psychiatric medications and the legal requirement for informed consent. Andrew Wakefield – A former UK physician who falsely claimed a link between the MMR vaccine and autism. He manipulated data, conducted unethical experiments on children without clearance, and had financial conflicts of interest. His misinformation fueled vaccine hesitancy, contributing to outbreaks of preventable diseases. As a result, he lost his medical license and remains a symbol of one of the most serious cases of medical fraud in history. J. Marion Sims – A 19th-century physician known as the "Father of Modern Gynecology."​ He performed experimental surgeries on enslaved women without anesthesia or consent, violating ethical medical practices. While his work contributed to gynecological advancements, it also deepened mistrust in healthcare among marginalized communities. His legacy has been re-evaluated, leading to the removal of his statue in 2018 and increased recognition of the women he experimented on: Lucy, Anarcha, and Betsy. Harold Shipman – A UK doctor who murdered approximately 284 patients over 30 years.​ He used his position to administer fatal drug overdoses and overprescribed medications, primarily targeting elderly patients. His crimes led to increased oversight of doctors, stricter prescribing regulations, and changes to death certification procedures. Convicted in 2000, he later died by suicide in prison. Edward Livingston Trudeau – A physician who pioneered tuberculosis treatment.​ He made groundbreaking discoveries in tuberculosis treatment and founded the Adirondack Cottage Sanatorium. His research on environmental therapy revolutionized TB care, leading him to become president of the National Association for the Study and Prevention of Tuberculosis (now the American Lung Association). Clara Barton – A nurse and founder of the American Red Cross in 1881.​ She provided life-saving care on the battlefield, introduced triaging strategies, and advocated for emergency medical aid regardless of race or politics. Despite facing wage disparity and government resistance, she revolutionized disaster response, emergency medicine, and humanitarian aid. Barry Marshall – An Australian gastroenterologist who discovered Helicobacter pylori as the cause of gastric ulcers.He proved that H. pylori caused gastric ulcers by ingesting it himself, leading to a Nobel Prize-winning discovery. His work transformed ulcers from a chronic condition into a treatable disease with antibiotics. Jonas Salk – A virologist who developed the first successful polio vaccine.​ He eradicated polio in many parts of the world by using a "killed" virus instead of a live virus, making vaccination safer. Despite obstacles like limited lab facilities and a background from a lower-class immigrant family, his research also contributed to advancements in influenza and AIDS treatment. Luigi Mangione – An engineer who murdered a healthcare CEO to protest high insurance costs.​ He believed violence was the only way to expose healthcare corruption and spark reform. However, his illegal actions, while drawing attention to systemic healthcare issues, did not lead to significant policy changes and remain ethically controversial. Edward Jenner – An English physician who developed the first smallpox vaccine.​ He saved millions of lives by developing the smallpox vaccine but conducted unethical experiments on children without consent. By injecting an 8-year-old boy with cowpox and later exposing him to smallpox, he laid the foundation for immunology and contributed to the eventual eradication of smallpox. Alice Hamilton – A physician and researcher known for pioneering industrial toxicology and advocating for worker safety. She was a leading figure in investigating occupational diseases caused by industrial toxins like lead and mercury. Her research led to major reforms in labor laws and workplace safety regulations. As the first woman appointed to the faculty at Harvard Medical School, she broke barriers for women in medicine. Her work helped establish occupational medicine as a recognized field, influencing policies that continue to protect workers' health today. John Bodkin Adams – A British general practitioner suspected of murdering over 160 patients for financial gain.He was accused of administering lethal doses of morphine and heroin to elderly, wealthy patients, many of whom left him money in their wills. Although he was arrested and tried for murder in 1957, he was acquitted, leaving lingering suspicions about his role in their deaths. His case led to increased scrutiny of doctors benefiting financially from patient deaths and reinforced ethical guidelines regarding prescriptions, euthanasia, and doctor-patient relationships. Josef Mengele – A German physician and Nazi officer infamous for his inhumane medical experiments at Auschwitz. Known as the "Angel of Death," he conducted brutal experiments on prisoners, especially twins, often without anesthesia. His research included genetic manipulation, forced sterilization, and amputations, causing immense suffering. He personally selected victims for the gas chambers and evaded capture after WWII, fleeing to South America, where he remained until his death in 1979. His actions led to the development of strict ethical guidelines, including the Nuremberg Code, which established informed consent as a fundamental principle in medical research.