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In 1999, the Lewis Katz School of Medicine (LKSOM) established the standardized patient (SP) program, focusing on training healthcare professional students in patient interviewing and examination skills. Originating in 1963, SP programs have proliferated in American medical schools and abroad as a means to instruct and evaluate students without potential harm to real vulnerable patients. However, research indicates potential biases in SP evaluations, particularly with respect to subjective assessments such as the doctor-patient interaction (DPI). This study aims to explore attitudes towards the SP program from the perspective of both medical students and SPs to identify areas of bias and general concerns. In total, 14 medical students, nine SPs and 1 administrative faculty member were interviewed. Interviews were transcribed, coded and analyzed for major themes. Overall, students and SPs generally agreed to the importance of the SP program in medical education. However, attitudes diverged with regards to bias and standardization, with students noting multiple instances of interSP variability. A handful of solutions to concerns raised by study participants are outlined in this paper and concludes by highlighting the school’s duty to mitigate bias and ultimately foster equity, equality, and justice within the program. / Urban Bioethics

The non-identity problem attempts to explain the moral permissibility of certain procreative acts that determine a future individual’s existence. If we accept that this individual’s life is worth living, than we must also accept that these procreative acts are permissible. However, this is not the case. In this paper, I will argue against the permissibility of these acts and explain why our intuition, that these acts are morally wrong, is in fact correct. Because the non-identity problem affects particular persons, those whose existence is brought about, I argue in favor of a solution that explains that moral impermissibility in terms of the wrong done to this particular person. I do so by demonstrating why solutions offered by Derek Parfit, Elizabeth Harman, and Justin McBrayer have failed, whereas solutions offered by James Woodward and Gregory Kavka successfully explain moral impermissibility of non-identity acts in terms of wronging future individuals.

Student Number : 0215239Y - MA research project - School of Social Sciences - Faculty of Humanities / The purpose of this report is to investigate whether ethics is important to the credit insurance industry and to consider the role a code of ethics can play in helping to make better decisions. The conclusions that I reach are that ethics plays a vital role in building and sustaining a healthy credit insurance business and that a well designed and managed ethics policy is an invaluable tool in running an ethical business and in protecting the reputation and long term viability of a credit insurer. The report begins by providing - in part I - a brief outline of the major ethical theories including short reviews of the two closely related subjects of corporate governance and sustainable development. It continues by discussing the impact of ethics on business in general. I commence the heart of the report by examining in part II ethics in the credit insurance industry, by defining credit insurance and describing the special roles it plays in national and international economies. I then focus on the pertinent operational aspects of a credit insurance business, i.e. marketing and sales, underwriting, claims and reinsurance with particular reference to the role ethics can and should play in each of them. By drawing together the outcomes of these various deliberations the basic guidelines for the drafting of codes of ethics in the credit insurance industry will be developed (obviously each company has to design its own code in line with its own corporate culture, values and circumstances). Finally I attempt to show the benefits a well drafted and properly managed code can have for a credit insurer (part III).

手稿本(cops. 2-3複印本) / Thesis (Ph. D.)--香港中文大學. / Shou gao ben (cops. 2-3 fu yin ben) / Includes bibliographical references: leaves 392-399. / Thesis (Ph. D.)--Xianggang Zhong wen da xue. / 前言 --- p.1 / Chapter I --- 後設倫理學與規範倫理學 / Chapter II --- 後設倫理觀點的抉擇 --- p.16 / Chapter 一 --- 描述主義 --- p.17 / Chapter A --- 描述主義的理論及批評 --- p.17 / Chapter 1 --- 描述主義的論記 --- p.18 / Chapter 2 --- 自然主義的繆誤 --- p.42 / Chapter 3 --- 實然與應然的關係 --- p.55 / Chapter B --- 描述主義的兩種形態 --- p.76 / Chapter 1 --- 相對主義 --- p.78 / Chapter 2 --- 直覺主義 --- p.97 / Chapter 二 --- 指令論 --- p.12 / Chapter A --- 指令論的理論 --- p.12 / Chapter 1 --- 道德判斷的指令性 --- p.12 / Chapter 2 --- 道德判斷的普遍化可能性 --- p.17 / Chapter B --- 普遍指令論所引申的效益主義 --- p.19 / Chapter 1 --- 現代效益主義 --- p.19 / Chapter 2 --- 對現代效益主義的批評 --- p.25 / Chapter III --- 為何我應該道德 --- p.276 / Chapter IV --- 儒家對「為何道德」的解答 ── 人禽之辨 --- p.306 / Chapter V --- 儒家與效益主義 ── 義利之辨 --- p.327 / Chapter VI --- 儒家與指令論──知行合一說 --- p.338 / 註釋 --- p.350 / 參考書目 --- p.392

A thesis submitted to the School of Public Health, Faculty of Health Sciences, University of Witwatersrand in fulfilment of the requirements for the degree of Doctor of Philosophy Johannesburg, South Africa 2017. / Introduction: As Prevention of Mother-to-Child Transmission and HIV treatment programmes have scaled-up, more women are being kept alive and fewer children are infected with HIV. One of the challenges that HIV-infected women face is how to disclose their own HIV status to their children. The disclosure literature suggests that the main reason for women’s HIV-disclosure is to obtain social support, including financial, practical and emotional assistance, to help women to manage their HIV infection. HIV-related stigma, lack of knowledge of how to disclose, uncertainty about a child’s reaction to disclosure, and a perception that a child lacks the developmental capacity to handle HIV-disclosure are factors that affect disclosure decisions. HIV-disclosure is considered a critical element in strengthening the capacity of families in the continuum of HIV care. In 2011, the World Health Organization published guidelines for parental HIV-disclosure to children. These guidelines recommended full disclosure to primary school-aged children (from 6 years up to 12 years) and partial disclosure to younger children. Globally, but particularly in sub-Saharan Africa, HIV-disclosure interventions are lacking. The Amagugu maternal HIV-disclosure intervention was developed, piloted and evaluated between 2010 and 2012 to assist mothers to disclose their HIV status to their HIV-uninfected children. The intervention enrolled 281 mothers and their primary school-aged HIV-uninfected children, and aimed to increase maternal capacity to disclose their HIV status. This was implemented through six lay counsellor- led, home-based, sessions, including a health intervention at a primary health care clinic. The Amagugu intervention was acceptable and feasible in a high HIV prevalence, resource-poor, rural setting, and increased maternal HIV-disclosure to primary school-aged HIV-uninfected children. Methods: This PhD study was nested within the Amagugu study and was conducted at the Africa Centre for Population Health, now the Africa Health Research Institute (AHRI), in the Hlabisa sub-district of Umkhanyakude, northern KwaZulu-Natal, South Africa. The aim of this PhD was to explore, in more depth, the experiences of women enrolled in the Amagugu intervention, including their experiences of the health intervention. Both quantitative and qualitative methods were used. The sample for the PhD study comprised three groups: 1) all mothers from the Amagugu study (N=281); 2) a sub-sample of mothers from the Amagugu study (N=20) and 3) health care staff employed in the clinics where the Amagugu study took place (N=87). The quantitative data used in the PhD study xvi were collected at different time points from the 281 women, using questionnaires specifically designed for the Amagugu study, including baseline and post-disclosure questionnaires. Data on the clinic experiences were collected from the 281 mothers using semi-structured questionnaires administered after the health intervention. Semi-structured questionnaires, specifically designed for this PhD study, were administered to the clinic staff during the health intervention. Qualitative data were collected using semi-structured questionnaires with the clinic staff (N=87), nine focus groups with clinic staff after the health intervention, and in-depth and semi-structured interviews with the sub-sample of women (N=20) who were enrolled after the Amagugu intervention had been completed. The University of KwaZulu-Natal Biomedical Research Ethics Committee (BREC Ref: BF 144/010) and the University of Witwatersrand Human Research Ethics Committee (Ref: R14/49) granted ethical approval for the PhD study. Results: The results reported in this PhD are drawn from four papers written during the course of this PhD, (three published papers and one paper accepted for publication). The results have been integrated from the data collected from the women and health care staff that were used for the PhD, and a literature review that resulted in a publication. The three main themes that emerged from the PhD are: 1. HIV-related stigma and HIV-disclosure: The literature review revealed that fear of HIV-related stigma was the most common reason for non-HIV-disclosure of HIV to both adults and children. In the sub-sample of 20 women, only two women had not disclosed to other adults due to fear of HIV-related stigma prior to the intervention. Those who had disclosed to only some, but not all other adults in their close social networks, reported HIV-related stigma at household (6/18), community (2/18) and clinic levels (1/18). Although HIV-related stigma was reported, there was also a normalisation of HIV and antiretroviral therapy (ART) in some communities due to the high social exposure to HIV in the study area. Qualitative data from the focus groups with clinic staff, and interviews with the sub-sample of 20 women, recognised that children’s exposure to HIV education has played a role in the normalisation of HIV. 2. HIV-disclosure and family strengthening: The majority of women in the sub-sample had disclosed their HIV status to other adults including their partners, friends and xvii other relatives, prior to the Amagugu intervention. Most women reported living positively with HIV and receiving necessary support from those to whom they had disclosed. Of those women who had disclosed to partners, about half had disclosed to their partners first before disclosing to any other adults. Their partners had mixed reactions to disclosure but were overall supportive. Whilst women’s original fear of disclosing their HIV status to their children had been that they would be stigmatised by their children, on the contrary, most children were supportive. The majority of women in the sub-sample expressed that they would advise other women in similar circumstances to disclose their HIV status to their children for social support, because disclosure increased family cohesion and improved antiretroviral therapy adherence. The health staff echoed the same sentiments regarding social support and family cohesion in the focus groups. 3. HIV-disclosure and access and adherence to HIV treatment: The interviews with the sub-sample of 20 women, and the semi-structured questionnaires and focus groups with 87 clinic staff, all revealed that participants agreed that whilst maternal HIVdisclosure was challenging, it was necessary for women to obtain social support from their children. Health care staff also agreed that maternal HIV-disclosure to their children was instrumental in supporting HIV-infected women to access and adhere to their HIV treatment. The clinic staff recognised the role they could play in health promotion and increasing opportunities for children to participate in activities at health facilities, but acknowledged that they needed support to address logistical constraints that hinder child-friendliness in health facilities, including heavy workloads, poor clinic infrastructure and staff shortages. The health intervention provided clinic staff with child-friendliness training and materials that were found to be acceptable and feasible, and yielded encouraging results. Discussion: This study contributes to the literature about the experiences of African, HIVinfected, rural women with HIV-uninfected children living in an ART-era. In particular the experiences of women who have participated in a maternal HIV disclosure intervention in Africa have not been explored previously. The findings of this work indicate that a decade after being diagnosed with HIV, women in this resource-poor setting are generally living positively with HIV. However, HIV-disclosure to other adults does not necessarily translate xviii to disclosure to children, and parents require specific interventions to assist them with this, and to understand the development and level of understanding of their children. Conclusion: Despite concerns raised by women prior to the intervention, including fear of HIV-related stigma and a perception that children lacked the developmental capacity to grasp knowledge about maternal HIV status, the women in this study reported no regrets in disclosing their status to children. They also reported receiving support from their children, which in turn, assisted them with adherence to their own HIV treatment. Future studies could test the same Amagugu intervention materials in a group of HIV-infected women with uninfected children not previously involved in research to explore whether similar results are found. / MT2017

Thesis (M. Div.)--Emmanuel School of Religion, 2004. / Vita. Includes bibliographical references (leaves 78-82).

This thesis provides and ethical discussion of the place of marketing in U.S. public schools.  This problem is especially interesting in a time where schools are having their budgets vastly cut.  The importance of education is lauded as the reason to allow marketing, along with it being used as a teaching tool, among other reasons.  The opponents of in-school marketing are discussed, such as health and psychological problems and the social functions of school.  I conclude that marketing in U.S. public schools should no longer be allowed, but that it is only realistic to eliminate it gradually.

Thesis (Ph. D.)--University of Texas at Austin, 2003. / Supervisors: Thomas Seung and James Fishkin. Vita. Includes bibliographical references. Available also from UMI Company.

<p>This thesis paper defends a novel conception of the child's best interest in regard to elective pediatric surgeries (EPS). First, children's capacity for decision-making is examined, and the best decision-making model for EPS is identified as the Best Interest Standard. What follows is a discussion of the interests of children in EPS, the correlation of fundamental interests to rights, and guidelines for weighing children's competing interests. Next, the role of families is considered, especially the rights and duties of parents. Finally, a reinterpretation of the Best Interest Standard is proposed, identifying as paramount a child's ability to make elective medical decisions for herself when she reaches maturity. </p>