Back Issue: Vol.11 No.4 (Fall 2025)
ISSN 2474-2309
RESEARCH ETHICS
Pages: 1-21
Since the 1960s, bioethics has emerged as a field to address the increasingly prevalent clinical ethical dilemmas that accompany advancements in medical capabilities. Nowadays, over 97% of U.S. hospitals benefit from healthcare ethics services, with evidence suggesting that bioethics education correlates with enhanced physician knowledge, attitude, and practice. However, medical school ethics curricula are not standardized, and credit hour requirements vary across institutions. Although there is a need for expanding bioethics education in medical schools, there should also be emphasis on pre-health professionals gaining exposure to medical ethics during undergraduate years; this way, aspiring healthcare workers would gain better insights into the clinical difficulties of their desired careers. As such, the Institute of Clinical Bioethics (ICB) at Saint Joseph’s University instituted its Undergraduate Research Fellowship Program (URFP) in 2006, offering undergraduates clinical ethics exposure and bioethics research experience. This article sheds light on the importance of pre-health professionals acquiring early exposure to clinical ethics and provides readers with the ICB’s URFP outline, which is made available for undergraduate bioethics centers to incorporate into their programs.
Pages: 22-37
Water fluoridation is a population –level public health intervention widely endorsed by health authorities; it’s ethical justification remains contested. Water fluoridation is considered scientifically safe and effective by the proponents of water fluoridation. However, the opponents of water fluoridation regularly raise concerns about efficacy and ethics of water fluoridation which culminates in a debate.
This paper is an attempt to elucidate on the key issues of the ethical considerations of water fluoridation, based on the principles of bioethics. In particular, it raises questions about which of the competing values of the health authorities, the community, and the individual values; one must uphold in the consideration of fluoridation of the water.
This paper provides a perspective on the key principles of bioethics regarding the pros and cons of water fluoridation, highlighting the considerations of non-maleficence, beneficence, autonomy and justice. The justificatory and the stewardship model are two types of ethical frameworks used to evaluate public health interventions. The application of ethical frameworks in the evaluation of water fluoridation in a particular place, are discussed in this paper.
An intervention such as water fluoridation explicates the benefits of equity and justice as it ensures that the opportunity to be free from caries and dental morbidity is distributed equally among all members of society. This paper concludes that continuing the practice of water fluoridation for the prevention of caries and dental morbidity, can be ethically justifiable, and provided a balanced and progressive approach is applied, underpinned by strong scientific evidence.
Pages: 38-47
This article explores the growing role of Artificial Intelligence (AI) in medicine, with a special focus on the surgical field, and analyzes the profound bioethical dilemmas that its implementation raises. While AI offers significant advances, such as high-precision robotic surgery, standardized evaluation of professional performance, and optimization of clinical processes, its adoption requires critical reflection to avoid the dehumanization of medical practice.
The text addresses several key aspects:
Medical Training: It examines the paradigm shift in surgical education, where AI, through the analysis of surgical videos, can offer immediate feedback that is less variable than some human ratings, in contrast to the traditional model of human mentorship. Although this technology is efficient, it raises the question of what is lost by replacing the inspiring figure of the human mentor who transmits values, empathy, and emotional support.
Surveillance and Autonomy: The use of AI-based video surveillance systems in operating rooms raises questions about professional privacy and autonomy. The article warns about the “Hawthorne effect,” where constant monitoring could increase stress and pressure on professionals, rather than fostering an environment of continuous improvement.
Justice and Equity: It discusses the inequalities that AI can exacerbate. The asymmetrical access to these technologies between countries and between the public and private sectors, coupled with algorithmic biases trained on data from specific populations, could deepen healthcare gaps.
Governance and Responsibility: Finally, the article concludes that the implementation of medical AI is not a neutral process. It advocates for shared and transparent ethical governance, where clear responsibilities are defined between humans and machines. It proposes an “anticipatory bioethics” that, instead of reacting to problems, prevents them by integrating ethical principles from the design phase of the technology. The ultimate goal is to use AI as an ally of care, not as a substitute for the human dimension of medicine, ensuring that technological advancement is oriented toward social well-being and human dignity.
HEALTH ORGANIZATION AND ETHICS
Pages: 48-58
Blockchain technology offers secure, decentralized solutions for managing mental health records and identity verification; however, its ethical implications necessitate rigorous scrutiny. This paper evaluates four blockchain ethical design frameworks—Beeck Center’s Blockchain Ethical Design Framework, The Institute of Electrical and Electronics Engineers (IEEE) 7000 Value-Based Engineering Model Process, Value-Sensitive Design (VSD), and Ishmaev’s (2025) ethical risk analysis—with the National Association of Social Workers (NASW) and Louisiana State Board of Social Work Examiners (LABSWE) Rules, Standards, and Procedures by identifying and defining key ethical principles, analyzing their alignment, and exploring practical implications for trauma-informed, client-centered mental health practice. To foster and guide ethical blockchain integration, we must ensure alignment with social work values of dignity, equity, and autonomy.
NARRATIVE REVIEW
Pages: 59-82
While advancements in neurodiversity initiatives in the workplace are notable, a persistent gap remains in effectively addressing the high unemployment and turnover rates among individuals with autism. Objective: This literature review focuses on the main challenges faced by autistic employees in the workplace and solutions either proposed or enacted. Methods: Multiple databases were searched within the date range of January 1st, 2010 and May 1st, 2025 using the keywords listed. This initial search yielded 886 publications. Following a screening process, 187 publications met the inclusion criteria for further analysis. Results: Communication issues were the most common barrier to workplace success cited by the autistic employee, coworkers, and management. Educating coworkers and management about autism was associated with reducing this barrier and others associated with it. A strong support circle consisting of HRM, job coaches, and a direct manager with autistic employee experience were able to decrease turnover and increase morale. The direct manager is especially important in ensuring a harmonious workplace and preventing burnout in the autistic employee. The work environment, consisting of both workflow and physical factors, could also be improved to ensure success. Bullying was best handled with a zero-tolerance policy which many organizations already have but nothing specific to autistic or neurodivergent employees who are more prone to such behavior. Masking was the most common technique autistic employees used to fit in but was found to be both exhausting and a contributor to burnout if used at high levels. Disclosure of autistic status, especially in hopes of obtaining accommodations, was found to have mixed results. Conclusion: An organization that prepares a work environment for an autistic employee before their employment has a far better chance of success. This included education of the staff, ensuring the direct manager has additional education and skills regarding autism, and altering the workflow and physical environment of the workplace to better suit the autistic employee. Evaluating current leadership and their devotion to diversity and inclusion deserves evaluation, as those in charge ultimately determine the success or failure of these policies.
CASE STUDIES
Pages: 83-92
To ensure minimum levels of quality of care in CMS (Centers for Medicare and Medicaid Services) long term care facilities (LTC), Life Safety Code (LSC) surveys and Health Care Facilities Code (HCFC) surveys are required to be conducted on a 9–15-month cycle. The purpose of this study was to evaluate if LSC and HCFC occurring simultaneously is associated with the number of deficiencies cited in Alabama skilled nursing homes. The theoretical framework was grounded Donabedian’s quality theory for examining health services and evaluating quality of health care through structure, process, and outcomes (Donabedian, 1988). This study included two research questions evaluating if there was a correlation between LCS deficiencies and HCFC deficiencies occurring at the same time and if the number of HCFC deficiencies was lower due to LCS surveys occurring at the same time as HCFC surveys in Alabama long term care facilities. A quantitative correlation research design was used with non-probability sampling to include Alabama nursing homes that had LCS surveys at the same time as HCFC surveys using secondary data from CMS updated July 1, 2025, and released on July 30, 2025. A Pearson Correlation Coefficient Calculator determined a significant positive correlation between the independent variables LCS deficiencies and dependent variables HCFC deficiencies. The Mann-Whitney U test determined there was a statistically significant difference between the two groups LSC deficiencies and HCFC deficiencies. The potential impact of this study on positive social change is at the individual, organizational, and policy levels. Individual patients and nursing home facilities can benefit from the recognition of the association the timing of LSC surveys affects the number of HCFC deficiencies.