To develop stronger and more varied end-of-life treatment care plans, end stigmatization of death, and strengthen the economic stability of healthcare in America, it is imperative that the Department of Health and Human Services adapt the Washington State Death with Dignity Act 70.245 RCW to the national level, legalizing and increasing regulations for physician-assisted suicide in the United States. Currently, in the United States, healthcare spending is at an all-time high and costs the country $3.3 trillion dollars annually. It is imperative to reduce spending while also increasing the choice that patients have in their care. One major sector of healthcare spending is end-of-life care and according to the Kaiser Family Foundation, “63% of those who say their own health is only fair or poor…say most people in the U.S. have too little control” (Hamel, et. al, 2014). Per the same report, over 75% of Americans support “having Medicare cover discussions between doctors and patients about end-of-life treatment options” (Hamel, et. al, 2014). One treatment that is not discussed is physician-assisted suicide (referred to in this proposal as PAS). This is because, at the federal level, PAS is illegal and unsupported in the medical community. Dr. Atul Gawande, executive director of Ariadne Labs and professor at Harvard School of Public Health argues that “Congress need[s] to incentivize healthcare systems…by initiating…changes that are more likely to make a difference” (Gawande). It is critical to the aging population of America to be able to discuss freely their medical decisions regarding palliative and end-of-life care with their medical providers. To solve this financial, restrictive, and ethical challenge posed to the American people and government, United States Congress and the Department of Health and Human Services must implement new regulations, following the design of Washington’s Death with Dignity Act, to legalize and strongly regulate PAS across the country.
Honorable Mention – Policy Proposal
ZAINAB FEROZE, ROBBY DOUGHTY, HARNEET KAUR
The volunteer abroad industry has rapidly expanded in recent years, with some estimating the net worth of the industry to be upwards of $173 billion a year (The Wilson Quarterly). With tens of thousands of volunteers, including thousands of pre-health college students, volunteering abroad a year, it is important to be aware of the ethical impacts of the ever-growing field of “voluntourism”.
In this brief editorial, I advocate that pre-health students ought to adopt an attitudes-based framework to discern if an international medical service trip is ethically permissible. After a reflection of my own experience as an international volunteer, I examine the ways in which international medical service trips benefit and harm volunteers and community members. I argue that the qualities of “excellence” and “humility” are crucial for students to consider when searching for an international medical service trip, if they decide to participate on one. I include an framework of some questions students should ask when evaluating international medical service trips.
For the past twenty years, Uganda has made significant strides in increasing access to education for all of its citizens, particularly with the introduction of the Universal Primary Education (UPE) and Universal Secondary Education (USE) schemes, both of which sought to eliminate monetary barriers for children to attend public schools. However, a gender gap persists in the completion of both primary and secondary school in Uganda, as girls are significantly more likely to drop out of school than boys. Several studies have pointed to poor menstrual hygiene management in schools as an important determinant of school absenteeism amongst girls in Uganda. Menstrual hygiene management (MHM) can be defined as the articulation, awareness, information and confidence to manage menstruation with safety and dignity using safe hygienic materials together with adequate water and spaces for washing and bathing and disposal with privacy and dignity. An estimated 3.75 million Ugandan schoolgirls currently live without access to proper sanitary care. Not only is this a fundamental issue of ethical and human rights concern, but one with far reaching societal impacts. As an important determinant of completion of primary and secondary school education amongst girls, MHM impacts facets of society such as teenage marriage and childbearing, total fertility rate (TFR) and infant and child mortality rates. This is particularly concerning in Uganda given that the country currently faces dangerous population growth that threatens to further strain the country’s available resources. Therefore, menstrual hygiene management is ultimately a public health concern and must be addressed as such at the national level. The objective of this paper is to elucidate the current state of policy interventions in Uganda aimed at addressing MHM in primary and secondary schools, identify the gaps that remain, and make evidence-based, comprehensive recommendations for addressing menstrual hygiene management at the national level.
Janelle advocates for the enactment of law that permits death row prisoners to be organ donors. Janelle discusses the potential benefit to the entirety of American society and the potential opportunity for moral contrition for the donor, and wrestles with the ethical questions of coercion and autonomy as it pertains to the individual’s decision to donate.
Andrew proposes legislation to use federal funds to mandate an influenza vaccine for healthcare workers, with an exception for those who cannot receive the vaccine for medical reasons. Andrew draws upon the duty of healthcare providers to do no harm to their patients to advocate for the mandate on flu vaccines while weighing the potential conflict of individual healthcare providers’ autonomy.
LUCIE FELDER, ALANA KURTTI, SANA CHARANIA, + OLIVIA REYES
The team calls for mandated vaccinations among populations at high risk for influenza infection, specifically children and the elderly. The team’s proposal considers the ethical questions of coercion and excessive costs associated with such legislation.
Rosa promotes the implementation of the Spanish model of organ donation to address the kidney donation shortage in the United States. Rosa suggests that this model, which actively recruits potential donors and counsels the families of brain-dead or recently deceased patients, will increase the number of lives saved, reduce healthcare costs, and significantly diminish the length of the kidney transplant waitlist.
Alisha highlights the negative implications of the severe deficit of STEM (Science, Technology, Engineering, and Math) professionals that the US is currently facing. Public education does not provide the tools necessary for students to maintain an interest in STEM subjects. She proposes a mandatory transfer of out-of-date, but still usable, STEM equipment from federally funded universities to public schools to provide the opportunity for public school students to deeply engage with STEM subjects.
KELLY SONG + SIMONE WAHNSCHAFFT + JOHN CAMPBELL JR.
Kelly, Simone, and John leverage an ethical framework to propose a program that would use innovative mobile primary care technology to first prevent diabetes before its onset, and then to improve access to sustainable health services to address diabetes in Ghana.
The goal of their proposal is to improve individual and population health status proactively and, in particular, to prevent diabetes before its onset, rather than treat the disease reactively after the person’s health has already been compromised. The program put forth in this proposal will function to deliver diabetes prevention information and care in line with international best practices by promoting changes in health behavior, providing outreach to patients in their homes, and providing effective health services throughout the continuum of care from prevention to follow-up.
2016 FIRST PRIZE WINNER (TIED)
Hannah seeks to increase access to appropriate mental health and psychosocial services for adolescent Syrian refugees in Jordan. This proposal drew upon Alex London’s Human Development Approach to humanitarian intervention in the developing world to augment access to appropriate mental health care for adolescent Syrian refugees in Jordan. London emphasizes equitable, directed, and “thoughtful distribution of scarce resources” and investment in “community social programs”.
Given this ethical framework, the overall conclusion of her project was to propose a pilot program in Jordan’s smallest refugee camp and a smaller northern Jordanian city that integrates general and psychological healthcare using mobile healthcare units.