American Indian literature is replete with language that refers to broken or hollow promises the US government has made to American Indians, one of the most prominent being that the US government has not kept its promises regarding health services for American Indians/Alaska Natives (AI/AN). Some commenters refer to treaties between tribes and the US government as the origin of the promise for health services to AI/AN. Others point to the trust relationship between the sovereign nations of American Indian tribes and the US government, while still others assert that the Snyder Act of 1921 or the Indian Health Care Improvement Act (IHCIA) contained the promise for health care. While the US has provided some form of health care for AI/AN since the country was in its infancy, and continues to do so through the Indian Health Service, the promise of health services for AI/AN is not explicit.

Philosophers have articulated that a promise contains a moral obligation to fulfill it because of others’ expectations created by that promise. As the US government made its first promises in early treaties with AI/AN tribes and subsequently made promises in the years since, it is morally obligated to fulfill those promises, be they lying promises or not, because of resulting expectations. Yet, the US government has historically acted to restrict the rights of AI/AN—rights that include access to health services—through assimilation, separation, or termination policies. Further, the policies of the US government have kept the AI/AN populations socioeconomically impoverished, dependent on the US government for basic needs, and susceptible to health-compromising conditions.

Using case studies, this dissertation looks not only at the policies and events that directly affected health services and health status, but also at how those policies and events contributed to health outcomes and the expectations of AI/AN. Given the history of the US government in fulfilling (or not fulfilling) its promises, this dissertation examines the expectations of AI/AN for their own future health outcomes under the policy of self-governance.

The landscape of science education is changing. Scientific research and the academy are both becoming increasingly complex, competitive, interdisciplinary, and international. Many federal research agencies, scientific professional societies, and science educators seem to agree on the importance of strong ethics education to help young scientists navigate this increasingly craggy terrain. But, what actually should be done? When it comes to teaching ethics to future scientists, is the apparent current emphasis on basic responsible conduct of research (RCR) sufficient, or should moral theory also be taught in science ethics education? In this thesis I try engage this question by focusing on an existing, related debate on whether moral theory should be part of teaching professional ethics more generally. After delving into the respective approaches promoted by the three primary participants in this debate (C. E. Harris, Bernard Gert, and Michael Davis) I unpack their views in order to ascertain their practical application potential and relative benefits. I then take these findings and apply them to ethics education in science, paying particular attention to its purported learning objectives. In the end I conclude that the presentation of these objectives suggests that moral theory may well be required in order for these objectives of ethics education in science to be fully achieved.