The physician assistant (PA) profession is lacking in diversity, both in practicing PAs and the PA student population. PA organizations, including the PA Education Association and the Accreditation Review Commission on Education for the PA, have been advocating for action to address this lack of diversity, and many educational institutions have responded by innovating their recruitment and admissions strategies. Another appropriate response to address the lack of diversity in PA education would be to critically evaluate the curriculum, specifically professionalism curriculum, for inclusiveness. Professional identity formation (PIF) provides a framework for teaching professionalism that focuses on the evolving identities of medical learners (Irby & Hamstra, 2016) as influenced by their individual, relational, and collective identities (Cruess et al., 2015). However, PIF has been critiqued for lacking inclusion of sociocultural contexts (Wyatt et al., 2020). Through this mixed methods action research study, I utilized community of inquiry (CoI; Garrison et al., 1999) as a theoretical framework for creation and facilitation of a professional development workshop for PA educators aimed at evaluating academic medical journal articles focused on the topics of professionalism in medical education, PIF, and PIF experiences in underrepresented in medicine students. My goal was to increase awareness of PIF as a pedagogical framework which has the potential to alter the learning environment toward one of inclusion and belonging. Additionally, through my CoI, I further aimed to expand upon the PIF conceptual framework to include elements of intersectionality by focusing on how sociocultural factors influence student perspectives on professionalism and their PIF process. I used Ajzen’s (1991) theory of planned behavior to evaluate participants’ intention to incorporate PIF into their professionalism curricula and to prioritize sociocultural factors in their professionalism pedagogies. Using pre- and post-intervention surveys, participant interviews, and workshop session exit questions, I determined that my professional development workshop contributed to an increased likelihood of PA educators to integrate PIF and prioritize sociocultural factors into their professionalism curricula, and further, changed perspectives regarding the definition of professionalism in PA education to include an understanding and appreciation for how professionalism is influenced by a student’s sociocultural factors.

Advocacy groups work across many aspects of “death with dignity” practice and treatment, and provide insight across multiple aspects of “death with dignity”. This study argues that key advocacy groups in the American death with dignity movement influenced the broader conceptualization of death with dignity in a way that makes patients more able to achieve it. This influence has been a dynamic process across different periods of practice starting the discussion of “death with dignity” in 1985 through today, although this thesis extends only to 2011. The question in this study is how do the three main historical advocacy groups in the US: the Hemlock Society, Compassion in Dying, and Compassion and Choices, conceptualize death with dignity with regards to patient and doctor relationship, legal and policy factors, and medical technologies and protocols? This study found that the Hemlock Society (1980-2005) characterized death with dignity as a terminally ill patient being able to “self-deliver” from suffering via autoeuthanasia regardless of medical community approval or legality. Compassion in Dying (1993-2007) characterized death with dignity as involved advocacy work with terminal patients and their communities to pursue palliative care and hospice up to the point of assisted death. This organization was also involved in the passing of Oregon Death with Dignity Act. Compassion and Choices (2007-present) characterized death with dignity similarly to Compassion in Dying but also advocated for adequate management of pain and suffering symptoms in palliative care to prevent people from desiring death over the illness. Conceptualizing death with dignity is important for understanding why patients want death with dignity and better accommodating their end of life needs when they are suffering with terminal illness.

It is no secret that humans at some point in their lives will endure some sort of immense pain or suffering that continues, making life difficult to live in such a way. The question then becomes how a sufferer goes about dealing with their distress and whether or not they choose to deal with it or continue to live a life that is detrimental to them. This is a topic in which I will discuss in the terms of modern day psychology and how people who suffer from psychological disorders can embrace a new path to recovery through words and being able to rewrite their stories. Throughout this thesis, I shall argue, with the assistance of various philosophic works, that everyone is born into a story and responsibility lies within a person either to continue with a story to which they have become accustomed or choose to embark on a new journey all together. When the decision is rendered to rewrite the path one has taken, it is essential to look at what is driving the story or the goals one has been pursuing. The person suffering can then go to treatment based upon the exchange of words between them and their psychoanalyst in hopes of regaining a sense of responsibility in their lives.

Techno-scientific thinking, which has become firmly grounded in modern medicine, moves towards reifying medicine as a science, losing all aspects of what it means to heal beyond curing a patient’s physical malady. A blueprint has been made on how best to interact with patients, a formulaic way of approaching medicine that seeks to get to the bottom of the patient’s biological disease. But this blueprint is the very reason doctors and patients misrecognize the potential befriending suffering has to heal the psychological dis-ease the patient feels when confronted by suffering. Thus, the process of treating patients is in need of reform. To do this, we must recover the dimension of depth that has been seemingly lost in the medical field. Doctors and patients alike should be critical of this systematic way of thinking about the doctor-patient relationship, a way of thinking that has far more implications than typically recognized. Science itself is not the problem; rather, it is thinking that says science is the only way one ought to approach and understand medicine and the only way to cure patients when there is much more to healing than curing.
In befriending suffering, one has the opportunity to re-understand herself and reorient herself to the world. Through dialogue, one can befriend her suffering and attempt to hear what it might be saying to her. Furthermore, by being a virtuous friend to her suffering, being one who is sincere, reverent, tender, and effortful, one can discover the generative aspects of suffering. By turning toward suffering together, the doctor and patient can connect in a way that better helps them understand themselves and each other. By understanding themselves and their individual suffering, each has the possibility of becoming a more authentic person and living more meaningfully in their daily lives. In understanding each other, the doctor has the potential to heal her patients—and patients, one could say, have the potential to heal their doctors as well. To do this, both must enter into conversation openly and with the virtues of friendship in mind. It may be difficult, but each one’s worldview might expand and new insights gleaned. By coming together, each has the possibility of living better individually.

Cochlear implants are electronic medical devices that create hearing capabilities in those with inner ear damage that results in total or partial hearing loss. The decision to get a cochlear implant can be difficult and controversial. Cochlear implants have many physical and social impacts on cochlear implant users. The aim of this study was to evaluate how patient narratives written by people with cochlear implants (or their caregivers) express issues of quality of life and personhood related to the use of this medical device. The methodology used to answer this question was a content analysis of patient narratives. The content analysis was done using grounded theory and the constant comparative method. Two sensitizing concepts, quality of life and personhood, were used and became the large umbrella themes found in the narratives. Under the major theme of quality of life, the sub-themes that emerged were improved hearing, improved communication skills, and assimilation into the hearing world. Under the major theme of personhood, the sub-themes that emerged were confidence, self-image, and technology and the body. Another major theme, importance of education, also emerged. In general, cochlear implant users and their caregivers expressed in their narratives that cochlear implants have positive effects on the quality of life of cochlear implant users. This is because almost all of the narrative writers reported improved hearing, improved communication skills, and better assimilation into the hearing world. In addition, it was found that cochlear implants do not have a significant affect on the actual personal identity of cochlear implant users, though they do make them more confident. The majority of cochlear implant users expressed that they view the cochlear implant device as an assistive tool they use as opposed to a part of themselves. Lastly, there is a need for more awareness of or access to education and therapy for cochlear implant users.

Through this thesis, I intend to explore what sociologist Arthur Frank means when he describes illness as "a dangerous opportunity" (Frank, 1991, p. 1). It is my objective to more fully understand the lived experience of illness and how narrative can aid in transforming illness from tragic to transcendent. In doing so, it is first necessary to understand how illness differs from disease and how the medicalization of human health has displaced narrative from medical practice. Since illness is best understood as a lived experience, I will discuss how narrative is an exemplary means of communicating these experiences and restoring identity that is threatened by illness. Lastly, I will address how narrative might be more effectively utilized in the context of medicine, in respect to both patients and physicians. In this work, I propose that the opportunities posed by illness might be seized by actively exploring it by means of narrative expression. It is my hope that this thesis might contribute to extending the notion that narrative is a means of attributing greater meaning to illness and constructing a more complete, compassionate approach to medicine.

Death with Dignity is a concept that initially began as a set of philosophical and ethical principles that sought to define what it meant to die a "good" death that was reasonable to the person experiencing the dying process. This dying process is terminal illness, or any condition that cannot be cured and who's ultimate prognosis is death. Today, Death with Dignity still embodies this, but it is also a set of legal and medical treatments and practices that can be used to aid terminal patients in accomplishing a "good" death. The Death with Dignity treatment options that are chiefly discussed in this study are patient withdrawal of care, patient control of pain medications, and physician-assisted suicide. Physician-assisted suicide is legal in six states in the US excluding Arizona. Considering that Oregon is the first state to pass a Death with Dignity Act and that it is the precedent for all other Acts, this study sought to understand the differences in perception of physician-assisted suicide between Arizona and Oregon in the pursuit of clarifying what barriers are still in place in Arizona to passing a Death with Dignity act. To ask the question of "Do physicians and ethics committee members in Arizona support Death with Dignity in the forms of patient control of pain medications, withdrawal of treatment, and physician-assisted suicide?", a literature review was conducted to determine important national and local perceptions of physician-assisted suicide and Death with Dignity, a 14-question, structured survey was created with the identified concerns, and it was distributed to Arizona health care workers by email and in person. This survey was approved by ASU's Institutional Review Board. This survey found that 100% of participants would vote for a Death with Dignity Act in Arizona if it were on a ballot measure. 76% of participants would aid a terminally-ill and eligible patient in physician-assisted suicide under some circumstances if it were legal in Arizona, and 24% of participants would never aid a patient in physician-assisted suicide. The concerns with physician-assisted suicide that were marked most important by Arizona healthcare workers were that hospice is a better option for the terminally ill and that physician-assisted suicide may be misused with disadvantaged persons. The most important factors of terminal illness that influence views of physician-assisted suicide marked by Arizona healthcare workers were the amount of pain the patient is expected to experience in the end of life, the amount of pain that can be relieved for the patient, the expected quality of life of the patient, and the patient's right to autonomy in healthcare. The significant differences between Oregon and Arizona in this study were the importance of expected mental decline of patient, patient's wishes that differ from family's, and hospice being a better option than suicide in influencing views of physician-assisted suicide. These differences could be deemed hurdles to Death with Dignity legislation in Arizona. This study recommended addressing those differences in public education and medical education and seeking Death with Dignity legislation via ballot measure.