Example of an Annotated Bibliography (APA Style) Gipson, T., Lance, E., Albury, R., Gentner, M., & Leppert, M. (2015). Disparities in identification of comorbid diagnoses in children with ADHD. Clinical Pediatrics, 54(4): 376-381. The authors examine ADHD children with relevant comorbid conditions and medication prescribing habits based on comprehensive neurodevelopmental evaluations versus insurance limited evaluations to behavior management and medication. This was done using a retrospective review of medical records at the Center for Development and Learning Clinic. Data for demographics, comorbidities, medications, and interventions were analyzed for associations between groups. Results demonstrated that kids who received comprehensive evaluations had a greater degree of diagnosis for comorbidities. This stimulates the question of income levels and comprehensive evaluations in ADHD kids and comorbid conditions. Hinojosa, M., Hinojosa, R., Fernandez-Baca, D., Knapp, C., & Thompson, L. (2012). Parental strain, parental health, and community characteristics among children with attention deficit-hyperactivity disorder. Academic Pediatrics, 12(6): 502-508. The authors examined the impact on parents who have a child with ADHD and comorbidities. Using the National Survey of Children’s Health dataset, they conducted a bivariate, multivariate, and descriptive analysis to look for associations between kids with ADHD and comorbid conditions and the strain on parents, social support, mother’s mental health, and local amenities. Results showed an increase in parental strain when caring for an ADHD child with a co-occurring condition. It also showed that lack of social support and lack of access to community amenities were predictors of increased parental strain. This study demonstrates the impact on the health of caregivers to ADHD children with comorbidities. Radigan, M., Lannon, P., Roohan, P., & Gesten, F. (2005). Medication patterns for attention-deficit/hyperactivity disorder and comorbid psychiatric conditions in a low-income population. Journal of Child and Adolescent Psychopharmacology, 15(1): 44-56. The authors examined the psychotropic medications usage of low-income kids who have been diagnosed with ADHD comparing those with and without comorbid conditions. The New York State Department of Health Medicaid Encounter Data System was used to extract information on 6,922 kids 3-19 years of age. A multivariate logistic regression was conducted to look at associations between ADHD with comorbid conditions and medication usage. Results showed the strongest predictors of medication use to be comorbid conditions and Social Security Income Medicaid eligible status. This study stimulates the question of the possibility for ADHD children with comorbidities to have treatment variations based on income status. Rockhill, C., Violette, H., Vander Stoep, A., Grover, S., & Myers, K. (2013). Caregivers’ distress: Youth with attentio ...

1. Example of an Annotated Bibliography (APA Style)
Gipson, T., Lance, E., Albury, R., Gentner, M., & Leppert, M.
(2015). Disparities in
identification of comorbid diagnoses in children with ADHD.
Clinical Pediatrics, 54(4): 376-381.
The authors examine ADHD children with relevant comorbid
conditions and medication prescribing habits based on
comprehensive neurodevelopmental evaluations versus
insurance limited evaluations to behavior management and
medication. This was done using a retrospective review of
medical records at the Center for Development and Learning
Clinic. Data for demographics, comorbidities, medications, and
interventions were analyzed for associations between groups.
Results demonstrated that kids who received comprehensive
evaluations had a greater degree of diagnosis for comorbidities.
This stimulates the question of income levels and
comprehensive evaluations in ADHD kids and comorbid
conditions.
Hinojosa, M., Hinojosa, R., Fernandez-Baca, D., Knapp, C., &
Thompson, L. (2012). Parental strain, parental health, and
community characteristics among children with attention
deficit-hyperactivity disorder. Academic Pediatrics, 12(6): 502-
508.
The authors examined the impact on parents who have a child
with ADHD and comorbidities. Using the National Survey of
Children’s Health dataset, they conducted a bivariate,
multivariate, and descriptive analysis to look for associations
between kids with ADHD and comorbid conditions and the
strain on parents, social support, mother’s mental health, and

2. local amenities. Results showed an increase in parental strain
when caring for an ADHD child with a co-occurring condition.
It also showed that lack of social support and lack of access to
community amenities were predictors of increased parental
strain. This study demonstrates the impact on the health of
caregivers to ADHD children with comorbidities.
Radigan, M., Lannon, P., Roohan, P., & Gesten, F. (2005).
Medication patterns for attention-deficit/hyperactivity disorder
and comorbid psychiatric conditions in a low-income
population. Journal of Child and Adolescent
Psychopharmacology, 15(1): 44-56.
The authors examined the psychotropic medications usage of
low-income kids who have been diagnosed with ADHD
comparing those with and without comorbid conditions. The
New York State Department of Health Medicaid Encounter Data
System was used to extract information on 6,922 kids 3-19
years of age. A multivariate logistic regression was conducted
to look at associations between ADHD with comorbid
conditions and medication usage. Results showed the strongest
predictors of medication use to be comorbid conditions and
Social Security Income Medicaid eligible status. This study
stimulates the question of the possibility for ADHD children
with comorbidities to have treatment variations based on income
status.
Rockhill, C., Violette, H., Vander Stoep, A., Grover, S., &
Myers, K. (2013). Caregivers’ distress: Youth with attention-
deficit/hyperactivity disorder and comorbid disorders assessed
via telemental health. Journal of Child and Adolescent
Psychopharmacology, 23(6): 379-385.
The authors examined the additional impact of comorbidities in
kids with ADHD and the relationship to caregiver distress.
Data was obtained from the Children’s ADHD Telemental

3. Health Treatment Study for kids with ADHD in underserved
communities. ANOVA and ANCOVA were used to look for
associations between ADHD alone, ADHD plus one comorbid
condition, and ADHD plus two or more comorbidities and
caregiver distress. They found that parents of ADHD kids plus
one or more comorbid conditions had higher levels of
depression, stress, and strain compared to parents of kids with
ADHD alone. This study reinforces the need to better
understand the dynamics of ADHD and comorbidities and
potential disparities.
Controversial Issues in Biology and Ethical Decision making
Objective: This assignment is designed as an introduction to
thinking ethically. The goal for students: identify facts and
parties involved as well as the ethical standards necessary in
ethical and policy decision making.
Directions:
1. Visit the following website: bioethics.com
2. select an article from the numerous available categories.
Click on the article title to pull up the entire article.
3. Post a short essay (500-750 words) describing the research
and your reaction to this controversial issue in biology today.
Please use the questions in the rubric below to guide you in
your efforts.
4. Suggested topics may include stem cell research, cloning,
GMOs, end of life decisions, transhumanism or any issue that
relates to the environment or ethical treatment of animals.
Select a topic that interests YOU.
5. You may also site other references which may or may not be
peer reviewed as we are generating public discussion and
debate.
6. Please Visit the following website: for excellent examples of
student blogshttps://uhethics.wordpress.com/page/2/
Question or concern
1.Please post the link to the article you visited

4. Point value
1
2. What is the ethical issue or topic of concern? Why is this
issue controversial?
3
3. What is the procedure, activity, research or technology used
for?
4. What is the goal?
5. What studies are being conducted?
4
6. What are the pros and cons?
5
7. What parties are affected?
8. What moral rights do the affected parties have?
9. How are these rights being violated?
4
10. What role has the media or education system played (if any)
in reporting this issue and how has it affected the public?
11. Do you feel the reporting has been fair and unbiased?
2
12. What treatment (policy or decision) do you support?
13. Which method (below) will you use to arrive at this
decision? PLEASE UNDERLINE YOUR METHOD IN YOUR
WRITE UP. Use the “Introduction to ethics” guide attached
below.
1. What leads to the best overall consequences? (Utilitarian
approach)
2. Which course of action best respects all parties’ rights?
(rights approach)
3. Which course of action treats everyone the same and does not
show discrimination? (The fairness or justice approach)
4. Which course of action advances the common good (common
good approach)
5. Which course of action develops moral virtues (The virtue
approach)
5

5. 14. Find another article on this same issue. Include the link here
in your write up. Describe how this article relates to the article
you summarized (above) (Does the study contradict what you
found? IS the author for or against the technology? Etc.)Please
the link to the 2nd article you found.
6
15. Respectfully respond to one other student blog; Reply to
any comments made to your blog. Your comments should
attempt to generate discussion and dig deeper into the issues.
5
Total points
35
INTRODUCTION:
THINKING ETHICALLY A Framework for Moral Decision
Making
***This article updates several previous pieces from Issues in
Ethics by Manuel Velasquez - Dirksen Professor of Business
Ethics at Santa Clara University and former Center director -
and Claire Andre, associate Center director. "Thinking
Ethically" is based on a framework developed by the authors in
collaboration with Center Director Thomas Shanks, S.J.,
Presidential Professor of Ethics and the Common Good Michael
J. Meyer, and others. The framework is used as the basis for
many programs and presentations at the Markkula Center for
Applied Ethics.
TAKEN FROM:
http://www.scu.edu/ethics/practicing/decision/framework.html

6. Moral issues greet us each morning in the newspaper, confront
us in the memos on our desks, nag us from our children's soccer
fields, and bid us good night on the evening news. We are
bombarded daily with questions about the justice of our foreign
policy, the morality of medical technologies that can prolong
our lives, the rights of animals or perhaps the fairness of our
children's teachers dealing with diverse students in their
classrooms.
Dealing with these moral issues is often perplexing. How,
exactly, should we think through an ethical issue? What
questions should we ask? What factors should we consider?
WHAT IS ETHICS?
Simply stated, ethics refers to standards of behavior that tell us
how human beings ought to act in the many situations in which
they find themselves-as friends, parents, children, citizens,
businesspeople, teachers, professionals, and so on.
According to The National Institute of Health: “Ethics seeks to
determine what a person should do, or the best course of action,
and provides reasons why. It also helps people decide how to
behave and treat one another, and what kinds of communities
would be good to live in.”
“Bioethics is a subfield of ethics that explores ethical questions
related to the life sciences. Bioethical analysis helps people
make decisions about their behavior and about policy questions
that governments, organizations, and communities must face
when they consider how best to use new biomedical knowledge
and innovation”.
WHAT ETHICS IS NOT:
• Ethics is not the same as feelings. Feelings provide important
information for our ethical choices. Some people have highly

7. developed habits that make them feel bad when they do
something wrong, but many people feel good even though they
are doing something wrong. And often our feelings will tell us
it is uncomfortable to do the right thing if it is hard.
Ethics is not religion. Many people are not religious, but ethics
applies to everyone. Most religions do advocate high ethical
standards but sometimes do not address all the types of
problems we face.
• Ethics is not following the law. A good system of law does
incorporate many ethical standards, but law can deviate from
what is ethical. Law can become ethically corrupt, as some
totalitarian regimes have made it. Law can be a function of
power alone and designed to serve the interests of narrow
groups. Law may have a difficult time designing or enforcing
standards in some important areas, and may be slow to address
new problems.
• Ethics is not following culturally accepted norms. Some
cultures are quite ethical, but others become corrupt -or blind to
certain ethical concerns (as the United States was to slavery
before the Civil War). "When in Rome, do as the Romans do" is
not a satisfactory ethical standard.
• Ethics is not science. Social and natural science can provide
important data to help us make better ethical choices. But
science alone does not tell us what we ought to do. Science may
provide an explanation for what humans are like. But ethics
provides reasons for how humans ought to act. And just because
something is scientifically or technologically possible, it may
not be ethical to do it.
THINKING LIKE A BIOETHICIST: MAKING ETHICAL
DECISIONS

8. The first step in analyzing moral issues is obvious but not
always easy: Get the facts. Some moral issues create
controversies simply because we do not bother to check the
facts. This first step, although obvious, is also among the most
important and the most frequently overlooked.
But having the facts is not enough. Facts by themselves only
tell us what is; they do not tell us what ought to be. In addition
to getting the facts, resolving an ethical issue also requires an
appeal to values.
Philosophers have developed five different approaches to
values to deal with moral issues.
1. The Utilitarian ApproachUtilitarianism was conceived in the
19th century by Jeremy Bentham and John Stuart Mill to help
legislators determine which laws were morally best. Both
Bentham and Mill suggested that ethical actions are those that
provide the greatest balance of good over evil.
To analyze an issue using the utilitarian approach, we first
identify the various courses of action available to us. Second,
we ask who will be affected by each action and what benefits or
harms will be derived from each. And third, we choose the
action that will produce the greatest benefits and the least harm.
The ethical action is the one that provides the greatest good for
the greatest number.
2. The Rights ApproachThe second important approach to ethics
has its roots in the philosophy of the 18th-century thinker
Immanuel Kant and others like him, who focused on the
individual's right to choose for herself or himself. According to
these philosophers, what makes human beings different from
mere things is that people have dignity based on their ability to
choose freely what they will do with their lives, and they have a
fundamental moral right to have these choices respected. People
are not objects to be manipulated; it is a violation of human

9. dignity to use people in ways they do not freely choose.
Of course, many different, but related, rights exist besides this
basic one. These other rights (an incomplete list below) can be
thought of as different aspects of the basic right to be treated as
we choose.
· The right to the truth: We have a right to be told the truth and
to be informed about matters that significantly affect our
choices.
· The right of privacy: We have the right to do, believe, and say
whatever we choose in our personal lives so long as we do not
violate the rights of others.
· The right not to be injured: We have the right not to be
harmed or injured unless we freely and knowingly do something
to deserve punishment or we freely and knowingly choose to
risk such injuries.
· The right to what is agreed: We have a right to what has been
promised by those with whom we have freely entered into a
contract or agreement.
In deciding whether an action is moral or immoral using this
second approach, then, we must ask, Does the action respect the
moral rights of everyone? Actions are wrong to the extent that
they violate the rights of individuals; the more serious the
violation, the more wrongful the action.
3. The Fairness or Justice ApproachThe fairness or justice
approach to ethics has its roots in the teachings of the ancient
Greek philosopher Aristotle, who said that "equals should be
treated equally and unequals unequally." The basic moral
question in this approach is: How fair is an action? Does it treat
everyone in the same way, or does it show favoritism and
discrimination?
Favoritism gives benefits to some people without a justifiable
reason for singling them out; discrimination imposes burdens on
people who are no different from those on whom burdens are
not imposed. Both favoritism and discrimination are unjust and

10. wrong.
4. The Common-Good Approach
This approach to ethics assumes a society comprising
individuals whose own good is inextricably linked to the good
of the community. Community members are bound by the
pursuit of common values and goals.
The common good is a notion that originated more than 2,000
years ago in the writings of Plato, Aristotle, and Cicero. More
recently, contemporary ethicist John Rawls defined the common
good as "certain general conditions that are...equally to
everyone's advantage."
In this approach, we focus on ensuring that the social policies,
social systems, institutions, and environments on which we
depend are beneficial to all. Examples of goods common to all
include affordable health care, effective public safety, peace
among nations, a just legal system, and an unpolluted
environment.
Appeals to the common good urge us to view ourselves as
members of the same community, reflecting on broad questions
concerning the kind of society we want to become and how we
are to achieve that society. While respecting and valuing the
freedom of individuals to pursue their own goals, the common-
good approach challenges us also to recognize and further those
goals we share in common.
5. The Virtue ApproachThe virtue approach to ethics assumes
that there are certain ideals toward which we should strive,
which provide for the full development of our humanity. These
ideals are discovered through thoughtful reflection on what kind
of people we have the potential to become.
Virtues are attitudes or character traits that enable us to be and
to act in ways that develop our highest potential. They enable us
to pursue the ideals we have adopted. Honesty, courage,

11. compassion, generosity, fidelity, integrity, fairness, self-
control, and prudence are all examples of virtues.
Virtues are like habits; that is, once acquired, they become
characteristic of a person. Moreover, a person who has
developed virtues will be naturally disposed to act in ways
consistent with moral principles. The virtuous person is the
ethical person.
In dealing with an ethical problem using the virtue approach, we
might ask, What kind of person should I be? What will promote
the development of character within myself and my community?
Putting the Approaches Together
Each of the approaches helps us determine what standards of
behavior can be considered ethical. There are still problems to
be solved, however.
The first problem is that we may not agree on the content of
some of these specific approaches. We may not all agree to the
same set of human and civil rights .We may not agree on what
constitutes the common good. We may not even agree on what
is a good and what is a harm.
The second problem is that the different approaches may not all
answer the question "What is ethical?" in the same way.
Nonetheless, each approach gives us important information with
which to determine what is ethical in a particular circumstance.
And much more often than not, the different approaches do lead
to similar answers.
Ethical Problem Solving **Students should be familiar with
these five steps in ethical problem solving
These five approaches suggest that once we have ascertained the
facts, we should ask ourselves five questions when trying to
resolve a moral issue:

12. 1. What benefits and what harms will each course of action
produce, and which alternative will lead to the best overall
consequences? (The Utilitarian Approach)
2. What moral rights do the affected parties have, and which
course of action best respects those rights? (The Rights
Approach)
3. Which course of action treats everyone the same, except
where there is a morally justifiable reason not to, and does not
show favoritism or discrimination? (The Fairness or Justice
Approach)
4. Which course of action advances the common good? (The
Common Good Approach)
5. Which course of action develops moral virtues? (The Virtue
Approach)
This method, of course, does not provide an automatic solution
to moral problems. It is not meant to. The method is merely
meant to help identify most of the important ethical
considerations. In the end, we must deliberate on moral issues
for ourselves, keeping a careful eye on both the facts and on the
ethical considerations involved.
WEIGHING ETHICAL CONSIDERATIONS
Please Note: Sometimes it is not easy or even possible to act in
accordance with all the relevant considerations at the same
time.
For example, you might want to show respect for your
grandmother by allowing her to continue driving, even when her
eyesight is failing, but to minimize harm, you might feel a
responsibility to take her keys away. In a case like that, it’s
hard both to show respect for her desire to move around freely
and to protect her and others from the harm that might be
caused by a car accident. Which of these core ethical
considerations should count more (respect for persons, which

13. motivates you to allow her to keep driving, or minimizing
harms, which motivates you to take her keys away)? How
should you decide?
When an ethical problem arises, each individual may prioritize
and choose which considerations should be favored in a
different way. Often, there is no one right answer. In addition,
people can emphasize different ethical considerations in the
process of ethical analysis but arrive at the same decision about
what should be done