Bioethics for Breakfast: Autism Spectrum Disorder: Fair Sharing of the Therapeutic Pie?

Bioethics for Breakfast Seminars in Medicine, Law and SocietyJeanette M. Scheid, MD, PhD, and Connie Sung, PhD, presented at the Bioethics for Breakfast event on November 30, 2017, offering perspective and insight on the topic, “Autism Spectrum Disorder: Fair Sharing of the Therapeutic Pie?”

Autism Spectrum Disorder (ASD), as the name implies, occurs across a broad spectrum of cognitive, psychological, behavioral, and social interactive manifestations. There is a genetic component to the disorder, though the precise pathology remains something of a mystery. There is no cure for the disorder, though there are some behavioral therapies that address what might otherwise be lifelong manifestations. A number of ethical issues might be raised regarding ASD. First, given some genetic connection to the disorder, should parents be strongly advised to have genetic testing (maybe Whole Genome Sequencing) to inform future reproductive decisions. Second, there are resource allocation issues related to potential therapies. There are at least two evidence-based behavioral interventions that have demonstrated effectiveness in improving aspects of the disorder. There are also a number of “therapies” that have little formal evidence-based support but strong advocates who expect insurance coverage. Third, the two accepted therapies require strong parental involvement in providing/ maintaining these therapies at home (which reduces social costs for these therapies). How might we best ensure such involvement? Fourth, therapeutic resources for ASD are disproportionately available across the lifespan. Is that an injustice? These questions and more were discussed by speakers and attendees.

Jeanette M. Scheid, MD, PhD
Jeanette M. Scheid, MD, PhD, is an Associate Professor of Psychiatry at Michigan State University. She is board certified in general and child and adolescent psychiatry. In that role she teaches medical students and residents and provides clinical care to children, adolescents and adults. Her primary practice sites are in community mental health and child residential treatment facilities. Dr. Scheid sees patients with a broad range of mental health concerns. She has particular interest in the systems of care and issues facing children and adolescents exposed to maltreatment.

Connie Sung, PhD
Connie Sung, PhD, is an Assistant Professor of Rehabilitation Counseling and co-director of Spartan Project SEARCH at Michigan State University. She received her PhD in Rehabilitation Psychology from University of Wisconsin-Madison and completed a pre-doctoral psychology internship at Waisman Center, Madison, WI. Previously as an occupational therapist and now as a rehabilitation counseling educator and researcher, she has over 10 years of experience working with individuals with autism spectrum disorder throughout the lifespan and has a special interest in working with the transition youth population. Currently, she is a principal investigator of several community-based participatory research projects, including evaluation of intervention strategies to improve psychosocial and vocational outcomes of transition-age individuals who are on the autism spectrum.

About Bioethics for Breakfast:
In 2010, Hall, Render, Killian, Heath & Lyman invited the Center for Ethics to partner on a bioethics seminar series. The Center for Ethics and Hall Render invite guests from the health professions, religious and community organizations, political circles, and the academy to engage in lively discussions of topics spanning the worlds of bioethics, health law, business, and policy. For each event, the Center selects from a wide range of controversial issues and provides two presenters either from our own faculty or invited guests, who offer distinctive, and sometimes clashing, perspectives. Those brief presentations are followed by a moderated open discussion.