Center Assistant Professor Dr. Karen Kelly-Blake is co-author of an article published in Health Services Research and Managerial Epidemiology, “Sex Differences in Statin Prescribing in Diabetic and Heart Disease Patients in FQHCs: A Comparison of the ATPIII and 2013 ACC/AHA Cholesterol Guidelines.”
The team of Michigan State University College of Human Medicine researchers, Nazia Naz S. Khan, Karen Kelly-Blake, Zhehui Luo, and Adesuwa Olomu, found statin underprescribing for both men and women with atherosclerotic cardiovascular disease and diabetes mellitus in Federally Qualified Health Centers.
The full text is available online with open access via Sage Journals.
Center Assistant Professor Dr. Laura Cabrera is co-author of an article in the January issue of Social Science & Medicine. The article, “Online comments about psychiatric neurosurgery and psychopharmacological interventions: Public perceptions and concerns,” was written by Dr. Cabrera, Marisa Brandt, Rachel McKenzie, and Robyn Bluhm.
The study was supported by a Science and Society at State (S3) internal Michigan State University grant, “Psychiatric Interventions: Values and Public Attitudes.”
Abstract: The field of biological psychiatry is controversial, with both academics and members of the public questioning the validity and the responsible use of psychiatric technological interventions. The field of neuroethics provides insight into these controversies by examining key themes that characterize specific topics, attitudes, and reasoning tools that people use to evaluate interventions in the brain and mind. This study offers new empirical neuroethical insights into how the public responds to the use and development of psychiatric technological interventions by comparing how the public evaluates pharmacological and neurosurgical psychiatric interventions, in the context of online comments on news media articles about these topics. We analyzed 1142 comments from 108 articles dealing with psychopharmacological and psychiatric neurosurgery interventions on websites of major circulation USA newspapers and magazines published between 2005 and 2015. Personal anecdote, medical professional issues, medicalization, social issues, disadvantages, scientific issues and cautionary realism were among the main themes raised by commenters. The insights derived from the comments can contribute to improving communication between professionals and the public as well as to incorporating the public’s views in policy decisions about psychiatric interventions.
The full text is available online via Science Direct (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera and co-authors Hayden M. K. Boyce, MD, Rachel McKenzie, and Robyn Bluhm, PhD, have an article in the August 2018 issue of Neurosurgical Focus. “Conflicts of interest and industry professional relationships in psychiatric neurosurgery: a comparative literature review” stems from the authors’ Science and Society at State (S3) project, “Psychiatric Interventions: Values and Public Attitudes.”
Abstract: Objective: The research required to establish that psychiatric treatments are effective often depends on collaboration between academic clinical researchers and industry. Some of the goals of clinical practice and those of commercial developers of psychiatric therapies overlap, such as developing safe and effective treatments. However, there might also be incompatible goals; physicians aim to provide the best care they can to their patients, whereas the medical industry ultimately aims to develop therapies that are commercially successful. In some cases, however, clinical research may be aiming both at improved patient care and commercial success. It is in these cases that a conflict of interest (COI) arises. The goal of this study was to identify differences and commonalities regarding COIs between 2 kinds of somatic psychiatric interventions: pharmacological and neurosurgical.
The full text is available online via Journal of Neurosurgery (MSU Library or other institutional access may be required to view this article).
To learn more about this study, listen to Laura Cabrera, Robyn Bluhm, and Rachel McKenzie on the Center’s podcast, No Easy Answers in Bioethics: Public Perception of Psychiatric Interventions: Cabrera, Bluhm, and McKenzie – Episode 5.
Center Assistant Professor Dr. Devan Stahl and co-author John Banja (Emory University) have a target article in the current issue of AJOB Neuroscience, titled “The Persisting Problem of Precedent Autonomy Among Persons in a Minimally Conscious State: The Limitations of Philosophical Analysis and Clinical Assessment.”
Abstract: Determining whether it is ethical to withdraw life-sustaining treatments (WOLST) from a patient in the minimally conscious state (MCS) recalls recurring debates in bioethics, including the applicability of precedent autonomy and the usefulness of quality-of-life assessments. This article reviews the new clinical understanding of MCS and the complexities involved in detecting covert awareness in patients. Given the diagnostic and prognostic uncertainty surrounding most MCS determinations, we review the ongoing debates concerning precedent autonomy as they apply to making WOLST determinations for patients in MCS. We also consider the moral obligations clinicians might have to understand an MCS patient’s advance directives, current preferences, and quality of life. We argue that an optimal approach for making WOLST determinations requires weighing patients’ previous wishes against their current circumstances but that even here, factual as well as ethical vagaries and disagreements will be relatively commonplace.
The full text is available online via Taylor & Francis Online (MSU Library or other institutional access may be required to view these articles).
Authors Trevor M. Bibler (Baylor College of Medicine), Myrick C. Shinall, Jr. (Vanderbilt University Medical Center), and Center Assistant Professor Dr. Devan Stahl have a target article in the May 2018 American Journal of Bioethics, on “Responding to Those Who Hope for a Miracle: Practices for Clinical Bioethicists.” Additionally, AJOB published correspondence from the authors, “Response to Open Peer Commentaries on “Responding to Those Who Hope for a Miracle: Practices for Clinical Bioethicists”,” where the three authors discuss significant points of disagreement, clarification, and agreement from the responses to their article.
Abstract: Significant challenges arise for clinical care teams when a patient or surrogate decision-maker hopes a miracle will occur. This article answers the question, “How should clinical bioethicists respond when a medical decision-maker uses the hope for a miracle to orient her medical decisions?” We argue the ethicist must first understand the complexity of the miracle-invocation. To this end, we provide a taxonomy of miracle-invocations that assist the ethicist in analyzing the invocator’s conceptions of God, community, and self. After the ethicist appreciates how these concepts influence the invocator’s worldview, she can begin responding to this hope with specific practices. We discuss these practices in detail and offer concrete recommendations for a justified response to the hope for a miracle.
The full text as well as the response are available online through Taylor & Francis Online (MSU Library or other institutional access may be required to view these articles).
Center Professor Dr. Leonard Fleck has a new article published in the April 2018 issue of Cambridge Quarterly of Healthcare Ethics. The article, “Controlling Healthcare Costs: Just Cost Effectiveness or “Just” Cost Effectiveness?,” appears in a special section on justice, healthcare, and wellness.
Abstract: Meeting healthcare needs is a matter of social justice. Healthcare needs are virtually limitless; however, resources, such as money, for meeting those needs, are limited. How then should we (just and caring citizens and policymakers in such a society) decide which needs must be met as a matter of justice with those limited resources? One reasonable response would be that we should use cost effectiveness as our primary criterion for making those choices. This article argues instead that cost-effectiveness considerations must be constrained by considerations of healthcare justice. The goal of this article will be to provide a preliminary account of how we might distinguish just from unjust or insufficiently just applications of cost-effectiveness analysis to some healthcare rationing problems; specifically, problems related to extraordinarily expensive targeted cancer therapies. Unconstrained compassionate appeals for resources for the medically least well-off cancer patients will be neither just nor cost effective.
The full text is available online through Cambridge University Press (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera has a new article in the October 2017 issue of Cambridge Quarterly of Healthcare Ethics. The article, “Pesticides: A Case Domain for Environmental Neuroethics,” appears in a Clinical Neuroethics theme issue.
Abstract: There is growing evidence about the influence of chemical exposures on specific molecular systems and mechanisms involved in cognitive and mental function. Evidence is also emerging about the negative impact of these chemical exposures on mental health, including depression, suicide, and other risks. Despite the growing appreciation of these factors, however, little attention has been paid to the ethical and social implications of their interactions. Drawing on recent work that argues for an environmental neuroethics approach that explicitly brings together ethics, environment, and conditions of the central nervous system, this article focuses on these critical issues for pesticides specifically.
The full text is available online via Cambridge University Press (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera is co-author of a new open peer commentary in the September issue of The American Journal of Bioethics. The article, “Environmental Neuroethics: Bridging Environmental Ethics and Mental Health,” was written by Adam J. Shriver (University of British Columbia), Laura Cabrera, and Judy Illes (University of British Columbia).
The full text is available online via Taylor & Francis (MSU Library or other institutional access may be required to view this article).
Center Assistant Professor Dr. Laura Cabrera is a co-author of the article “Teaching bioethics to a large number of biology and pharma students: Lessons learned,” published online ahead of print in Ethics & Behavior.
The article is authored by Sabrina Engel-Glatter, Laura Y. Cabrera, Yousri Marzouki, and Bernice S. Elger.
Abstract: In order to be made aware of bioethical issues related to their disciplines, undergraduate students in biology and pharmaceutical sciences at the University of XXX are required to enroll in the bioethics course “Introduction to Bioethics”. This paper describes the chances and challenges faced when teaching a large number of undergraduate biology and pharmaceutical sciences students. Attention is drawn to the relevance and specific ethical issues that biology and pharmaceutical sciences students may be confronted with, and how these could be integrated into ethics curricula. Results from a survey addressing the knowledge and opinion of students taking the course in spring semester 2012, 2013, and 2014 are presented and discussed. Finally, we describe the lessons learned and how we have improved the course based on students’ feedback throughout the following years.
The full text is available online through Taylor & Francis.
The work of Center Professor Dr. Leonard Fleck appears in the new book Prioritization in Medicine: An International Dialogue, published by Springer. Dr. Fleck’s chapter is titled “Just Caring: Fair Innings and Priority Setting.”
Dr. Fleck also has an article in the current APA Newsletter on Philosophy and Medicine (Volume 15 Number 2) titled “Just Rationing in the ICU: What Benefits Count?” The current issue can be accessed on the American Philosophical Association website, or you can go directly to the PDF.