Dr. Stahl attends Galveston Brain Injury Conference

stahl-crop-2015Center Assistant Professor Dr. Devan Stahl attended the Galveston Brain Injury Conference on May 4-5 in Galveston, Texas. She was part of a work group that considered how to handle requests to withdraw/withhold life-sustaining treatments from patients in minimally conscious states.

The group was divided into three tracks which considered the topic from the vantage points of the law, ethics, and clinicians. Dr. Stahl was part of the ethics group. The task of this group was to consider the most ethically relevant debates which may arise when considering whether or not to honor a request (either by a patient or surrogate) to end life-sustaining treatments. The group considered questions, such as diagnostic and prognostic uncertainty, the abilities of persons in minimally conscious states, well-being and quality of life, and the proper use of advance directives and surrogate decision making. The group intends to publish a series of articles which will describe the ethical challenges which arise in treating patients in minimally conscious states. Ultimately, the group hopes to enhance discussions about when it is appropriate to continue or withhold life-sustaining treatments for persons in minimally conscious states.

Bioethics for Breakfast: Eye on the Prize: The Goal of Protecting College Football Players’ Best Interests

bioethics-for-breakfastLeonard Fleck, PhD, and Randy Pearson, MD, FAAFP, FACSM, presented at the Bioethics for Breakfast event on May 12, 2016, offering perspective and insight on the topic, “Eye on the Prize: The Goal of Protecting College Football Players’ Best Interests.”

In order to reduce the incidence of traumatic brain injury, should the profession of medicine advocate for further “best practice” changes in the way football is played and injuries managed? If so, what enforcement powers might physicians wield when facing a player’s desire to stay with the team and a college’s desire to have a winning team? Kathleen Bachynski writes in the New England Journal of Medicine (2/4/16), “Repetitive brain trauma can have serious short- and long-term consequences, including cognitive and attention deficits, headaches, mood disorders, sleep disturbances, and behavioral problems.” The NCAA notes that over 200,000 college athletes are injured in competition or practice each year, with 36.3% being in college football. Who should be concerned? Physicians? Parents? Players?

The media has focused on professional football players and the effect of repeated concussions later in life. What are the lifelong risks for college football players who may never play professional football? Is it one chance in a thousand that their life might end prematurely with chronic traumatic encephalopathy? Or is it one chance in ten? Problematically, thus far medical research cannot provide a definitive answer to these questions. Given that, should we (society) say that parents and players should be informed of risks to the extent that they are known, then allowed to judge whether the risks are worth whatever they see as potential benefits? Until clearer evidence is available regarding the actual level of risk to players should medical groups advocate for further protections in the game itself aimed at minimizing potential for brain trauma? And if so, should similar precautionary approaches be taken with other “risky” sports?

Leonard Fleck, PhD
Professor of Philosophy and Medical Ethics
Center for Ethics and Humanities in the Life Sciences
College of Human Medicine, Michigan State University
Dr. Fleck is the author of Just Caring: Health Care Rationing and Democratic Deliberation (Oxford University Press, 2009).

Randy Pearson, MD, FAAFP, FACSM
Professor, Department of Family Medicine, MSUCHM
Senior Associate Director, Sparrow/MSU Family Medicine Residency
Associate Director, MSU/Sparrow Sports Medicine Fellowship
Assistant Dean for Graduate Medical Education, MSUCHM

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.