Center faculty present at 16th Annual ASBH Meeting in San Diego

asbh logoThe 16th Annual American Society for Bioethics and Humanities Meeting was held October 16-19, 2014, in San Diego, CA. Three Center faculty members attended and presented on various topics.

tomlinsonTom Tomlinson, PhD
Along with John Lizza, Robert Truog, and Don Marquis, I was on a panel entitled “Donation Following Cardiac Death: Does It Matter Whether Donors Are Really, Most Sincerely Dead?” The discussion focused on when it was legitimate to say that these donors had “irreversibly” lost circulatory and respiratory function, so that they could be declared dead prior to organ retrieval. My panel presentation was titled “Irreversibility is a Relational Property.”

list-cropMonica List
I presented a paper titled “The Case for Veterinary Bioethics”; this was part of a paper session on Animal Ethics. My presentation focused on examining the ethical frameworks used in veterinary medicine, and identifying gaps in these frameworks that may signal a need to expand them. I proposed that these broadened frameworks can be conceptualized as “veterinary bioethics.” Despite the fact that animal ethics has never been a very prominent track at ASBH conferences, the session was well attended. I received several interesting questions from the audience; one of those questions was whether or not a veterinary bioethics framework would contribute anything new to medical bioethics. I thought this was a great question that our work at the Center might help answer, since our faculty teach in the Medical Colleges as well as the Veterinary College. Building on the feedback and comments I received, I hope to further develop this project for future publication.

Leonard Fleck, PhDLeonard Fleck
I did a presentation titled “Whole Genome Sequencing: The Devil in the DNA.” The basic argument was this: Whole Genome Sequencing [WGS] is very promising from a medical point of view. It can be used to identify an individual’s responsiveness to drugs, or an individual’s carrier status (which may be important for reproductive decisions), or whether an embryo is free of serious genetic vulnerabilities. The promises of WGS are easier to realize because the cost of doing this is about $1000 today. However, there are some devilish details within this DNA. Continue reading “Center faculty present at 16th Annual ASBH Meeting in San Diego”

Center faculty travel to Atlanta to present at 15th Annual ASBH Meeting

asbh logoThe 15th Annual American Society for Bioethics and Humanities Meeting was held October 24-27, 2013, in Atlanta, GA. Several of our faculty members attended and presented on various topics.

“Autonomy’s Child: Exploring the Bounded Warp and Woof of Shared Decision-making”bogdanlovis-crop-facKelly-blake
By Elizabeth (Libby) Bogdan-Lovis and Karen Kelly-Blake

Shared decision-making is commonly cited as a clinical encounter ideal, yet current assessments suggest that multiple barriers impede its full implementation. To explore some of those barriers we examined obstacles to shared decision-making surrounding the place of birth, where the available clinical evidence on best practice is ambiguous. Disagreement over interpretation of the available evidence, presentation of the relevant information, maternal and fetal rights and responsibilities and physician rights and responsibilities commonly confound the interaction. This presentation examined shared decision-making complexities over who is, and who should be, the authorized decision maker for the mother-baby dyad when there is profound disagreement over interpretations of risks as well as determination of best interests. This presentation usefully highlighted difficulties in robust shared decision-making implementation.

“The e-portfolio as a teaching approach: fostering reflective thinking in interdisciplinary bioethics programs”
list-cropPoster by Monica List

Bioethics is arguably defined as an interdisciplinary field. However, how this interdisciplinarity is expressed in the teaching of bioethics depends strongly on the nature and purpose of each particular program. In 2012, the Specialization in Bioethics, Humanities, and Society (BHS) at Michigan State University launched a 1 credit, fully online e-portfolio course. One of the main objectives of the course was to provide BHS students with an opportunity to integrate, and critically reflect on, the knowledge and experiences gained through their specialization coursework. In this first offering of the e-portfolio course, 10 undergraduate students from 9 different majors conducted an analysis of the case of STD research in Guatemala from 1946 to 1948, using a study guide prepared by the Presidential Commission for the Study of Bioethical Issues. This experience provided valuable information on the benefits and shortfalls of using e-portfolios in interdisciplinary teaching and assessment in bioethics programs at the undergraduate level.

“Parsimonious Care: Penurious Promises or Just Prudence?”
By Leonard M. Fleck, Ph.D.Leonard Fleck

The American College of Physicians generated a small media firestorm with the 6th edition of their Physicians Ethics Manual wherein they recommended physicians should provide “parsimonious care” to their patients for reasons of both equity and efficiency. Some critics noted that parsimony carries the connotation of stinginess; other critics maintained that parsimonious care represented disloyalty to the best interests of patients.

Dr. Fleck defends the claim that parsimonious medical care is presumptively morally permissible if the following conditions are met: (1) We have limited resources to meet virtually unlimited health care needs. (2) As a society we are failing to meet numerous just claims to needed health care because we squander resources on the very well- insured. (3) Objective medical grounds exist for believing a specific intervention will likely yield little benefit. (4) Those objective medical grounds are captured in evidence-based, expert-derived practice protocols congruent with the core values of medicine. (5) The parsimonious practice protocols are public and transparent and legitimated through a process of rational democratic deliberation. (6) Savings achieved through parsimonious practices are captured and redistributed toward meeting higher priority health care needs. (7) High-cost patients are not discriminated against; instead their health care needs are met as efficiently as possible with effective health care interventions, even if those interventions are not cost-effective. The goal is not maximal parsimony but equitable parsimony.

“Stewardship Model of Biobanking: Ethical Challenges are Systems Challenges”
mongoven smallPoster by Ann Mongoven, Michigan State University and Stephanie Solomon, St. Louis University

Although there is currently great interest in increasing informed consent for biobanking, informed consent for biobanking is incoherent. Biobank recruits asked for biosamples cannot weigh risks and benefits of future unknown research. This poster argued that the use of advance directives and surrogate decision-makers in clinical medicine offers a model for biobanking ethics. Patients considering future unknown medical scenarios can express relevant values through advance directives, and appoint a surrogate decision-maker. In practice, advance directives are the most effective when they are neither too vague nor too specific, and when they focus on general values rather than specific treatment choices—like the popular “Five Wishes” advance directive. They are also more successful when they are reinforced systematically within a health system and community. Biobanks should develop an analogue of the “Five Wishes” that is neither too vague (blanket consent) nor too detailed (tiered consent), that stresses relevant values rather than specific research choices, and that is formed by and forming of community engagement to support the biobank’s de facto surrogate role.

“Biobank or Biotrust?: Metaphor and the Ethics of Biobanking”
Poster by Ann Mongoven

Metaphors are word-symbols that are partially formative of the moral world. Because non-literal, all metaphors highlight some aspects of the moral landscape while obscuring others. Common metaphors used in biobanking ethics are often used unreflectively: biobank; specimen; donor; etc. For example, while “bank” aptly signals a repository, “bank” is a commercial metaphor. It may not well capture potential public purposes of biobanking. “Donor” implies intent, but many biobank participants are unaware that their tissue has been banked or is being used in research. They may be more “conscript” than “donor.” Metaphorical analysis enables a two –way critique, exploring the relationship between the language used for biobanking and actual institutions or practices. The poster argues that many commonly-used metaphors for biobanking are ethically distorting; that we should experiment with other metaphors; and that given the complexity of this new enterprise we may need multiple metaphors to describe it and resist distortions.

Join us for the upcoming Bioethics Brownbag & Webinar Series lecture with Karen Kelly-Blake

Shared Decision-Making: The Gold Standard in Patient-Centered Care, But is it Achievable?

Shared Decision-Making (SDM), with patients requires that clinicians communicate effectively with patients and help them review screening and treatment options to make an informed decision. Implementation of SDM in routine practice, however, has been challenging. Physician challenges to engaging in SDM include patient literacy, numeracy barriers, and patient cultural backgrounds that do not foster autonomous decision-making. Clinicians worry that adding deliberation over medical evidence may take extra time in the encounter, and that patients may not have the skills to evaluate their options. This suggests that improving SDM implementation may require increased provider SDM skills supported by increased training.

Dr. Karen Kelly-Blake will present results of a program that expands a previously tested and frequently presented workshop in patient-centered interviewing to engage primary care providers (PCP) in SDM using a Decision Aid that described choices between no treatment and active treatment for stable coronary artery disease (CAD).

Karen Kelly-Blake, PhD, is a medical anthropologist and Research Associate in the Center for Ethics and Humanities in the Life Sciences at MSU. Her research interests include health services research, medical shared decision-making, physician training, and medical school curriculum development. Dr. Kelly-Blake was recently awarded the National Cancer Institute’s Research Supplement to Promote Diversity in Health-Related Research to conduct research on the use and acceptability of information technology (IT) to improve clinician-patient communication about colorectal cancer screening options.

Join us for Dr. Kelly-Blake’s lecture on Wednesday, December 12, 2012 from noon till 1 pm in person or online:

In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Event flyer: BB_Webinar ad dec 12_13

Bioethics Brownbag & Webinar Series welcomes Douglas Olsen; Continuing Nursing Education credit available

Douglas P. Olsen, PhD, RN, joined the MSU College of Nursing faculty this fall as Associate Professor. He comes most recently from the US Department of Veterans Affairs’ National Center for Ethics in Health Care. Prior to his work at there, he was an Associate Professor in the School of Nursing at Yale University. He is on the editorial board of Nursing Ethics and a contributing editor at The American Journal of Nursing. He is a founding member of the International Centre for Nursing Ethics at the University of Surrey and has taught ethics at the Sechenov Moscow Medical Academy as a Fulbright Fellow; Tokyo Women’s University, and as Visiting Associate Professor at Hong Kong Polytechnic University.

Health Behavior: Ethics and Compliance

There is an increasingly compelling need to address people’s ability and willingness to behave in ways consistent with optimum health. Still, ethical uncertainty and values conflicts arise for clinicians working with patients who behave in ways that damage their health. This presentation will review those issues with emphasis on the relational aspects including the ethical use of influence, discontinuity of risk perception, and the effect of clinician perception of patient’s responsibility for pathology. The issues will be reviewed in reference to an obese patient being cared for at home by his wife with nursing support. The patient requires but refuses assistance turning in bed to prevent bedsores – which when ignored result in severe and potentially fatal complications.

Join us for Dr. Olsen’s lecture on Wednesday, November 7, 2012 from noon till 1 pm in person or online:

In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

1.0 Continuing Nursing Education (CNE) Contact Hour will be provided for this presentation. Criteria for successful completion includes verification of attendance at the entire program and submission of a completed evaluation form. Partial credit will not be awarded.
Michigan State University College of Nursing (OH-294, 08/01/15) is an approved provider of continuing nursing education by the Ohio Nurses Association (OBN-001-91), an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation.

Event flyer: BB_Webinar ad nov 12_13_credit

BHS Advisor Monica List to speak in the Bioethics Brownbag & Webinar Series this month

In addition to serving as the BHS advisor, Monica List is also a doctoral student in the Department of Philosophy at Michigan State University. She earned a veterinary medicine degree from the National University of Costa Rica in 2002, and an MA degree in bioethics, also from the National University, in 2011. She will be sharing from her expertise unique and fascinating insights into the relationship of human and the animal Other.

Her research interest include: environmental philosophy, sustainability, animal ethics, veterinary ethics, development ethics, and bioethics.

Eeek! How fears shape our ethical relationships with animal and human others

The other is a being, human or animal, who has the power to place inescapable ethical demands on us as social beings. To be other also means to be different in fundamental ways; these differences are precisely what makes others unknowable, something that can never be fully grasped. Such differences also foster fears toward others that are not always recognizable; furthermore, admitting fears to ourselves, especially when they relate to human others, may prove to be an especially difficult task. The difficulty of bridging the chasm between ourselves and others increases in special ethical encounters, including for instance, doctor- patient relationships. Exploring and understanding the fear dynamic through the lens of our fear of animal others may be a useful tool in recognizing and addressing our fears of human others, as a relevant component of our ethical relationships.

Join us for Monica’s lecture on Wednesday, October 24, 2012 from noon till 1 pm in person or online:

In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Event flyer: BB_Webinar ad oct 12_13

Bioethics Brownbag & Webinar Series Special Event: Professor Masahiro Morioka lecture

The Center for Ethics has partnered with the Department of Philosophy and the Asian Studies Center to welcome Masahiro Morioka, Professor of Philosophy and Ethics at Osaka Prefecture University in Japan, for a special lecture in the Bioethics Brownbag & Webinar Series.

Professor Morioka is considered to be one of the most influential thinkers in Japanese philosophy and sociology. He is the director of the Research Institute for Contemporary Philosophy of Life at Osaka Prefecture University, and is the editor-in-chief of the Journal of Philosophy of Life. He specializes in philisophy of life, life studies, bioethics, gender studies, and criticism of contemporary civilization.

Brain Death, the Concept of  ‘Persona,’ and the Principle of Wholeness

Japan is a country where unique discussions on brain death take place not only among specialists but also lay persons. Using narratives, Professor Morioka will present his theories on some philosophical aspects of brain death, that is to say, the concept of ‘persona’ and the principle of ‘wholeness.’

Join us for Professor Morioka’s lecture on Friday, September 28, 2012 from noon till 1 pm in person or online:

In person: The lecture will take place in the International Center on MSU’s East Lansing campus, in Room 303. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Event flyer: BB_Webinar ad morioka event 12_13

Announcing Fall 2012 Bioethics Brownbag and Webinar Series

The Center for Ethics and Humanities in the Life Sciences at Michigan State University announces the lineup for their Bioethics Brownbag & Webinar Series for fall 2012.

The series hosts a variety of lecturers, from clinicians to medical researchers to philosophers, offering a broad range of relevant bioethical topics. The event may be attended live in person on MSU’s campus in East Lansing, or live via webinar, where listeners can stream the audio while watching a slide presentation. A question and answer session will follow each lecture, with the option for the online audience to type in questions which will be read aloud. All lectures will be recorded and made available on our website, bioethics.msu.edu, shortly after the event.

Everyday Ethics: What Clinicians and Patients Say about Relationships and Why they Work

Larry R. Churchill, PhD is the Ann Geddes Stahlman Professor of Medical Ethics at Vanderbilt University.

Read a full description of this lecture.

Special Event!

Brain Death, the Concept of  ‘Persona,’ and the Principle of Wholeness

For this added event in the Bioethics Brownbag & Webinar Series, the Center for Ethics welcomes Professor Masahiro Morioka, a Professor of Philosophy and Ethics at Osaka Prefecture University in Japan, where he is also the director of the Research Institute for Contemporary Philosophy of Life.

Read a full description of this lecture.

Eeek! How fears shape our ethical relationships with animal and human others

Monica List, DVM, MA, is a PhD Candidate in the Department of Philosophy at MSU.

Read a full description of this lecture.

Health Behavior: Ethics and Compliance

Douglas P. Olsen, PhD, RN, joined the MSU College of Nursing faculty this fall as Associate Professor. He came to MSU from the US Department of Veterans Affairs’ National Center for Ethics in Health Care.

Read a full description of this lecture.

Shared Decision-Making: The Gold Standard in Patient-Centered Care, But is it Achievable?

Karen Kelly Blake, PhD, is a Research Associate in the Center for Ethics and Humanities in the Life Sciences at MSU.

Read a full description of this lecture.

All Sessions are 12-1 pm.

To attend the lectures:

In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Series flyer: BB_Webinar ad 12_13

Grant awarded for “Clinical Communication Following a Decision Aid” project

Margaret Holmes-Rovner, PhD, was recently awarded a grant through the Agency for Healthcare Research Quality (AHRQ) for her project: Clinical Communication Following a Decision Aid.

The project will focus on a particularly difficult area of shared decision-making by looking at doctor-patient interactions for patients who have been diagnosed with prostate cancer. Deciding on prostate cancer treatment is troubling and controversial, because data does not consistently show any treatment that improves overall survival, and there are large differences in side effects. The project will analyze audio recordings of doctor visits and patient surveys collected in a previous study to 1) better understand how doctors and patients decide on treatment when patients are well-informed and 2) to evaluate the impact of the amount of shared decision-making in the doctor visit on patients’ decisions.

Join us for the upcoming Bioethics Brownbag & Webinar Series lecture with Karen Kelly-Blake

Shared Decision-Making: The Gold Standard in Patient-Centered Care, But is it Achievable?

Shared Decision-Making (SDM), with patients requires that clinicians communicate effectively with patients and help them review screening and treatment options to make an informed decision. Implementation of SDM in routine practice, however, has been challenging. Physician challenges to engaging in SDM include patient literacy, numeracy barriers, and patient cultural backgrounds that do not foster autonomous decision-making. Clinicians worry that adding deliberation over medical evidence may take extra time in the encounter, and that patients may not have the skills to evaluate their options. This suggests that improving SDM implementation may require increased provider SDM skills supported by increased training.

Dr. Karen Kelly-Blake will present results of a program that expands a previously tested and frequently presented workshop in patient-centered interviewing to engage primary care providers (PCP) in SDM using a Decision Aid that described choices between no treatment and active treatment for stable coronary artery disease (CAD).

Karen Kelly-Blake, PhD, is a medical anthropologist and Research Associate in the Center for Ethics and Humanities in the Life Sciences at MSU. Her research interests include health services research, medical shared decision-making, physician training, and medical school curriculum development. Dr. Kelly-Blake was recently awarded the National Cancer Institute’s Research Supplement to Promote Diversity in Health-Related Research to conduct research on the use and acceptability of information technology (IT) to improve clinician-patient communication about colorectal cancer screening options.

Join us for Dr. Kelly-Blake’s lecture on Wednesday, December 12, 2012 from noon till 1 pm in person or online:

In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Event flyer: BB_Webinar ad dec 12_13

Brownbag & Webinar Series welcomes Douglas Olsen in November

Douglas P. Olsen, PhD, RN, joined the MSU College of Nursing faculty this fall as Associate Professor. He comes most recently from the US Department of Veterans Affairs’ National Center for Ethics in Health Care. Prior to his work at there, he was an Associate Professor in the School of Nursing at Yale University. He is on the editorial board of Nursing Ethics and a contributing editor at The American Journal of Nursing. He is a founding member of the International Centre for Nursing Ethics at the University of Surrey and has taught ethics at the Sechenov Moscow Medical Academy as a Fulbright Fellow; Tokyo Women’s University, and as Visiting Associate Professor at Hong Kong Polytechnic University.

Health Behavior: Ethics and Compliance

There is an increasingly compelling need to address people’s ability and willingness to behave in ways consistent with optimum health. Still, ethical uncertainty and values conflicts arise for clinicians working with patients who behave in ways that damage their health. This presentation will review those issues with emphasis on the relational aspects including the ethical use of influence, discontinuity of risk perception, and the effect of clinician perception of patient’s responsibility for pathology. The issues will be reviewed in reference to an obese patient being cared for at home by his wife with nursing support. The patient requires but refuses assistance turning in bed to prevent bedsores – which when ignored result in severe and potentially fatal complications.

Join us for Dr. Olsen’s lecture on Wednesday, November 7, 2012 from noon till 1 pm in person or online:

In person: The lecture will take place in East Fee Hall on MSU’s East Lansing campus, in the Patenge Room (C102). Directions. Feel free to bring your lunch! Beverages and light snacks will be provided.

Online: Here are some instructions for your first time joining the webinar, or if you have attended or viewed them before, go to the meeting!

Event flyer: BB_Webinar ad nov 12_13