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”

The Undergraduate Bioethics Society: a new space for thinking about current issues in bioethics

JordanKriegercrop Guest Editorial
By Jordan Krieger, President
Undergraduate Bioethics Society, Michigan State University

We are in the era of medicine and health care. Currently, changes are being made to the United States health care system through the Affordable Care Act; research is constantly improving the medical technologies available to health care professionals, and people are facing a whole new set of chronic diseases. With the changes and advancements in the medical field also comes an expanse of ethical and moral questions that must be asked.

The Undergraduate Bioethics Society (UBS) is a student organization committed to increasing awareness of, and cultivating student interest in ethical issues in medicine, healthcare, biotechnology, and biomedical research. The organization will hold bi-weekly meetings on Tuesday nights; from 7:00 to 9:00 p.m. Locations will be announced as meeting dates approach. These gatherings will not be mandatory, but will be great fun so be sure to join us! Meetings will feature various faculty and professional speakers followed by a student based discussion, as well as service projects, fundraising, field trips, and student debates centered on previously determined topics.

Already, members of UBS have had an opportunity to explore different ethical issues in health care by attending the National Undergraduate Bioethics Conference (NUBC) at Loyola University in Chicago, April 4-6 of this year. While listening to various speakers and the “bioethics bowl” (NUBC’s version of a debate competition), students were able to listen to and explore various topics of interest to them within the health care field, all while exploring the wonder that is Downtown Chicago! Aside from the keynote speaker T.R. Reid, the presentations were all done by students our age about topics such as end-of-life decision making, prisoner organ donation, electronic records, surrogacy and other various controversial areas. Reid talked about various health care systems around the world, and elaborated by making recommendations for our very own system here in the United States. Since NUBC is an annual event, with enough preparation, the organization hopes to continue sending individuals to the conference to listen, present and, if they are up to it, compete in the bioethics bowl. The location for the 2015 will be Florida State University, we will have more updates as plans for the conference move forward.

If you are interested in being a part of UBS, or if you have any questions, we encourage you to email us at ubs@msu.edu to be added to the mailing list and become notified when we have upcoming events. There will be a membership fee of $20 but that includes an awesome UBS t-shirt as well as food and refreshments at most meetings.

Members of the UBS e-board will have a booth set up at Sparticipation in the Fall and we invite you to approach us with any questions or recommendations you may have for our organization. We are a society of the students, for the students, and your input matters to us. In the meantime remember; when it comes to bioethics, there are no easy answers!

BHS MA alum Dr. Faith Fletcher Receives Kaiser Permanente Burch Minority Leadership Development Award

faith-fletcher-2013Read more via ASPPH: “UIC Faculty Receives Kaiser Permanente Burch Minority Leadership Development Award”

Dr. Faith Fletcher is a 2006 graduate of the Michigan State University Bioethics, Humanities, and Society MA program. Dr. Fletcher is an assistant professor in the division of community health sciences at the University of Illinois at Chicago School of Public Health.

Feature in ‘MSU Today’ on work of BHS MA grad Melissa Elafros

Read about Melissa’s work in Zambia: “Student view: Melissa Elafros: At home in Zambia”

Melissa is a 2008 graduate of the Bioethics, Humanities, and Society MA program at MSU. Visit bhs.msu.edu for information on the BHS Undergraduate Specialization.

CHM student presents at the 2013 Meeting of the Michigan State Medical Society

MSU-Seal-Green_RGB-1-inchAkshay Srikanth presented  the following poster at the Annual Meeting of the Michigan State Medical Society, which was held October 23-25, 2013 in Troy, MI.

“Evaluation of the use of a decision aid during diagnosis visits in early stage prostate cancer.”
Poster by Srikanth A, Kahn VC, Rovner DR, Greenwell A, Ellsworth E, Harder M, Holmes-Rovner M.

This poster evaluated the relevance of an informational decision aid during diagnosis visits in early state prostate cancer by using tape-recorded clinical encounters. Results show that a decision aid is significant during diagnosis visits through the number of times it was referenced by both the patient and physician. Additionally results show the decision aid was referenced most often in the context of treatment options and was used most often to learn more or validate something during the discussion. A decision aid can be used in cases of early stage prostate cancer to help patients make a more informed decision and may facilitate during the shared decision making process.

Akshay Srikanth is a second year College of Human Medicine student. He is working with Center faculty member Margaret Holmes-Rovner on an ongoing AHRQ (Agency for Healthcare Research and Quality) funded research project titled “Clinical Communication Following a Decision Aid.”

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.

Center faculty members present at SMDM 2013 in Baltimore

holmes-rovnerKelly-blakeThe Society for Medical Decision Making’s annual meeting took place October 20-23, 2013, in Baltimore, Maryland. Dr. Margaret Holmes-Rovner, Professor Emerita in the Center for Ethics, and Dr. Karen Kelly-Blake, Research Associate in the Center for Ethics, each presented posters relating to the topic of shared decision-making.
Read more about each presentation