Dr. Cabrera co-authors article in ‘Frontiers in Human Neuroscience’

Laura Cabrera photo

Center Assistant Professor Dr. Laura Cabrera is co-author of an article published last month in Frontiers in Human Neuroscience. Appearing in the Brain Imaging and Stimulation section of the journal, “International Legal Approaches to Neurosurgery for Psychiatric Disorders” was written by an international group of researchers.

Abstract: Neurosurgery for psychiatric disorders (NPD), also sometimes referred to as psychosurgery, is rapidly evolving, with new techniques and indications being investigated actively. Many within the field have suggested that some form of guidelines or regulations are needed to help ensure that a promising field develops safely. Multiple countries have enacted specific laws regulating NPD. This article reviews NPD-specific laws drawn from North and South America, Asia and Europe, in order to identify the typical form and contents of these laws and to set the groundwork for the design of an optimal regulation for the field. Key challenges for this design that are revealed by the review are how to define the scope of the law (what should be regulated), what types of regulations are required (eligibility criteria, approval procedures, data collection, and oversight mechanisms), and how to approach international harmonization given the potential migration of researchers and patients.

The full article is available online with free and open access from Frontiers.

Dr. Fleck published in ‘Hastings Center Report’ on Black Lives Matter and inequities in the U.S. healthcare system

Leonard Fleck photo

In the current issue of the Hastings Center Report, Center Acting Director and Professor Dr. Leonard Fleck shared a perspective on “Some Lives Matter: The Dirty Little Secret of the U.S. Health Care System.”

Abstract: Our health care system in the United States reflects the inequities that are part of the larger society, which is why our system for financing access to needed and effective health care is so complicated and unfair.

Visit the journal’s website for free access to the full text. Dr. Fleck is one of more than 200 Hastings Center Fellows.

Dr. Cabrera a co-author of human enhancement editorial in ‘Frontiers in Genetics’

Laura Cabrera photoCenter Assistant Professor Dr. Laura Cabrera and co-author Dov Greenbaum have written an editorial published in Frontiers in Genetics, titled “ELSI in Human Enhancement: What Distinguishes It From Therapy?”

The open access editorial, published June 23, is available in full from Frontiers in Genetics.

Center faculty published in ‘Brain Sciences’ on deep brain stimulation patient study

Laura Cabrera photoKaren Kelly-Blake photoCenter for Ethics Assistant Professor Dr. Laura Cabrera and Associate Professor Dr. Karen Kelly-Blake, along with Dr. Christos Sidiropoulos of the Department of Neurology & Ophthalmology, are co-authors of a new article in Brain Sciences. Their article “Perspectives on Deep Brain Stimulation and Its Earlier Use for Parkinson’s Disease: A Qualitative Study of US Patients” appears in a special issue on “Brain Stimulation and Parkinson’s Disease.”

Abstract
Background: Deep brain stimulation (DBS) is being used earlier than was previously the case in the disease progression in people with Parkinson’s disease (PD). To explore preferences about the timing of DBS, we asked PD patients with DBS whether they would have preferred the implantation procedure to have occurred earlier after diagnosis. Methods: Twenty Michigan-based patients were interviewed about both their experiences with DBS as well as their attitudes regarding the possible earlier use of DBS. We used a structured interview, with both closed and open-ended questions. Interviews were transcribed verbatim and analyzed using a mixed-methods approach. Results: We found that the majority of our participants (72%) had high overall satisfaction with DBS in addressing motor symptoms (mean of 7.5/10) and quality of life (mean of 8.25/10). Participants were mixed about whether they would have undergone DBS earlier than they did, with five participants being unsure and the remaining nearly equally divided between yes and no. Conclusion: Patient attitudes on the early use of DBS were mixed. Our results suggest that while patients were grateful for improvements experienced with DBS, they would not necessarily have endorsed its implementation earlier in their disease progression. Larger studies are needed to further examine our findings.

The full text is available online via MDPI.

Dr. Tomlinson co-author of medical education article

Tom Tomlinson photoCenter Director and Professor Dr. Tom Tomlinson is co-author of an article in the open access e-journal MedEdPublish. The article, “Reframing Professionalism: The Virtuous Professional,” was written by College of Human Medicine faculty members William Wadland, Margaret Thompson, Donna Mulder, Tom Tomlinson, Steven Roskos, John Foglio, John Molidor, and Janet Osuch.

Abstract: In response to prevalent unprofessional behaviors during the 1990s, the medical school administration at Michigan State University’s College of Human Medicine developed a student curriculum for professional development, called “The Virtuous Student Physician.” However, as students adopted these professional aspirations and attributes, they noted that faculty members were not being held to the same standards.

The medical school’s senior associate dean for faculty affairs and development convened a task force to reframe professionalism for all faculty, residents, and students. Our first step was to survey our faculty regarding their awareness of the student professionalism curriculum and their own perceived professional weaknesses. This survey showed the following: most faculty members were aware of “The Virtuous Student Physician” curriculum, that faculty members identified social responsibility as the most difficult attribute to achieve, and that the most difficult behavior identified was working to resolve problem behaviors with colleagues.

The task force then developed a new curriculum “The Virtuous Professional: A System of Professional Development for Students, Residents, and Faculty.” The task force identified three core virtues (Courage, Humility, and Mercy) and reframed the professional attributes encompassed by these virtues to be aspirational for the entire learning community. The faculty of the College subsequently adopted the new principles and practices, including the use of routine, anonymous student evaluation of faculty professionalism.

We are currently collecting data from student evaluations of their clinical faculty members. We plan to use this feedback to guide faculty development and recognize those who model exemplary professionalism as well as to address those who engage in unprofessional behavior.

The full text is available online from AMEE MedEdPublish.

Article from Dr. Stahl in April ‘AMA Journal of Ethics’

Devan Stahl photoCenter Assistant Professor Dr. Devan Stahl and co-author Christian J. Vercler (University of Michigan) have an article in the April 2018 issue of the AMA Journal of Ethics. Their article, “What Should Be the Surgeon’s Role in Defining “Normal” Genital Appearance?,” appears in the journal’s issue on ethical considerations in plastic and reconstructive surgery.

Abstract: The recent rise in women seeking cosmetic surgery of their genitalia (labiaplasty) coincides with the increasing number of surgeons posting videos of these operations on social media accounts and websites. Sociocultural influences significantly contribute to our ideas of what constitutes healthy and pathologic, and surgeons have historically played a role in defining “normal” and “abnormal” anatomy. In the nineteenth century, Saartjie Baartman—a woman with a large posterior and unusually long labia minora—was used by physicians to “educate” the public about these differences. We examine the parallels with the twenty-first century practice of surgeons using social media to educate patients about the operations they perform and discuss ethical and professional hazards associated with this practice.

The full article text is available online via the American Medical Association.