Tag: research

Examining how doctors and patients distinguish between normal and pathological events through the case of epilepsy

Bioethics Public Seminar Series green and white icon

The 2022-2023 Bioethics Public Seminar Series continues this month with a webinar from Center Assistant Professor Megh Marathe, PhD, on “Expedient Classification: Diagnosis in Lived Experience and Medical Practice.” This virtual event is free to attend and open to all individuals. This event will be available as a live broadcast only.

Wednesday, March 22, 2023
1:30-2:30 PM EDT (UTC−04:00)
Zoom webinar registration: bit.ly/bioethics-marathe

This talk examines how doctors and patients distinguish between normal and pathological events through the case of epilepsy. Epilepsy is a chronic illness and disability characterized by recurrent and unpredictable seizures. Seizures are transient events during which people lose control over parts of body-mind function. The talk shows that the diagnostic boundary between seizure and non-seizure events is fluid, dynamic, and porous in lived experience and medical practice. Calling an event a seizure has consequences well beyond treatment, also affecting a patient’s financial stability, social participation, and life aspirations. Hence, doctors and patients take an expedient approach to classifying seizures, informally modifying the very definition of seizure to postpone or avoid severe consequences. Doing so enables doctors and patients to bend rigid classification schemes to suit the complex realities of people’s lives. This work advances scholarship on classification and expertise in information studies, science and technology studies, and disability studies.

Megh Marathe with Spartan helmet graphic

Megh Marathe is an assistant professor in the Center for Bioethics and Social Justice in the College of Human Medicine and the Department of Media and Information in the College of Communication Arts and Sciences at Michigan State University. Marathe’s research seeks to foster inclusion in expert practices and technologies by centering the perspectives of marginalized people. They do this by studying the experiences and practices of multiple stakeholders – doctors and patients, citizens and civic officials – that is, laypeople and professionals, people who are marginalized as well as those in powerful positions, to generate critical theory and practical interventions for inclusive practice and technology design. Marathe adopts an ethnographic approach that is inflected by their computer science training and software industry experience.

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What do clinicians think about using deep brain stimulation to treat obsessive-compulsive disorder in pediatric patients?

Bioethics Public Seminar Series green and white icon

The 2022-2023 Bioethics Public Seminar Series continues next month with a webinar from Center Assistant Professor Michelle T. Pham, PhD, on “Clinician Perspectives on the Potential of DBS for Pediatric Patients with Treatment-Resistant OCD.” This virtual event is free to attend and open to all individuals.

Wednesday, February 15, 2023
1:30-2:30 PM EST (UTC−05:00)
Zoom webinar registration: bit.ly/bioethics-pham

The World Society for Stereotactic and Functional Neurosurgery has argued that at least two successful randomized controlled trials should be available before deep brain stimulation (DBS) treatment for a psychiatric disorder is considered “established.” DBS is currently offered to children ages 7 and older with refractory dystonia under an FDA-humanitarian device exemption. No randomized control trials were conducted – practitioners relied on evidence from DBS use in adults. In addition, accumulated research supports the safety and effectiveness of DBS for obsessive-compulsive disorder (OCD) in adults (Wu et al. 2021).

Approximately 10-20% of children with OCD have treatment-resistant presentations, so it is likely that there will be interest in offering DBS for some children (POTS 2004). Both ethical and empirical anticipatory work is needed to evaluate whether, and if so, under what conditions it might be appropriate to offer DBS in this context. This seminar will present qualitative data from semi-structured interviews with 24 clinicians with expertise in this area regarding: (a) acceptable levels of evidence to offer DBS in this patient population and (b) institutional policies or protocols needed to effectively provide care for them.

Michelle Pham with Spartan helmet graphic

Michelle T. Pham is an assistant professor in the Center for Bioethics and Social Justice and the Department of Medicine in the Michigan State University College of Human Medicine. She conducts research in the interdisciplinary field of Neuroethics and connected issues in the Philosophy of Science. Some recent topics include promoting post-trial care for patient-participants in experimental brain implant studies and decision-making in the context of pediatric deep brain stimulation. Pham also researches ways to promote engagement with patient-participants who contribute to neuroscience and neurotechnology research; and she has raised the concern that patient-participants in these brain implant studies may be exploited.

Can’t make it? All webinars are recorded and available in our archive of recorded lectures. To receive reminders before each webinar, please subscribe to our email list.

Center for Bioethics and Social Justice: new name, mission, and leadership

Green Spartan helmet with text: Center for Bioethics and Social Justice, College of Human Medicine, Michigan State University

The MSU Center for Ethics and Humanities in the Life Sciences is proud to announce its new name: Center for Bioethics and Social Justice. This name change as of April 1 reflects an updated mission with a focus on social justice-oriented bioethics. The Center has a vision of a health system that is compassionate, respectful, and responsive to people’s needs, so that equity, inclusion, and social justice are available to all.

Photo of Sean Valles
Director Sean A. Valles, PhD

“Without an orientation, bioethics has no built-in real-world goals; it is merely a field of study. Doing social justice-oriented bioethics means we have a goal—advancing social justice in the real world with meaningful applications—as the north star for our journey as an institution,” said Center Director Sean A. Valles, PhD.

The updated name and mission follow the appointment of Valles as director earlier this year, along with the promotion of Karen Kelly-Blake, PhD, to assistant director.

“One key piece of the new name and mission is a rethinking and a recommitting of our identity,” said Valles. “The Center aims to be a hub for collaborations and conversations around the relationship between social justice and health. To do that, we will actively seek to engage with our college and university colleagues, local communities, and organizations in order to learn their concerns about the ways our society makes it hard to live a healthy life, and to begin trying to help.”

Photo of Karen Kelly-Blake
Assistant Director Karen Kelly-Blake, PhD

The Center’s mission is to educate health professionals with skills, knowledge, and attitudes necessary to contribute to a world in which health practices are equitable, inclusive, and bolstered by conditions of social justice; to research the nature of bioethics and enhance its applications to the pursuit of equitable, inclusive, and just healthy societies; and to engage researchers, clinicians, policymakers, and communities around shared interests in the attainment of a healthier and more just world.

“Building bridges among MSU experts and outward to communities is of value to everyone involved,” added Valles.

The Center began in 1977 with the formation of the Medical Humanities Program. In 1988, the program became the Center for Ethics and Humanities in the Life Sciences. Faculty in the Center are committed to teaching medical students in the College of Human Medicine and developing social context of clinical decisions content for the Shared Discovery Curriculum. Center faculty are also committed to research, scholarship, and public outreach and education—all working toward the goal of creating a more just world.

Visit the Center’s website to learn more about its faculty and outreach activities, such as public seminars, podcast episodes, and monthly blog posts that explore timely bioethics topics.

Related: Announcing Center Director Sean A. Valles and Assistant Director Karen Kelly-Blake

Dr. Cabrera co-authors article on osteopathic medical student attitudes on neuroenhancement

Laura Cabrera photo

Authors Aakash A. Dave and Dr. Laura Cabrera, Assistant Professor in the Center for Ethics, have an article in the December issue of the Journal of Cognitive Enhancement. The article, “Osteopathic Medical Students’ Attitudes Towards Different Modalities of Neuroenhancement: a Pilot Study,” was available online first in January of this year.

Abstract: The advancement of society has coincided with the development and use of technologies intended to improve cognitive function, which are collectively known as neuroenhancers. While several studies have assessed public perception towards the moral acceptability of pharmacological and device-based cognitive enhancers, just a few have compared perceptions across different modalities of cognitive enhancers. In this pilot study, 154 osteopathic medical students were asked to read one of six possible vignettes describing a certain type of improvement—therapy or above the norm—brought about by using one of three modalities—neurodevice, pill, or herbal supplement. Subjects answered questions that were designed to reveal their attitudes towards the given scenario. Our participants suggested that improvement using neurodevices and herbal supplements is more acceptable than when pills are used. We also found that acceptable attitudes towards cognitive enhancement were subserved by reasons such as “positive outcome from use” and “it’s safe” and unacceptable attitudes by reasons such as “safety concerns” and “no need.” Furthermore, a majority of participants would prefer to consult with a physician regarding the use of cognitive enhancers prior to accessing them. These results provide novel insights into pressing neuroethical issues and warrant further studying.

The full text is available online via Springer Link (MSU Library or other institutional access may be required to view this article).

Dr. Cabrera presents at International Neuroscience Society annual meeting

Laura Cabrera photoLast month Center Assistant Professor Dr. Laura Cabrera presented at the International Neuroethics Society (INS) Annual Meeting in Chicago. The meeting theme, “Mapping Neuroethics: An Expanded Vision” resulted in a gathering of a truly diverse group of scholars, scientists, clinicians, and professionals dedicated to the responsible use of advances in brain science.

Dr. Cabrera participated in the panel “Incapable Patients and Psychiatric Neurosurgery: What do Law and Ethics Have to Say?”, discussing the regulatory and ethical landscape around psychiatric neurosurgery. Additionally, Dr. Cabrera had two posters discussing results from her NEURON collaboration with Dr. Judy Illes (University of British Columbia), and two posters discussing results from her NIH BRAIN Initiative grant on psychiatric electroceutical interventions. Undergraduate research assistants Emily Castillo and Marissa Cortright were there to present the posters discussing results from the developmental stage of the ongoing NIH BRAIN project. They are pictured below with the posters “Public Views About Treating Depression Across Four Treatment Modalities” and “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression.”

Marissa Cortright with poster at INS 2019
Marissa Cortright with the poster “Public Views About Treating Depression Across Four Treatment Modalities.” Photo courtesy of Emily Castillo.

Emily Castillo with poster at INS 2019
Emily Castillo with the poster “Perceived Invasiveness of Psychiatric Electroceutical Interventions as Treatment for Clinical Depression.” Photo courtesy of Emily Castillo.

Dr. Cabrera will help guide ethical development and use of electrical-based psychiatric treatments

Laura Cabrera photoA team led by Center Assistant Professor Dr. Laura Y. Cabrera will examine the ethical concerns, beliefs, and attitudes of psychiatrists, patients, and healthy members of the public, including caregivers, regarding the development and use of psychiatric electroceutical interventions (PEIs).

The U.S. National Institutes of Health BRAIN Initiative has awarded a four-year, $1,414,478 grant to the Michigan State University team, which also includes Professor Aaron M. McCright (Sociology), Associate Professor Robyn Bluhm (Philosophy and Lyman Briggs College) and Associate Professor Eric Achtyes (Director of the College of Human Medicine Division of Psychiatry and Behavioral Medicine).

Using electrical stimuli to treat psychiatric conditions, PEIs offer great promise in addressing the profound suffering related to such disorders. While PEIs have been available in various forms for years, divergent perceptions among medical professionals, patients, and the broader public have impeded their wider adoption in practice. Key stakeholders’ concerns, beliefs, and attitudes also might affect the future adoption of novel, more invasive PEIs. As new PEIs emerge in the neurotechnology landscape, it is urgent to understand such concerns and related social policy choices.

“This grant could not come at a better time, and we are grateful to the National Institutes of Health for recognizing the importance of this issue and supporting our proposal,” said Dr. Achtyes, who has seen firsthand the benefits of such treatments.

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Pictured left to right: Laura Cabrera, Aaron McCright, Eric Achtyes, Robyn Bluhm.

Dr. Cabrera, whose research focuses on neuroethics and is leading the effort as the Principal Investigator, said, “I am delighted for this exciting opportunity to lead our team of experts and work together towards the sustained ethical development and translation of this type of psychiatric treatment.”

The significance of this work lies in anticipating potential future policy challenges in ways that will both effectively safeguard sustained ethical PEI development and translation, and benefit individuals affected by mental health disorders.

“One strength of our project is that we have experts from philosophy, neuroethics, psychiatry, and sociology working closely together. So, the insights we generate will likely transcend typical disciplinary boundaries and hopefully will be more meaningful to key stakeholders,” said Dr. McCright.

Please visit the Center’s website for updates on this project.

Dr. Stahl presents at International Academy for Bioethical Inquiry

Devan Stahl photoOn July 16, Center Assistant Professor Dr. Devan Stahl presented “Ethics Beyond Autonomy: The Case of Snapchat Surgeons” at the International Academy for Bioethical Inquiry (IABI) Summer Symposium, held at Saint Louis University. Based on her recent publication in AMA Journal of Ethics, Dr. Stahl discussed the rise in vaginal cosmetic surgery performed on the social media platform Snapchat and its implications for our cultural conceptions of ‘normal genital appearance.’ Dr. Tobias Winright offered a response to the paper, which was then thoroughly discussed by the conference attendees.

Dr. Stahl presents at Interdisciplinary Forum on Humanities in the Health Sciences

Devan Stahl photoOn Friday, March 30, Center Assistant Professor Dr. Devan Stahl participated in an Interdisciplinary Forum on Humanities in the Health Sciences, presented by the Vice President for Research and Graduate Studies at Michigan State University.

The panel consisted of five presenters discussing their latest research: Drs. Elahe Crockett (Department of Medicine), Robert Root-Bernstein (Department of Physiology), Natalie Phillips (Department of English), William Hart-Davidson (Department of Writing, Rhetoric and American Cultures), and Dr. Stahl. Each presenter discussed bridges between arts and science, how essential synthesis and translation are to medical science, and the ambiguity inherent in art, communication, and medicine. Using resources from fine art, literature, and communication, each speaker showed how medicine can benefit from engagement with the humanities and vice versa. The event was well attended by faculty from all parts of the university who were eager to discuss how to engage in interdisciplinary work.

For more on Dr. Stahl’s work at the intersection of art and medicine, listen to Episode 7 of No Easy Answers in Bioethics, the Center’s monthly podcast.

Episode 6: Medical Workforce Diversity and the Professional Entry Tax

No Easy Answers in Bioethics logoEpisode 6 of No Easy Answers in Bioethics is now available! This episode features guests Libby Bogdan-Lovis, Assistant Director of the Center for Ethics and Humanities in the Life Sciences, and Dr. Karen Kelly-Blake, Assistant Professor in the Center for Ethics and the Department of Medicine at the Michigan State University College of Human Medicine. As leaders of a multi-institutional research team, they were interested in examining strategies and associated rationales for expanding underrepresented minority presence in U.S. undergraduate medical education. In this episode, they provide insight on what their scoping review has revealed, focusing on the notion that underrepresented minorities in medicine are often expected to pursue a service track—an expectation not placed on their white majority peers.

Ways to Listen

This episode was produced and edited by Liz McDaniel in the Center for Ethics. Music: “While We Walk (2004)” by Antony Raijekov via Free Music Archive, licensed under a Attribution-NonCommercial-ShareAlike License. Full transcript available.

About: No Easy Answers in Bioethics is a podcast series from the Center for Ethics and Humanities in the Life Sciences in the Michigan State University College of Human Medicine. Each month Center for Ethics faculty and their collaborators discuss their ongoing work and research across many areas of bioethics—clinical ethics, evidence-based medicine, health policy, medical education, neuroethics, shared decision-making, and more. Episodes are hosted by H-Net: Humanities and Social Sciences Online.

Ethics in Surgical Research and Publication

Marleen Eijkholt photoCenter Assistant Professor Dr. Marleen Eijkholt co-authored the chapter “Ethics in Surgical Research and Publication” in Ethical Issues in Surgical Care, a fall 2017 publication from the American College of Surgeons Division of Education. Dr. Eijkholt’s co-authors are Lance K. Stell, MA, PhD, FACFE, and Richard B. Reiling, MD, FACS.

Chapter summary: Surgical research is the foundation of evidence-based surgical practice. The question “what makes research ethical?” entails particular challenges for surgical research. For example, uncertainty and controversy exist in areas of research methodology, given the unique circumstances of each surgical intervention. Placebo control groups and randomization practices, too, raise major methodological issues in surgical research. This chapter discusses controversies in surgical research and publication thereof. The chapter follows the submission of a hypothetical research study through the institutional review board, to highlight areas of ethical controversy, and describe such issues too for the publication of such studies.

For more information on Ethical Issues in Surgical Care, please visit the American College of Surgeons website.