Dr. Kelly-Blake a co-author of shared decision-making article in ‘American Journal of Preventive Medicine’

Kelly-blakeCenter Associate Professor Dr. Karen Kelly-Blake is co-author of a research article in the July 2019 issue of the American Journal of Preventive Medicine. The multi-institution research team includes lead author Dr. Masahito Jimbo of the University of Michigan.

“Interactivity in a Decision Aid: Findings From a Decision Aid to Technologically Enhance Shared Decision Making RCT” reports on a study that used a randomized control trial to compare the effect of a web-based decision aid that addressed colorectal cancer screening. They concluded that the interactive decision aid did not improve the outcome compared to the non-interactive decision aid.

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

Bioethics for Breakfast: Medicaid Work Requirements: Blood, Sweat and Tears Too?

Bioethics for Breakfast Seminars in Medicine, Law and SocietyAdrianne Haggins, MD, presented at the Bioethics for Breakfast event on February 8, 2018, offering perspective and insight on the topic, “Medicaid Work Requirements: Blood, Sweat and Tears Too?” Leonard Fleck, PhD, moderated this session.

The Trump administration has proposed giving states permission to attach work requirements for Medicaid eligibility. So far, ten states are seeking that permission. Is this a good idea, either from an ethical perspective or a policy perspective? Our speaker, Dr. Adrianne Haggins, is part of a research team at the University of Michigan that evaluated the impact of Michigan’s Medical expansion on employment—as reported in JAMA Internal Medicine (Dec. 11, 2017)—as well as health, and healthcare utilization.

A researcher at Kaiser Health News has added, “States will have to figure out how to define the work requirement and alternative options, such as going to school or volunteering in some organizations; how to enforce the new rules; how to pay for new administrative costs; and how to handle the millions of enrollees likely to seek exemptions.” Dr. Haggins also discussed some of her own research regarding health disparities and emergency department utilization.

Audience participants questioned such things as the administrative costs associated with implementation as well as the value and accuracy of labeling individuals as able-bodied with its attendant underlying stigma of deserving/undeserving of medical care. It was noted that much of the national conversation is linked to racialized assumptions that those utilizing Medicaid benefits are largely persons of color. Finally, many audience members argued the point that all people unconditionally deserve access to health care and some observed how that point too often gets lost in the semantics.

Related Reading:

Adrianne Haggins, MD
Adrianne Haggins is a clinical assistant professor in emergency medicine at the University of Michigan Medical School, and alumnus of the MSU College of Human Medicine class of 2007. She is a member of a research team at the University of Michigan evaluating the impact of Michigan’s Medicaid expansion, the Healthy Michigan Plan, using a mixed-methods approach. This evaluation provides rich data on enrollee and health care provider experiences with the Michigan Medicaid program, as well as health care utilization. Dr. Haggins’ specific interests are related to examining the impact of health care reform on emergency department utilization.

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.

How do we explain to patients what genetic test results might mean for their baby when they have only been validated in other populations?

Bioethics Brownbag & Webinar Series logoExpanded Carrier Screening for an Increasingly Diverse Population: Embracing the Promise of the Future or Ignoring the Sins of the Past?

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Race and ethnic groups have been tracking heritable conditions endemic within their communities for decades, but past public health screening programs—e.g., sickle cell testing for African Americans 1970s—were adopted with little thought to scientific accuracy or potential discrimination. Currently, carrier genetic testing is generally offered under professional guidelines aiming to balance potentially clinically actionable information with concerns about healthcare costs and patient anxiety: recommended testing on the basis of family history, self-reported race or ethnicity, or for a condition deemed worthy of universal screening. But some private companies have begun to offer expanded carrier screening, testing all conditions for all patients. Scientists at one such company reported in 2016 in JAMA that expanded carrier screening might increase detection of potentially serious genetic conditions. But what are the implications of returning ancestry information when patients seek medical advice? How do we explain to patients what results might mean for their baby when they have only been validated in other populations? This talk will explore policy options at the intersection of race, reproduction, and commercial use of data.

sept-13-bbagJoin us for Kayte Spector-Bagdady’s lecture on Wednesday, September 13, 2017 from noon till 1 pm in person or online.

Kayte Spector-Bagdady, JD, MBioethics, is a Research Investigator in the Department of Obstetrics and Gynecology at the University of Michigan Medical School and also leads the Research Ethics Service in the Center for Bioethics and Social Sciences in Medicine (CBSSM). Her current research explores informed consent to emerging technologies with a focus on reproduction and genetics. Kayte received her J.D. and M.Bioethics from the University of Pennsylvania Law School and School of Medicine respectively after graduating from Middlebury College. She is a former drug and device attorney and Associate Director of President Obama’s Bioethics Commission.

In person: This lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. 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!

Can’t make it? All webinars are recorded! Visit our archive of recorded lecturesTo receive reminders before each webinar, please subscribe to our mailing list.

Announcing the Fall 2017 Bioethics Brownbag & Webinar Series

bbag-icon-decThe Center for Ethics and Humanities in the Life Sciences at Michigan State University is proud to announce the 2017-2018 Bioethics Brownbag & Webinar Series, featuring a wide variety of bioethics topics. The fall series will begin on September 13, 2017. You are invited to join us in person or watch live online from anywhere in the world! Information about the fall series is listed below. Please visit our website for more details, including the full description and speaker bio for each event.

Fall 2017 Series Flyer

sept-13-bbagExpanded Carrier Screening for an Increasingly Diverse Population: Embracing the Promise of the Future or Ignoring the Sins of the Past?
How do we explain to patients what results might mean for their baby when they have only been validated in other populations?
Wednesday, September 13, 2017
Kayte Spector-Bagdady, JD, MBioethics, is a Research Investigator in the Department of Obstetrics & Gynecology and leads the Research Ethics Service at the Center for Bioethics & Social Sciences in Medicine at the University of Michigan Medical School.

oct-11-bbagCrossing the Biology to Pathobiology Threshold: Distinguishing Precision Health from Precision Medicine
What level of risk will be tolerated for interventions that are developed for treating “pre-diseased” patients?
Wednesday, October 11, 2017
Christopher H. Contag, PhD, is a John A. Hannah Distinguished Professor of Biomedical Engineering and Microbiology & Molecular Genetics, Chair of the Department of Biomedical Engineering, and Director of the Institute for Quantitative Health Science and Engineering at Michigan State University.

nov-29-bbagProspects, Promises and Perils of Human Mind-Reading
What are the prospects for such technology to be widely used?
Wednesday, November 29, 2017
Mark Reimers, PhD, is an Associate Professor in the Neuroscience Program in the College of Natural Science at Michigan State University.

In person: These lectures will take place in C102 (Patenge Room) East Fee Hall on MSU’s East Lansing campus. 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!

Can’t make it? Every lecture is recorded and posted for viewing in our archive. If you’d like to receive a reminder before each lecture, please subscribe to our mailing list.

Dr. Stahl presents at CBSSM Research Colloquium

Stahl headshotThe Center for Bioethics and Social Sciences in Medicine (CBSSM) at University of Michigan held its 5th annual Research Colloquium on April 27, 2016. Assistant Professor Dr. Devan Stahl attended and presented on the patients’ right not to know their prognosis, and topic that generated much conversation among the participants both during and after the presentation.

The colloquium brought together scholars working in a variety of areas of bioethics. Presentations included topics such as clinical ethics consultation,  medical insurance, VIP patients, breastfeeding, gene sequencing and community engagement in research. Overall, it was a very engaged group who had much to offer one another on a variety of interesting topics.

Abstract: There is a widespread presumption within medicine that terminally ill patients have a “right not to know” their prognosis. Guidelines for giving bad news (SPIKES; ABCDE) all require that the patient be asked first. There may be a dark side to this practice, however: terminally ill patients’ ignorance or denial of their prognosis too often lasts to the very end, one important factor discouraging timely referral and use of palliative and hospice care. Because of a possible link between a right not to know one’s prognosis and the aggressive treatment that patients with advanced illness too often receive at the end of life, the claim that there is a right not to know needs much more serious examination than it has received.

The authors argue that patients with advanced illness do not have a right not to know their prognosis. Withholding prognostic information in deference to a right not to know impedes patients’ capacity to make informed autonomous decisions about their treatment, encourages denial, and increases the likelihood of poor end of life care.

Re-envisioning shared decision making in primary care

bbag-icon-decRe-envisioning shared decision making in primary care

Event Flyer

Shared decision making is increasingly advocated as the best approach to patient care for many if not most medical decisions. Yet, actually implementing shared decision making in the primary care setting has remained vexingly elusive. This talk will explore the following questions: Can shared decision making include a primary care provider’s recommendation? If so, how can care recommendations be tailored to be more patient-centered?

apr-13-bbag.jpgJoin us for Tanner Caverly’s lecture on Wednesday, April 13, 2016 from noon till 1 pm in person or online.

Tanner Caverly, MD, MPH, is a general internist and health services researcher at the University of Michigan and Ann Arbor VA Center for Clinical Management Research. In 2012 Dr. Caverly co-founded the Do No Harm Project – an award-winning program that uses clinical vignettes written by clinical trainees to improve recognition of the harms that can result from medical overuse. His research explores the general question: How can population evidence and clinical practice guidelines be better translated for and communicated to patients? In both his teaching and research, Dr. Caverly strives to promote the vision set out by Dr. Bernard Lown to do “as much as possible for the patient and as little as possible to the patient.”

In person: This lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. 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!

Can’t make it? All webinars are recorded! View our archive of recorded lectures.

How do health care providers understand the social basis of conscience?

bbag-icon-decWhat people mean when they say “I can’t do that, it violates my conscience”

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“Conscience clause” legislation, first enacted following Roe v. Wade, intends to protect a health care provider’s (HCP) right to refuse services on the basis of conscience. And yet, 40 years later, the precise meaning of conscience is not well understood. When conscience is defined, it is in abstract, theoretical terms that are removed from the meaning of conscience in day-to-day practice. We use a sociological perspective to challenge this asocial depiction: while individuals act on their consciences, one’s conscience has a social basis. Using interviews with 61 care providers we identify the social basis of conscience and how health care providers understand it in their everyday practice, examining the conditions under which conscience is invoked in the process of deciding whether or not to perform a medical procedure. University of Michigan “conscience” research team collaborators: Lisa Harris, MD, PhD; Danielle Czarnecki, MA; Mercedes Dunn, BA; Katie Hauschildt, BA; Renee Anspach, PhD.

apr-15-bbagJoin us for Raymond De Vries’ lecture on Wednesday, April 15, 2015 from noon till 1 pm in person or online.

Raymond G. De Vries, PhD, is Professor and co-Director in the Center for Bioethics and Social Sciences in Medicine (cbssm.org) at the University of Michigan. He is the author of A Pleasing Birth: Midwifery and Maternity Care in the Netherlands (Temple University Press, 2005), and co-editor of The View from Here: Bioethics and the Social Sciences (Blackwell, 2007) and Qualitative Methods in Health Research (Sage, 2010). Dr. De Vries is co-editor of a special issue of Social Science and Medicine that examines how bioethics is shaped by social and cultural forces, and, together with Libby Bogdan-Lovis and Charlotte De Vries, co-edited a special issue of the Journal of Clinical Ethics on the ethics of choice of place of birth.

In person: This lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. 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!

Can’t make it? All webinars are recorded! View our archive of recorded lectures (over 30 lectures and counting!).

Moral Concerns and the Willingness to Donate to a Research Biobank

tomlinsonA new study led by Center Director Dr. Tomlinson was published this week in The Journal of the American Medical Association, surveying concerns people may have about donating to a research biobank. You can hear more about the research from Dr. Tomlinson in a feature that appeared in MSU Today: “What’s Happening With Your Donated Specimen?.”

“Moral Concerns and the Willingness to Donate to a Research Biobank” by Tom Tomlinson, PhD; Raymond De Vries, PhD; Kerry Ryan, MA; Hyungjin Myra Kim, ScD; Nicole Lehpamer, MA; Scott Y. H. Kim, MD, PhD.

Watch every lecture from the 2013-2014 Bioethics Brownbag & Webinar Series

Largent-slideReye’s Syndrome: A Medical Mystery and a Modern Dilemma
This talk from Mark A. Largent, PhD, examines the history of Reye’s syndrome, the hunt to uncover its cause, and the debates that have emerged over last twenty years about the role of aspirin in Reye’s syndrome. View Webinar

Bosk-slideMedical Sociology as Vocation
This presentation from Charles L. Bosk, PhD, discusses what it means to speak of ‘medical sociology as a vocation,’ using Weber’s classic essay ‘Science as a Vocation’ as its departure point. View Webinar

 

Fisch-slideThe Declining Provider: Refusal, Responsibility, and Reasonableness
This presentation from Deborah Fisch, JD, examines how we arrived at our current VBAC position, its implications for maternal and child health, and the connection to other instances of declining providers. View Webinar

Loup-slideAre Researchers Ever Obligated to Provide Individual Research Findings to Non-participant Third Parties?
This presentation from Allan Loup, JD, addresses an emerging consensus that, in some circumstances, researchers have obligations to return individual research results to research participants. View Webinar

Normandin-slide

“Enlightened” Breath: Breathing and Biomedicine
While much is known of the physiological importance of breathing in biomedicine, there is almost no appreciation of its possible therapeutic role. This presentation from Sebastian Normandin, PhD, argues for a new era – an age of enlightenment – in the use of breath and breathing as a healing tool. View Webinar

Vercler-slidePlastic Surgery Ethics: An Oxymoron?
In this lecture, Dr. Christian J. Vercler examines the distinctions made between cosmetic and reconstructive surgery, discusses how plastic surgeons think about those distinctions, and uncovers the different ethical frameworks that support these practices. View Webinar

 

Click here to watch more lectures dating back to 2010, and save the date for the first webinar of the 2014-2015 Series: September 17, 2014.

Learn the reality of ethics in plastic surgery — it’s not what you see on TV

bbag-iconPlastic Surgery Ethics: An Oxymoron?

Event flyer: Vercler Flyer

Most plastic surgeons portrayed in the media exhibit questionable moral judgment. After watching shows such as Nip/Tuck, Extreme Makeover, Dr. 90210, and The Swan, one could easily conclude that ethics plays no part in the practice of plastic surgery. Indeed, some have charged cosmetic surgery with being entirely outside the scope of medical practice. Dr. Vercler will examine the distinctions made between cosmetic and reconstructive surgery, discuss how plastic surgeons think about those distinctions, and uncover the different ethical frameworks that support these practices.

apr-23-bbagJoin us for Christian J. Vercler’s lecture on Wednesday, April 23, 2014 from noon till 1 pm in person or online:

In person: The lecture will take place in C102 East Fee Hall on MSU’s East Lansing campus. 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!

Can’t make it? View this webinar and others as archived recordings.

Christian J. Vercler, MD, is Clinical Assistant Professor in the Division of Craniofacial Surgery in the Section of Plastic and Reconstructive Surgery at the University of Michigan. He serves on the faculty of the Center for Bioethics and Social Sciences at the University of Michigan. He completed a Fellowship in Clinical Ethics at the Emory University Center for Ethics and also has an MA in Bioethics. He has served on ethics committees since 1998, and has taught medical ethics to residents and medical students at Emory University, Harvard, and the University of Michigan. Dr. Vercler graduated from Wheaton College with a BS in Biology and an MA in Theological Studies. He went to medical school at the University of Illinois. He completed general surgery training at Emory University and plastic surgery at Harvard. He then did an additional fellowship in Craniofacial Surgery at the University of Michigan.