Center for Ethics and Humanities
in the Life Sciences

College of Human Medicine

 

 

Recorded Webinars

Mark Reimers photo

Prospects, Promises and Perils of Human Mind-Reading

In recent years, several research groups have been able to infer the contents of subjects' thoughts from fMRI scans. E-commerce sites are tracking customers' purchases and making ever better predictions about what people will buy. What are the prospects for such technology to be widely used? Are there fundamental technical limitations?
We may readily imagine dystopian scenarios for such technology, where privacy as we have known it is no longer meaningful, and the powerful monitor the thoughts of everyone else. We may also imagine that therapists could better communicate with autistic or troubled people, or to detect incipient mental illness.
Mark Reimers, PhD
Associate Professor, Neuroscience Program, College of Natural Science, Michigan State University
Recorded November 29, 2017

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Crossing the Biology to Pathobiology Threshold: Distinguishing Precision Health from Precision Medicine

Diseases have long been defined by their symptoms, and therefore patients have typically been treated when they are symptomatic. However, through advances in “omics,” wearable sensors, insertable microscopes, liquid biopsies, point-of-care pathology, and other innovations, it is possible to make a molecular diagnosis prior to apparent symptoms. These tools will enable a transition from Precision Medicine where the molecular etiology is determined after symptoms appear, to Precision Health in which the molecular etiology of diseases can be anticipated and symptoms averted. However, is it ethical to treat “asymptomatic disease” and at what cost to the healthcare system? What level of risk will be tolerated for interventions that are developed for treating “pre-diseased” patients? Since many of these assays will predict likelihood of disease and not absolute progression to disease, what level of certainty is needed to intervene at all? Medicine is being redefined and we are behind in understanding what is meant by the simple terms health and disease.
Christopher H. Contag, PhD
John A. Hannah Distinguished Professor of Biomedical Engineering and Microbiology & Molecular Genetics; Chair, Department of Biomedical Engineering; Director, Institute for Quantitative Health Science and Engineering, Michigan State University
Recorded October 11, 2017

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Social Determinants of Behavioral Health

It is well established that place matters with respect to health and health outcomes. In behavioral health studies of violence, alcohol and other drug use, and mental health, there is growing evidence that environmental risk and social determinants are strong predictors of behavior in highly disordered environments. In fact, they may be more salient predictors of high-risk behavior than individual-level risk factors. The field of health equity research studies the context where people live, work, and play – i.e., where they experience health. Health equity research examines how the environment shapes and influences opportunities for optimal/sub-optimal health and considers related structural and policy interventions to address both built and social environments. Dr. Furr-Holden provides examples of innovative environmental assessment methods that offer policy-relevant approaches to address the environment and environmental risk. In particular, highlighting policy-based research and implementation efforts in Flint, Michigan and the larger Michigan Department of Health and Human Services Region 5. Such action-oriented research builds on advancements in the field of geographic information systems and offers promising research, service, and advocacy integration in health equity and behavioral health promotion.
C. Debra Furr-Holden, PhD, is a C.S. Mott Endowed Professor of Public Health, Division of Public Health; Professor, Department of Epidemiology and Biostatistics; Director, Flint Center for Health Equity Solutions; MSU co-Director, Healthy Flint Research Coordinating Center, Michigan State University College of Human Medicine.
Recorded April 19, 2017



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Expanded Carrier Screening for an Increasingly Diverse Population: Embracing the Promise of the Future or Ignoring the Sins of the Past?

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.
Kayte Spector-Bagdady, JD, M.Bioethics
Assistant Professor, Department of Obstetrics & Gynecology, Chief, Research Ethics Service, Center for Bioethics & Social Sciences in Medicine, University of Michigan Medical School
Recorded September 13, 2017

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The Choice to Become a Research Subject: A First-Person Perspective

Patients with serious illnesses are often invited to participate in clinical trials. After being diagnosed with advanced cancer, I became one of those patients. I had to choose between two options: a treatment regimen my doctors had recommended, or a trial evaluating different treatments for my disease. As someone who had taught and written about research ethics, and a long-time member of an Institutional Review Board, I was in some ways better prepared than many patients are to make this choice. And I knew about the important health benefits that come from research, as well as the arguments that patients have a duty to participate in research. Nevertheless, I decided not to enroll in the trial. Was this a defensible choice, or did I have a responsibility to contribute to a study that could help future patients in my situation?
Rebecca Dresser, JD, is a Professor of Law at Washington University in St. Louis.
Recorded March 22, 2017



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