Center for Ethics and Humanities
in the Life Sciences

College of Human Medicine

 

 

Recorded Webinars

Debra Furr-Holden photo

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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Rebecca Dresser photo

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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Karen Kelly-Blake photo Libby Bogdan-Lovis photo

Covert Costs of Racial and Ethnic Concordance in the Medical Workforce

Over the past century US medical workforce demographics have shifted. Moving away from a white male dominated profession, there is a welcomed push towards increasing gender, ethnic, racial and linguistic representation. Commonly, that push is linked to notions of desirable doctor/patient identity matching - described here as “concordance.” That demographic shift is accompanied by policy initiatives and rhetoric shaping the professional futures of Native American, African American, and Latino underrepresented minority (URM) physicians. Do these policy initiatives carry social costs that inadvertently influence URM’s futures in the medical workforce? This analysis considers the nature of medical workforce policy strategies. Findings suggest that selectively placing service expectations not similarly placed on their non-minority physician colleagues along with unexamined assumptions of racial/ethnic concordance between patient and physician may place an undue burden on URMs.
Karen Kelly-Blake, PhD, is an Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Medicine; Libby Bogdan-Lovis, MA, is the Assistant Director for the Center for Ethics and Humanities in the Life Sciences in the College of Human Medicine at Michigan State University. Bogdan-Lovis and Kelly-Blake are co-leading a multi-institutional research project on Doctor-patient Race/Ethnic Concordance in the Medical Workforce. They are interested in unpacking the complexities surrounding underrepresented minority service to the underserved and how that service may distract those physicians from pursuing other medical professional opportunities.
Recorded January 18, 2017



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Laura Cabrera photo

Recurrent and Neglected Ethical Issues in the Psychiatric Brain Stimulation Discussion

What are key ethical concerns surrounding the use of psychiatric deep brain stimulation (DBS)? Are those concerns shared broadly for all aspects of DBS or alternatively are they specific to the intended targeted use of that intervention? Dr. Cabrera discusses results from a recent study conducted by a multidisciplinary research team in which they examined ethical issues discussed in both the scientific and ethics literature around psychiatric DBS. Dr. Cabrera makes the case that understanding the ethics of DBS for psychiatric interventions provides important insight into the way in which ethical concerns for a single technology might vary depending on their intended use.
Laura Y. Cabrera, PhD, is an Assistant Professor of Neuroethics in the Center for Ethics and Humanities in the Life Sciences and the Department of Translational Science & Molecular Medicine in the Michigan State University College of Human Medicine.
Recorded February 15, 2017



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Trust and the Learning Health System

Data sharing on a large scale is integral to emerging national initiatives such as learning health systems and precision medicine. Realizing the vision of learning health systems, “in which knowledge generation is so embedded into the core of the practice of medicine that it is a natural outgrowth and product of the healthcare delivery process and leads to continual improvement in care” requires a “trust fabric” to integrate policy and practice in health care, public health, and research. However, as increased data sharing stretches the currently disjointed regulatory and policy environment, the texture and resilience of this trust fabric will be challenged in its capacity to protect the public and its vulnerable populations, and to assure data will be used in ways that reflect societal values. What will it take to trust the health system with all that information? This presentation examines these tensions and dynamics. Based on preliminary data from the clinic and the community, Dr. Platt discusses a proposed a framework for trust to guide decision-making for local, state, and national learning health systems.
Jodyn Platt, MPH, PhD, is an Assistant Professor in the Division of Learning and Knowledge Systems in the Department of Learning Health Sciences at the University of Michigan Medical School.
Recorded November 9, 2016



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