Center for Ethics and Humanities
in the Life Sciences

College of Human Medicine

 

 

Recorded Webinars

Spector Bagdady photo

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

To turn on closed captions for this video, click the CC icon in the video player and select English.

 

Watch on MSU MediaSpace

Back to List

 

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



Watch on MSU MediaSpace

Back to List

 

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



To turn on closed captions for this video, click the CC icon in the video player and select English.

 

Watch on MSU MediaSpace

Back to List

 

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



To turn on closed captions for this video, click the CC icon in the video player and select English.

 

Watch on MSU MediaSpace

Back to List

 

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



Watch on MSU MediaSpace

Back to List