Fall 2002 Brown Bag Series

Tuesday, September 10, 2002 --- Alice Domurat Dreger, Ph.D.
Why Not Use Medicine to Solve Social Problems?

When a child is born with an unusual anatomy such as ambiguous genitalia or conjoinment ("Siamese twinning"), or when an adult has a socially challenging medical condition like cancer, often medicine is offered as a means to solving the social problems that arise because of the condition. Indeed, often medicine is seen as the only appropriate response to the social challenges raised by unusual or pathological anatomies. In this lecture, I use two perspectives-that of a historian of medicine as well as that of a disability rights activist-to explore the benefits of and problems with using medicine to "solve" social concerns. I argue that medicine perhaps should be used to address the social distress that arises from anatomical concerns, but that the current medical approach is not as ambitious as it ought to be.

Alice Domurat Dreger is a historian of anatomy at Michigan State University, in East Lansing, Michigan, where she holds the titles of Associate Professor of Science and Technology Studies and Associate Faculty in the Center for Ethics and Humanities in the Life Sciences. She is also Chair of the Board of Directors of the Intersex Society of North America, a non-profit advocacy and policy organization. Her research and outreach focus on the biomedical and social treatment of people born with unusual anatomies. Her books include Hermaphrodites and the Medical Invention of Sex (Harvard University Press, 1998), Intersex in the Age of Ethics (University Publishing Group, 1999) and One of Us: How Conjoined Twins Unite Us All (Harvard University Press, forthcoming in 2003). Dr. Dreger's essays on the human origins and impacts of science have appeared in the New York Times.

Wednesday, October 9, 2002 -- Fred Gifford, Ph.D.
Ethics and History of Development and Health Care in Costa Rica

For the past two summers, the philosophy department at MSU has hosted a study abroad program examining the Costa Rican health care system within the context of public health issues, the environment and development.  Costa Rica, though it has limited resources, boasts a system of near universal health care coverage for its population.  It also can claim infant mortality and life expectancy figures equivalent to those of the developed world.  Despite these impressive figures there remain grave policy challenges arising from long waiting lists, bureaucratic inefficiencies, and complicated interactions between the public and private health care sectors. In this talk I will give an overview of ethical and policy dilemmas that arise in this context.

Fred Gifford is Professor in the Department of Philosophy at Michigan State University and is Associate Faculty in the Center for Ethics and Humanities in the Life Sciences. His research and teaching interests include philosophy of medicine and biology, in addition to health care ethics.  He has taught in the London study abroad program, "Medical Ethics and History of Health Care in London" four times, and he taught the first two offerings (summers 2001 and 2002) of "Ethics and History of Development and Health Care in Costa Rica."

Wednesday, November 6, 2002  -- Harry Perlstadt, Ph.D., M.P.H.
A Researcher's Bill of Rights

Over the past decade Office of Human Research Protections in the US Department of Health and Human Services (OHRP-DHHS) and Institutional Review Boards (IRBs) have tipped the balance between their administrative definitions of what is required to protect human subjects and the academic freedom of researchers in favor of their administrative powers. Given the diversity and multiplicity of universities in the U.S., it is inevitable that, without strong protections, some IRBs will use "the interest of research subjects" as a guise for restricting research that is not injurious to subjects but that is threatening to some University social and political constituencies or increases the University's legal liabilities. In addition to whatever conflicts of interest may exist for researchers vis-a-vis research subjects, the conflicts of interest that exist for IRBs by virtue of their institutional location must be taken into account.The proper framework for thinking about these issues is not the simple triad of researcher, research subject, and IRB but the five party framework that adds the university's various institutional interests and the American constitutional tradition to the mix. This can be explored through a Researcher's Bill of Rights that calls for fair and uniform procedures and due process in the review of applications, consistent interpretations and enforcement of the federal regulations, and an appeal to a neutral third party.

Harry Perlstadt is Professor in the Department of Sociology and the Institute for Public Policy and Social Research at Michigan State University.   He has conducted evaluation research on community based health programs locally, nationally and internationally and thereby became familiar with various aspects of human research protection protocols.  He is chair of the Science Board of the American Public Health Association.He teaches sociology of health care systems which is an option within the Interdisciplinary Program in Health and Humanities and social epidemiology.Dr. Perlstadt earned his Ph.D. in sociology at the University of Chicago and his M.P.H. in health planning and administration from the University of Michigan.

This activity has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Michigan State University, College of Human Medicine and the Center for Ethics and Humanities in the Life Sciences. The Michigan State University College of Human Medicine is accredited by the ACCME to provide continuing medical education for physicians.

Michigan State University College of Human Medicine, designates this educational activity for a maximum of 1 hour in category 1 credit per session towards the AMA Physician's Recognition Award.  Each physician should claim only those hours of credit that he/she actually spent in the activity.

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