Center for Ethics and Humanities
in the Life Sciences

College of Human Medicine

 

 

2017-2018 Bioethics Brownbag & Webinar Series

Sept 13 calendar icon

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

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

September 13, 2017
12 - 1 pm; C102 Patenge Room, East Fee Hall

Blog Post
Event Flyer
Watch Recorded Webinar

Abstract
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.

Bio
Kayte Spector-Bagdady is an Assistant Professor in the Department of Obstetrics and Gynecology at the University of Michigan Medical School and is also Chief of 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.

 

Oct 11 calendar icon

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

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

October 11, 2017
12 - 1 pm; C102 Patenge Room, East Fee Hall

Event Flyer
Webinar Instructions

Abstract
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.

Bio
Dr. Contag is the chair of the inaugural Department of Biomedical Engineering and founding Director of the Institute for Quantitative Health Science and Engineering at Michigan State University. Dr. Contag is also Professor emeritus in the Department of Pediatrics at Stanford University. Dr. Contag received his B.S. in Biology from the University of Minnesota, St. Paul in 1982. He received his Ph.D. in Microbiology from the University of Minnesota, Minneapolis in 1988. He did his postdoctoral training at Stanford University from 1990-1994, and then joined Stanford faculty in 1995 where he was professor in the Departments of Pediatrics, Radiology, Bioengineering and Microbiology & Immunology until 2016. Dr. Contag is a pioneer in the field of molecular imaging and is developing imaging approaches aimed at revealing molecular processes in living subjects, including humans, and advancing therapeutic strategies through imaging. He is a founding member and past president of the Society for Molecular Imaging (SMI), and recipient of the Achievement Award from the SMI and the Britton Chance Award from SPIE for his fundamental contributions to optics. Dr. Contag is a Fellow of the World Molecular Imaging Society (WMIS) and the recent past President of WMIS. Dr. Contag was a founder of Xenogen Corp. (now part of PerkinElmer) established to commercialize innovative imaging tools for biomedicine. He is also a founder of BioEclipse—a cancer therapy company, and PixelGear—a point-of-care pathology company.

 

Nov 29 calendar icon

Prospects, Promises and Perils of Human Mind-Reading

Mark Reimers, PhD
Associate Professor
Neuroscience Program
College of Natural Science
Michigan State University

November 29, 2017
12 - 1 pm; C102 Patenge Room, East Fee Hall

Event Flyer
Webinar Instructions

Abstract
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.

Bio
Dr. Reimers' research focuses on analyzing and interpreting the very large data sets now being generated in neuroscience, especially from the high-throughput technologies developed by the BRAIN initiative. He obtained his MSc in scientific computing, and his PhD in probability theory from the University of British Columbia in Canada. He has worked at Memorial University in Canada, the Karolinska Institute in Stockholm, at several start-up companies in Toronto and in Boston, at the National Institutes of Health in Maryland, the Virginia Institute for Psychiatric and Behavioral Genetics in Richmond, and since January 2015 in the Neuroscience Program at Michigan State University.

 

Feb 14 calendar icon

Details TBA

February 14, 2018
12 - 1 pm; C102 Patenge Room, East Fee Hall

 

March 14 calendar icon

Pain But No Gain: Pain as a Problematic and Useless Concept?

Marleen Eijkholt, JD, PhD
Assistant Professor
Center for Ethics and Humanities in the Life Sciences
Department of Obstetrics, Gynecology and Reproductive Biology
Michigan State University College of Human Medicine
Clinical Ethics Consultant
Spectrum Health System

March 14, 2018
12 - 1 pm; C102 Patenge Room, East Fee Hall

Event Flyer
Webinar Instructions

Abstract
References to the human experience of “pain” are common, but those references are often ambiguous and vague. Such ambiguity creates conceptual and practical challenges, especially in the work of clinical ethics consultation. Conceptual challenges arise, for example, from the distinction between pain and suffering. Practical challenges arise from tensions between objective and subjective components of pain, and clinical ethical challenges arise in cases like Charlie Gard’s. Here, on the one hand, the court argued that Charlie was in such extreme pain and suffering, he should be allowed to die. Alternatively, others stated that we could not truly know about the experience of his pain, and that treatment therefore should be made available. While pain is a relevant clinical problem, it is also a social construct shaped by culture, environment and gender. These distinctions however get lost in a simple “pain” reference. With several clinical ethics scenarios, Dr. Eijkholt will ask if references to pain help us with anything, or if we should perhaps abandon pain as a “useless concept.”

Bio
Marleen Eijkholt focuses on a wide range of Ethical, Legal and Social Implications (ELSI) in health care ethics, including neurotechnology, reproductive medicine, clinical medicine and clinical research. Her work is eclectic like her background, including projects on pain, placebos, and reproductive rights, or deep brain stimulation, and experimental treatments like stem cells. She combines ethical, legal and philosophical theories in her research and scholarship. Additionally, she engages these in her professional life as an ethics consultant at Spectrum Health System. Marleen also contributes her expertise to the College of Human Medicine’s Shared Discovery Curriculum.

 

April 11 calendar icon

Ethical Issues Related to Fundraising from Grateful Patients

Reshma Jagsi, MD, DPhil
Professor and Deputy Chair, Department of Radiation Oncology
Director, Center for Bioethics and Social Sciences in Medicine
University of Michigan Medical School

April 11, 2018
12 - 1 pm; C102 Patenge Room, East Fee Hall

Event Flyer
Webinar Instructions

Abstract
Health care institutions are becoming increasingly deliberate about philanthropic fundraising given the need to sustain their missions in the face of decreases in governmental research funds and lowering reimbursement for clinical care. Donations from grateful patients constitute 20% of all philanthropic contributions to academic medical centers, totaling nearly $1 billion a year in recent years. Institutions frequently employ development professionals to facilitate philanthropy. The development literature describes various approaches for identifying patients capable of contributing, cultivating potential donors, and engaging physicians in the solicitation of grateful patients, emphasizing that patients themselves may also benefit from exercising altruism in this way. However, little evidence exists to guide the ethical practice of grateful patient fundraising, and concerns exist regarding privacy and confidentiality, patient vulnerability, and physicians' conflicts of obligations in this context. Therefore, we will discuss how the process of philanthropic development should be structured in order to demonstrate respect for all persons involved, including patients who donate, those who might consider donation, those who do not wish to donate, and those who cannot afford to do so.

Bio
Reshma Jagsi, MD, DPhil, is Professor and Deputy Chair in the Department of Radiation Oncology and Director of the Center for Bioethics and Social Sciences in Medicine at the University of Michigan. She graduated first in her class from Harvard College and then pursued her medical training at Harvard Medical School. She also served as a fellow in the Center for Ethics at Harvard University and completed her doctorate in Social Policy at Oxford University as a Marshall Scholar. Dr. Jagsi’s medical research focuses on improving the quality of care received by breast cancer patients, both by advancing the ways in which breast cancer is treated with radiation and by advancing the understanding of patient decision-making, cost, and access to appropriate care. Her social scientific research includes research into issues of bioethics arising from cancer care and research regarding faculty development and gender issues, including studies of women's representation in the medical profession. Dr. Jagsi is the author of over 200 publications in peer-reviewed journals, including The New England Journal of Medicine and JAMA. Her research has been funded by the National Institutes of Health through multiple R01 awards, as well as by numerous philanthropic foundations, including the American Cancer Society, the Robert Wood Johnson Foundation, and the Doris Duke Foundation. She has been elected to the Board of Directors of the American Society of Clinical Oncology (ASCO), for which she formerly served as Ethics Committee Chair, and the Steering Committee of the Group on Women in Medicine and Science of the American Association of Medical Colleges (AAMC). In recognition of her research contributions, she was inducted into the American Society of Clinical Investigation.