Fall 2005 Brown Bag Series

Thursday, September 15, 2005 -- Hasan Shanawani
The Use of Race in Genomics Studies: It's Not so Black or White

This talk represents preliminary research on how investigators conceptualize race and ethnicity and the incentives to use race in research without consideration of the social effects of published investigations. The use of race as an independent variable in medical research is complicated by inconsistent definitions of race and ethnicity. Genomics studies of complex diseases have brought to the forefront the complexities and ambiguities of group labels in biomedical research. As we continue to use terms of race and ethnicity arbitrarily to define social cohorts in genetics studies, questions of the relationship between race, genes, and population health are becoming harder to characterize, more complex to study, and increasingly controversial. This is especially the case in the study of diseases where social causes of health disparities are known to exist. At the end of this lecture, the participant should be able to:

Hasan Shanawani, MD, MPH, is a research fellow and lecturer at the University of Michigan School of Medicine since July 2005. He just completed a clinical fellowship in pulmonary and critical care medicine, where he was also an ethics and policy fellow at the Duke Institute for Genome Sciences and Policy. He is currently researching ethics and policy issues related to the use of race in genomics of asthma and in the use of race as a clinical variable by physicians.

Thursday, October 6, 2005 -- Paul Ndebele
The Problem of “False Confidence” in Microbicide Trials in Zimbabwe and Lessons Learned from Microbicide Trials Elsewhere

The problem of “false confidence” has been shown to be very serious in microbicide trials and it threatens to minimize the advancements that have been achieved in microbicide and HIV vaccine research. The phenomenon of “false confidence” which is similar to the problem of “therapeutic misconception” may lead to an increase in risky behaviors among microbicide trial participants as they feel that they are protected from HIV infection by the product that is being studied. Trial participants may even reduce or fail to take actions aimed at protecting themselves against HIV infection. In this session, the presenter will highlight some of the ways that are currently being considered to minimize the problem of “false confidence” among microbicide trial participants in Zimbabwe. The strategy focuses on trial participants’ comprehension and internalization of important trial procedures as a way of creating an awareness among trial participants of the fact that they are participating in a trial of a product whose efficacy is yet to be proven through research. This session will highlight ethical challenges inherent in microbicide trials and provide a convenient forum for exploring ways of improving informed consent and minimizing the problem of “false confidence” and therapeutic misconception in clinical trials.

Paul Ndebele is an Assistant Visiting Professor at the Center for Ethics and Humanities in the Life Sciences at Michigan State University. He holds a Master of Science degree in Demography and is currently a Bioethics Fellow in the SARETI Program at University of Kwa Zulu Natal where he is undertaking further studies in Research Ethics. Paul has several years experience in the area of Bioethics and he was one of the first three Fellows in the Fogarty Bioethics Programme at Johns Hopkins University (Maryland) in 2001. Paul has a keen interest in research oversight programs as well as in the operations of IRBs.

Thursday, November 3, 2005 -- Rebecca Kukla, Ph.D.
Pregnant Bodies as Public Spaces

Drawing upon advice books, cable television shows, popular web sites, medical textbooks, and photo essays, I argue that our contemporary culture of prenatal care transforms the pregnant body into a public space in three interdependent senses: the space of the pregnant body is visually displaced from and experienced third personally by the pregnant woman; the pregnant body is a site of civic investment and meaning; the pregnant body's normative and interpretive possibilities are fixed by a common narrative space, which is itself constituted by pubic cultural products. I argue that these transformations have important consequences for women's identity and agency during the vulnerable period of pregnancy. Participants can expect to learn some of the history of medical representations of pregnant and fetal bodies, from the birth of professional obstetrics in the seventeenth century to the present; how women's experience of pregnancy is shaped by medical and cultural representations of pregnant bodies; the ethical challenges raised by the routinization of fetal ultrasounds; and how our contemporary practices of prenatal care impact women's agency.

Rebecca Kukla is an associate professor of philosophy at Carleton University in Ottawa, Canada, and an affiliated associate professor at the Kennedy Institute of Ethics at Georgetown University. From 2003-2005 she was a Greenwall Fellow in Bioethics and Health Policy at Johns Hopkins University, and in 2004 she was a Visiting Scholar at the Food and Nutrition Assistance Research Program at the USDA. She is a member of the executive board of the Centre on Values and Ethics and a member of the Research Ethics Board at Carleton University. . She is the author of Mass Hysteria: Medicine, Culture, and Mothers' Bodies (Rowman and Littlefield 2005).

Thursday, December 1, 2005 -- Mark Largent , Ph.D.
Beyond Eugenics: The Uses of Coerced Sterilization in Twentieth-Century America

Coerced sterilizations in the United States are generally associated with the American eugenics movement. In this context, the sterilizations were motivated by a belief that complex social, economic, moral, and medical problems could be solved by reducing the number of people considered biologically and socially inferior by authorities. However, American politicians and medical providers worked to coercively sterilize patients and prisoners years before the start of the American eugenics movement, and the sterilizations continued for years after eugenic motivations for public policy initiatives were widely discredited. This presentation will explore some of the motivations that led health care providers to coercively sterilize at least 60,000 Americans during the twentieth century as well as the relationships between coercive sterilization, social control, and the authority of the American scientific and medical communities. This presentation will examine the ways in which particular social, political, and economic contexts and assumptions motivated American politicians, biologists, and health care providers to advocate involuntary sterilization as a solution to complex social and medical problems. Moreover, it will examine how these contexts and assumptions continue to influence public policy and health care policy decisions well into the twenty-first century.

Mark Largent is an Assistant Professor in James Madison College at Michigan State University, where he teaches history of science and science policy courses. He earned his Ph.D. in 2000 in the History of Science and Technology from the University of Minnesota, and for the past four years he has been Visiting Assistant Professor of Science, Technology and Society at the University of Puget Sound in Tacoma, Washington. His research focuses on the role of biologists and health care providers in the American eugenics movement, particularly in advocating sterilization as a solution to social, economic, and political problems

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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