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Wed, February 15, 2017

According to a study by Reshma Jagsi and colleagues, doctors often fail to recommend genetic testing for breast-cancer patients, even those who are at high risk for mutations linked to ovarian and other cancers. They surveyed 2,529 breast-cancer patients and found that although two-thirds of the women reported wanting genetic testing, less than a third actually got it. About 8 in 10 women at highest risk for BRCA mutations — because of family history or ancestry — said they had wanted testing, but only a little more than half received it.

In videos for The Trust Project, bioethicist and sociologist Raymond De Vries explores trust in medicine from a sociological perspective.

In How Trust Shapes the Medical Field: A Sociologist's Perspective, De Vries offers a historical perspective on trust in medicine:

  • What role did industrialization play in changing interpersonal trust?
  • What can we learn about trusting relationships from past societies?

In The Rise of Bioethics in Response to Medical Distrust: Key Findings, De Vries discusses some key research in the field of trust and bioethics:

  • How did the erosion of trust in medicine lead to the rise in the study of bioethics?
  • Does the bureaucracy that comes with research ethics committees enhance or undermine trust?

An another video, Evolution of Trust in Bioethics medical research ethics.

The Trust Project at Northwestern University features scholars and executives exploring Trust in videos that cover theory, research and practice. By combining multiple and diverse perspectives, The Trust Project aspires to illuminate new insights for research and management.

CBSSM Seminar: Peter Jacobson, J.D., M.P.H.

Tue, October 10, 2017, 3:00pm
Location: 
NCRC, Building 16, Room 266C

Peter Jacobson, J.D., M.P.H.
Professor of Health Law and Policy
Director, Center for Law, Ethics, and Health

Title:  Addressing Health Equity Through Health in All Policies Initiatives.

Scholars and public health advocates have expressed optimism about the potential for Health in All Policies (HiAP) initiatives to improve both health equity and population health. HiAP is a collaborative approach across multiple sectors. In a qualitative study to assess these concepts, we found considerable variation across the sites on: how HiAP and equity initiatives are defined and governed; the integration of equity as a core goal; institutional capacity; and the determination of actual policy changes. We found a general migration from a HiAP-centered strategy to one based more on health equity. Regardless of the specific nomenclature, the implementation focus was directed more toward changing practices than policies.

 

Tue, June 19, 2018

In a study led by Susan Goold, published in the Journal of General Internal Medicine, researchers surveyed 2104 Michigan primary care providers who provide care for patients insured by the Healthy Michigan Plan. According to surveyed providers, extending medical insurance to low-income Michigan residents meant better access to health care, earlier detection of serious illnesses, better care for existing health problems and improved ability to work, attend school and live independently.

Research Topics: 
Tue, April 10, 2018

In light of the #MeToo campaign denouncing sexual assault and harassment, Reshma Jagsi, MD, DPhil has written a perspective piece in the New England Journal of Medicine about sexual harrassment in academic medicine. This perspective piece and a recent survey published in JAMA related to sexual harassment and gender bias in academic medicine has been highlighted in multiple media outlets.

Announcement of Position: Clinician Ethicist

Announcement of Position: Clinician Ethicist


Background
The Program in Clinical Ethics within the Center for Bioethics and Social Sciences in Medicine (CBSSM) represents an expansion of existing services designed to promote a culture of patient-centered excellence by developing a comprehensive set of ethics-related activities. The aims of this program are to: liaise with and provide support to the adult and pediatrics ethics committees; streamline clinical ethics consultation; assist with ethics-related policy development on a regular and proactive basis; organize and administer structured educational programs in clinical ethics; and coordinate empiric research with relevance to clinical ethics within CBSSM.


Program Organization
The Program in Clinical Ethics is co-directed by the chairs of the adult and pediatric ethics committees and consultation services, Christian J. Vercler, MD MA and Andrew G. Shuman, MD. A dedicated clinician ethicist will manage the program on a daily basis. A cadre of eight faculty ethicists will rotate on service throughout the year and work closely with the clinician ethicist. Trainees and students will rotate as well. Dedicated administrative support will be organized through CBSSM.


Position
One individual will serve as the program’s clinical ethicist. This individual will serve as the “first responder” and contact person for all ethics consults during business hours, ensure continuity with consults, and work in conjunction with faculty ethicists. The role will include arranging team/family meetings, ensuring follow-ups on all consults, and arranging additional consultations as needed for selected cases. He/she will also regularly review relevant institutional policies and attend all ethics committee meetings. Another major component of this role will be to organize and participate in educational efforts and preventative ethics rounds. This position will provide $50,000 of direct salary support annually, to be distributed and allocated in conjunction with their home department. The initial appointment will last two years and is renewable.


Qualifications
Candidates are expected to be employees or faculty at UMHS with a master’s or equivalent terminal degree in their field; any professional background is acceptable. Direct experience with clinical ethics consultation is required. Familiarity with ethics education and related clinical research would be helpful. Excellent organizational and communication skills across multidisciplinary medical fields are required. Candidates are expected to have qualifications that meet the standards outlined by The American Society for Bioethics and Humanities (ASBH) for accreditation for clinical ethics consultants.


Application Process
Candidates will be vetted, interviewed and chosen by a nomination committee. Candidates are asked to submit:

  • Curriculum vitae or resume
  • One page maximum summary of (1) education/training related to ethics consultation; (2) clinical ethics consultation experience; and (3) motivation/interest in the position
  • Letter of support from Department Chair/Division Head/Center Director or equivalent
  • Submit formal application via email to: valkahn@med.umich.edu


Timeline

  • Application is due December 11, 2015 with interviews shortly thereafter
  • Appointment will take effect January 1, 2016


Contacts

  • Co-Directors of the Program in Clinical Ethics: Christian J. Vercler, MD MA & Andrew G. Shuman, MD
  • Administrative contact: Valerie Kahn – valkahn@med.umich.edu 734 615 5371

CBSSM Seminar: Rana Awdish, MD

Thu, February 15, 2018, 3:00pm
Location: 
NCRC, Building 16, Room 266C

Dr. Rana Awdish is the author of In Shock, a memoir based on her own critical illness. She is also Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit and a practicing Critical Care Physician. She lectures to physicians, health care leaders and medical schools across the country on the necessity of compassionate care. She was recently named Medical Director of Care Experience for the Health System.

In Shock will describe Dr. Awdish's personal transformation from critical care physician to critically ill patient and describe how the events surrounding her near death changed her understanding of the culture of medicine and lead her to alter the course of her institution. Focusing on Physician communication training, narrative medicine and visual thinking strategies, and a culture of caring, she will illuminate the path towards creating a more resilient culture for everyone involved in health care.

 Objectives:

1. Describe the ecosystem of medical training and practice and the way it compromises empathy and compassion.

2. Illustrate how medical humanities and a purpose driven culture can be used to promote a culture of resilience.

3. Recognize the barriers to implementing institutional change and empowering individuals.

4. Identify practices that will engage providers and leaders in promoting development of resilient systems.

Rana Awdish, MD
Director, Pulmonary Hypertension Program, Henry Ford Hospital, and Medical Director, Care Experience, Henry Ford Health System, Detroit, MI

Dr. Rana Awdish is the Director of the Pulmonary Hypertension Program at Henry Ford Hospital in Detroit and a Critical Care Physician. She also serves as Medical Director of Care Experience for the Henry Ford Health System. Dr. Awdish’s mandate as well as her passion is to improve the patient experience across the system. 

After suffering a sudden critical illness herself in 2008, she has become a tireless activist, refocusing her fellow providers on the patient experience and improving empathy through connection and communication. She lectures to physicians, hospital leadership and medical schools around the country. Her book, In Shock: My Journey from Death to Recovery and the Redemptive Power of Hope, has been featured in the Washington Post, NPR, The Today Show, The Times Literary Supplement, and is now an LA Times Bestseller.

Dr. Awdish received the Schwartz Center’s National Compassionate Caregiver of the Year Award in 2017. She was named Physician of the Year by Press Ganey in 2017 for her work on improving communication, and received the Critical Care Teaching Award in 2016. She, along with three others, began the CLEAR Conversations Project at Henry Ford, using improvisational actors to train physicians in patient-centered empathic communication. 

Prior to coming to Henry Ford, Dr. Awdish completed her training at Mount Sinai Beth Israel in Manhattan. She attended Wayne State University Medical School, and completed her undergraduate degree at the University of Michigan in Ann Arbor. She is board-certified in Internal Medicine, Pulmonary and Critical Care Medicine.

Working Group

The Working Group provides a forum for project focused discussions and interdisciplinary collaborations in topics related to bioethics, health communication, decision making and any other topic that fits within the 5 domains of CBSSM.

Working group meetings provide an opportunity for investigators to receive feedback on research proposals, drafts of papers, grant applications, or any other aspects of projects at any stage of development. These sessions are to help move forward a project in any stage of its development. So if your project is in the works, in the planning stages, or perhaps it is still just an idea, you design the session and determine how to best solicit the help and support of your colleagues.
Some examples could be:

  • Outline sketch of specific aims for a grant. (Presenter would provide a one page summary before the session)
  • Outline of a proposed paper or paper in draft stage. (Discussion would be based on one page summary. Presenter would walk the group through the outline or draft, and solicit feedback on significance and coherence of ideas)
  • Determining a paper’s relevance. (Presenter could ask group members to read a paper, in order to discuss/determine if that paper is crucial to the project that the person has in mind-- different from a journal club exercise.)

This meeting is designed as an informal working group not a formal presentation.

The working group usually meets on Tuesdays or Wednesdays at 4pm in NCRC B16-266C. To be added to the email list, please contact Amy Lynn at lynnam@umich.edu OR join our email list.

 

 

 

 

Research Ethics

Research Ethics Service

The Research Ethics Service, led by Kayte Spector-Bagdady, JD, MBioethics and Raymond De Vries, PhD within the Center for Bioethics and Social Sciences in Medicine, aims to enable a culture of normative, empirical, and educational inquiry to serve as the ethical backbone of research at Michigan Medicine. Its three areas of focus include:


1. Education: providing instruction on Research Ethics and Responsible Conduct of Research;
2. Consultation: offering a consulting service for colleagues with questions about the ethical conduct of research; 
3. Research: using a variety of methods to study issues in Research Ethics.


Research Ethics and Responsible Conduct of Research Education

Coursework and independent projects into research ethics and the responsible conduct of research may be available upon request. Current courses include the Responsible Conduct of Research for K Awardees (RCR4K) Implementation Package offered through the Michigan Institute for Clinical & Health Research (MICHR) and Legal Rules and Ethical Issues for Clinical Research (HMP 540) through the Clinical Research Design and Statistic Analysis Masters Program at the UM School of Public Health.


Research Ethics Consultation Service

Personalized Research Ethics Consultation may be available during normal business hours for investigators across Michigan Medicine designing or conducting their own research protocols. For further information or to request a consultation please contact kaytesb@med.umich.edu.


Mixed Methods Research into Human Subjects Research Ethics

The Program in Research Ethics also supports a vibrant mixed-methods empirical program for research on human subjects research ethics.

Bioethics Grand Rounds -Reshma Jagsi, MD, DPhil

Wed, October 25, 2017, 12:00pm
Location: 
UH Ford Auditorium

Reshma Jagsi, MD, DPhil

Title – "Ethical Issues Related to Fundraising from Grateful Patients"

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.

Lunch is provided. Please note: Lunch is first come, first served.

 

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