Kunal Bailoor and Darin Zahuranec are developing a project for Kunal’s Bioethics Path of Excellence capstone project to investigate the acceptability of physician paternalism in decisions on life-sustaining treatments after stroke.
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Check out the Ethics Path available to Michigan medical students through the Paths of Excellence (PoE) program. The ethics path provides opportunities for individualized, independent study, combined with field work with CBSSM, and a capstone project in the M4 year.
Click here for more information about the PoE program.
Funded by the NIH
In the past 30 years, the incidence of thyroid cancer has tripled. The majority of the rise in thyroid cancer incidence is attributed to an increase in low-risk, well-differentiated thyroid cancer, a disease that has a 10-year mortality close to zero. Our previous work suggests that patients with low-risk thyroid cancer are at risk for overtreatment, defined as the use of surgical and medical interventions in the absence of a clear survival benefit. The overtreatment of thyroid cancer has inherent costs, both to patient health and to society. The reason for the intensive management and potential overtreatment of low-risk thyroid cancer remains unclear. By using SEER-linked patient and physician surveys, we plan to understand the treatment decision making in low-risk thyroid cancer. We hypothesize that knowledge and attitudes influence decision making. Specifically, we anticipate that lack of knowledge of risks of death, recurrence and treatment complications is associated with treatment that is more intensive. In addition, we postulate that a general preference for active treatment will also be associated with more intensive cancer treatment. Although both patient and physician perceptions of treatment need (i.e., knowledge and attitudes) likely contribute to treatment intensity, we anticipate that the primary driver will be physicians, even after controlling for their patients' perceptions. This study will serve as the foundation for future intervention studies. By identifying the specific role of physician and patient knowledge and attitudes toward thyroid cancer treatment, we will be able to create tailored educational interventions to personalize surgical and medical care for thyroid cancer patients, thus minimizing overtreatment and its inherent risks and costs. As the rising incidence, low mortality, and pattern of intensive treatment make thyroid cancer arguably the best cancer model for overtreatment, this proposed study will also serve as a model to understand overtreatment in other malignancies. For more info: http://grantome.com/grant/NIH/R01-CA201198-01A1
PI: Megan Haymart
CBSSM Co-Is: Sarah Hawley & Brian Zikmund-Fisher
BROCHER RESIDENCIES 2016 -- CALL FOR PROPOSALS
The Brocher Foundation offers visiting researchers the opportunity to come at the Brocher Centre in a peaceful park on the shores of Lake Geneva, to write a book, articles, an essay or a PhD thesis. The visiting positions are an occasion to meet other researchers from different disciplines and countries as well as experts from numerous International Organizations & Non Governmental Organizations based in Geneva, such as WHO, WTO, WIPO, UNHCR, ILO, WMA, ICRC, and others. The Brocher Foundation residencies last between 1 and 4 months.
They give researchers (PhD students to Professors) the opportunity to work at the Brocher Centre on projects on the ethical, legal and social implications for humankind of recent medical research and new technologies. Researchers can also apply with one or two other researchers to work on a collaborative project.
CHECK CONDITIONS AND APPLY ON WWW.BROCHER.CH/CALLS
Funded by the Department of Health and Human Services / Rand Corporation
Funding years: 2007-2013
Dr. Kenneth Langa will continue to collaborate with Michael Hurd, PhD and other RAND researchers on a research project designed to determine the full societal costs of dementia in the United States. Dr. Langa and Dr. Hurd collaborated on the original R01 project from 2007 through 2013, and will now continue collaborating on this no-cost extension for the project. The proposed studies during this no-cost extension will build on our prior collaborative work on dementia costs by: 1) Identifying costs of dementia at the household level over time, and its effect on the economic position of affected households); and 2) Extending our model of the probability of dementia by the inclusion of genetic information.
PI: Kenneth Langa
CBSSM is co-sponsoring the MICHR Research Education Symposium: Life at the Interface of Genomics and Clinical Care. This event will be held March 15th, 8-1 pm. Keynote speaker is Dr. Ellen Wright Clayton, JD, MD, Rosalind E. Franklin Professor of Genetics and Health Policy; Craig-Weaver Professor of Pediatrics; Professor of Law; and Director, Center for Biomedical Ethics and Society, at Vanderbilt University. Dr. Wright Clayton’s topic will be “Addressing Biomedical Ethics.”
Funded by: National Cancer Institute (NCI)
Funding Years: 2016-2021
The development of Learning health systems is causing radical transformation of the environment within which the NCI pursues its Mission; understanding the Ethical and social implications of these changes is of paramount importance. In rapid Learning systems (RLS), routinely collected Patient data drive the process of discovery, which in turn becomes a natural outgrowth of clinical care. As the Institute of Medicine has noted, such systems have substantial promise for improving the quality of care and research, and ultimately the value of health care. As such systems develop, the blurring of the current distinction between clinical practice, quality of care, and research necessitates careful consideration of Ethical implications. As RLSs are in their infancy, it is critical to conduct research to generate informed and considered Patient perceptions of the ethical implementation of such systems, particularly regarding ways to ensure respect for Patient autonomy and privacy, including best approaches for informing participants and governance of data use, in order to realize the potential benefits of these systems. Therefore, we propose an innovative study that uses cutting edge methods of deliberative democracy to generate considered and informed opinions of cancer Patients, leveraging a unique opportunity to evaluate Patient experiences during the roll-out of a real-world RLS. Specifically, the American Society of Clinical Oncology (ASCO) has developed a real-world Oncology RLS known as CancerLinQ. CancerLinQ is being implemented in 15 vanguard practices over the next year, and the approach to Patient notification/consent and data governance in this System is actively evolving. We propose an empirical Investigation with two distinct approaches and aims, in collaboration with ASCO and its vanguard practices. First, we will use a deliberative democracy approach to determine the range of informed and considered individual and group opinions and recommendations of cancer Patients on the optimal approach for obtaining Consent and appropriate uses of information routinely collected in the course of medical care as part of a RLS that seeks to improve quality and advance research. Second, following CancerLinQ roll-out, we will survey Patients experiencing the real-world Implementation of this RLS in order to evaluate their knowledge and perceptions of that System. Conducting the proposed work in parallel with the development of a real-world RLS provides an opportunity to directly inform the development and Implementation of a national learning system that will ultimately impact tens of thousands of Patients, and it also allows for the consideration of real- life rather than purely hypothetical scenarios in ways that increase the likelihood that these investigations will yield insights that are directly applicable in other settings. the findings will have substantial relevance to the research Mission of the NCI, as Oncology Learning systems are fundamentally altering the context for research across the spectrum of cancer causation, diagnosis, Prevention, treatment, and survivorship care. For more info: http://grantome.com/grant/NIH/R01-CA201356-01A1
PI: Reshma Jagsi, MD. PhD.
CO(s): Raymond De Vries, PhD. & Sarah Hawley, PhD, MPH
Dr. Naomi T. Laventhal joined the University of Michigan in August 2009, after completing her residency in pediatrics, fellowships in neonatology and clinical medical ethics, and a master’s degree in public policy at the University of Chicago. She is a Clinical Associate Professor in the Department of Pediatrics and Communicable Diseases in the Division of Neonatal-Perinatal Medicine, and in the Center for Bioethics and Social Sciences in Medicine (CBSSM).
Andrew G. Shuman, MD is an Assistant Professor in the Department of Otolaryngology - Head and Neck Surgery at the University of Michigan Medical School. He is also the Chief of the ENT Section of the Surgery Service at the VA Ann Arbor Health System. He is a service chief of the Clinical Ethics Service in the Center for Bioethics and Social Sciences in Medicine (CBSSM). His current research interests explore ethical issues involved in caring for patients with head and neck cancer, and in managing clinical ethics consultations among patients with cancer.