H. Myra Kim is a Research Scientist at the Center for Statistical Consultation and Research and and Adjunct Professor at the Department of Biostatistics. She received her Sc.D. in Biostatistics from Harvard University in 1995 and worked at Brown University as an Assistant Professor from 1995 to 1997. She has worked at UM since 1997 and has collaborated with various researchers from around the UM community as well as from other universities.
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Co-sponsored by the Center for Ethics in Public Life and the Center for Bioethics and Social Sciences in Medicine, the 2nd annual Bioethics Colloquium took place on Friday, May 20, 8:30-3:30 pm, in the Alumni Center. The colloquium featured presentations of research in or about bioethics conducted by U-M faculty, fellows, and students.
The keynote speaker was Susan Dorr Goold, MD, MHSA, MA, who gave a talk entitled, "Market failures, moral failures, and health reform."
Nearly 70 people attended the event, which featured 10 presentations by faculty, graduate students, and undergraduate students drawn from a variety of disciplines.
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.”
Timothy R. B. Johnson, M.D. served as Chair of Obstetrics and Gynecology at the University of Michigan from 1993-2017. He is Bates Professor of the Diseases of Women and Children; and also Arthur F. Thurnau Professor; Professor, Women’s Studies, and Research Professor, Center for Human Growth and Development. His education and training have been at the University of Michigan, University of Virginia and Johns Hopkins.
Reshma Jagsi, MD, DPhil, is the lead author on a new study showing that breast cancer patients who have had mastectomies and need radiation are less likely to receive these treatments than patients who have had lumpectomies. The article appears in the Journal of Clinical Oncology (online March 29, 2010). Additional authors are Paul Abrahamse, Sarah T. Hawley, Jennifer J. Griggs, Steven J. Katz, Monica Morrow, John J. Graff, and Ann S. Hamilton. Read a press release about the research here.
Should people with more severe health problems receive state funding for treatment before people with less severe health problems? See how your opinion compares with the opinions of others.
Imagine that you are a government official responsible for deciding how state money is spent on different medical treatments. Your budget is limited so you cannot afford to offer treatment to everyone who might benefit. Right now, you must choose to spend money on one of two treatments.
- Treatment A treats a life threatening illness. It saves patients' lives and returns them to perfect health after treatment
- Treatment B treats a different life threatening illness. It saves patients' lives but is not entirely effective and leaves them with paraplegia after treatment. These patients are entirely normal before their illness but after treatment will have paraplegia.
Suppose the state has enough money to offer Treatment A to 100 patients. How many patients would have to offered Treatment B so that you would have difficulty choosing which treatment to offer?
How do your answers compare?
The average person said that it would become difficult to decide which treatment to offer when 1000 people were offered Treatment B.
What if you had made another comparison before the one you just made?
In the study, some people were asked to make a comparison between saving the lives of otherwise-healthy people and saving the lives of people who already had paraplegia. After they made that comparison, they made the comparison you just completed. The average person in that group said it would take 126 people offered Treatment B to make the decision difficult. The differences are shown in the graph below
Why is this important?
The comparison you made is an example of a person tradeoff (PTO). The PTO is one method used to find out the utilities of different health conditions. These utilities are basically measures of the severities of the conditions. More severe conditions have a lower utility, and less severe conditions have a higher utility, on a scale of 0 to 1. Insurance companies, the government, and other organizations use these utilities as a way to decide which group to funnel money into for treatments.
On the surface, it seems like basing the money division on the severity of a condition is a good and fair method, since theoretically the people who are in the greatest need will be treated first. However, the PTO raises issues of fairness and equity that aren't accounted for in other utility elicitation methods like the time tradeoff (TTO) and rating scale (RS).
For example, when asked to decide how many people with paraplegia would have to be saved to equal saving 100 healthy people, many people say 100; that is, they think it is equally important to save the life of someone with paraplegia and a healthy person. Going by values obtained using the TTO or RS, an insurance company may conclude that 160 people with paraplegia (using a utility of .6) would have to be saved to make it equal to saving 100 healthy people. This would mean that less benefit would be gotten by saving someone with paraplegia, and thus they might not cover expenses for lifesaving treatments for people with paraplegia as much as they would for a healthy person. The PTO shows that many people would not agree with doing this, even though their own responses to other utility questions generated the policy in the first place.
For more information see:
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.
This will be the first year that CBSSM will be participating in Researchpalooza. Please come and enjoy the fun!
Wednesday, August 27, 2014
11:00 a.m. - 2:00 p.m.
Circle Drive in front of Med Sci I
All UMHS employees from the Hospitals and Health Centers and Medical School are invited to celebrate this annual event.
Stop by the University Hospital Courtyard and Medical School Circle Drive for:
- Ice Cream sundaes and sugar-free alternatives
- Karaoke and musical entertainment
- Festival Games
- Department and vendor tables with information and giveaways
Kathryn Moseley served as one of the judges at "The Big Ethical Question Slam 5" hosted by a2ethics.org. In addition, Naomi Laventhal, Michele Gornick, Christian Vercler, Lauren Smith, and Lauren Wancata served as judges at the "Michigan Highschool Ethics Bowl 2."
Thanks to all the CBSSM folks who contributed their time!
For more information about these events and other great ethics-related activites, go to a2ethics.org.
A short video about the Highschool Ethics Bowl can be found here.