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Adam Marks, MD

Faculty

Dr. Marks is associate director of the adult Palliative and Supportive Care Clinic at the East Ann Arbor Health and Geriatrics Center, as well as the Adult Palliative Care medical director at Arbor Hospice. He received his medical degree and masters of public health from the Wisconsin School of Medicine and Public Health in Madison, Wisconsin. He completed his combined internal medicine-pediatrics residency at the University of Michigan, where he also completed his fellowship training in palliative care.

Last Name: 
Marks

We are delighted to officially announce that Raymond De Vries will be joining Angie as the new Co-Director of the Center. Ray has been an active faculty member of CBSSM for several years.  He is a Professor in the Departments of Medical Education, Obstetrics and Gynecology, and Sociology, as well as a visiting Professor at Maastricht University in the Netherlands.  He is particularly interested in the regulation of science; clinical trials of genetic therapies and deep brain stimulation; international research ethics; and the social, ethical, and policy issues associated with maternity care.

Scott Kim recently stepped down from the Co-Directorship of CBSSM to take on a new position as Senior Investigator in the Department of Bioethics at the National Institutes of Health.  He continues to assist with various CBSSM-related research projects.

 

Medicine and Society

This special interest group is led by Dr. Raymond De Vries, a Professor in the Department of Learning Health Sciences and Obstetrics and Gynecology, and Sociology at the University of Michigan, and Professor at Academie Verloskunde Maastricht, Zuyd University and Maastricht University/CAPHRI School for Public Health and Primary Care. This group examines the social and cultural aspects of health, disease and healing, with an explicit focus on how bioethical issues are defined, discussed, and resolved. Using both qualitative and quantitative research methods, the topics explored include: 

  • Social and cultural aspects of disease and illness
  • Social organization of medical care
  • Medical and premedical education
  • Childbirth and reproductive technologies
  • Women in medicine and health care
  • Complementary and alternative medicine
  • Cultural and social dimensions of bioethics
  • Faith, healing and medicine
  • Integrity in medical research
  • Globalization of bioethics
Mon, October 19, 2015

Beth Tarini is lead author on study published in the Journal of Pediatrics that found that few primary care physicians say they would order genetic testing or refer a child to a genetics specialist as a first step when they see children with two or more developmental delays, despite the higher risk of genetic disorders in these children.

Brian Zikmund-Fisher and Wendy Uhlmann are also co-authors.

Citation:

Tarini, Beth A., Brian J. Zikmund-Fisher, Howard M. Saal, Laurie Edmondson, and Wendy R. Uhlmann. "Primary Care Providers' Initial Evaluation of Children with Global Developmental Delay: A Clinical Vignette Study." The Journal of Pediatrics.

Research Topics: 

Program in Clinical Ethics

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.

Background
The Program in Clinical Ethics within 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 manages the program on a daily basis.  A cadre of eight faculty ethicists rotate on service throughout the year and work closely with the clinician ethicist.  Trainees and students rotate as well.  Dedicated administrative support will be organized through CBSSM.

Clinical Ethics Consultation Service
The Clinical Ethics Program offers adult and pediatric ethics consultation services across UMHS, and are available 24/7/365.  More information about the adult and pediatric ethics committees and consultation services can be found on the Adult Ethics Committee and Pediatrics Ethics Committee web pages.

Preventative Ethics
The concept of preventative ethics is critical in anticipating, navigating and mitigating potential conflicts and tensions before they become true ethical dilemmas or crises, and necessitate formal consults.   This model facilitates awareness and proactive decision-making on the part of patients, families, trainees and staff, and creates a more visible presence for ethics in the health system.  The Program in Clinical Ethics offers regular preventative ethics rounds in a variety of care settings across UMHS.

Educational Program
Medical ethics is an integral component of contemporary education for all clinicians. There is a vibrant program for longitudinal ethics education within the medical school, and a more intensive curriculum as part of its path of excellence program.  The Program in Clinical Ethics provides a robust program for longitudinal education and awareness of clinical ethics for UMHS staff and trainees. 


People
Christian J. Vercler, MD MA
Andrew G. Shuman, MD
[more to be named soon!]

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

The new, enhanced UMHS Ethics committee was featured in the Office of Clinical Affairs "Chief Brief." According to the article, "ECCA members complimented the committee’s improved access to ethics consultation services, focus on proactive and preventative ethics education, and unification of adult and pediatric efforts. Since the programmatic rollout, there has been a 45 percent increase in clinical ethics consultation volume from the prior year, and an 82 percent increase from average of the prior five years." Dr. Andrew Shuman and Dr. Christian Vercler are the co-directors of CBSSM's Program in Clinical Ethics. Dr. Janice Firn is the clinical ethicist who manages the program on a daily basis.

Raymond G. De Vries, Ph.D., together with M. Nieuwenhuijze, gave a talk at the 7th International Conference on Clinical Ethics and Consultation in Amsterdam, Netherlands, in May 2011.

Funded by the National Institutes of Health/Brigham and Women's Hospital/Boston University

Funding years: 2010-2013

The rapid identifcation of genetic risk factors for common, complex diseases poses great opportunities and challenges for public health. Genetic information is increasingly being utilized as part of commercial effors, including direct-to-consumer (DTC) genetic testing to provide risk information on common diseases to consumers. Very few empirical data have been gathered to understand the characteristics of DTC test consumers, the psychological, behavioral and health impact (clinical utility), and the ethical, legal and social issues associated with DTC services.

In the proposed research, we will survey users of the two leading US companies providing DTC genetic testing (23andMe and Navigenics) regarding their response to genetic test s for common diseases of interest, including heart disease, diabetes, Alzheimer's disease (AD), arthritis, and breast, colon, lung and prostate cancers. Each company now has thousands of customers and each anticipates extensive sales in coming years. Each has agreed to allow our group to survey consumers using third-party data collection and analysis procedures that will enable an independent consideration of the benefits and risks of DTC testing in this format. The companies have also agreed to provide genetic test information (with respondents' permission) for analyses. A total of 1000 consumers (500 from each company) website will be surveyed via the Internet at three time points: 1) before receipt of genetic test results; 2) approximately two weeks following receipt of test results; and 3) six months following receipt of results.

More information: http://www.psc.isr.umich.edu/research/project-detail/35031

PI: Scott Roberts

Co-I: Mick Couper

2012 CBSSM Research Colloquium

Fri, May 18, 2012 (All day)

The 2012 Research Colloquium presentations by U-M faculty, fellows and students highlighted research on medical decision making.  The colloquium presenters and their topics were as follows:

  • Melissa Constantine, PhD: Making a baby in the 21st century: An updated user manual
  • Vida Henderson, PharmD, MPH, MFA, and Deliana Ilarraza: Using community-based participatory research and user-centered design approaches in developing an interactive diabetes decision aid
  • Naomi Laventhal, MD, MA, and Stephanie Kukora, MD: Resident attitudes toward ethical and medical decision-making for neonates born at the limit of viability
  • Kathryn Moseley, MD, MPH: Distrust of pediatricians' sleep advice: Focus group results from the Project for African American Infant Safety
  • Laura Scherer, PhD: What's in a name? The effect of a disease label on parents' decision to medicate a colicky infant
  • Lauren Smith, MD: Cracking the code: Ethical issues involved in the decision to undergo genetic testing
  • Ralph Stern, MD: The myth of individual risk
  • Wendy Uhlmann, MS, CGC: The swinging gate: Genetic testing and ethical issues

CBSSM Seminar: Kayte Spector-Bagdady, JD

Wed, December 09, 2015, 3:00pm to 4:00pm
Location: 
NCRC, Building 16, Room B004E

Kayte Spector-Bagdady, JD


CBSSM Postdoctoral Fellow

From the Guatemala STD Experiments to the NPRM for Revisions to the Common Rule: Why We Still Don’t Have Human Subjects Research Ethics Right

While much has been made of scandals, and academics zealously deliberate nuances, we still find ourselves revisiting the most basic of human subjects research ethics questions: What is a research subject? What is informed consent? This talk will address this ongoing debate but also the less often asked question of why—what are the structural pressures that bring us time and again to step one and is human subjects research ethics a zero sum game?

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