Yale’s Friday Newsletter — 11/9/2012

Here’s this week’s Yale Friday Newsletter, slightly edited for our readers.  Enjoy!

Yale Interdisciplinary Center for Bioethics Director Steve Latham has the following announcements to share:

  • Congratulations to Bioethics Center Affiliated Scholar Bonnie Kaplan on her publication this month of “Sorrell v. IMS Health: issues and opportunities for informaticians,” in the Journal of the American Medical Informatics Association.  The article is an analysis of a recent Supreme Court decision striking down  a Vermont law that had required data-mining companies to obtain permission from individual providers before selling prescription records that included identifiable physician prescription information to pharmaceutical companies for drug marketing.
  • This week’s election left us with head-spinningly many bits of news to digest: besides President Obama’s re-election and the various high-profile changes in the Senate and House, there were important votes on same-sex marriage, marijuana legalization, Puerto Rican statehood, and more. You had to be paying close attention to notice that Massachusetts voters passed a medical marijuana bill (with 65% of voters in favor) and narrowly rejected an initiative to establish an Oregon-like “Death With Dignity” regime in that state (51%-49%). The provision would have permitted physicians to assist certain of their competent, terminally-ill patients in ending their own lives. Interestingly, according to this local Massachusetts article, the anti-Death-With-Dignity campaign spent $4.5 million to the proponents’ $1.2, with much of that money coming from Roman Catholic and out-of-state organizations. The pro-medical marijuana lobby spent $1 million, and were opposed by groups spending only a paltry $10,000.
  • The Department of Social Science, Health & Medicine and the Centre of Medical Law and Ethics, both at King’s College London, are launching a new Master’s program in bioethics.  Their first intake of students will be in September 2013.  For more information, click here.

 And Associate Director Carol Pollard has the following articles to share: click here.

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Bioethics Center Events

Monday, November 12 at 12 PM
Special Event
Location: 77 Prospect St, Library (2nd floor)
Speaker:Lasse Nielsen, Political Science, Aarhus University, Denmark
Topic:Competing bases for a theory of health justice

This Week on Campus

Monday, November 12

Law School’s Storrs Lecture (1 of 2)

Time: 4:30 PM

Location: 127 Wall St, room 127

Speaker: Cass R. Sunstein, Felix Frankfurter Professor of Law, Harvard Law School, Former Administrator of the White House Office of Information and Regulatory Affairs (2009-2012)

Topic: Human Error and Paternalism

Tuesday, November 13

Rudd Center Seminar

Time: 12:30 PM

Location: 309 Edwards St, conf room

Speaker: Amy B. Jordan, PhD, Director, Media & the Developing Child, Annenberg Public Policy Center, University of Pennsylvania

Topic: Testing the Effectiveness of Public Service Advertising Aimed at Reducing Consumption of Sugar-Sweetened Beverages

BioHaven Entrepreneurship Seminar

Time: 4 PM
Location: 210 Whitney Ave, Auditorium

Speakers: Michael Woody, from Washington lobbying firm East End

David Boyer, from lobbying firm BGR Government Affairs

Topic: Innovation and the Future of the Affordable Care Act after Election 2012

Law School’s Storrs Lecture (2 of 2)

Time: 4:30 PM

Location: 127 Wall St, room 127

Speaker: Cass R. Sunstein, Felix Frankfurter Professor of Law, Harvard Law School, Former Administrator of the White House Office of Information and Regulatory Affairs (2009-2012)

Topic: Human Error and Paternalism

Thursday, November 15

Perspectives on Medicine Lecture

Time: 1 PM

Location: 315 Cedar St, room 110

Speakers: Neel Butala, YSM/SOM ‘14 Jones-HAVEN Fellow Executive Director, HAVEN Free Clinic

Kelly Foss, YSPH ‘13 Executive Director, HAVEN Free Clinic

Janine Sun, YSN ‘13 Executive Director, HAVEN Free Clinic

Topic: HAVEN Free Clinic: Progress in Clinical Quality and Interdisciplinary Student Collaboration

Program for Humanities in Medicine’s Barwick Lecture

Time: 5 PM

Location: 300 Cedar St, Anlyan Auditorium

Speakers: Janice Baker, MA, Coordinator of Arts for Healing at Yale-New Haven Children’s Hospital

Kendra Carlson, MAAT, ATR

Laki Vazakas, MA

Aaron Jafferis, MFA

Topic: The Patient’s Journey: A Portrait of Healing

Grants & Fellowships

University of Pennsylvania Perelman School of Medicine Department of Medical Ethics and Health Policy Penn Fellowship in Advanced Biomedical Ethics

The Department of Medical Ethics and Health Policy at the University of Pennsylvania Perelman School of Medicine invites applications for a new  postdoctoral Fellowship in Advanced  Biomedical Ethics, beginning in September 2013. The mission of this 2—year Fellowship is to  train scholars nd  future leaders in academic biomedical ethics. Fellows will participate fully in the life of the Department of Medical Ethics and Health Policy, which is among the world’s leading bioethics departments. They will have full access to the intellectual resources of the larger Penn community. The core fellowship experience will  consist of:

1. Mentored research: Working with one or more faculty mentors, Fellows  will be expected  to conduct original research that will lead to the publication of a minimum of 2 manuscripts in top—tier peer—reviewed journals.

2. Master of Science in Medical Ethics: Fellows will undertake  a 2—year program of study that will lead to a Master of Science in Medical Ethics  (MSME) degree. Coursework will  include core topics in medical ethics (4 courses), a grounding in empirical research methods (4 courses), as well research—related electives.

3. Department seminars: Fellows will participate in and lead regular  department seminars, including sessions devoted to works—in—progress, presentations by department and affiliated faculty as well as by invited scholars, and journal  clubs devoted to  critical analysis of conceptual and empirical articles in bioethics.

4. Ethics committee, consultation,and institutional review board experience: Consistent with their interests, Fellows will join an ethics committee and/or an institutional review board  at a Penn—affiliated hospital and  will participate in  consultations, protocol reviews and other committee activities.

Applications are invited from scholars with  doctoral degrees in hand (PhDs or equivalent, JDs, MDs),or  who will have received such degrees by September 2013. Doctorates may be in any relevant field, including but not limited to philosophy, political science, psychology, sociology, economics or anthropology. Fellows will receive an annual stipend, benefits, and full tuition for coursework required for the MSME degree. Interested applicants should send the following materials to Olivia Hamilton, Graduate Program Coordinator, olivh@upenn.edu by January 2, 2013: 1.A curriculum vitae 2.  Personal statement (maximum  1200 words) that describes your reasons for applying to the fellowship, your career goals, and your specific areas of  interest, if any, within bioethics. 3. A published or unpublished writing sample (maximum 12 pages of text if a published work, 25 pages if an unpublished manuscript). 4. In addition, applicants should arrange for 2 letters of recommendation to be submitted by individuals familiar with their academic work. Such letters must be submitted to Olivia Hamilton, Graduate Program Coordinator, olivh@upenn.edu  by the recommender, rather than forwarded by the applicant. 5. Physician applicants who are currently enrolled in a clinical or research training program at Penn should contact Autumn Fiester, PhD at the address below for additional requirements. For additional information, contact: AutumnFiester, PhD,  Director of Education, Department of Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine  fiester@mail.med.upenn.edu

Calls for Papers & Nominations

7th International Conference on Ethical Issues in Biomedical Engineering

This conference will be held at Brooklyn, April 20th and 21st, 2013.  This conference is sponsored by SUNY Downstate Medical Center and co-sponsored by the International Federation of Medical and Biological Engineering (IFMBE), the American Institute of Medical and Biological Engineering (AIMBE); Sigma Xi, The Scientific Research Society, and many other scientific societies and universities. Please note that due the disruptions caused by the storm Sandy, the deadline for acceptance of abstracts has been extended by three weeks to Nov 26, 2012. Click here for more information.

Employment Opportunities

Centre for Research Ethics & Bioethics (CRB) Uppsala Univesity

Looking for two researchers to join our team! [2012-11-06] CRB is currently recruiting two researchers. We need a creative person who likes to collaborate and work in a multi-disciplinary environment and is fluent in English. We are looking for a person with a doctoral degree in health economics with documented skills in Discrete Choice Experiments. We are also looking for a researcher in ethics/biobank/registry research regulations. This is a person with a doctoral degree in ethics or law, or someone with a doctoral degree in medicine or life sciences with an interest in ethical issues. Both positions have a 2 year period of appointment, with possible prolongation. Application deadline: November 29 2012. Read more:

Researcher in health economics (UFV-PA 2012/2684)

Researcher in ethics/biobank/registry research regulations (UFV-PA 2012/2683)

Centre for Research Ethics & Bioethics (CRB)

Uppsala University

Box 564

SE-751 22 Uppsala

Phone +46 18 471 62 22

E-mail crb@crb.uu.se

web www.crb.uu.se

In the News

Drugs & Pharmaceuticals

Doucleff, Michaeleen. Researchers Say Drug Subsidies Led To Overtreatment Of Malaria In Africa. NPR. 1 November 2012.

There’s a hot debate in global health right now. And the stakes are high. This month the Global Fund will vote to continue or scrap a $225 million project that subsidizes the cost of the most effective malaria drugs in seven African countries. Supporters of the pilot program say it has been a success. It slashed the cost of effective drug treatment and boosted its availability. Continue reading…

Food & Nutrition

Pollack, Andrew. After Loss, the Fight to Label Modified Foods Continues. NPR.  7 November 2012.

Advocates for the labeling of genetically modified food vowed to carry their fight to other states and to the federal government after suffering a defeat in California on Tuesday. Continue reading…

Health Care

Doctors With More Experience May Have Lower Care Costs. U.S. News Health. 5 November 2012.

he most highly experienced doctors spend less money treating patients than those with fewer years of experience, according to a new study. Researchers used private insurance plan claims for more than 1 million Massachusetts residents in 2004 and 2005 to create health care cost profiles for more than 12,000 doctors in the state, according to the study, published in the November issue of the journal Health Affairs. Continue reading…

Whitney, Eric. Attention, Shoppers: Health Care Prices Go Online In Colorado. NPR. 2 November 2012.

If you need an MRI of your knee in Colorado, the price varies — a lot. You can pay anywhere from $350 to $2,336. It’s a huge range, but the truly remarkable thing about the prices is that we know them at all. Prices for health care aren’t public in most places, making shopping for the best deal nearly impossible. And patients pay different amounts for the same procedure based on their insurance coverage, too. Continue reading…

Hensley, Scott. For Simple Care, Retail Clinics are a Popular Choice. NPR. 5 November 2012.

If you’ve got the sniffles or need a shot, do you go to the doctor or stop in at a clinic in a nearby drugstore? Lots of people are opting for the clinics, which are springing up inside grocery stores, big-box retailers and chain drugstores across the country. There are already 1,388 clinics like these in the U.S., according to data from Merchant Medicine, a consulting firm. Continue reading…

Medical Ethics

Hotz, Robert Lee. Personalized Medicine Moves Closer. Wall Street Journal. 31 October 2012.

In a major step toward an era of personalized medicine, researchers reported Wednesday that they have sequenced the complete DNA material of more than 1,000 people from 14 population groups in Europe, Africa, East Asia and the Americas. Continue reading…

Organ Donation

Organ donation: Jewish and Muslim presumed consent worries. BBC News. 5 November 2012.

Plans to introduce presumed consent organ donation in Wales face opposition from within the Jewish and Muslim communities. Some members of both religions have concerns about Welsh government proposals to create the UK’s first opt-out donor system. It would mean everyone is deemed to be a willing organ donor when they die, unless they have stated otherwise.Continue reading…

Public Health

Seaman, Andrew. One in five smokers lights up while hospitalized. Reuters Health. 5 November 2012.

The number of smokers lighting up on hospital grounds has fallen about seven percentage points since 1995, according to a new study. Continue reading…

Harris, Gardiner. As Dengue Fever Sweeps India, a Slow Response Stirs Experts’ Fears. New York Times. 6 November 2012.

An epidemic of dengue fever in India is fostering a growing sense of alarm even as government officials here have publicly refused to acknowledge the scope of a problem that experts say is threatening hundreds of millions of people, not just in India but around the world. Continue reading…

Pittman, Genvra. Heart risks still higher in blacks than white. Reuters. 6 November 2012.

Black men and women are more likely to die of a heart attack or heart failure than whites in the United States, according to a new study.. Continue reading…

Stem Cells

Mundell, E.J. Two Years On, Stem Cells Still Healing Damaged Hearts. U.S. News. 6 November 2012.

Updated two-year results from a small trial using cardiac stem cells to repair damaged hearts suggest the treatment’s healing effect persists. Patients with heart failure caused by prior heart attacks who got the treatment continue to see reductions in cardiac scar tissue, improvements in the heart’s pumping ability and even a boost in their quality of life, researchers said. Continue reading…

Technology

Khazan, Olga. For some doctors, electronic records aren’t a miracle cure. Washington Post. 5 November 2012.

Washington orthopedic surgeon Vincent Desiderio doesn’t mind flipping through folders. His Spring Valley office has seven filing cabinets full of patient charts, some as thick as two inches. Despite feeling the federal government’s push to move to electronic medical records, Desiderio, who has been in practice for more than 30 years, likes his paper file system and may retire before he’s convinced to switch. Continue reading…

Gallagher, James. Gene therapy Glybera approved by European Comission. BBC News 2 November 2012.

A treatment which corrects errors in a person’s genetic code has been approved for commercial use in Europe for the first time. The European Commission has given Glybera marketing authorisation, meaning it can be sold throughout the EU. Continue reading…

In the Journals

Bramstedt, Katrina. Harms and Responsibilities Associated with Battery-Operated Implants (BOI): Who Controls Postmortem Explantation? Pacing and Clinical Electrophysiology. November 2012.

The postmortem issues raised by battery-operated implants (BOI) are complex and issues of consent, setting (clinical vs research), and environmental risks have received little attention in bioethics literature. Analyzing the issues, the following are argued: (1) Patients receiving BOIs should sign a consent form that includes a requirement for postmortem explant of the device; (2) BOI consent forms should require the explanted devices be returned to their manufacturers for Returned Product Analysis; (3) Failure to explant and analyze devices from the research setting fails the research goal of generation of knowledge for the benefit of future patients; (4) Failure to explant and analyze devices from the clinical setting allows product defects to be potentially hidden from patients, families, clinicians, manufacturers, and regulatory agencies; (5) Bodies buried with BOIs potentially harm the environment; (6) Religious or philosophical objections to autopsy should not supersede the duty to explant and analyze BOIs; (7) The concepts herein for BOIs could potentially extend to non-BOI if the device has failure modes that can lead to a potentially life-threatening event or can cause permanent debilitating health issues, and the burial or cremation of the device poses environmental harm. In these situations, neither the patient (premortem) nor family (postmortem) should have the right to refuse explant. Continue reading…

Brody, Howard. The Placebo Phenomenon: Implications for the Ethics of Shared Decision-Making. Journal of General Internal Medicine. June 2012.

Recent research into the placebo effect has implications for the ethics of shared decision-making (SDM). The older biomedical model views SDM as affecting which therapy is chosen, but not the nature or likelihood of any health outcomes produced by the therapy. Research indicates, however, that both the content and manner in which information is shared with the patient, and the patient’s experience of being involved in the decision, can directly alter therapeutic outcomes via placebo responses. An ethical tension is thereby created between SDM aimed strictly and solely at conveying accurate information, and “outcome engineering” in which SDM is adapted toward therapeutic goals. Several practical strategies mitigate this tension and promote respect for autonomous decision-making while still utilizing the therapeutic potential of SDM. Continue reading…

Disilvestro, Russel. The Ghost in the Machine is the Elephant in the Room: Souls, Death and Harm at the End of Life. Journal of Medicine and Philosopy. October 2012,

The idea that we human beings have souls that can continue to have conscious experiences after the deaths of our bodies is controversial in contemporary academic bioethics; this idea is obviously present whenever questions about harm at the end of life are discussed, but this idea is often ignored or avoided because it is more comfortable to do so. After briefly discussing certain types of experiences that lead some people to believe in souls that can survive the deaths of their bodies, I begin to answer the question, “If personal postmortem survival of some sort is real, then how should this alter the way we approach our bioethical discussions about death, the harm of death, and harming the dead?” The bioethics issues I briefly discuss in the remaining two sections are the debate about defining death and the decision whether to forego life-prolonging treatments. Continue reading

Fox, Marie. Realizing Social Justice in Public Health Law. Medical Law Review. November 2012.

Law has played an important, but largely constitutive, role in the development of the public health enterprise. Thus, law has been central to setting up the institutions and offices of public health. The moral agenda has, however, been shaped to a much greater extent by bioethics. While social justice has been placed at the heart of this agenda, we argue that there has been little place within dominant conceptions of social justice for gender equity and women’s interests which we see as crucial to a fully realized vision of social justice. We argue that, aside from particular interventions in the field of reproduction, public health practice tends to marginalize women—a claim we support by critically examining strategies to combat the HIV pandemic in sub-Saharan Africa. To counter the marginalization of women’s interests, this article argues that Amartya Sen’s capabilities approach has much to contribute to the framing of public health law and policy. Sen’s approach provides an evaluative and normative framework which recognize the importance of both gender and health equity to achieving social justice. We suggest that domestic law and international human rights provisions, in particular the emerging human right to health, offer mechanisms to promote capabilities, and foster a robust and inclusive conception of social justice. Continue reading…

Opinion

Buzzfeed

Reinsberg, Hillary. How bioethicists want doctors to approach LGBT patients differently. November 8, 2012.

Dr. Lance Wahlert is a co-director of The Project on Bioethics, Sexuality, and Gender Identity at the University of Pennsylvania who is leading the way in establishing the burgeoning academic field of Queer Bioethics. He explains some of the issues he’s studying, and why the medical community needs to start thinking differently about LGBT issues differently. Continue reading…

Los Angeles Times

Editorial. Gay rights and the marriage march. November 8, 2012.

It took a long time for same-sex marriage to win at the ballot box, but when it finally happened Tuesday, it happened in a big way. In the states where voters considered measures to recognize gay marriage rights — Maine, Maryland and Washington — all three won approval. In Minnesota, voters rejected a Proposition 8-like measure that would have embedded a ban on same-sex marriage in the state constitution. Continue reading…

Editorial. Sandy: Act of God or act of man? November 1, 2012.

Is global warming to blame for Sandy the “Frankenstorm”? Pundits and politicians were arguing about that even before the massive storm struck the Atlantic coast; now that it has moved on, after killing 50, flooding the New York subway system, ripping away chunks of New Jersey’s coastline and causing myriad other damage that will place Sandy among the most expensive natural disasters in U.S. history, it’s a more pressing question. After all, if the storm were an act of man rather than an act of God, we might be able to prevent such disasters from recurring. Continue reading…

National Review Online

Smith, Wesley. Zombies and the real problem of bioethics. November 3, 2012.

Pop Bioethics has a fun article out describing how a bioethicist might analyze the ethics of euthanizing zombies. But beneath the tongue in cheek, I see a serious point to be made about the threat of bioethics to human exceptionalism and universal human rights. Continue reading…

New York Times

Editorial. End the death penalty in California. November 5, 2012.

A ballot initiative in California, Proposition 34, gives voters the chance to abolish capital punishment in the state. Initiatives are generally a bad way to make law, but a vote by the people is the only way to overturn the death penalty in California because that was how it was adopted in 1978. Continue reading…

Editorial. Bad medicine for women. November 6, 2012.

No one should expect a postelection letup in the continuing courtroom fights over state efforts to restrict women’s access to safe and legal abortions. Two important cases — one in the United States Court of Appeals for the Ninth Circuit, in San Francisco, the other in the Court of Appeals for the Sixth Circuit, in Cincinnati — show how intense these battles have become and how important it is for basic women’s rights to prevail. Continue reading…

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