EGR Past events
COVID 19 may overwhelm our healthcare system. But healthcare professionals aren’t just stretched during a pandemic. The way healthcare is structured means everyday they are torn, advocating for individual patients while juggling competing demands of a group of patients.They are responsible for healthcare systems and populations, not just individual patients. The way we talk about professional responsibility doesn’t always account for the anguishing challenges many healthcare professionals routinely face. In this Ethics Grand Rounds we addressed this urgent public health crisis and discussed whether the ways we think and talk about professional responsibility reflect these complex challenges not just during a public health crisis but in everyday patient care.
A traditional ethic of medicine asserts that physicians have special obligations to individual patients with whom they have a clinical relationship. Professionalism requires that physicians uphold the best interests of patients while simultaneously insuring just use of health care resources. Yet contemporary trends in US healthcare financing like bundled payments seem to threaten traditional conceptions of special obligations of individual physicians to individual patients; their population-based focus sets a tone emphasizing responsibilities of physicians working within organizations to groups of patients served by those organizations. Likewise, while, population health has the potential to improve patient care and health outcomes for individual patients, specific population health activities may not be in every patient's best interest in every circumstance. This can create ethical tensions for individual physicians and other health care professionals practicing within health systems with population health strategies.
Speaker: Dr. Tilburt is a professor of medicine and biomedical ethics at Mayo Clinic where he has been on staff since 2007. He trained in philosophy, internal medicine, and health services research. He studies and writes about ethics and professionalism while conducting grant-funded research on communication and decision making in healthcare delivery. He’s inspired by a desire to recover and reinvent human connection in industrialized healthcare, striving to insure care is meaningful and fitting.
Most American women are not aware that routine mammograms can lead to overdiagnosis and overtreatment of breast cancer. Dr. Gollust presents findings from a 2019 survey assessing women's attitudes about breast cancer screening and their response to various messages about the potential for overdiagnosis. She discusses the ethical, political, and communication challenges related to balancing competing evidence-based recommendations amid a complex, politically-charged information environment.
This is an event of the Office of Academic Clinical Affairs (OACA) hosted by the Center for Bioethics and created in partnership by the following University of Minnesota units: the Masonic Cancer Center, the Division of Health Policy & Management in the School of Public Health, the Hubbard School of Journalism & Mass Communication, and the Women's Health Research Program.
Each year, 44,000 Minnesotans die. Nearly one-fourth die from cancer. Many of these patients want to control the timing and manner of their death. Today, terminally ill patients have several “exit options” in Minnesota. But they generally do not have access to medical aid in dying (MAID). This may be changing. Across the country, access to MAID has been in a rapid state of flux. Ten years ago, MAID was available in only two U.S. jurisdictions. Today, it is available in ten. This presentation reviews the history, status, and prevalence of MAID in the United States. It also summarizes ten new points of ethical debate over whether traditional eligibility requirements and safeguards are too permissive or too restrictive.
Speaker: Thaddeus Pope, JD, PhD, Director, Health Law Institute, Mitchell - Hamline School of Law; Affiliate Faculty Member, Center for Bioethics, University of Minnesota. Learn more about Professor Pope here.
Speaker: Chris Collura, MD, MA, Neonatology, Pediatric Palliative Care, Bioethics, Mayo Clinic Children’s Center
Researcher, ethicist, and public health advocate Amos Laar, PhD connects the dots between HIV and the social, cultural, ethical and human rights issues systemically integrated with the disease in Ghana. For his MA, Laar's completed a masters' thesis in 2014 on ethically appropriate responses to HIV in Ghana. Laar was recently featured in the Lancet's Diabetes and Endocrinology journal for his nutrition work on regulating unhealthy foods in Ghana. This talk brings a social public health perspective to Ghana’s national response to HIV with a focus on how these variables contribute to HIV transmission as well as disease and implementation outcomes. Laar is a native of Ghana with academic training in Nutrition, Public Health as well as an MA in Bioethics from the University of Minnesota. This event was co-sponsored by the Center for Global Health and Social Responsibility and the School of Public Health.
Advance care planning supports patient-centered decision-making by discussing goals, values, and preferences for future medical care. This process involves three key stakeholders: the patient, their surrogate decision-maker, and their clinicians. How do the stakeholder roles change when the patient is an adolescent who has the capacity but not the legal right to make medical decisions? Dr. Jennifer Needle, a Pediatric Intensive Care physician from the University of Minnesota Masonic Children's Hospital and faculty member in the Center for Bioethics, addresses this question from the perspectives of these stakeholders in the context of adolescent advance care planning. She reviews the literature on the benefits and barriers to effective advance care planning, discusses clinician, patient, and surrogate perspectives on medical decision-making in adolescent patients, and discusses future areas of research to support adolescent patients and their families in making informed medical decisions. This event was co-sponsored by the Department of Pediatrics in the University of Minnesota's Medical School.
Speaker: Jennifer Needle, MD, MPH | Assistant Professor, Center for Bioethics, University of Minnesota
In this talk, Dr. Benya discussed the recent National Academies report that examines the effect of sexual harassment on women in scientific, technical, and medical fields in academia. Dr. Benya shared strategies and practices that can be used to prevent and address this discriminatory behavior, and discussed the research that supports these approaches. This event was co-sponsored by the University of Minnesota School of Nursing, The Center for Women in Medicine and Science, and the History of Science, Technology, and Medicine department.
Informed consent requires that research participants understand the study under consideration and appreciate its implications for their interests. Therapeutic misconception – which occurs when individuals confuse the purposes of clinical research with standard clinical care – compromises informed consent. Dr. Bryan A. Sisk expands the discussions beyond therapeutic misconception in clinical trials by explaining multiple ways in which understanding and appreciation of information about a clinical trial can be undermined. He offers a framework of therapeutic misperceptions to assist researchers in managing challenges to the informed consent process. This activity was designed for physicians and other healthcare professionals. By the end of this talk, attendees are able to do the following:
1. Identify two components of decisional capacity
2. Discuss challenges of therapeutic misperceptions in the clinic-research setting
3. Explore a framework of therapeutic misperceptions
3-100 Mayo, U of M East Bank Campus
The background to justice in bioethics revolves around fair access to costly health care resources. Meanwhile, social movements emphasize economic, racial, and identity inequalities within the United States. The demands of climate change add conceptions of justice: environmental justice, intra-specific justice, global inequality, differential responsibility for climate change, and generational justice. How are we to sort out these different emphases? Meanwhile, the rate of climate change is accelerating, and 27 years of negotiations has yielded no actual reduction in global greenhouse gas emissions. While we argue, inevitable misery is mounting up unjustly for young people and future generations.
Speaker: Andrew Jameton, PhD, Affiliate Faculty, Center for Bioethics, UMN; Professor Emeritus, College of Public Health University of Nebraska Medical Center
What truly is a patient's right to self-determine? Can an advance directive take any form? This talk will look at the complexities of autonomous decision making and end of life through the eyes of a young adult expressing her wishes in the form of a tattoo.
Speaker: Nneka Sederstrom, PhD, MPH, MA, FCCP, FCCM, Director, Clinical Ethics Department, Children's Hospital and Clinics of Minnesota and Affiliate Faculty, Center for Bioethics