As we look back on 2019 and forward to 2020, our guests are editors of key healthcare ethics journals with an international readership:

• Gregory E. Kaebnick, Editor, The Hastings Center Report
• Leslie LeBlanc, Managing Editor, Journal of Clinical Ethics
• Nate Hibner, Primary Editor, Health Care Ethics USA and Director of Ethics at the Catholic Health Association of the United States

What are the issues in health care ethics that are impacting ethics committees, health systems, public policy and patients over the past year? What issues do they expect to continue and emerge within the next year? What are they hearing from authors and readers? What key articles published in their journals published in the last year might they recommend to you, our listeners? We explore these questions and more in this episode of EthicsLab.

Additional resources relating to or referenced in this episode:

• Of Slide Rules and Stethoscopes: AI and the Future of Doctoring, Robert D. Truog
• Patient as Gift, Lydia Dugdale
• Changing the Question, Daniel Brudney
• The Inner Life of Ethicists: The Importance of Cultivating an Interior Life, Paul J. Waddell
• Ethics and Medical Standards of Care: Hysterectomy, Tubal Ligation or Salpingectomy?. Sr. Patricia Talone and Amy Warner

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New research findings regarding HIV status will impact how we understand and practice disclosure of HIV status of patients… specifically whether or not to disclose a sick patients’ HIV serostatus to their family or partner. The new research demonstrates that when an HIV-positive person sticks to their treatment, their HIV is undetectable and untransmittable (U=U). Our three guests are working together on bioethical projects to spread the awareness of U=U.

Our guests in this episode include:

• Jamie Crist, JD, MA a Clinical Ethics Fellow at the Baylor College of Medicine, Houston Texas and doing clinical ethics consultation at Houston Methodist Hospital. Jamie has a JD and Masters in Bioethics at Case Western University.
• Nicole Meredyth, MD, is a clinical ethics fellow at Weil Cornell Medicine in New York Presbyterian Hospital. She is also completing her surgical residency at Weil Cornell University.
• Nekee Pandya, MD; is a clinical ethics fellow at Weil Cornell Hospital and also a hospitalist at that hospital.

Additional resources relating to or referenced in this episode:

• HIV Law and Policy
• CDC HIV Treatment as Prevention
• HIV viral load and transmissibility of HIV infection: undetectable equals untransmittable

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Imagine you are a patient that is seriously ill and the standard clinical treatment is not working for you. You may want to try experimental drug products, still being investigated and not yet approved by the US Food and Drug Administration (the FDA)…what are your options? There are currently a couple of pathways: First, you could enroll as a participant in a controlled clinical research drug trial. These drug trials are reviewed by institutional research boards or IRBs. A key focus of an IRB is to review how well participants are being fully informed of the risks and benefits of the drug trial.

But maybe you don’t meet all the criteria and don’t qualify for the drug trial. Then, there are two other pathways you might pursue – the Food and Drug Administration has an expanded access program and now, there exists Federal “Right to Try” legislation that was signed into law by President Trump in May of 2018. Both pathways are attempting to create more access and also navigate between ensuring patient safety and the ability of a patient with a life-threatening condition to have access to not yet approved approaches by the FDA. This change begs the question, “What level of patient safety is appropriate and what is unhelpful bureaucracy?” What are the risks and benefits of these different approaches to increasing patient access?

Ashley Snyder, our Summer intern at EthicsLab in 2019, will be interviewing our guests. Ashley completed her Masters in Public Health in Epidemiology at the Colorado School of Public Health, University of Colorado and in the Fall will be pursuing her PhD in Public Health at the University of Utah.

Our guests in this episode include:

• Carolyn Chapman, faculty affiliate of the Division of Medical Ethics in the Department of Population Health in the NYU School of Medicine
• Kelly McBride Folkers, Senior Research Associate at the Division of Medical Ethics in the NYU School of Medicine at NYU Langone Health, and a member of the Working Group on Compassionate Use and Pre-approval access

Additional resources relating to or referenced in this episode:

• NYU Langone Health, Division of Medical Ethics Working Group on Compassionate Use & Preapproval Access
• The Hastings Center Report, Federal Right to Try: Where Is It Going? by Kelly Folkers, Carolyn Chapman and Barbara Redman
• U.S. FDA, Expanded Access
• The Goldwater Institute, The Right to Try

Are you a graduate or post graduate student interested in the EthicsLab Podcast intern program? If so, contact us here.

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Why would the question of whether to provide food and water to a patient come up at all? One might assume it is always helpful and never harmful to offer nutrition and hydration to patients. Is that accurate? When might it be appropriate or not appropriate? Our lead contributor in this episode is Alan Sanders, Vice President of Ethics Integration and Strategy at Trinity Health is in conversation with guests in this episode to explore a number of ethical issues related to providing nutrition and hydration to patients who cannot feed themselves.

Our guests in this episode include:

• Dr. George J. Giokas M.D., Director of Palliative Care, Palliative Care Partners, Inpatient Palliative Care Consult Service, Ellis Hospital
• Fr. John J. Raphael, SSJ, Catholic Chaplain and Staff Chaplain at Saint Thomas West Hospital in Nashville, TN

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In healthcare, we are able to capture ever increasing levels and types of data. The potential is there for more accurate diagnosis and more relevant which would better inform healthcare decisions and potentially avoid medical error or unnecessary treatments. Artificial intelligence technologies are increasingly accurate in text, in sound or in image recognition with the capability to process and analyze large volumes of data. They have the potential to lighten the load on healthcare professionals and therefore allowing them to spend more time with patients, potentially improving healthcare decision making and delivering higher quality healthcare. What are ethical questions that arise with this data, and with artificial intelligence technologies?

Our guest in this episode, Anita Ho, is a healthcare ethicist with a background in philosophy and public health and has worked university and hospital settings in Canada, The United States and Singapore. She is currently associate professor at the University of British Columbia Center for Applied Ethics, and Associate Professor at the Bioethics Program at the University of California, San Francisco. A focus of her work has been the ethical impact of innovative technologies such as artificial intelligence in healthcare. We are very pleased to be in conversation with Anita in this episode!

Resources Referenced in this Episode:

• Hastings Center Report Article: Deep Ethical Learning: Taking the Interplay of Human and Artificial Intelligence Seriously, by Anita Ho

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