No Easy Answers in Bioethics

This month the Center was proud to officially announce its new name: Center for Bioethics and Social Justice. This name change reflects an updated mission with a focus on social justice-oriented bioethics. This episode features a conversation between Director Sean Valles, PhD, and Assistant Director Karen Kelly-Blake, PhD. Together they discuss moving forward in the bioethics space, what engaging in service to the people means to them, and the important work to be done to a create a healthier and more socially just world. They also explore questions related to the practical application of bioethics, and the challenge of preparing medical students for clinical practice in an inequitable world.

In this episode, Senior Academic Specialist Libby Bogdan-Lovis is joined by Dr. Sarah Pletcher, Vice President and Executive Medical Director of Virtual Care at Houston Methodist. Dr. Pletcher shares her telehealth expertise in a conversation that explores the benefits of telehealth for patients and providers, the influence of the COVID-19 pandemic on telehealth adoption, reimbursement models, the future of telehealth, and more. Recorded March 5, 2021

This episode focuses on work being done in Michigan to support the well-being of farmers, agribusiness professionals, and the broader statewide agricultural community. Center Assistant Director and Associate Professor Dr. Karen Kelly-Blake is joined by Community Behavioral Health Extension Educator Eric Karbowski and Dr. Melissa Millerick-May, who holds appointments in the Division of Occupational and Environmental Medicine, Environmental Health & Safety, and MSU Extension. Mr. Karbowski shares MSU Extension resources available to farmers experiencing stress, including webinars, teletherapy, and other programs that help to reduce stigma still associated with behavioral health. Dr. Millerick-May discusses her ongoing work on farm safety, including tools developed in response to the COVID-19 pandemic. Both guests also discuss what led them to the work they are currently doing at MSU. Finally, please note that this episode does contain brief mentions of suicide in the context of suicide awareness and prevention. Recorded in February 2021

In the words of guest Mark Van Linden, “adversity can present itself to anybody at any time.” This episode features a personal narrative of life with a spinal cord injury. Center Associate Professor Dr. Karen Kelly-Blake is joined by Mark Van Linden, MSA, and president of Adversity Solutions LLC. Mr. Van Linden experienced a spinal cord injury in 2009. In conversation with Dr. Kelly-Blake, Mr. Van Linden candidly shares his story, discussing his life before and after his injury, and addressing not just the physical impact, but the mental, emotional, and relational impact of becoming paralyzed at age 39. Recorded May 1, 2020

What would you do if you needed surgery, but seeking care would mean $25,000 or more in medical debt? Would you consider traveling to another country to receive the same surgery at a fraction of that cost? Would you put off seeking care entirely, until it became an emergency situation? These questions related to access to care, health insurance, and medical tourism are explored in this episode, which features Center for Ethics faculty members Len Fleck and Larissa Fluegel. Dr. Fluegel, a clinician born and raised in the Dominican Republic, shares her personal experience of needing gallbladder surgery, and the reasons why she traveled from Michigan to the Dominican Republic to receive that surgery. It may not be surprising that the main reason was cost. Discussing the healthcare systems in both countries, Drs. Fleck and Fluegel explore the challenges that under- and uninsured individuals in the U.S. face when seeking care.

This episode features guests Dr. Karen Kelly-Blake, Associate Professor in the Center for Ethics and Humanities in the Life Sciences, and Dr. Masahito Jimbo, Professor in the Department of Family Medicine at University of Michigan Medical School. Drs. Kelly-Blake and Jimbo discuss their NIH-funded study known by the acronym DATES—Decision Aid to Technologically Enhance Shared Decision Making—which addressed shared decision-making, decision aids, and patient-physician communication regarding colorectal cancer screening. The two researchers provide insight into the study and its results, also reflecting on what the process of shared decision-making means to them in the present day.

What can neuroscience tell us about human consciousness, the developing brains of babies, or lab-grown brain-like tissue? How do we define “consciousness” when it is a complex, much-debated topic? In this episode, Michigan State University researchers Dr. Laura Cabrera, Assistant Professor in the Center for Ethics, and Dr. Mark Reimers, Associate Professor in the Neuroscience Program, discuss the many layers of consciousness. Examining recent research on lab-grown brain organoids, they discuss moral and ethical considerations of such research, including how future technologies could challenge our definitions of consciousness and moral agency. They distinguish consciousness from intelligence, also discussing artificial intelligence.

This episode focuses on the topic of social determinants of health, or the social and environmental factors that influence our health and access to resources. How can social determinants of health be integrated effectively into medical education and clinical practice? Center for Ethics faculty members Libby Bogdan-Lovis and Dr. Karen Kelly-Blake speak with College of Human Medicine student Brittany Ajegba, who emphasizes the need for standardization when training physicians on social determinants of health. From medical education to clinical encounters, they provide a variety of perspectives on this increasingly important work.

We can look at an individual’s DNA and know what their hair color is, but what about their behavioral traits? This episode features Center for Ethics Assistant Professor Dr. Laura Cabrera, and Dr. Mark Reimers, Associate Professor in the Neuroscience Program in MSU’s College of Natural Science. Drawing from their expertise as neuroscience researchers, they discuss what we know about how our DNA affects our behavior—from IQ scores to mental illness. They also explore possible ethical issues that may arise in the near future related to the study of behavioral genetics and gene expression.

What kinds of challenges currently exist within precision medicine? This episode focuses specifically on targeted cancer therapies, featuring a discussion between Center Professor and Acting Director Dr. Len Fleck and College of Osteopathic Medicine student Stephanie Mackenzie. Dr. Fleck discusses ethics, economic, medical, and health policy issues related to these high-cost therapies. Additionally, he provides insight into how U.S. pricing models for these therapies compare with other countries.