Evening Ethics Discussions

  "Asperger, Autism, and Nazi Medicine: Perspectives from a Historian" with Dr. Edith Sheffer

January 27th is International Holocaust Remembrance Day. The Red Army liberated Auschwitz on that day in 1945, so 2020 marks the 75th anniversary. Each year URemembers brings speakers and events to honor that history. The PMEH is happy to collaborate and welcome Dr. Edith Sheffer, historian, author and senior fellow at the Institute of European Studies at UC Berkeley, to discuss her historical research on Dr. Hans Asperger and his work with autistic and disabled children in Vienna during the Nazi regime. We invite you to join us and consider the ethical questions raised by the fraught histories of Asperger’s ide-as and actions. What do we do with medical research connected to Nazi ideology? How and when does the origin of medical research matter? The suggested reading for this session is the Introduction and Chapters 6 and 7 of Sheffer’s book, Asperger’s Children: The Origins of Autism in Nazi Vienna. Contact linda.carrlee@hsc.utah.edu  for a pdf of this material. 

See URemembers website for other events in this series.

This Evening Ethics is a collaboration with URemembers, The Office of Equity and Diversity, and the Eccles Health Sciences Library 

In Collaboration with Utah Presents: Healthcare Stories of Repair

Healthcare: Stories of Repair, the sequel to Fall 2019’s “Healthcare: Stories of Rebellion,” will examine the idea of repair in all its meanings. What does it mean to be healed? How do we cope with the process of repair? What happens when we try to fix something that isn’t broken? This evening of stories, with some storytellers selected from the audience, will bring us together as a community to grapple with complex questions and find comfort in shared experiences.

This is a UtahPresents event  that is co-sponsored with the Program in Medical Ethics and Humanities and the University of Utah Health’s Resiliency Center. 

This Event requires Tickets.

Emergent Ethics Issues Around COVID-19

Please join us for a discussion of two of the most pressing ethical issues raised by the quickly developing situation around COVID-19:  1. What do we owe people on the front line in health care?  2. If a shortage comes, how should we allocate ICU beds and ventilators?  This Evening Ethics will discuss your questions, among which we anticipate include:  What is the duty of health care providers to go to work in a pandemic? Should they still go in the absence of adequate personal protective equipment? Should their own health or family circumstances factor into the decision to go to work? When providing scare care or resources, should we give priority to the young, or to those without pre-existing conditions?  Should we give priority to first responders?  Or to those first in line?  Should we ever take people off ventilators because others come along who seem to have far better chances of survival if they can get support?  We wish—and profoundly hope—that these questions will not be presented to us in stark form.  Right now, however, it appears that the US is too far beyond the testing and contact-tracing curve, and too late with effective physical distancing, to avoid at least facing some of them.

Background Readings :

https://www.nejm.org/doi/full/10.1056/NEJMsb2005114?query=featured_home

 https://www.nytimes.com/2020/03/23/opinion/coronavirus-ventilators-triage-disability.html

Due to necessary physical distancing, this session will be held via the Zoom meeting platform. Questions and comments will be facilitated through the chat feature on zoom, which will be explained at the beginning of the meeting. Please join us through Zoom meeting  https://utah.zoom.us/j/311575958

"Emerging Ethical Issues in Psychedelic Research" with Ben Lewis, MD

We are experiencing a renaissance in the scientific study of psychedelics. A prolonged political and social moratorium on the scientific and psychotherapeutic study of this class of compounds is recently lifting, resulting in a dramatic upsurge in clinical research. Recent work in psychiatry- while involving small studies and limited control groups - has nonetheless been remarkably promising with large magnitude therapeutic effects after even single drug administrations, particularly for existential distress or anxiety in cancer patients (Griffiths et al 2016, Ross et al 2016, Grob et al 2011), smoking cessation (Bogenshutz et al 2015, Johnson et al 2014, 2017), treatment-resistant depression (Osorio et al 2015), alcohol use disorder (Krebs and Johansen, 2012) and OCD (Moreno et al 2006).

These emerging treatments raise a number of ethical questions. For instance, how ought we to think about the relative importance prior personal experience with psychedelics holds for psychedelic-assisted psychotherapists? And what issues are at stake with any kind of disclosures in this regard given current legal status? What issues arise in thinking through the possible harms of psychedelic tourism - i.e. the flocking of Westerners to S. America for ayahuasca ceremonies? Are there ethical ramifications at stake in the medicalization of this class of compounds, particularly in light of indigenous cultural use and/or the ways in which this set of treatments may interface with Big Pharma?

In this presentation Ben Lewis, MD, will briefly survey some of these questions but will devote the majority of his time to discussing what might be termed 'epistemic risks' at stake with the therapeutic use of psychedelics. Michael Pollan alludes to this set of concerns in his recent book How to Change Your Mind: What the New Science of Psychedelics Teaches Us About Consciousness, Dying, Addiction, Depression, and Transcendence:" It’s one thing to conclude that love is all that matters, but quite another to come away from a therapy convinced that “there is another reality” awaiting us after death ... or that there is more to the universe—and to consciousness—than a purely materialist world view would have us believe. Is psychedelic therapy simply foisting a comforting delusion on the sick and dying? "(Pollan 2015). The worry here is that mystical experiences are- in some sense- spooky and if mystical experience is involved in the causal chain for therapeutic change (as suggested by recent clinical research) there is a risk of violating our commitments to naturalism, or inducing non-naturalistic belief states that may carry unintended harms. This possible ‘Pascal’s Wager’ with psychedelic administration has a host of implications, ethical and otherwise, particularly in the context of vulnerable populations.

Background reading: ”The Trip Treatment” by Michael Pollan ( https://www.newyorker.com/ magazine/2015/02/09/trip-treatment) 

Optional readings:

For pdfs of readings, contact linda.carrlee@hsc.utah.edu

 

Race, Research, and the Coronavirus 

The Centers for Disease Control and Prevention recently published data demonstrating that Black Americans have been hospitalized with COVID-19 at higher rates than other racial and ethnic groups. Further, data also identified that Black Americans are dying at rates higher than their proportion of the population.   Some of the nation’s leading experts in equity, research and healthcare identified pre-pandemic inequities as implicated in this disproportionate burden on Black Americans during the pandemic. Recent protests in response to George Floyd’s death further identified structural bias and discrimination.  As our institution moves forward with equity, diversity and inclusivity research initiatives, discussion from our institutional community is needed to ensure we identify the ethical, legal and social complexities identified through this pandemic and the type of research needed to address these inequities associated with race in our community.  This discussion will consider inequities and how to address them in both COVID-19 and other research at the University of Utah.

Discussion will be facilitated by Erin Rothwell, PhD and Leslie Francis, PhD, JD

Background Readings:

https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-americans-cdc-data.html

https://www.cdc.gov/mmwr/volumes/69/wr/mm6928e1.htm

In Collaboration with Utah Humanities: "The Case for Universal Health Care" with David Colton, PhD, MPA, MEd

Except for the United States, all developed nations provide their citizens with quality, affordable health care. Even with Medicare, Medicaid, SCHIP, and the Affordable Care Act, nearly 25 million Americans do not have health insurance.   Millions that do can only afford high deductible plans, which may prevent them from accessing all but emergency care.

The U.S. is divided on political, fiscal, and religious grounds particularly in regard to the role of the social contract in governance.  Conservatives believe that health care should be an individual responsibility with costs managed throu the free market and little or no government.  Liberals believe that assuring health care is a shared responsibility, though the government guarantees all have access.  Because of this polarization, there has been limited effort to discuss health care from the perspective of our values and expectations as a society.

Background Reading: The Case for Universal Health Care, chapter 11: The Ethical & Moral Case for Universal Health Care (pdf)

Optional additional readings: Liberal and Conservative Representation of the Good Society: A (Social) Structural Topic Modeling Approach.  Sterling, Joanna, Jost, John, and Hardin, Curtis. Sage Open Publications, April-June 2019, 1-13.

 When It Comes to Universal Health Care, What Would Jesus Do? December 19, 2019

Contact linda.carrlee@hsc.utah.edu for pdf.

This Evening Ethics is a collaboration with Utah Humanities

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We jointly welcome author, David Colton, to lead this Evening Ethics Discussion and to the Book Festival Presentation on Friday 9/25/2020 at 5:30pm.  Click here to sign up for the Book Festival Event.

 

 

In Collaboration with the Spencer S. Eccles Health Sciences Library: "Mental Illnesss, Mass Shootings, and the Politics of US Firearms" with Jonathan M. Metzl, MD, PhD, 2020 Cowan Memorial Lecturer & Priscilla M. Mayden Endowed Lecturer

Dr. Jonathan M. Metzl, MD, PhD, our 2020 Cowan Memorial Lecturer and Priscilla M. Mayden Enowed Lecturer, is the Frederick B. Rentschler II Professor of Sociology and Psychiatry, and the director of the Department of Medicine, Health, and Society, at Vanderbilt University in Nashville, Tennessee.  Dr. Metzl will discuss his work as a psychiatrist and scholar of gun violence, race, and mental illness.  Please join us for an interactive discussion that will address questions such as: How are attitudes and debates about guns in the US intertwined with race? How are race and mental illness connected?  What is the medical provider's role in addressing gun violence, including the aftermath of mass shootings? Who benefits from polarized discussions about guns and gun violence?  What are the best ways to discuss mental illness in the context of gun violence?

Background reading for this session:

https://www.the guardian.com/us-news/2019/aug/08/racism-gun-control-dying-of-whiteness

Also recommended: Dr. Metzl's book, Dying of Whiteness: How the Politics of Racial Resentment is Killing America's Heartland

In Collaboration with Utah Humanities: “Solving the Opioid Crisis isn’t just a Public Health Challenge—It’s a Bioethics Challenge” with Travis N. Rieder, PhD

If you have learned about America’s opioid crisis primarily from the media or politicians, you’d be forgiven for thinking that the problem is a rather simple one. We must stop excess prescribing of opioids and prevent heroin from coming in over the southern border or fentanyl from coming through the US Postal Service from China. The problem is not simple, however. This laser-like focus on drug supply is an outdated War on Drugs approach to fighting addiction and overdose, and it simply doesn’t work. Indeed, it often makes things worse. For this reason, I argue that it takes genuine effort to determine what we should do in response to America’s drug problem. That is: we need to do ethics. Solving America’s opioid crisis is not a problem just for public health, or for medicine; it’s a problem for ethics and policy. And on my view, in order to determine what we should do, we need to better understand the nature of drugs and addiction. The goal of this discussion is to touch on all of these topics.

Background Readings: 

  1. “What Chronic Pain Patients are Deeply Afraid Of,” in the NYTimes, here: https://www.nytimes.com/2019/10/31/opinion/opioid-crisis-addiction.html
  2. “Solving the Opioid Crisis isn’t just a Public Health Challenge—It’s a Bioethics Challenge,” forthcoming from the Hastings Center Report

Recommended Reading for those Interested in Dr. Rieder’s broader story and view: 

  1. In Pain: A Bioethicist’s Personal Struggle with Opioids

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We jointly welcome author, Travis N. Rieder, to lead this Evening Ethics Discussion and to the Book Festival Presentation on Tuesday, 10/06/2020 at 5:30pm.  Click here to sign up for the Book Festival Event.

 

In Collaboration with the Department of History, Health Sciences Resiliency Center, College of Humanities, College of Health, and Tanner Humanities Center at the University of Utah: "Slow Medicine, Ethics, and the Case of Mrs. C." with Victoria Sweet, MD, 2020 Medical Humanities Lecturer

Victoria Sweet, MD, is an associate clinical professor of medicine at the University of California, San Francisco. She is the award-winning author of God’s Hotel: A Doctor, a Hospital, and a Pilgrimage to the Heart of Medicine and Slow Medicine: The Way to Healing. In these two books, Sweet argues for a new approach to medical care that takes into account valuable lessons learned from pre-modern practices. Sweet advocates for care based on viriditas, Hildegard of Bingen’s concept of the healing power of nature, onto which she grafts respect for modern medicine through engaging stories drawn from her own medical training. 

Please contact linda.carrlee@hsc.utah.edu for background reading and zoom link for this session.

 

DISCLOSURE:

This program is approved for 1-½ hours of CME credit.

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