Eat Your Heart Out Aristotle

Greetings!

BK Christopher and I are working and playing hard as we plan the retirement celebration for Rosemary Flanigan to be held October 19th from 6 to 8 pm at the Kansas City Downtown Library.

We chose a philosophical theme (Eat Your Heart Out, Aristotle!) in honor of Rosemary's teaching years and her raucous style of approaching health care ethics!

Please join the Center Staff, Rosemary's family, friends, past students and groupies to recognize her retirement and the Flanigan Chair, named in her honor. We promise an evening of fun, food, drinks and memories. Music will be provided by Kansas City's own Jazz For Good quartet.

Assist us in rolling out the red carpet for one of the most adored in Kansas City, Sister Rosemary Flanigan. Eat your heart out, Aristotle. Maybe drink a bit, too!

See you Octber 19!

Helen Emmott

Links:

Register and pay online by clicking here.

Bummer! You cannot attend what promises to be a raucous event. Please make a contribution by clicking here.

Please send your “words of wisdom” to be included in the Memory Book we are preparing for Rosemary. Just send to Donna Blackwood at dblackwood@practicalbioethics.org or Center for Practical Bioethics, Harzfeld Building, 1111 Main, Suite 500, Kansas City, MO 64105

Save the Date Card

Is this doctor treating lesbianism in the womb?

Lindsay Beyerstein
Slate
September 28, 2010

Dr. New is the latest pediatrician to be dragged into a controversy over how to treat girls with CAH, the leading cause of ambiguous genitalia in girls. In June, a Cornell surgeon who performs reconstructive surgery on young girls with this condition was declared barbaric.

Both are targets of ethicist activists who have decided that the correct treatment for ambiguous genitalia is no treatment, and that society should just come to accept these anatomical variations as part of the normal gender continuum.

Links:

Slate article

A Case Study in Unethical Transgressive Bioethics: Letter of Concern from Bioethicists About the Prenatal Administration of Dexamethasone, abstract, American Journal of Bioethics, September 2010

A Case Study in Unethical Transgressive Bioethics, Laurence McCullough, PhD, The Bioethics Channel, 8 minutes 20 seconds

Medical Futility Blog: Black Patients Get More Unwanted Life-Prolonging Care at the End of Life

Thaddeus Pope
Medical Futility Blog

End-of-life discussions and communication goals seem to assist white patients in receiving less life-prolonging EOL care, but black patients do not experience the same benefits of EOL discussions.

That's according to an article in this week's Archives of Internal Medicine.

For more click here.

Transforming Care for People with Advanced Illness

Myra Christopher
Bill Novelli

Living with advanced illness in America is painful, isolating and costly. Most people spend their last days alone in hospitals and nursing homes, often in pain, despite the availability of effective pain management.

The current system fails the public, health providers and society. That is why “The
Transformation Project: A New Initiative to Improve Advanced Illness Care” is creating a national consortium of leading organizations and individuals to work collaboratively on this issue.

The goal is to produce a system that provides quality care consistent with the patient’s goals and values.

In this edition of the Bioethics Channel host Lorell LaBoube visits with the co-directors of the initiative – Myra Christopher, president and CEO of the Center for Practical Bioethics, and Bill Novelli, Professor at the McDonough School of Business at Georgetown University.

Links:

Overview, Transformation Project

Podcast, 12 minutes 39 seconds

Ethics Consultations Curbside and Elsewhere

George Flangan, DMin, MA

Program Associate

Center for Practical Bioethics

Physicians in private practice settings, and often in hospital settings as well, do not go far to seek consultation for their ethical concerns. It is typical, especially in small communities where there are few physicians and no bioethicists, that a phone call or a hallway chat with a colleague, usually in the same practice, is deemed sufficient to make an ethically sound decision.

Do they know the right questions to ask?

The Center for Practical Bioethics has long recommended interdisciplinary ethics consultation teams/committees because the conversation allows a diversity of perspectives. Among physicians who practice together, as with most professional groups, there develops a culture of practice that may effectively limit the questions they ask about treatment decisions.

It’s as true in healthcare ethics as it is in any part of life: If I have an ethical concern or, at least, some uncertainty about a treatment, I will do best to include in the consultation someone who is willing to tell me I am, simply, wrongheaded, rather than merely helping me justify an action I have already decided I want to take.

Link: Consultations on ethics are not limited to the curbside, American Medical News, September 20, 2010

Making or Having Babies

The Center’s John B. Francis Chair Glenn McGee, PhD has written and spoken about ethics in genetics.

Here is an updated story on the Molly Nash case along with a podcast featuring Dr. McGee.

L2

'Savior sibling' raises a decade of life-and-death questions
Josephine Marcotty
Minneapolis Star Tribune
September 22, 2010

Those who have watched the technologies advance and spread say the larger ethical questions raised by the Molly Nash case are more urgent than ever. They say government and professional oversight of reproductive technology is long overdue.

Link: Podcast, Making or Having a Baby: The Ethics of Genetic Testing, Glenn McGee, PhD, The Bioethics Channel, 16 minutes 5 seconds

To Feed or Not to Feed?

The Legacy of Nancy Cruzan: 20 Years Later Are We Any Better at Healthcare?

November 12 and 13, 2010

Kansas City, Missouri

(Register for the conference NOW by clicking here.)

David Casarett, MD is one of three prominent clinical researchers in palliative medicine presenting a new model for resolving what they refer to as a false dichotomy -- to artificially feed or to starve.

Dr. Casarett joins a distinguished panel including Joan Teno, MD of Brown University and Dan Brauner, MD of the University of Chicago. John Carney of the Center for Practical Bioethics will moderate.

For more information about the conference and to register, click on the links below.

Links:

Conference Overview
Program
Speakers
Podcast with Dr. Casarett, 12 minutes 1 second

Should a Family Decide What Mom Didn't Say?

Debra Schuster, JD

September 17, 2010

9 minutes 36 seconds

It’s a balancing act between improving end of life care and protecting patient interests. Is surrogate decision making the answer?

Debra Schuster, an elder law attorney in St. Louis, talks about it in this edition of the Bioethics Channel. Ms. Schuster presents on the topic during the Sixth Annual Policy Summit of the Missouri End of Life Coalition September 30 in Jefferson City, Missouri.

Link to podcast here.

The Ethics of Donation after Cardiac Death

David Magnus, PhD

September 17, 2010

13 minutes 8 seconds

The debate continues on the ethics of donating organs after cardiac death. How do we make sure patients do not suffer, or that their dying is prolonged? When is someone truly dead, meaning that their organs can be used for transplant?

David Magnus of the Stanford Center for Biomedical Ethics provides some answers and insights in this edition of the Bioethics Channel.

Link to podcast here.

Eat Your Heart Out Aristotle

Save the Date – October 19 from 6 to 8 pm at the Kansas City Library downtown – for an extraordinary event featuring our own beloved Sister Rosemary Flanigan.

Eat Your Heart Out, Aristole is the Center’s way of celebrating Rosemary’s retirement while noting her special appreciation of all philosophers, then and now. It will be an evening filled with fun, laughter and reminiscing about all things Rosemary.

If you cannot attend, please consider making a contribution to honor Rosemary’s decades of work. Net proceeds from the event will fund the Rosemary Flanigan Chair at the Center for Practical Bioethics.

Please make your plans to attend by clicking here. You won’t regret it, and Sister Rosemary will be grateful!

Medical Futility Blog: Symbolic Resuscitation, Medical Futility, and Parental Rights

Thaddeus Pope says:

On Monday, PEDIATRICS posted a to-be-published debate article between Joel Frader, Eric Kodish, and John Lantos. The debate is whether a DNR order is appropriate for a 2-year-old girl with septo-optic dysplasia, microcephaly, seizure disorder, and other issues.

For more click here.

The Legacy of Nancy Cruzan: 20 Years Later, Are We Any Better at Healthcare?

A National Conference on the Past, Present and Future of the PSDA, Nutrition - Hydration, and Palliative Care

November 12 and 13

Kansas City, MO

REGISTER NOW at www.cruzan.bioethics.net

Twenty years ago, many policy leaders thought that the Nancy Cruzan decision and the Patient Self-Determination Act had established a policy framework to address one of society’s most vexing ethical issues – decision making for those without cognitive capacity including those who were permanently unconscious.

Since then, many have come to believe that this policy structure was insufficient, fractured, or simply wrong headed. It has certainly been insufficient.

On November 12th and 13th, leading bioethicists, clinical researchers, moral theologians and other thought leaders will convene in Kansas City “at the epicenter” where both Cruzan and PSDA have deep roots to reflect on these historic events and to revisit the concerns they attempted to address.

A new model will be presented and considered as a solution to these problems in an increasingly diverse and pluralistic society confronting limited financial resources.

For more information and to register click below.

Links:

Conference Overview
Program
Speakers

Registration

Guinea-Pigging: It's Not A Real Word, But It's A Real-World Phenomenon

"Guinea-pigging" really isn't even a word.

But it clearly is a well established part of the research establishment, as many of us know and this video clearly demonstrates.

Summer Johnson, PhD

For more click here.

Dr. Joseph Fins to Speak at Cruzan Conference

November 12 and 13, 2010

Westin Crown Center
Kansas City, MO

The questions raised by the Nancy Cruzan Case 20 years ago resonate to this day.

When is someone in a persistent vegetative state? What about other states of altered consciousness? When should artificial nutrition and hydration be withdrawn from such patients, and who decides?

Joseph Fins, MD, chief of medical ethics at Weill Cornell Medical College, joins Art Caplan, PhD and Glenn McGee, PhD on a panel to discuss these issues during “At the Epicenter: Cruzan and PSDA 20 Years Later” on November 12 and 13th in Kansas City.

For more information and to register click on the links below.

Links:

Conference Overview

Podcast: The State of Altered Consciousness, Joseph Fins, MD, 14 minutes 22 seconds

FDA and Office of Human Research Protection Respond to Fetal Dex Complaint

Glenn McGee, PhD

Blog: Bioethics.net

The September issue of The American Journal of Bioethics, presaged by such astonishing articles as "The Lesbian Drug" in Newsweek, stretched the boundaries of the Journal by engaging questions about the extraordinary implications of the social and medical debate concerning the administration of dexamethasone during pregnancy in females with congenital adrenal hyperplasia.

With the release of the September issue of the Journal, both the Food and Drug Administration and the Office of Human Research Protections have released letters responding to the complaints.

For more click here.

Link: A Case Study in Unethical Transgressive Bioethics, Laurence McCullough, Baylor College of Medicine

Center in the News

Glenn McGee, the Center's John B. Francis Chair in Bioethics, has been a busy man in recent days, quoted frequently in various news media. Here are the links.

L2

Obesity looms as weighty employment issue

Aly Van Dyke

Kansas City Business Journal

September 3, 2010

“You had to figure at some point people were going to put on a different pair of glasses when they looked at their employees,” said Glenn McGee, John B. Francis chair in bioethics at the Center for Practical Bioethics in Kansas City. “But does your boss have the right to expect that you won’t get fat?”

The Ethics of Genetic Selection
Glenn McGee, PhD

Up to Date with Steve Kraske

KCUR Radio

September 2, 2010

Steven Potter PhD and Glenn McGee, Ph.D., holder of the John B. Francis Chair in Bioethics at the Center for Practical Bioethics and founding editor of The American Journal of Bioethics discuss the science behind and ethical issues surrounding genetic selection, and the consequences of this new technology in terms of human evolution.

Human Egg Sales Raise Bioethical Issues
Scott Carney

Fast Company

September 1, 2010

Glenn McGee predicts that "we will soon begin to recognize the danger of an ant-trail model of reproduction whereby strangers without any responsibility to each other and clinicians able to vanish in a puff of smoke meet in a transaction that culminates in humanity's ultimate act: creation."

Most ED patients willing to wait longer to avoid nondoctor care
Kevin B. O'Reilly

American Medical News

August 30, 2010

"It's common courtesy that the health care professional introduces him or herself, so I see that as a basic primer of communication with patients and that is taught in nursing schools and medical schools," said Connie Ulrich, RN, who contributed a commentary to the American Journal of Bioethics in response to the study. "Any time we can be transparent, we should be."

What now Dr. Gawande?

Myra Christopher

John Carney

Dr. Atul Gawande has created ripples of reaction throughout the medical community with his article in the August 2, 2010 edition of The New Yorker. The piece is entitled “Letting Go: What should medicine do when it can’t save your life?”

In this edition of the Bioethics Channel Myra Christopher, president and CEO of the Center for Practical Bioethics, and John Carney, vice president for aging and end of life at the Center, share their viewpoints on the article.

Link to podcast here -- 17 minutes 8 seconds

Top Ten Lectures in Bioethics -- August 2010

Lectures in Bioethics are longer form presentations available through the technology of podcasting. It is a free podcast.

To subscribe via iTunes click here or you may click on lecturesinbioethics.libsyn.com/rss .

Top Ten Lectures in Bioethics -- August 2010

The Politics of Palliative Care
Kathleen M. Foley, MD

Eugenics, Race and Bioethics
Glenn McGee, PhD

Systems Reform and Innovation
Gary Pettett, MD

The Ethics of Living Forever
Glenn McGee, PhD

I'm dying, STAT! Call my...lawyer?
William Colby, JD

To Screen or Not to Screen? -- Ethical Controversies in Mammography Screening
Panel

Genetic testing from a traditional Jewish perspective - can testing before marriage help?
Daniel Eisenberg, MD

Bending the Cost Curve
Marcia Nielsen, PhD

Healthcare Economics of Healthcare for Older Americans -- From Virtue to Voodoo and Back Again
Perry Fine, MD

Why People Still Suffer at the End of Life
Myra Christopher

Top Ten Podcasts August 2010

The Bioethics Channel continues to grow with another record level of podcast downloads in August.

The Bioethics Channel is a free podcast. To subscribe via iTunes click here or you may click on medicalchannelsonline.libsyn.com/rss.

The Bioethics Channel – Top 10 August 2010

Hospice Care in Prison
Carol McAdoo

Ethics of Deactivating Implantable Devices
Glenn McGee

Diverse Ethics of Translational Research
Neema Sofaer

Stem Cells: The Ethics Debate Begins Anew
Glenn McGee

Mental Health & the End of Life
Brian Carpenter, PhD

Elderburbia: Aging with a Sense of Place
Phil Stafford

Case Based Palliative Care
Christian Sinclair, MD
Karin Porter-Williamson, MD

Sister Rosemary Retires
Rosemary Flanigan
Myra Christopher

A Conversation with Bill Colby
William Colby, JD

Presidential Bioethics
Barbara Atkinson, MD

Summer Johnson, PhD

Most ED Patients Willing to Wait Longer for MD

Kevin B. O'Reilly

American Medical News

August 30, 2010

"It's common courtesy that the health care professional introduces him or herself, so I see that as a basic primer of communication with patients and that is taught in nursing schools and medical schools," said Connie Ulrich, RN, who contributed a commentary to the American Journal of Bioethics in response to the study. "

Any time we can be transparent, we should be."

Link to article here.