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No Easy Answers in Bioethics is a monthly podcast presented by the Center for Bioethics and Social Justice. Each episode features Center faculty and their collaborators discussing their ongoing work and research across many areas of bioethics—clinical ethics, evidence-based medicine, health policy, medical education, neuroethics, shared decision-making, and more.
25 Episodes
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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.
How can shared decision-making tools and evidence-based guidelines be used to ensure that every patient receives the best care possible? How can patients be activated and equipped to interact with their provider and manage their health condition? In this episode, three Michigan State University researchers—Dr. Bill Hart-Davidson, Professor in the Department of Writing, Rhetoric, and American Cultures, Dr. Karen Kelly-Blake, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Medicine, and Dr. Ade Olomu, Professor of Medicine in the Department of Medicine—discuss a shared decision-making tool they developed called Office-GAP, Office-Guidelines Applied to Practice. Together they discuss the origins of the project, and the results so far in improving outcomes for patients managing chronic illness by using a simple checklist to get patients and providers on the same page.
According to recent data from Donate Life America, more than 110,000 people are waiting for lifesaving organ transplants; 80% of those patients are waiting for a kidney. In this episode, Center Acting Director and Professor Dr. Leonard Fleck is joined by Dr. Arthur Ward of Michigan State University’s Lyman Briggs College. Dr. Ward, a philosopher and bioethicist, shares his recent experience of anonymously donating a kidney to a stranger. He discusses how and why he made the decision to donate, and explains why he thinks more people should consider making the same choice to help others.
This episode was produced and edited by Liz McDaniel in the Center for Ethics. Music: "While We Walk (2004)" by Antony Raijekov via Free Music Archive, licensed under a Attribution-NonCommercial-ShareAlike License. A full episode transcript is available at bioethics.msu.edu.
What are the ethical implications of gene-editing human embryos? Do we risk stifling scientific advancement by banning such medical research? Guests Dr. Leonard Fleck, Acting Director and Professor in the Center for Ethics, and Dr. Marleen Eijkholt of Leiden University Medical Center in the Netherlands discuss the pros and cons, stemming from the recent news out of China of gene-edited babies. They share thoughts on the ethical implications of using such technology to alter human embryos, both now and in the future.
How do patients, their families, or their caregivers express hope for a miracle in the clinical setting? How can medical professionals respond to these desires for a miracle to occur? Guests Dr. Devan Stahl, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and Department of Pediatrics and Human Development at Michigan State University, and Dr. Trevor Bibler, Assistant Professor in the Center for Medical Ethics and Health Policy at Baylor College of Medicine, have written on this topic, with articles published in the American Journal of Bioethics and the Journal of Pain and Symptom Management. In this episode they discuss the framework for categorizing the various ways in which people hope for a miracle, while also drawing from experiences they have had as clinical ethicists. They also discuss the importance of not making assumptions when miracle language is used, emphasizing the need for all religious beliefs to be respected by medical professionals.
What does it mean to declare brain death in the clinical setting? How does the language we use surrounding death complicate these situations? What beliefs and philosophies exist regarding what constitutes the death of a person? Center for Ethics and Humanities in the Life Sciences faculty members Dr. Devan Stahl and Dr. Tom Tomlinson discuss these questions and more from both clinical ethics and philosophical perspectives. They go over the history of how brain death came to be defined in the United States, and discuss some cases in the news from recent years.
Would you ever consent to have your medical procedure broadcast on social media? This episode addresses a trend known as Snapchat surgeons – plastic surgeons who amass sometimes millions of followers on the social media platform Snapchat by posting uncensored videos of operations they are performing. These videos are often highly stylized, comedic, and meant to entertain.
Guests Dr. Devan Stahl, Assistant Professor in the Center for Ethics and the Department of Pediatrics and Human Development, and Dr. Christian Vercler, Clinical Associate Professor of Plastic Surgery in the Department of Surgery at the University of Michigan and Co-Chief of the Clinical Ethics Service in the Center for Bioethics and Social Sciences in Medicine, have published research on the subject, most notably in the AMA Journal of Ethics in April of this year. Together they offer their insight and expertise on the issue, and discuss whether these Snapchat performances are ethical. They also delve into the societal norms and power dynamics at play, and address how to move forward within the profession of plastic surgery in a world where social media seems to be here to stay.
What issues were bioethicists concerned with in the early days of the field? This episode features two senior Center faculty members, Director Tom Tomlinson, PhD, and Professor Len Fleck, PhD. Together they discuss and reflect on the accidental ways in which they entered the field of bioethics in the ‘70s and ‘80s, also touching on the creation of the program that became the Center for Ethics around that same time, and the early days of the College of Human Medicine. They discuss the changes they’ve seen around topics such as death and dying, advance directives, and advances in medical technologies. Finally, they speculate on where bioethics may be headed in the future.
What kinds of organ donation models exist around the world, and how effective are those models? This episode on organ donation models features Center Assistant Professor Dr. Marleen Eijkholt and Center Professor Dr. Len Fleck. Combining their clinical ethics and health policy expertise, they sat down together to discuss ethical issues within current organ donation models, stemming from recent legislation passed in the Netherlands to implement an opt-out system of organ donation. Drs. Fleck and Eijkholt discuss positive and negative aspects of opt-out and opt-in systems, also drawing from other countries around the world. Additionally they discuss reasons why individuals may choose not to be organ donors, and the types of situations that can emerge at the bedside when grieving individuals do not want their loved one’s organs to be donated.
The recently released book Imaging and Imagining Illness: Becoming Whole in a Broken Body began as a collaboration between sisters Devan Stahl, Assistant Professor in the Center for Ethics and Humanities in the Life Sciences and the Department of Pediatrics and Human Development, and Darian Goldin Stahl, artist and printmaker. The edited volume examines the impact of medical imaging technologies on patients and our wider culture. In this episode, guests Devan and Darian share the personal origins of their collaboration. They discuss Darian’s artistic process, how audiences have reacted to the artwork, and how they came to invite other scholars to build on their work. By and large, Devan and Darian’s story delves into the intersection of art, illness, disability, and self-identity.
This episode features Libby Bogdan-Lovis, Assistant Director of the Center for Ethics and Humanities in the Life Sciences, and Dr. Karen Kelly-Blake, Assistant Professor in the Center for Ethics and the Department of Medicine at the Michigan State University College of Human Medicine. As leaders of a multi-institutional research team, they were interested in examining strategies and associated rationales for expanding underrepresented minority presence in U.S. undergraduate medical education. In this episode, they provide insight on what their scoping review has revealed, focusing on the notion that underrepresented minorities in medicine are often expected to pursue a service track—an expectation not placed on their white majority peers.
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