Dr. Amy McGuire
Spring is finally here, and as our recent Off Script event’s theme of “Degeneration/Regeneration” suggests, it is a season of transformation. As the topic implies, the only constant in life is change.
This is never more apparent to me than on Match Day, when our fourth-year students learn what medical institutions they have been paired with for residency training. It is a day filled with anxiety, excitement and expectation. For all of the fourth-year students it represents the closing of one chapter in their lives and the beginning of something new. As the students rush to grab the envelopes with their names on it from the giant easel set up in the Baylor courtyard, the anticipation is palpable. Moments before their destiny is revealed, Dr. Klotman reminds them, it doesn’t matter if they got their first, second or third choice, because wherever they go will be the right place for them.
I have come to believe in my work and in my life that everything happens for a reason. My colleague Larry McCullough’s favorite 17th century philosopher, Gottfried Leibniz, agreed. He argued that there is a reason for everything (sufficient reason) and that everything is perfectly coordinated and connected (pre-established harmony). That does not mean we lack free will, that bad things don’t happen to good people or that we are powerless to change our circumstances and our reality. As Marianne Williamson once said, “the only failure in life is something we didn’t learn from.” This is something that is deeply ingrained in the philosophical, religious and cultural beliefs of the indigenous tribes in South America that several of us in the Center had the privilege of engaging with last summer and will be visiting again July 15-22, 2018. They believe that “the world is as you dream it,” that we can and must evolve our individual and collective condition, and that change is natural and good, even when it is unexpected or unplanned.
So as spring heralds the start of new things, I encourage you to trust the process of transformation and to look for opportunities for growth in your own life and work. Things may fall apart, but this creates space for even better, often unimagined things to come together, as long as we do not cling too tightly to our preconceived notions of how things should be. So much of what is great and wonderful lies in that unknown and uncomfortable space between degeneration and regeneration: the relationships that we build, the things that we accomplish and the exciting ways that we continue to flourish, individually and as a community.
Issue 3 | Volume 6 | 2018
Dr. Gabe Lazaro-Munoz speaks from the heart at The Conversation
Tickets for The Conversation speaker series cover lunch at Grappino di Nino
Bioethics Grand Rounds
Join us at Houston Methodist Hospital as we explore ever-changing topics within bioethics. Upcoming topics include code status, tissue ownership, end of life care and many more! Continuing education credit is available for a variety of healthcare professionals. Learn more about upcoming Grand Rounds topics on our website.
Are you interested in a cultural immersion this summer? Join Dr. Amy McGuire and eco-tourism pioneer Daniel Koupermann on a life-changing trip to Guatemala. Contact Linda Leyerle at LLeyerle@aol.com for full itinerary and additional information.
The Conversation Speaker Series
Only two more opportunities are left to catch this year's The Conversation Speaker Series. In April, Dr. Ricardo Nuila will tackle the challenging and relevant topic of access to care in Houston's vulnerable populations. Dr. Nuila brings the perspective of a physician and writer to a topic of great importance to our city and country. In May, Dr. Stacey Berg will explore the ethics of medical marijuana. As the Director of the Palliative Care Program at Texas Children's Cancer and Hematology Centers, Dr. Berg's views on marijuana as medicine are sure to spark an excellent discussion. Join us for lunch as we finish out an amazing year of topics and gear up for the next round of The Conversation.
Dr. Stephanie Morain engages with the audience at The Conversation
Interact with the Center for Medical Ethics and Health Policy
Issue 3 | Volume 6 | 2018
Kaisu Koski: Scenes of Disclosure
On Feb. 21st, BCM's Program in Narrative Medicine welcomed artist-researcher Dr. Kaisu Koski for a screening of her short film, "Scenes of Disclosure." The film explored the role of standardized patients in medical education and how empathy is developed or manufactured by both sides of the simulated patient-physician relationship. After the film, Dr. Kirsten Ostherr from Rice Unviersity and Dr. Ricardo Nuila joined Dr. Koski for a panel discussion about the film.
Stay informed about upcoming events
Interested in learning more about future Narrative Medicine events? Connect with the Program in Narrative Medicine on Facebook and Twitter @NarrativeMedBCM
The Healthcare Policy and Management Track continues to work hard to incorporate student feedback into our ongoing quality improvement efforts. Track leadership recently completed a focus group session with highly motivated learners who have completed the introductory lecture and seminar series. Their feedback proved thought-provoking and valuable as we continue to develop education programs that best serve the needs of the students and the college while capitalizing on the unique strengths of our faculty. In response, a new research elective is in development with a tentative launch date of Fall 2018.
The TMC has a storytelling night! On March 29th, our Program in Narrative Medicine hosted the 5th Off Script: an hour of tales from students, residents, faculty, and more. This installment explored the topic "Regeneration/Degeneration."
Issue 3 | Volume 6 | 2018
Dr. Andrew Childress hosts Off Script
Our Ethics Track students are working hard on finalizing their final projects before graduation. Some have even taken their efforts a step beyond and sought out opportunities to publish their work in scholarly journals. We would like to take this opportunity to congratulate the following students on their excellent publications stemming from their mentored research project. Their hard work has certainly paid off.
Suchi Agrawal: "Who calls the shots? The ethics of adolescent self-consent for HPV vaccination" with Stephanie Morain. Available now in BMJ Journal of Medical Ethics.
Ankita Patro: "The Patient Who Continues to Smoke On-Treatment: An Ethical Dilemma" with Christi Guerrini, Andrew Huang and Andrew Sikora. Available now in Otolaryngology - Head and Neck Medicine.
Tony Xu: "Delay in State Adoption of Newborn Screening Tests" with Vignesh Ganapathy and Stephanie Morain. Available now in Pediatrics.
Danielle Clark: "HEADS4: Social Media Screening in Adolescent Primary Care." Forthcoming in Pediatrics.
Healthcare Policy & Management Track
Scenes of Disclosure
LEssons learned from Hurricane Harvey
TMC Health Policy Course
The 2018 TMC Health Policy Course is a first-of-its-kind collaboration between the Texas Medical Center's academic institutions. The course teaches students the fundamentals of U.S. health policy and provides them with the background and context they need to analyze the most pressing policy challenges facing the country today. Stream the past and future sessions live or attend for free.
Associate Director of Health Policy Dr. Christopher Scott moderated a panel featuring Marc L. Boom, M.D., the President & CEO of Houston Methodist Hospital and Texas State Rep. Sarah Davis, J.D.. The panel explored entitlements to medical care, practical and ethical ramifications when patients refuse to be discharged due to an impending storm, rationing resources, and utilitarian considerations of whether or not the needs of the many should outweigh the wants or needs of a few.
Dr. Tim Garson leads the panel discussion at the Jan. 9th installment of the TMC Health Policy Course
Fifth Annual Health Policy Symposium
Join Dr. Cedric Dark and the Policy Prescriptions® team on Friday, April 20th, as they explore diverse, evidence-based topics in health policy. This half-day event will cover gun violence, pharmaceutical pricing, veteran's healthcare and many more newsworthy issues. The full schedule and registration are available online.
American Association for the Advancement of Science
Dr. Christopher Scott made the trip to Austin for the AAAS Conference and to moderate a panel on genome editing, religion and human identity. Panelists included theologian Nicanor Austriaco, responsible genetics advocate Marcy Darnovsky and Rice CRISPR biologist Gang Bo. More than 100 people attended this exciting panel discussion.
Lawsuits and public health
Claire Horner and colleagues recently published a paper in NPJ Regenerative Medicine entitled, “Can civil lawsuits stem the tide of direct-to-consumer marketing of unproven stem cell interventions.” In it, they analyze whether public health litigation strategies, which have been used to address public health issues ranging from tobacco companies to gun control, could be applied in the context of direct-to-consumer unproven stem cell interventions. Check it out to learn more about this important subject.
We are hosting “Ethics Week” from April 30 to May 4 at Houston Methodist Hospital. The program is intended to provide education to care providers about ethical issues arising in patient care and raise awareness about the ethics consultation service. The agenda includes three lunchtime talks: The first addresses alert but incapacitated and unrepresented patients, the second discusses miracle language, and the third will be a panel of healthcare providers discussing the ethics consultation service and the ways in which ethics consultation can facilitate conflict resolution at the bedside. The Center will also have a table set up throughout the week with information about advance directives, contact information for the service and a fun ethics quiz that earns participants raffle entries for great prizes!
Name: Sophia Fantus, Ph.D., M.S.W.
Professional interests: Clinical and research ethics, gestational surrogacy and assisted reproductive technologies, queer bioethics, social work ethics and moral distress.
Educational background: I received my B.A. in Religion and Bioethics from the University of Toronto, my Master of Social Work from New York University, and my Ph.D. from the University of Toronto with a collaborative specialization in Social Work and Bioethics.
A day in the life: During on-call weeks there is no such thing as a typical day! Most days will involve attending ICU rounds, participating in family meetings and interacting with patients, families and multidisciplinary care teams. I attend bioethics committee meetings, medical review boards and Center case consultation debriefs. During my research weeks, I have been working on initiating a qualitative project exploring moral distress among non-direct care practitioners at Houston Methodist Hospital. I'm also assisting with the development and analysis of Center faculty's qualitative studies, as well as trying to find time to publish. I also do some guest lecturing for pediatric residents and critical care clinicians.
Biggest accomplishment during fellowship: I think the biggest accomplishment I have experienced is just feeling more comfortable and confident with clinical ethics consultations over time. Feeling a sense of passion for and dedication to the work that I do is very exciting for someone who has been in school for so long. Also, being new to Houston, it's a real sense of accomplishment to feel like Houston is finally a place I consider home!
Most memorable experience during fellowship: I think there are many memorable experiences but, since I can't discuss specific cases, one of the highlights of my fellowship is coming to the office every morning and discussing with friends books we're reading, podcasts we're listening to, and sharing memes and tweets. It is a real sense of community and I'm lucky to work with some amazing people.
Where you hope to be in 5 years: I hope to have found a wonderful hybrid of a place that allows me to combine clinical ethics, social work and research.
The Center for Medical Ethics and Health Policy researches and influences policy on today’s most pressing ethical issues, like what do about the Zika virus, stem cell therapies that can make you live longer, the rights of Alzheimer’s patients, end-of-life decision making, and genetically designing babies. We are one of the largest and fastest growing bioethics centers in the country, and our goal is to build our infrastructure so that we can respond immediately to issues and help researchers and healthcare providers decide how to do the right thing. In order to accomplish this, we need your help. Please consider donating to the Center. Click here to learn more or contact us.
C.J. Guerrini, A.L. McGuire, M.A. Majumder, J.S. Bollinger, P.J. Rowan, Constraints on Gene Patent Protection Fuel Secrecy Concerns: A Qualitative Study, J. Law & Biosciences; 2017.
Lee K. Disability, Suffering and MAID. National Catholic Bioethics Quarterly; 2017.
Morain SR, Tambor E, Maloney R, Kass NK, Tunis S, Hallez K, Faden RR. Stakeholder Perspectives Regarding Alternate Approaches to Informed Consent for Comparative Effectiveness Research. Learning Health Systems; 2017.
Blumenthal-Barby JS, Ubel PA. Truth Be Told: Not All Nudging Is Bullshit. Journal of Medical Ethics; 2018.
Bibler, T, Shinall M, Stahl D. Responding to Those Who Hope for a Miracle: Practices for Clinical Bioethicists. American Journal of Bioethics. 18(4), 2018.
Lee K. Ethical and Legal Obligations to Individuals Returning to Canada and the United States After Receiving Stem Cell Treatments Abroad. 24 Dignitas 4; 2018.
Gutierrez AM, Robinson JO, Statham EE, Scollon S, Bergstrom KL, Slashinski MJ, Parsons DW, Plon SE, McGuire AL, Street RL. Portero versus Portador: Spanish Interpretation of Genomic Terminology during Whole Exome Sequencing Results Disclosure.Personalized Medicine14(6), 2017: 503-514.
Roberts JS, Robinson JO, Diamond PM, Bharadwaj A, Christensen KD, Lee KB, Green RC, McGuire AL. Patient understanding of, satisfaction with, and perceived utility of whole-genome sequencing: findings from the MedSeq Project. Genet Med. 2018 Jan 4.
Lázaro-Muñoz G, Farrell MS, Crowley JJ, Filmyer DM, Shaughnessy RA, Josiassen RC, Sullivan PF. Improved ethical guidance for the return of results from psychiatric genomics research. Mol Psychiatry. 2018 Jan
Morain, SR. CDC-Zika Update Roundtable. Society of Maternal Fetal Medicine Annual Meeting. Dallas, TX. February 2018.
McGuire, AL. There is No Genome for the Human Spirit. Women’s Day, Sisterhood of Congregation Emanuel Sisterhood. Houston, TX. January 2018.
Blumenthal-Barby, JS. Biases and Heuristics in Clinical Decision Making and Their Impact on Autonomy,Children’s Mercy Bioethics Center. Kansas City, MO.February 2018
Bibler, T, Lion, A. They Named Her 'Miracle': Understanding and Responding to the Hope for Miracles in Pediatric Medicine. Medicine and Religion. St. Louis, MO. April 2018. (Workshop)
Lee, K.Is Intention Enough? Legal Parentage in the Era of Assisted Reproductive Technologies. Reproductive Ethics: New Challenges and Conversations,Albany Medical College. Albany, NY. April 2018.
Fedson, S. New Models of Care: Palliative Care in End-Stage Heart Failure (HF). American College of Cardiology, Scientific Sessions. Orlando FL. March 2018.
Lázaro-Muñoz G. Right or Privilege? Continued Access to Investigational Brain Implants.University of Puerto Rico School of Law. San Juan, PR. February 2018.
Lázaro-Muñoz G. Improved Ethical Guidance for the Return of Results from Psychiatric Genomics Research.Texas Children’s Hospital, Research Resources Office Seminar. Houston, TX. February 2018.
Catch Center Director Amy McGuire in this video of highlights from Reproductive Health Research Day 2017.
Register for The Conversation Speaker Series
Through thought-provoking lectures and discussions, you are invited to explore your own decisions, issues and values in the context of the current complex medical ethics and health policy landscape. During each lunchtime session, a faculty member will present a relevant medical ethics dilemma.
There is still time to join us for the final two sessions this year:
April 12, 2018 – In our own backyard: Access to care in Houston’s vulnerable population
May 10, 2018 – The burning question: The ethics of medical marijuana
And stay tuned for an announcement about next year's speaker series!
The Conversation Speaker Series
In the News
Mary Anderlik Majumder, JD, PhD, was recognized as one of BCM's Women of Excellence. The award recognizes Baylor women faculty, staff, students and trainees who exemplify excellence as well as Baylor’s other values of respect, integrity, innovation and teamwork.
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BCM WOmen of excellence
Check out the latest hot topics in medical ethics and health policy capturing national public attention.
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